Being the male partner in the relationship, you probably feel the need to assume the role of protector, guardian and provider for your partner. In relation to childbirth, some common assumptions that men might have are that:
- This is a natural and normal process, therefore their partner will be able to cope fine without support; or
- As her partner, you are perfectly capable of being the sole support person without the ‘interference' of anyone else; or;
- Midwives will be continuously by your side and will be able to provide everything you need
Often I receive emails or see discussions where women express a strong interest and desire to have a Doula or Birth Attendant (an experienced birth support person) present with them during birth; however they don't know how to explain this need to their partner who doesn't feel that it's at all necessary. Usually, but not always, this is the case with couples about to experience their first birth. Yet after the birth of their first baby, most men realise what a big difference it would have made having extra support for the birth – not just for their partner, but themselves as well.
A friend of mine told me:
“When I told my husband I was thinking of having a Birth Attendant present for the birth of our child, he looked at me like I had two heads.”
Another woman shared her story in the BellyBelly Forums, after she asked her partner if they could have a Birth Attendant:
“I spoke to my husband about the possibility of using a Birth Attendant – the idea did not go down well. He said that from what I described, the role of a Birth Attendant is what the midwives will be doing for me anyway. I've explained the differences about 10 times and now and he is just angry. I think he's confused – maybe this is why he doesn't feel the need to really prepare because he thinks the midwives will do everything.
Having a Birth Attendant truly sounds wonderful, but it doesn't look like this will even be an option for me. I don't think I am being selfish wanting a Birth Attendant. More than anything I just want to set up a situation where things can run as smoothly as possible for BOTH of us. He later admitted that he felt like I was giving away his ‘job' and he thinks the Birth Attendant will take away something he obviously wants to provide on his own.
We talked about it a bit more after that and he said that the experience is meant to be just the two of us and not with a third person. The idea really appeals to me, however it's a touchy subject at the moment. I really just wish he didn't take it so personally because I don't see it as a reflection on him at all."
It's quite common for a woman to feel the need to have a trusted, experienced woman by her side as part of her birth support team. Not to replace you – but complimentary to you.
From the very earliest of days, women in labour were supported and gave birth in the presence of what were then called ‘wise women'. These women were knowledgable in all things birth and had given birth themselves. Times have now changed – the role of the ‘wise women' has unfortunately been divided into two. There are Birth Attendants who train and specialise in birth support and Midwives who are medically trained. Midwives will monitor the progress of labour, take observations and will catch the baby if the Obstetrician isn't there. It's usual for one Midwife to be assigned to cover several women at once, so she will be out of the room most of the time. During an actual birth or if a woman is having problems, a Midwife may call upon the assistance of another Midwife for back-up, so you can see how it can be difficult to have a Midwife support you for periods of time, when so much else is going on and there is paperwork to be done and phone calls to be made. One Midwife confided that she is saddened to see what she believes is the demise of the Midwife role, going down the path of simply a nurse, monitoring machines and providing observations. She feels that if you want any support during birth, you pretty much have to get your own.
Sometime in the 1970's, men were allowed to be present in the room while their partner was in labour – but it wasn't really until the 1980's that they were encouraged to support her through words and touch. However, we had introduced men into a role that wasn't traditionally theirs and one they knew nothing about. This brought both benefits and challenges into the birthing room.
Not being the usual domain for men, they felt uneasy, confused, anxious, fearful and panic-stricken about the process that was unfolding before them – something they had never witnessed or been involved in before, not knowing what to do or how to deal with their partner in a great deal of pain. This meant that the labouring woman had no ‘rock' to lean on when she too was feeling frightened and desperately needed support and reassurance. Women would opt for pain relief or interventions to get her out of that frightening situation in an attempt to have some control over the situation or so she would have sort of comfort in knowing what was going on. Sometimes their partner would encourage her to seek or accept pain relief or other interventions because he didn't know how else to support her or help her cope – he thought this would be helpful in some way.
Things haven't changed much nowadays, men are still inexperienced in birth (and I don't think that will change, anatomically speaking!) and they do not have knowledge or past experience with normal physiological childbirth.
Something that has unfortunately changed is that we have become a population living more isolated from our family than ever before and we live in a fast paced society. We have much less community support and most of us have none or little exposure to birth, babies and breastfeeding which once was a common, natural event – not a medical one. Today, so many women are labouring alone with just their partner, someone who is not familiar or confident with labour and birth. He doesn't know what it feels like or what it takes to get through a labour, and doesn't have the power of knowledge or experience.
Without an experienced support person with you who can help avoid these potential interventions, it may be difficult for a couple to know what they really do need and what they don't. It's more difficult to prevent these interventions on your own if you don't know if they are truly needed – of which I think you'll get at least one thrown at you at any birth. Without having the power of information or a ready resource behind you, or tools to make empowered decisions, you are almost guaranteed to follow this path.
One father commented:
“You can be in a situation where you are completely petrified and not have a clue about what you are supposed to do. My wife had a very long labour, she was exhausted and ‘out of it' due to the pain relief. The midwife and Obstetrician came in and said ‘xxx' could be a problem and I think you should have an ‘xxx' procedure done to avoid it. I didn't understand fully what had been said and I felt that I had to make an important decision not knowing what I was agreeing to. I didn't have any medical knowledge so I had no idea if there were any alternative things we could try or if what he was telling us was truly needed. I didn't even know if this was what my wife wanted or not. I just froze and agreed to whatever the Obstetrician told us.
My wife wasn't in a state to think for herself and it was one of the scariest things I have had to do. We had no resources behind us and at that point I wished we had someone else to help us, in a position where they had our best interests and birth plan in mind – even if what the Obstetrician was asking us to have done was needed, we would have felt much better at the time knowing that it was an informed decision and we were making the best choice for us."
It's important for labouring women to not worry about those supporting her and how they will cope, as well as worrying about herself – she needs to take in all the energy and support she can get, not give it out to those around her and have some left (hopefully) for herself. She needs to feel that she is surrounded by calm, strength and reassurance. Having someone support her who is nervous, frightened, anxious or unwilling can draw too much energy from the woman and this can result in extra stress and exhaustion, with an outcome of pain relief and / or other interventions likely. Interventions including inductions, medications, instrumental birth and caesareans are higher than ever – this is another reason why Birth Attendants are needed more than ever!
One woman said:
“I realised that I had made a mistake asking a child-less friend to support me during labour. During a contraction when I was groaning in pain, I reached out for her hand for support and she looked at me as white as a ghost and as if I might die! Her heart was in the right place, but she didn't know how I was going to get through it and felt helpless, which made it hard for me to focus on what I was meant to be doing. What I really needed was someone to be strong and confident enough to get me back on track.”
The greatest thing about having our partner with us at birth is obviously being able to share that beautifully intimate connection with our lover, with whom we conceived this amazing, tiny being. No-one else possibly can give us what our partner can give in terms of a deep loving connection. They are brilliant to have as part of the support team if both partners are willing. But a labouring woman needs more than your support and a loving connection. You will be able to provide a great deal more for your partner with gentle guidance and support from a Birth Attendant who can give you the confidence to better support your partner.
This is not to say that the support you can give her is not enough; but the support you can offer compared to an experienced woman is completely different. How? Well lets see what Doulas or Birth Attendants can offer:
Continuity of Care
An Birth Attendant will be with you continuously throughout the labour and for the birth. She will not support you in rostered shifts, be assigned to several other couples at the same time, or make an appearance at the very end as an Obstetrician would. She will be there from the beginning of labour, support both partners through each contraction, reassuring them when they start to question themselves or when they are not sure what to do. She doesn't leave your side until feeding is established and everyone is settled. Your Birth Attendant would have met with you prior to the birth and will have follow up visits after the birth, so you will get to know her better than any of the midwives in hospital and perhaps even your Obstetrician (who you see for five minutes a time before the birth and then again for a short time if he makes it to the birth!)
One father shares his experience of arriving in hospital anticipating the birth of his first baby in a large Melbourne hospital:
“When we arrived in the delivery suite, we were assigned a trainee midwife. There was not much I could actually do at this point, my first question was "have you been busy?" The midwife replied, "We are grossly understaffed today and are rotating our patient duties more than normal". This didn't make me feel any better. We got a swap of midwives every now and then, so I would ask questions to the other midwives and get answers from them, which I then relayed to the trainee nurse. It was frustrating but the only way we could find out anything.”
Support for YOU
A Birth Attendant will support you no matter how much you want to be involved. If you only want to be present and not hands-on, the attendant will help your partner as physically and emotionally as required. If you want to be as hands-on as possible, she will guide you and recommend ways in which you can support your partner. Studies have shown that after using an experienced attendant for birth, not only did mothers show greater satisfaction with her partner's role at the birth, but the father was also pleased to have had that support there for himself, which enabled him to feel more satisfied with his role too. Men who have experienced the care of a Birth Attendant do not feel that their role has ‘taken over' as perhaps initially thought, but instead, the sense of relief is what they notice most.
Lower Rates of Pain Relief and Medical Intervention
From drugs, to forceps to caesareans, Birth Attendants have shown in many studies from around the world that they can have a major impact on intervention rates, for example, caesareans reduced by over 50%, a shorter labour by an average of 98 minutes, forceps reduced by 57% – and much more. See the BellyBelly Birth Support Page for more information and statistics. Other factors may effect what a Birth Attendant can offer; for example if you have already planned an epidural or if the Obstetrician you are seeing has high caesarean rates, then there are some things that she cannot change – she cannot override medical decisions only help you make your own. But if you go in with an open mind and are empowered with the right information, anything is possible.
An Extra Pair of Hands
Have you thought what would happen if you need a toilet break, are extremely tired or need a food break? What f you need to move the car or have forgotten something and need to race back home? Would your partner want to be on her own? A midwife simply doesn't have the time to hold her hand until you come back.
Someone to Advocate
A Birth Attendant knows your birth intentions (birth plan) and her best interests lie with you. She facilitates and encourages communication between staff members and between the birthing couple. A Birth Attendant has knowledge which she can use in order to dig deeper and find out more information than what you might be given and understand what is going on – which can then be relayed back to you. She helps you make your own, unbiased decisions based on fact and helps you keep informed about what is going on, without all the jargon.
Someone to Trust
A Birth Attendant is someone whom you can trust, having been through birth herself and having been part of many births before. She knows what it takes to get through a labour, she knows how hard labour is and this can be a great reassurance. You also can trust her knowledge of the birth process; we often forget what we have been told in pre-natal classes but your Birth Attendant will have learned it many times. You can trust her when it gets tough.
She Thinks of the Little Things That Matter
After a birth, I will make sure I steal the camera away from dad for one minute so I can get some pictures of dad cutting the cord, pictures with his new baby and also of the new family. Often the emotions of the moment take over and the things you've been planning to do after the birth (like photography and videography!) get forgotten. I also have done the same with video cameras where the partner has been massaging or holding the woman, so I make sure I take some images of that, so all can remember the special things he did as a support person.
Of course, all these depend on hiring the right Doula for you – be sure to read our article, Hiring a Birth Attendant or Doula – Questions to Ask. There is a printable interview sheet and make sure you check with references if you are unsure. However use your instinct and it's often right.
Want it from a male perspective? One dad has this to say about his experience with a Birth Attendant:
"After going through two births with my wife — one with and one without a birth attendant/doula — I would thoroughly recommend having a birth attendant for the entire labour.
I found I could concentrate specifically on my wife and be right by her side through the whole labour. Any running around was handed over to the birth attendant — refreshing hand cloths and warming up heatpacks, leaving the room to consult with the midwives and playing traffic cop with any other visitors.
After advising the birth attendant of our birth preferences and how we saw the whole process going from the beginning, there was no need to worry about others being informed about how we envisioned the birth — the birth attendant took care of it all, and left us to immerse ourselves in the experience totally.
For those men who are unsure about having a birth attendant for your baby's birth, know that the presence of a birth attendant/doula allows you both to focus on each other and the baby, without worrying about anything else in the process."
What About a Friend or Relative?
You may think, ‘What about her mother, friend or relative?' After all, she knows the mother, she is free, and she may have birthed before. This may be an ideal option for some however it's important to remember:
- While it may not be essential she would likely have no support/birth training
- Her experiences in labour may not be beneficial to your own labour – i.e. if you want a natural birth and she only has had caesareans, then she will not know what it takes to get through a normal/natural birth
- Her attitudes towards labour – Some mothers who insist their daughters will end up with epidurals or will not be able to cope with the pain – with this to work with, do you think she will likely end up with an epidural?
- Her empathy towards her daughter while a caring notion can be a downfall during labour if she cannot stand seeing her daughter in pain. She needs a motivator and reassurer, not someone to drown her in sympathy. Some mothers do not like seeing their little girl in pain, and suggest to their daughter to request pain relief. A little pain relief can't be bad can it? Pain relief sets off a chain called ‘the cascade of interventions' where often one intervention (including pain relief) can lead to another.
A Birth Attendant can be compassionate and caring while at the same time, remaining objective, being able to help you make decisions without being biased. Because this is her job and you are paying for her services, it is in her best interests to ensure she does her best for you so you both have the most rewarding and satisfying birth experience possible – no matter what the outcome.
So before thinking that she is a woman and she will be fine (after all they have been doing this since the beginning of time, right?), remember that they have been labouring surrounded by women since the beginning of time, and it's been more recent for a woman to birth on her own as well as there being a huge increase of intervention use – it's as if we are going backwards.
Most Importantly – There's Absolutely No Need to Feel Inadequate!
It's important not to feel inadequate if she tells you she'd like a Doula or Birth Attendant for the birth of your baby. As per above, men are very new to the domain of birth support and you can't be expected to know and do everything on your own. Swallow your pride and see that this is something completely positive; it will help both of you have a more satisfying birth experience and will be something that you'll look back on with pride, feeling content knowing that you did everything that you could. Often after the birth couples look back and have lots of ‘what if's' which they carry for a long time, particularly mothers. Should you have a Birth Attendant and end up with some ‘what if's' she can help you debrief from your experience to gain some closure.
Should she request experienced birth support, offering your understanding and support is a wonderful gift, not just for your partner but for you too! Even better – be the one suggesting a Birth Attendant should she have not considered it yet. If you are not sure how you would feel about this, it's always worth interviewing a couple of Birth Attendants or Doulas just to get an idea of what they are like, and how you feel with them. You might be pleasantly surprised and relaxed hearing from them what they do and how they can help you both. First interviews are no strings attached – you don't need to go ahead with it so there's no harm in meeting a few!
Remember: Don't take her suggestions of birth support as her seeing you as being incapable because it's not – instead see it as an instinctual need that women experience. It runs so deep and ancient; and offers something completely different to the benefits you will offer her as part of her birth support team. Because you too have a very important role to play and will be able to offer something that no one else can.
Finally, don't just take it from me! Here are some comments from some more women as to why they would like to have professional birth support and the benefits they feel they can benefit from:
“The appeal to me is to have someone who isn't lost in the moment and the emotion of having the baby – and isn't living the pain. Someone who can wrangle with the doctors and get messages clearly and simply through about wishes about how things should be done. Also someone who has been taught and been through it many more times than either my husband and I have. Someone who has ‘seen it all', or at least heard of it!!! Someone who knows an alternative or the best course of action for a scenario. My husband's attitude on having a Birth Attendant was not good, he felt it was a statement on his effectiveness in the birthing process. He literally told me that ‘I would be very offended if you had someone else there'.”
“The reasons I think a Doula would be fantastic are:
a) Being able to do all those little things for the birthing mother, like finding the midwife when she disappears for up to an hour after saying she would be back in 10 minutes, instead of my having my husband chasing after her and being left alone.
b) Being able to notice different signs within the birthing mother i.e. if the pain has increased, if she is looking parched etc., those little signs that a husband may not pick up on.
c) Being able to assist the husband or other support people and guide them in how to better help the birthing mother.
d) Encouraging the mother by telling her how well she is doing etc. when things get tough, being able to repeat what the Midwives or Obstetricians have said, on a less technical level.
This time around, my husband is keen to have a doula as it will be relief for him knowing that someone can assist him too by guiding him on what to do. I know he felt helpless during the birth of the boys."
“Having a doula appeals to me due to my previous birth experience. Last time I felt that things were out of control, and although I had choices I felt like things were happening around me that I couldn't control. I know that by having extra support apart from my husband would help me to focus on the labour and work through it, rather than be distracted by the worries that were happening during my previous labour. My husband also felt out of control with what was going on and there were numerous Obstetricians and Midwives coming in and doing internals and discussing what was going on without too much communication other than pleading for a caesarean section. He got scared and confused. My husband thinks that this time having someone focused on the bigger picture and assisting with communication will help him focus on me better.”
“Having someone to talk for me and understand why is what I would love about having a Birth Attendant. I'm not very good at speaking up for myself (sometimes) and would easily be talked or pushed into something and then look back and realise it wasn't necessary. So having someone to stand up for me would be the drawcard for me.”
“It would definitely appeal to me to have extra support for my husband and I – someone who has more knowledge in the labour/birth process other than us who can outline more options. We will be having a doula for our next birth, we both definitely want one.”