Topics to research prior to labour - Husband preparation plan!

[innocuous]

Hi,

My wife is pregnant with her first. She can be a bit of a worrier and she does not like the idea of putting together a birthing plan. Instead she is just focused on healthy mum/healthy baby and making decisions based on medical advice etc. She knows that she is not the most flexible person once she has researched and made a plan, and this is her way of controlling her anxiety and staying flexible.

I don't suffer from such anxiety, and I have agreed with her that I will take the burden off of her further by researching all the different aspects of the labour. Hopefully I will get a good grasp of the implications of the decisions that we may need to take so as to make better decisions faster. This will also help her more confidence in our decisions and make her worry less, as I will have a better grasp of the situation and will be able to reassure her having done my research.

I have done a bit of research already, but I don't know what I don't know so would like your help compiling a comprehensive list of research topics.

So far I have:

• how to measure dilation levels, and what to do at different stages of labour e.g. when to go to hospital.
  
• Natural methods of pain control for when we are at home and at hospital
  
• Advantages and disadvantages of different drugs
  
• Different things that we can do at the start of labour to prepare for the birth, e.g. keeping energy / fluids up, things that may ease the risk of Perineal tears.
  
• Methods to help the baby engage in the correct position
  
• Techniques to help control the speed of labour
  
• Different positions for delivery
  
• Best ways to support my wife during labour
  
• When to make the call to have a caesarean, risks etc.
  
• Risks with baby being delivered in different positions
  
• Risks from forceps
  
• Medical management of placenta delivery
  
• Different emotions, pains, aches etc likely to be experienced throughout the labour, both those that are normal and abnormal.
  
• Watch as many birthing videos as possible so that I know what to expect and can support her properly.
  

Now I am sure that I have missed so much. So please feel free to point out any other topics that I should prepare for.

Thanks so much, I really want to do my best in supporting my wife so it is important to me that I do not miss anything.

Jon

[BiscuitsofYum]

Jesus....

You are more prepared than my DP! In fact more prepared than me!

The only things i've done is make various routes to the hospital depending on traffic!

Well done though you sound like a really supportive husband

[quellerosiel]

Way to be a man OP!

I only hope my DH is half as proactive as you :-)

[funchum8am]

Have a look at what to do if she is offered sweeps and/or induction if overdue or for medical reasons. You do not have to accept any intervention you don't want but obviously they are recommended for a good reason (well, usually!). Look at the relative and absolute risk posed by things like having an epidural, being induced for post dates and MLU vs hospital birth if you are considering both of these.

Full disclosure: I was induced for post dates at 40+12 so ended up on ante natal ward all night with no DH as outside visiting hours, having very frequent very painful contractions and denied pain relief by midwives who just didn't believe I was in that much pain because I was not dilated. I now wish I had waited a bit longer as it took lots of syntocinon drip to get things moving in the end and I feel that baby just wasn't ready. Ended up with forceps, and prepped for a CS, though they got DD out in the end and she was fine. I had nightmares and flashbacks for months until I had a debrief and formal apology from the hospital.

I know now that induction for post dates is routinely recommended because the relative risk of stillbirth goes up by 50% after 40+14 which sounds bad BUT what this means is that the absolute risk goes from 2 in 1000 births to 3 in 1000. so I could have waited 2 more days with little increase in risk, and the level of risk is one I can live with anyway...will not be induced until 40+14 this time (38+2 today).

You sound like you are being a fantastic support to your wife...best of luck!

[innocuous]

Thanks all for your supportive messages.

Induction is something that I should have put on here. I missed it off as we have been told that it we are recommended to be induced the day following our due date. We has some issues with recurrent miscarriage in the beginning and had some great private treatment from a specialist, who also happens to be head of obstetrics at our preferred hospital.

We are therefore both already expecting to be induced...

[redexpat]

How to care for a newborn. We read everything about birth, then found it was over in a day and had to look after this tiny living thing.

[LittleRedRidingHoodie]

I'd ask her how she feels when she's agitated / in pain and how she likes to be supported. My husband always questions what I ask e.g.
Me: Ouch, that hurts, could you pass that pillow?
Him: this one? Would you prefer the green one?
Me: ouch, no, that ones fine!
Him: it's just the green one is the memory foam one
Me: just pass it!
Him: why don't you try the green one?
Me: oh for gods sake! Just pass the freaking pillow!!

He has learnt now that when I ask for something I just get more and more wound up as he questions it, I know he's trying to be helpful but - argh!

Also I sometimes like to be touched and sometimes I'm 'GET OFF!' Usually when pain is acute I want to be left to cope with it and then comforted while it's building up / easing off.

So you've done tonnes of research into birth etc, but how well do you know how your partner responds to pain and stress and how you can best ease this for her?

[sillymillyb]

I just wanted to say that you sound lovely, but maybe be prepared for all your research to go out the window?

I would say I have a good grasp of all the subjects you have listed, but in the end, my birth was fast and I had no time to worry about anything except getting the baby out. Knowledge is power, but the actual experience, is so often not like the text books that that can be a shock too.

I also second the pp who said look into how some research on how to care for a newborn - they handed me my son and I totally panicked!

Good luck, I hope everything goes well for you and your wife

[Mmolly2013]

Maybe do some research on how to help her after the birth aka the recovery as that can be worse sometimes. Ways to help her, things to prepare beforehand such as making and freezing food. Tips if she's in pain when peeing for example, things she can take such as paracetamol and dulcolax if she needs it.

Maybe think of some meal ideas in advance so you can make her some nice food when she's tired etc

You sound lovely

[Mmolly2013]

For some reason during my labour my partners voice was all I could hear so always stay calm and supportive. But at the same time listen to the midwives because during my labour the midwives were discussing an episiotomy and I had informed my partner beforehand I really was afraid of this. (I didn't hear them say this as I was in the zone)

Once he realised what they wanted to do he came up to my ear and told me to push in a calm but forceful way and I just focused on his voice and the baby came out without me having to get cut so for that I thank him for paying attention and remembering my wishes.

[innocuous]

This is all fantastic advice, I will definitely look into it, and be prepared to throw it out the window if things are different on the day.

I think I am already fairly well versed in supporting her during pain, 4 miscarriages have given us plenty of experience in that category and I have gotten better at read her mood and reacting appropriately after each one.

I will definitely look into post birthing tips too. Both DW and I are very well versed in looking after young babies as we have a large extended family and are both very maternal/paternal. That said, having our own will be a completely different experience so we do need to prepare!

[NickyEds]

You sound lovely and very well read! It's hard because no matter how much research you do it's very hard to prepare for labour and birth, sometimes things can and do escalate/plans change so it's important to be adaptable. Most of the medical stuff is explained to you again during labour, decisions are sometimes largely out of your hands. My OH had specific tasks, always having plenty of cash, fully charged phone etc.

When you're pregnant it's easy to focus completely on the birth (we did!!) and, despite buying all of the right babygrows and kit etc, actually having a new born at home is sort of unplanned. I wish we'd thought about/planned better for:
-Caring for stitches- lavender oil, soft pillows, cushions for piles etc.
-If your wife is planning to breast feed- nct and LLL support line numbers, infant feeding specialist numbers, Lanisoh. In fact you could do a whole thread on preparing to bf!
_If you're planning to bottle feed learn how to sterilise and make up feeds now.
-Prepare to sleep in shifts-our LO wouldn't be put down for the first week or two so we had to do the night in 2 hour shifts (this is really common and normal). Lots to watch on sky box etc, box sets, snacks.
-Learn how to fit the car seat. Learn how to do it when you're very tired/excited/nervous!
-Batch cook food that you can eat with one hand and is ok cold.
-What are you going to do about guests?

In my experience of all of the new mums I've met labour and birth just happen the way they do but we all wish that we'd been better prepared for the first two weeks at home

[SomeSunnySunday]

You sound like a lovely husband! People have given you great advice; the only thing I would add is that, although you will be the person who has done all of the research, how women cope in labour is quite unpredictable and honestly, in my case anyway, labour was like nothing I had ever experienced before (I've also had a few first tri miscarriages, and although they were awful and painful they weren't like labour). I had drilled DH thoroughly on my wishes pre-labour, and he was a great advocate for me in labour. Except that, once I was actually in labour, what I had thought I wanted to happen went out of the window. I remember him trying to talk me through positions and breathing (in a calm and supportive way, exactly as I had asked him to do) while I begged for an epidural, and he kept telling me (and the midwives) that I didn't want one, didn't need one, would be better staying active etc (as this is what I'd told him to tell me, pre-labour). At one point I shouted at the midwife to take him away . I got my epidural.

I think it would be hard to be a man in the position of having done all of the research and then watch everything you've researched go to pot, but as long as you remember that ultimately your wife needs to be entirely in control then I'm sure you'll do fine.

[funchum8am]

I'm sorry to hear of your miscarriages, I have had two myself. If you are definitely looking at induction be aware that it can for some be much more painful than natural labour even in very the early stage (ie before any dilation occurs) and be clear with the midwives about the need for pain relief even if your DW is not yet "really" in labour. I was fobbed off with paracetamol and told they don't have gas and air on the antenatal ward, which I knew from my mw was not true, but contractions were coming so frequently I couldn't argue my case and DH had been sent home as it was past 8pm

At the meeting about my complaint they said they have in fact got 40 canisters of gas and air on the ward, just some midwives prefer not to use it....

I'm sure your hospital is much better but do be prepared to argue forcefully for what you know your wife needs on the day!

Also if syntocin on drip is used some people say have an epidural first as that too can cause very painful contractions. I did this despite not going in wanting an epi, and am very glad because the contractions were already painful before I had it, and then went on for another 11 hours!

You sound fab and your DW is in very good hands by the sound of it!

[HopeNope]

It's the post-birth stage you really need to prepare for.

• Decide on what the strategy is re visitors. They can be stressful.
• cook your favourite foods before the birth and freeze them, ready to defrost.
• have a stash of painkillers with you, and at home
• prepare for the 1st two months to be really really tough. Don't have any pre-commitments
• arrange for a cleaner to come and help you twice a week
• decide on the name before the birth
• decide on what type of feeding but remain flexible
• have car seat fitted and the pushchair etc ready
• have your nappy bag ready
• prepare all the different hospitals bags you'll need
• have loads of snacks at home so you don't need to worry about going out
• have pre-made formula and a bottle to handy even if breastfeeding
• have local takeaway menus

[Mmolly2013]

Bring snacks for labour and for your partner to keep in hospital with her as all I got was toast after and I was starving. Partner was also starving during labour

[larryphilanddave]

Just want to agree with a good post-birth prep, particularly for your DW to get plenty of rest and be able to heal. The better she can rest, the better and quicker she should heal. I learned this the hard way first time around Second time around and I'm trying very hard to make sure I don't do myself a mischief. Personally, I feel that a good 2 week period of low stress, low expectation is a good idea - no pushing yourself to go out, clean, tidy etc. Life happens and sometimes she might have to do something, but to keep it as a easy as possible. Even if you feel really good after the birth, it can get difficult later if you don't rest properly.

Also tips for healing post-birth and perineal care - there is a lot of info on MN and various past threads, and they come up regularly too. Things like witch hazel on pads, a jug for warm water to pour over, Epsom salts/lavender, etc.

A general lay of the land in/by where she'll be giving birth is good. Our hospital is in a central area so I knew I could send DH out for stuff - lots of nice food places that do carry out, coffee shops, plus supermarket and pharmacies, so pretty much anything could be picked up if we really needed. So my focus on food to bring was for the labour, brought sports drinks and simple snacks like rice cakes. I didn't bring anything specific for after because I knew I would be sending DH out for sushi and a latte However if there isn't much nearby it would be a good idea to pack some nice things to eat, treats etc.

Like another pp said, inductions can be faster and more painful, depending on how you react to it and the method of induction. So be confident in requesting whatever pain relief it is that she needs. My last was induced and the contractions ramped up in record time. I needed G&A. DH went to get the MW and helped me to deal with the pain in the meantime - only about a 5min delay but felt like ages at the time! They wheeled over a canister straight away and I was fine from that point. DH has been so much help to me in both labours in terms of managing pain, recognising something is up and communicating it to the MW when I've been a bit out of it. I have no idea what I would have done without him being my advocate and keeping an eye on everything - the MWs are very good at our hospital and very supportive, but they don't know me like he does and he could point things out and ask them things on my behalf.

Finally some information on what they do with baby. Admittedly I didn't really know much about what happens if there is meconium in the waters, what foetal distress really means, etc, and this was all part of my second labour. Fortunately the MWs explained everything to me and DH as we went along but obviously it would be good to have a better awareness of these things prior.

[larryphilanddave]

PS doesn't mean 2 weeks is the perfect figure for healing, I just like to aim for at least that where possible.

[stargirl1701]

My preparation for both births was as follows:

Mat leave started early at 32 weeks

Physio exercises 'Fit for Birth' x3 daily from 32 weeks until delivery

Birth ball rocking/bouncing as much as possible daily e.g. during meals, watching TV, etc.

Pregnancy Yoga - class weekly and daily exercises

My birth preference plan was hierarchical so I would know which options I had left to try.

1. Paracetamol
2. A bath
3. Birth ball
4. TENS machine
5. Visualisations with breathing
6. Chanting
7. Birth pool
8. Gas and air
9. Diamorphine

10. Epidural

This helped me feel in control (I am naturally quite anxious). I went up to 7 for DD1 and 8 for DD2.

I specified no Kiellands (sp?) forceps - straight to c section if they were the next step. I wanted the Vit K jab for both. Physiological third stage preferred for both.

I included my Breastfeeding preferences too. Skin-to-skin with me (Dad if I was unable) for 24 hours so only nappy on baby. Biological nursing approaches. Side car cot for my bed.

I delivered in the free standing MLU both times. All my preferences were acknowledged and, luckily, all fulfilled.

Good luck, OP!

[innocuous]

This is all wonderful and really helpful stuff. My mind is whizzing with different things to look up and work out.

@Stargirl1701 - As a project manager, your kind of logic and planning really appeals to me. Anything can happen etc, but having a good simple hierarchical process in place with different things to try sounds really useful. Even if some steps are missed because the do not feel right at the time, it is a quick reference tool that can help make decisions.

We want to try and aim for an MLU, not sure it will happen given our history and the likelihood of induction. That said a lot of what you have said can be applied.

Showing me your plan really has helped, I am definitely going to build something similar for DW so that she can pull from it if and when she wants to.

[InFrance2014]

My partner was very supportive like you and made a big difference in terms of pre-birth preparation and during the birth.
We had a lot of pain management techniques lined up (I really recommend both of you reading Juju Sundin's book on this, it's based on physiological ways to deal with pain), but in the end it almost all went out the window because the birth was WAAAY faster than we expected for a first time- we were thinking like you about needing snacks to keep my energy up over 24hours plus; but instead of a marathon it was more of a sprint.
Waters broke 11pm, baby was born at 5.30am. So that's only 6.5 hours!!

Another thing that was surprising was that contractions didn't have any genuinely restful periods in between- it still hurt a lot! And they were close almost from the start, so of all the pain techniques, I ended up just using vocalising (= bellowing like a rutting stag) as I couldn't concentrate on anything else.
Also be prepared for ALL the bodily fluids- when we arrived I had vomiting and diarrohea as well as amniotic fluid, blood, it was a big mess.
The most helpful thing husband did during the labour was counting me into and out of contractions, as I totally lost sense of time, and it was really useful knowing when I needed to come out of my semi-unconscious state on the bed and heave myself up again before the next contraction started.

I also would advise making loads of frozen meals before the birth, we managed a month's worth and were SO GLAD. Everyone tells you you have no time with a newborn to do anything, and it's completely true.
Another thing that supported me post-birth, but which depends on your circumstances (my husband is stay at home dad), was that he kept me company for some of the night feeds with cups of tea (and croissants!) and did almost all the night changes. This helped me feel like we were a team, and it wasn't quite so overwhelming as it might have been!

Last piece of advice for life as parents- support each other, be prepared for lack of sleep to make you both grumpy, and avoid competitive tiredness.

Good luck!

[thomasstockmann]

Hopefully simply sharing a little of my own experience will help you. I think you have covered most important things.

I'd say what was not made very clear in antenatal classes is the intensity of contractions/pain when you enter active labour (dilation 4/5 maybe). The only two things I could do at that point were: remember to breath and grunt. Nothing else (no resting between contractions, no calmly discussing my wishes with midwives, no listening to music, no "I'm enjoying this as I know my baby is coming" as all advertised in antenatal classes). Grunting and trying to breath deeply, that was all.

The implications were then that I had to trust my husband to follow my choices on my behalf. Your wife might not feel as vulnerable as I did but then she might. At that point all I needed was encouragement: breath, do you need to change position?, do you need a drink? (remember to pack straws), more gas and air? and "no, this is not what you wanted-let's breath".
Help her try the equipment until one works (birthing stool, birthing ball, using the bed as a prop etc).

Last but not least, if a midwife/obstetrician suggests something, do ask why and what the other options are. Breaking waters manually? Why? And what if we say no?; Pethidine? Why? And what if we say no?; Ventouse? Why? Are there other options? What are the risks? How often have you done this and how successful are you? etc
If you strongly disagree, ask if you can speak to a more senior midwife

[minipie]

You sound great but if you have spare research time I'd spend it researching hospital bag contents and baby care in the first few weeks/months rather than labour.

A lot of labour is really out of your hands. IMO it is worth looking into:

• when to go to hospital (NB also research any warning signs to look for eg signs of pre eclampsia, lack of movements etc).
  

• the pros and cons of different forms of pain relief, including hypnobirthing/tens/natural pain management.
  

• things that might affect what choices you make eg you might want more pain relief if induced or back to back.
  

• recovery from a c section. This is often not focused on as nobody thinks the c section will happen to them!
  

Everything else depends so much on your wife's exact situation at the time and you will need to be guided by the medics. For example there is not much point deciding "no forceps" if the doctors then tell you that your baby is in distress and forceps is the only way to get them out quick enough. There is not much point deciding to labour on your hands and knees if you then need continuous heartbeat monitoring and the monitor only works with your wife flat on her back. Etc. I had a plan a bit like stargirl's, all went out the window when I went into labour at 34 weeks, immediate high risk. It doesn't take much to be high risk unfortunately (meconium, induction, infection, etc) and then your choices are much reduced.

Also bear in mind that - no matter what she says now - when in labour your wife may not want you to be the guy who knows it all. She may want to just listen to what her own body is telling her right at that moment. (My DH had read about the panic that some women have during transition and kept telling me "you can do it" when in fact I knew damn well that DD was stuck at crowning and I needed an episiotomy).

[minipie]

Totally agree with thomas about asking WHY and what are the pros and cons. If there is time. Very useful role for the DH to play.

[ffallada]

OP - did you post earlier this year in the pregnancy section about your wife panicking because she found out that the whooping cough jab also contained stuff like tetnus?

Have you considered that her levels of anxiety might need addressing? Is she in contact with her local mental health team? There is no shame in finding pregnancy difficult, and while it's lovely that you are researching on her behalf, it's unlikely that you will be able to help her deep routed anxiety given that you are not an expert.

She should be talking too her midwife, her mental health team and her GP. If she develops post natal depression these people will need to help her. She will need medication which you will not be able to give.

All your questions would be addressed by any half decent antenatal course, which you can attend together. Have you considered this?

[TheBooMonster]

Firstly, I wish more men were like you OP!! My DH did no research at all, and trying to talk him through everything and keep him calm between contractions made things so much worse >.<

I can't say enough: stay calm, no matter what's going on, the calmer you sound the calmer you will encourage her to be, also if you are calm then if you genuinely pick up on something that the medical staff haven't picked up on they're more likely to listen to you.

Also once you and your wife have everything together for the hospital bag you should be the one to pack it, that way you will know where to find everything.