My sister had a baby last week, so birth is on the mind.
Almost ten years ago I was working at a drug addiction treatment center for mothers and pregnant women. One day a woman went into labor during a group therapy session and I was asked to take her to the hospital. This was not part of my regular job duties, so I had never done it before. I had also never given birth or seen a woman in labor.
I sat with her in triage for a few hours and it completely changed my life.
She was obviously in a lot of distress. Every time a contraction would come, she would just cling to the side of the bed, furrow her brow, shake, and suffer. Alone. With me in the room just watching and a little horrified. I had absolutely no idea what to do. I would say things like, “You’re doing a great job,” and, “I’m so sorry it’s so hard.” And I would continue to sit in my chair and watch her.
I decided right then that I needed to learn about birth so that if I was ever with another laboring woman, I wouldn’t be so useless. Fortunately, I overheard a nurse in the hallway recommending a doula to someone. I went right out and asked that nurse for the doula’s information.
And wouldn’t you know it, that doula happened to be one of the most experienced doulas in the state and she also hosted 3-month doula training courses AND the next one was set to begin in just a couple weeks. Of course, I signed right up and my life was never the same again.
Although I never really practiced as a doula for my profession, I was able to learn SO MUCH about how to support a laboring woman, and I’ve been to 8 or so births since that time, including my own home birth with my first baby.
I’m here to tell you that birth is such an amazing, miraculous, and natural event and it can be a wonderful and empowering experience for the mother, especially if she has the right support.
On that note, I now present to you: The top 4 things everyone should know about supporting a woman in labor.
But wait, why would I need to know this if everyone I know plans on getting an epidural anyway?
Great question. I see many good reasons to know this, even when you’re going to support someone giving birth with an epidural.
First of all, epidurals don’t always work. In fact, I guarantee you know someone whose epidural didn’t work, or only partially worked, or ran out, or whatever. If you go in with epidural being your only plan and then it doesn’t work, you might want some back up coping tools in your toolbelt.
Second, sometimes birth goes too fast! Some women plan on getting an epidural only to find that they are too far along and about to push. Yikes!
Third, I have a friend who recently told me that she might not be eligible to have an epidural with her next birth because of some medications she is on. However, she won’t know for sure until the day of, basically. You don’t want to start planning ways to cope with labor the day you go into labor…
Better to be prepared, just in case.
So! Here are some tools you can have on hand the next time you find yourself with a laboring woman…
Fear, Tension, Pain Cycle
Labor is certainly a very intense experience. It’s a LOT of pressure and it lasts a long time. However, there are things that can make the experience more difficult than necessary and one of those things is fear.
When you are afraid, your body tenses up. You go into fight or flight and you can’t relax. In labor, this is very unhelpful, because the more tense you are, the more it hurts. What you actually need to do is relax! Relax and let your body do its job.
When a laboring woman feels fear, she tenses up, and then she feels tons of pain. This pain makes her even more afraid, and even more tense, and the cycle goes on.
The key is to remove the fear and relax.
As the support person, you can explain this cycle to the laboring woman. Ideally this would be done before labor begins, but you do what you gotta do.
And then, to help relieve fear, you say things like this to her:
“You can trust your body and your baby to know what to do.”
“I am right here with you. You have all the support you need. You are safe.”
“Each contraction is bringing your baby closer to you.”
“You are doing a great job. Your baby is so lucky to have you as a mom.”
Counter Pressure
For many women, counter pressure is key to having a more peaceful labor and birth. As I mentioned before, the laboring woman’s body is already producing plenty of pressure in the abdomen as it moves the baby down. As the support person, you can counter that pressure from the outside. A few things to try include:
Pressure on the low back: Using an open hand or the palm of your hand, press firmly in the center of her lower back, where her sacrum is. Listen to her feedback to know if you should press harder or softer.
Hip squeeze: Place one hand on each hip and squeeze together during a contraction. This helps open the pelvis more and relieves some of the pressure from the mom.
Press on the knees: If she is sitting, you can press on her knees during a contraction, or even put one hand on her lower back and one hand on her knee and squeeze together.
Relax and Open
Did you know the pelvic floor muscles mirror the muscles in the throat? They look a lot alike and they also affect one another. When a laboring woman tenses up, clenches her jaw, or does high-pitched shrieks, she is closing off her throat muscles, and her pelvic floor likes to close up along with it.
If you can help the mother to relax those throat muscles and keep them open, her pelvic floor will do the same. You can do this by deep breathing and making low moaning and groaning sounds.
It often helps to make the sounds with her, at least to get her started, so she can hear and copy and not have to think. Just open up your throat and say in a low voice, “Open your throat… lower your voice… open… low… oooohhhhh.”
Along with that, remind her during the contractions to relax her forehead, relax her jaw, relax her shoulders, and open the palms of her hands. If it’s helpful, you can touch or put a little pressure on each of these locations as you are telling her to relax them.
Breathing
The crazy thing about a natural labor is that it’s actually a lot of just hanging out and waiting. You have an intense, all-consuming contraction that lasts maybe a minute, and then you have multiple minutes of just sitting there feeling like your normal self.
So really, all you have to do is get through one hard minute at a time and then enjoy a nice break for a while.
Deep breathing is a wonderful way to help your body relax and pass that minute. When a contraction is beginning, you can remind the mom to breathe in really deep – aim for a slow count of four. Then breathe out even more slowly for up to twice as long as you breathed in. One long, slow, deep, relaxed breath like that can take 15-20 seconds. Do that 3 times and the contraction is over.
And there you have it. If you can help the mom breathe, relax, open, and give her a little counter pressure white you’re at it, she’ll make it through hours of labor just fine. You can totally do it, and so can she.
Suggested Reading
If you want to learn more about helping a woman in labor, I recommend a book called “The Birth Partner” by Penny Simkin. She goes into all the glorious details and you’ll be a pro by the end. I also recommend reading “Ina May’s Guide to Childbirth.” The first half just tells a bunch of birth stories – it’s more than many people have heard if all they know is movie births. The second half talks about how labor works and how to prepare for it. It’s very informative and helpful!
