Birth partners and doulas
A birth partner is someone you know and trust who will remain by your side throughout your labour. They will support you when the going gets tough and can be anyone you choose – such the father of your child, your mum, a good friend or a doula
Why do I need a birth partner?
You’re under no obligation to have someone with you during labour and birth, but studies have shown that having the support of a birth partner can lessen how scared and tired you feel and reduce your perception of pain. The presence of a birth partner has also been shown to decrease the chance that you'll need an epidural, have a caesarean end up with a forceps delivery. Pretty impressive – shame they can't bottle it.
It’s also unfortunate but true that midwife teams are stretched to their absolute limit these days, so it’s unlikely you will have the same midwife throughout your whole labour. You may even have periods where you are left to your own devices while they check on other women. It can feel pretty daunting being on your own in labour so having someone on hand, especially someone familiar, is a huge help.
What does a birth partner do?
Support, reassurance and encouragement are a birth partner's main duties – but they might also be your advocate if you’re not able to speak (or are off your face on the drugs), and they are there as well to take care of anything practical you need. Here are just a few of the ways a birth partner can help:
- Massaging your back
- Ensuring you're keeping your fluid levels up
- Feeding you glucose tablets
- Encouraging you and telling you you're doing great when you feel like giving up
- Reminding you to keep mobile
- Passing you the gas and air
- Holding your hand and letting you squeeze the life out of theirs
- Supporting your decisions and reiterating them for the medical team
- Reminding you of your breathing relaxation techniques
If intervention is suggested, they should try to ensure you:
- Know what's going on
- Have enough information to make an informed choice
- Are given enough time to weigh up your options (where possible)
How many birth partners are you allowed?
If you're having a home birth you can have as many people as you want to attend you – although you probably won't want a big crowd. Although it might look like one, birth is not a floor show. Some hospitals allow you to have two birth partners, but check their policy first. Due to space, some limit it to one.
Does my partner have to be my birth partner?
Not at all. Your husband or partner is the most common choice, certainly, but plenty of women give birth every day in all sorts of circumstances. No one will bat an eyelid if you decide your partner isn’t the person you want there on B-Day.
Some partners feel squeamish, others have cultural reasons for not wanting to be present in the delivery room. Talk it over between you and decide, above all, what’s going to be most useful to you on the day. If they’re likely to lose it with the midwives, faint, complain about the uncomfortable seating etc, it’s probably best they aren’t there. It is, however, a lovely way for parents to bond with their child so it’s worth considering. They may well be able to cut the cord if they want to, and it’s often the birth partner who is handed the baby while the mother is being stitched up, having a shower and generally recovering, so it’s an opportunity to spend a few very early precious moments together. And remember that being a good birth partner has nothing to do with being a good parent. Some people just aren’t cut out for it.
You might instead choose to have your mum, or another relative, a good friend or even a doula (see below).
How to choose a birth partner
It wasn't that long ago that a birth partner – if you had one – constituted your mum. Your partner's first glimpse of the newborn was of a swaddled bundle, dozing happily in your arms (by which point you'd done your hair, applied your lippy and looked remarkably serene).My best friend asked me to be her birthing partner as her partner was squeamish. I had to be there in case he passed out. It was the most amazing experience I'd ever had.
Nowadays, partners are more than likely to be down at the, ahem, business end, see the baby crowning and even cut the umbilical cord. Which is great if you both want that – and the vast majority do attend the birth of their child – but if you've got any concerns about them being there, or they don’t want to be there, it's important you talk about it.
Regardless of who else is in the room, labour is an intensely personal experience and you need to be able to let your primal instincts take over and focus solely on yourself. You cannot do this if you are worrying your partner is hating every second, about to pass out or has just seen you poo yourself.
If either of you feels uncomfortable at the thought of labouring 'together', then you need to sit down and go through all your concerns and fears and discuss exactly what you want from your birth partner and what your partner feels able to give.
It may be you'd be better off having a back-up (a friend/relative or doula) on standby who can take over if needs be. That said, if 'dad being there' really isn't right for you as a couple, then so be it. Who cares what the fashion is if it doesn't work for you? (Remember puff-ball skirts?)All you dads just remember – whatever your partner says to you in the heat of the moment, the fact that you're there and trying to help really means something
The same advice applies whoever you’re considering. Some women are the type to share everything with their mums and lots of grans-to-be are honoured and thrilled to be able to see their grandchild come into the world. Others can’t think of anything worse than having to see their daughter in pain – quite understandably. You might love your best friend dearly, but if she’s the sort to point out the cellulite on your thighs during transition, there might be someone better suited to the task. It’s a question of finding the best fit.
What preparation can a birth partner do?
You should discuss with your birth partner what sort of birth (in an ideal world) you'd like, as well as what choices you plan to make if things don't go quite as hoped. Here are a few more things it’s useful for a birth partner to do in the run up to your due date:
- Learn about labour
- Know what the early signs of labour are, what the first stage is like, what happens during transition when you push the baby out… not forgetting the third stage (delivery of the placenta)
- Come to antenatal classes to learn more about what to expect both at the birth and beyond
- Read your birth plan so they know what your wishes are and if there’s anything you definitely don’t want to happen, and also know what the options are if things don’t go to plan
- Become familiar with what’s in your hospital bag and be able to find it at a second’s notice
- Ensure they have on them enough snacks and drinks for you both, as well as a camera, mobile, charger and numbers for anyone you might want them to call after the birth
How can a birth partner prepare for a caesarean delivery?
If things go a little awry and you end up having an emergency C-section, your birth partner will be more important than ever, in supporting you, keeping you calm and relaxed and letting you know what’s going on and what to expect. Unless it’s a crash C-section, your partner should be able to come in with you, dressed in scrubs and ready to hold your hand and welcome your baby with you.
They can also be really useful once the baby is out in making sure you get to hold your baby as soon as possible and that you get any help you might want with breastfeeding (which can be tricky right after a caesarean).
If you’re having a planned caesarean, there’s also still plenty for them to do. Going into theatre can be an anxious time, so a familiar face you trust to calm and reassure you is an enormous help. They can also make sure you’re comfortable, put on a chosen CD you've chosen if you want it, and ensure that any other wishes in your birth plan (having the lights dimmed after the baby comes out, for example) are carried out. They could do worse than making sure you get a nice cup of tea afterwards, too.
Tips for birth partners
The golden rule is: don’t argue with a woman in labour. But there are a few more things your birth partner might like to keep in mind:
Even though you might have written it in blood in your birth plan, you're allowed to change your mind about how you'd like your care to proceed at any point. Yes, it's their job to remind you that you didn't really want pethidine and why, but you're the one giving birth and what you say goes.
You may forget your Ps and Qs at some point and possibly behave in ways they had no idea you were capable of, so even though they (hopefully) know you very well, be prepared for a few surprises.
It will help immensely if they can don a thick skin for the duration and agree that anything said in the delivery room doesn't go beyond it.
Having a doula as a birthing partner
More and more women now are hiring a doula as their birth partner or simply as a second pair of hands to help out and support you at the birth.
What does a doula do?
The word ‘doula’ comes from the Greek word for ‘slave’. A doula is a (usually female) birth partner who isn’t qualified in midwifery but is a sort of ‘experienced pair of hands’ who can be with you through labour and birth, supporting you, offering advice and helping in any way you want really.
Most doulas will offer a couple of antenatal classes before the birth with you to discuss any concerns, go through your birth plan and talk about what sort of birth you’re hoping for. They are usually ‘on call’ for a couple of weeks either side of your due date so you can give her a ring as soon as you go into labour.
A doula is a nice idea if you’re worried about how your partner will be at the birth. She can support them as well as you and could even stay with you while your partner nips out for a nap if your labour is long. (We know this sounds suspiciously like he’s getting to skive off but trust us – you’ll be glad one of you managed to get a nap in when you get home with a newborn after two sleepless nights in labour).
They’ll usually do a follow-up visit after birth too, when they can help with things like breastfeeding, general babycare advice, or just making you a cup of tea and a sandwich. Some are also ‘postnatal doulas’ – like a mother’s help but with loads of baby knowledge, too, and will come and help you out on a paid hourly basis.
What are the benefits of having a doula?
As well as the obvious boon of extra help, an experienced person to guide you through labour and the added support and care, studies have shown that having a doula can:
- Decrease the length of first-time labour by as much as two hours
- Reduce the chances of you needing drugs for pain relief
- Reduce the chances of you needing a caesarean by up to 50%
What do doulas charge?
Prices vary from area to area but DoulaUK says an average is between £600 and £2000 depending on area and experience. You can hire a ‘mentored doula’ (like a doula-in training) for much less.
Try Mumsnet’s Childbirth Talk Forum to find other mums who have used a doula and hear their experiences.
How do I find a doula?
Doula UK is a non-profit association and can help you find a doula, ask the right questions and so on. You can search by location on the DoulaUK website.
You can also book a doula through the NCT.
What Mumsnetters say about having a birth partner
“My husband was just amazing. We had talked both labours through in advance, so he knew exactly what I wanted. They were very keen to give me an epidural first time but I really didn't want it and he was able to explain my wishes. The second time they were going to do an episiotomy. He was able to explain to the midwife how I would rather have a tear than a cut. It was helpful to have a real advocate, someone who could talk for me when I couldn't!”
“I think fathers should try not to be too vocal. My husband started off by 'talking me through' each contraction. Saying things like 'well done – it's nearly over now, you're over the worst' until I asked through gritted teeth how the hell he knew. So, partners – ask if what you're doing is alright, don't take offence if it's not and don't, whatever you do, try the gas and aid while chewing gum (as mine did) – it's not supposed to be your drama.”
“I had an amazing doula and her support helped me feel confident.”