Instructions for birth partner - what would you add?

[Plateofcrumbs]

I'm writing my DH a bullet-point list of 'instructions' for what he needs to do/how he can help during birth. From trivial (feed me jelly babies!) through to important medical stuff (if I have an EMCS make sure they remember that...).

Here's my headings so far - what would you add?

• packing (double check have got maternity notes etc).

• food drink and comfort (reminder of what's in hospital bag to feed me, help me stay cool etc)

• coping (what he can do to help me keep calm - breathing/hypnobirthing stuff etc)

• advocacy (key stuff from the birth plan he should make a fuss about to HCPs if needed).

Only one I found important, what to do if the baby arrives and needs treatment, do you want your DH to stay with you (you might be in a mess) or stick with the baby. I said no matter how ill or close to death I was, once the baby was out he stuck to it like glue, so when they took dc1 to the other side of theatre to the re-suss machine, DH went too.

We've been lucky, I do know a family where the baby was born, needed intensive care that wasn't available at that hospital so they blue lighted the baby at 10 minutes old to another hospital in the next town, it had been a crash c section so the mum was knocked out completely as there wasn't time to do a spinal, the dad said he had a moment of not knowing what to do then decide to go with the baby, his dw said while coming round without him or the baby was traumatic, she was glad he made that choice.

Epiduralq@ are great, why would anyone who hasn't ever had one decide they are the work of the devil? Nobody gives you an award for bravery. If you need it, have it

Make sure he eats, but make sure he goes away to eat.

I wasn't allowed to eat from when they started my drip, not sure if it's the same for women in non-induced labour, but I told OH to go and get something to eat. He said he'd bring something back to the room, and I just growled 'No'. He went away, ate and then came back and told me what a lovely meal he had.

I nearly hurled the drip stand at his head

• Tell him what you want re: pain relief, but make sure that he knows that if you change your mind, you've changed your mind, and he shouldn't talk you out of it. Reminding you of your earlier choice is fine - trying to stop you is not.
• OH had to hold the gas and air for me due to the faff of getting the drip in meaning I had an incredibly painful cannula in one hand, and a just-flushed blood clot in the other, so he had to hold the gas and air. Make sure he knows that if he takes it away, even for a second, it's on fear of death everyone assumed I was about 5cm six hours after the drip went in.. I was waiting for them to tell me I was 5 or 6cm so I could ask for epidural... they checked me and I was 10cm, so when I was pushing with no epidural and syntocin contractions, the gas and air was my lifeline

Discuss your feelings about different things beforehand - not just the big stuff like cutting the cord, but also whether you want him to watch DC being born, or stay up at the head end. I've got to say, OH watched DD being born and says it was incredible. But it's things that you need to discuss beforehand, to avoid confusion or distress in the labour room :)

it's funny how people can be about pain relief whilst giving birth - no-one would advocate having a filling without anaesthetic, or having a broken leg set - but giving birth? Of course it needs to be as painful as fuck .

Odd.

For what it's worth, one of the best benefits I had from having an epidural was that it allowed me to sleep for, I think, about 3 hours. Given that I had been awake for 3 and a half days by that point, it was worth it just for that alone!

I think staying awake is the single biggest thing. My first was a 13 night labour- mostly overnight.

OH slept through most of it, snoring loudly.

Staying awake is great- anything else is a bonus.

I do urge caution about pain relief. Most women are shocked by the intensity of labour pain, and although I had written in my birth plan I wanted none I was irritated by the midwives who were trying to talk me out of my requests for diamorphine.
They thought they were being supportive of my birth plan, but when I was in labour I quickly changed my mind as I realise my decision about pain relief was written from a point of ignorace.

Better to remain open and flexible.

Be aware that there is a window of opportunity, dilation wise, in which an epidural canula can be inserted. Once you have dilated beyond the specific number of CMs then you cannot have the canula inserted no matter how much you beg.

The best course is to have the canula inserted in your back while you are within the 'window' and then you have the choice to have the epidural drip slotted into the canula if you decide you could use the relief. Sometimes staff for reasons of their own will ask you to defer having the canula in and will try to soft talk you into waiting and seeing how things are going before deciding on pain relief. If you listen to them you run the risk of being told 'Too late' when you decide you want an epidural.

If you end up having an emergency CS they can use the canula in situ to numb you locally for the operation while you remain conscious. Maybe better than being TKO.

I can't remember the CM limit for getting the hardware in situ. I'm sure it's online somewhere.

I do agree you can overdo the birth planning. Birth is going to take its own course. A partner needs to not be annoying or self absorbed, lend a hand to squeeze, and to make encouraging noises. If medical intervention is needed then you really don't have the choice to refuse or to get up and take your business elsewhere.

What you need to do is sit down and look at 'worst case scenarios' together --
CS needed -- will DH stay for the op?
Blood pressure issues, baby in distress, labour stalling -- will you have a CS or will they allow labour with intensive monitoring? DH may need to ask about options.
Baby taken to NICU and you are being stitched up -- does DH go to NICU?

One thing your DH needs to be completely on top of is transport and parking.
He needs to make sure there is at least half a tank of petrol in the car at all times coming up to delivery.
He needs to anticipate any traffic problems there may be on the route to the hospital in the period from 38 weeks to 42 weeks and if there is going to be any major roadwork, any event like a concert, game, etc that could result in massive delays, then he needs to plan a few alternative routes.
He needs to find out if the hospital does valet parking or if you can be dropped off at the emergency entrance while he goes and parks, and if so how will he find you after they whisk you away.
He needs to find out if there is any priority parking for maternity patients, or if you will end up going round and around a carpark looking for a spot while you get closer and closer to delivery.
He needs to know whether there are metres to feed, etc or if he can get a waiver.
He needs not to lose the parking token or his keys.
He needs to figure out how close he can get the car to the exit for when you are getting home.

I say this because I once shared a room post natally with a woman whose husband wasn't aware there was valet parking for emergencies and they went into the huge carpark instead. By the time they found a spot the woman wasn't able to walk and the hospital had to send a stretcher party into the carpark to look for them.

Stop.

You're making this far too difficult.

He just needs to be there. The rest will come.

The only real advice I'd give is to trust his instinct and be pushy. If you can't because of medication he is the one fighting for you both. No regrets, y'know? A doc is only human, question them if you feel something's off.

Tbh that's generally advice not required.

Good luck.

One other thing -- this is from my own experience.
Internal exams - you and your DH can ask staff to wait until a contraction is over before doing one, you don't have to agree to let students do them, and can question the need if you think staff are doing too many.

I just told my DH to fight my corner and if I asked for something to make sure I got it.

He was absolutely superb! I was on the verge of things going very wrong when my waters were (incorrectly) artificially broken - 3 times. He demanded an epidural on my request and would not allow it to be fobbed off or refused like they tried. In fact he took it a little too far and threatened to sue :-s I got it though and I wouldn't have managed the end if I hadn't. DS popped out 20 mins later!

I had a conversation with my best friends DH last week as she is due at the end of the month and I literally said this to him. Just fight her corner and give her whatever she says she wants ( or I'll box your ears!!)

Definitely don't want to give impression of being control-freaky about this - I don't even have a written birth plan as such yet, and I'm planning on keeping it v brief. No pain relief options or inteventions are off the table, I'm just planning to take it as it comes.

The only thing I feel strongly about is not being confined to lay still on bed if I'm on CTG monitor so I want DH to be supportive on that.

Also having invested enough time listening to natal hypnotherapy CDs, I want DH to know a few key principles for helping me stay calm.

And related to that make sure he knows what useful bits and bobs are in the hospital bag etc (like if I'm hot, there's a mini-fan and a water spray, he doesn't need to start improvising with a damp paper towel and wafting a newspaper) so he can make himself useful on the small stuff without having to bother me.

I like the idea of encouraging him to check whether I'm having a 'wobble' vs really needing more pain relief. Frankly I'm not sure how either of us will know that in advance, but can't hurt for him to be alert to the possibility that I might just need coaxing through an 'I can't do this!' moment rather than him being off on an immediate mission to find the nearest anaesthesiologist.

If you feel "I can't do this" you do want your dh to ask for an anaesthetist. Many women find thee are none available when they want one.

I too don't understand why women want to give birth on a hypno cd, you wouldn't have any other painful procedure done that way, giving birth is sheer agony take the drugs that make it easier. Martyrs don't get free nappies for life....

Sounds like a sensible plan plateofcrumbs.

I totally get wanting to do it Heels...better for reducing birth interventions without and better for baby...but if you need it you need it!

Remind him that you may not know what is going on and he needs to tell you. DS was a horrible scarey forceps birth and rushed off to be resuscitated. I was calling out 'what's happening?'Wasn't even sure if the baby was out, if it was breathing or what sex it was. DH was sort of caught up in the drama around the baby and did not tell me what was going on quickly enough. (DS is a big strapping 15 year oldnow btw)

Heels - Of course there are no medals. If there was a one off injection into your arm with no side effects and no down sides, I doubt many women would refuse it. But spinal anaesthesia is not a perfect technology in that respect, there are risks (mostly of incomplete relief but enough impact on mobility to make that difficult to cope with) and downsides and they are legitimate reasons for women to want to avoid an epidural. FWIW, I had one first time and, for various fairly rare reasons, it was hellish and something I was desperate to avoid repeating.

If you use a Tens machine make sure DH knows how to use it.

rub my back. Just keep rubbing my back. In fact even if your arm falls off find a way to keep rubbing my back.

I didn't want touched at all during labour.

Staying awake is really difficult in a long labour. I don't think it's fair to criticise partners for this. It's very intense for them too.

This was part of the reason why I had my best mate there as well.

My labour was 30 hours and I don't think DP actually slept, but he did go off for a walk in the fresh air for an hour at one point to clear his head. When he came back he was so much better, more supportive, more involved. I was so glad he could do that. He also got to eat (out of my sight, I did not want anyone eating anywhere near me!!) which must have helped his stamina a lot.

I wouldn't have let him do that if my friend wasn't there. She also slept for a few hours at one point in the labour. Meant she was chirpy enough to make us breakfast in bed after the birth and generally be very helpful! (we had a home birth)

I am considering a whole tribe of people for my second labour, in my first I would have thought that the worst idea ever

Oh and I really wanted to be massaged etc and talked DP through this at great length and then didn't let him touch me the entire time and smacked his hand if he tried. hah. You really don't know how you'll react.

Dh's instructions were pretty minimal- keep me from going bonkers and double check I want drugs I I ask for them, if I couldn't for whatever reason then to have skin to skin with ds and if they separated me and ds, then sod me play chase the baby as I had huge anxiety about something going wrong for ds. I wanted him to tell me whether we had ds or dd.

For after birth, being me the biggest strongest vat of coffee from the hospital costa outlet.

I should have added:

• don't snore when the mw fetches you a pillow and blanket because labour is taking such a bloody long time and I had no implements to chuck at him to make him move.
• don't faint when they fuck up my epidural

This time round, I think it'll be similar although it'll be an elcs so snoring shouldn't be a problem.

Forget about trying to decide if you're having a wobble or need more pain relief.

There is no shame in having pain relief. There are no medals handed out for gritting your way through this.

There are mobile epidurals.

The downsides of epidurals are very unusual. The advantages are many, and the advantages of having the canula inserted when this is a possibility are huge.

I think that's a slightly over-rosy picture of epidurals Math. Don't get me wrong, I think they should be available and every woman who wants one should get one. I think it is great the option is there. But not every hospital offers mobile epidurals (mine didn't). And the biggest downside is incomplete pain relief, which happens in about 10% of cases (including to me).

You can't know until you are in the midst of it. And I totally agree that there is no shame in having pain relief. But not should anyone think it's a magic cure. Not least because, for many first time mums, there is a lot of hard slog to get through before you'll be admitted to the ward and eligible for an epidural.

Incomplete pain relief is a lot better than none. The majority of women experience significant pain relief after an epidural, and a woman needs to be able to have some sense of having contractions and the urge to push, plus the ability to direct pushing effort. Even a non-mobile epidural is an improvement on pain that is getting to be too much to bear.