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 Birth Choices: your birth partner

The mountain of choices and decisions that face a newly pregnant woman can seem insurmountable. So it is not surprising that the choice of who will be there to support the mother during the birth can be overlooked. Many women assume that their partner will be there and is the best choice and give it no further thought. In fact there are lots of choices and the final decision could be one of the most important of the whole birthing process and needs consideration.

A fearful, jittery and unsure birth partner may not make the best advocate or birth supporter. Somebody who is forceful in their opinions and likely to override the birthing mother may also not be ideal. It may help when starting to consider birth partners to talk to other mothers about what they found useful during the birth and the kind of support and help that they needed.

Everyone is different, however, and one woman’s perfect partner is another woman’s nightmare! So maybe the best place to start is with yourself.

What kind of person are you?

Are you strong-minded? Do you value advocacy and support? Are you looking for an objective but knowledgeable voice during your labour? Are you happy to just go along with whatever advice your health professional gives you? Or do you feel more comfortable being left to your own devices? Do you value hands on support or hands off and mind-your-own-business support?

All these questions are valuable when considering your choice of birth partner. Once you have given thought to the kind of support you may want during labour you can then start looking for the perfect match. Sometimes this will be your partner, sometimes it won’t, sometimes it will be another person in addition to your partner. To go into labour assuming you already have the best choice of birth partner may be to overlook a great deal of wonderful people who could make a fantastic difference to your experience of birth.

What will the birth partner do?

Once you have visualised your birth partner and the personal attributes she will ideally have, it is then worth considering what you want her to do. Do you want somebody to come to antenatal appointments with you? Are you thinking that you want somebody with shared values and ideas but only need support at the birth? Do you envisage the supporter being part of your child’s life in some capacity afterwards?

You may think it is vital that your birth partner is experienced in some forms of natural techniques such as massage, aromatherapy, relaxation, hypnotherapy or acupuncture. It may be important to you that your birth partner has given birth naturally herself, or given birth at home, or breastfed her children. You may think it more important that she is an experienced supporter and that you are able to talk to some of the women she has supported. The answers to all these questions and clarification of these points could lead you in the direction of your ideal birth partner.

Place of Birth

This is another important consideration. If you have decided on your place of birth then you need to know the views of your birth partner, and whether they can fully support your birth choice. You may have a friend who is perfect but anti-home birth, or a relative who is not comfortable coming into a hospital with you. If they are not comfortable with this choice (or any others) then you need to know if they can advocate and support you fully during your birth. The very last thing you need is to feel undermined or unsupported.

So, what are your choices?

The father

Most women expect the father to be present during the birth and many fathers feel the same way.

For centuries birth has been ‘women’s business’ and the question of the father being present at birth would not have been entertained. Why has there been such a radical change? Michel Odent says that for the first time in history healthy, pregnant women are now expected to leave their homes and go to a large hospital to be attended by strangers during their births and the extended family has largely been reduced to the nuclear family so there are no female family members to assist or support during birth. Odent tells us that during the 60’s and 70’s theoreticians thought that the participation of fathers during the birth would be positive. It would strengthen ties between couples, reduce divorce rates and make birth easier as the woman would have a familiar face with her. Caesarean rates would drop as a result. I don’t think we need to examine these too closely or dig out any statistics to know that none of these things have come to pass.

There is lots of discussion about this among midwives who have experienced the difference between a wholly female birth and one with a male, including the father, present Having personally been a supporter during both kinds of birth I can vouch for the fact that the birth room consisting entirely of women seems to be calmer, have less words, be ‘earthier’ in some way and you can almost smell the female hormones in the air. The women, often, seem to be freer to express their needs and are less inhibited.

However, fathers being present is the norm now and many mothers and fathers are reticent to admit their reluctance at this prospect. In the case where both parents want the father to support during the birth, I think it is really worth considering having a second birth partner.

Pros

  • You know him well! You know his views and opinions, his strengths and weaknesses.

  • He has an emotional link to you and your baby that nobody else shares.

  • He normally doesn’t charge!

  • Many are happy to learn new skills such as massage and relaxation.

  • It is an amazing shared experience that you will never forget, or tire of discussing.

Cons

  • He has an emotional link to you and your baby – this sometimes colours his ability to advocate for you. It is virtually impossible for him to remain objective.

  • Many midwives recognise the presence of the father changes the behaviour of the mother and inhibits her. She can be preoccupied with him.

  • Sometimes, he doesn’t want to be there but feels unable to say no.

  • Usually, the father has never attended a birth before so the whole experience is totally new.

Friend or Relative

Once you clarified the ideal personal attributes you may find a person pops straight into your mind. Or you may not have had to think very hard at all before knowing the ideal person. You may know somebody who fulfils your criteria already.

If you have found the ideal birth partner is a friend or relative, don’t be shy about asking them! In my experience most women who have given birth themselves would jump at the chance to support another woman. They are also often very intuitive during the birthing process.

You may have taken some kind of course during your pregnancy – antenatal classes, pregnancy yoga or hypno-birthing – and found a natural affinity with the practitioner running the course. Most are very happy to be birth supporters for women who have attended their courses, and are used to being asked. If you have no friend or relative who is suitable, but know an ‘acquaintance’ like this who you think might be a good birth partner – then again, don’t be afraid to ask. Most women are flattered to be considered and will take the role very seriously.

Pros

  • You already know this person so don’t have to go through the ‘getting to know you’ stage of the relationship

  • This kind of birth support is normally free!

  • You will know the persons views and ethos around birth, and therefore know that they will support you as necessary.

  • They are normally quite happy to learn and practise massage, and endlessly discuss what you want your birth to be like.

  • Often they can play a part in your child’s life afterwards, if that is something you are looking for.

Cons

  • Often they have no prior birth support experience, so may not be the best advocate.

  • The mother can sometimes unexpectedly feel inhibited during the birth by the presence of a friend or relative.

  • They could say no, think about how you would feel if they did.

Doula

A doula is a ‘professional birth supporter’ who believes in ‘mothering the mother‘. If you know other mothers, ask around for a recommendation. Otherwise, you can find local doulas through Doula UK. Once you have a list of two or three local doulas you can arrange to meet them to discuss your requirements, get an idea of their views and see if they are a good ‘fit’ for you.

Pros

  • Most are mothers themselves.

  • A doula will be an experienced birth partner, who has supported women through a variety of different births.

  • They tend to remain calm and unflappable!

  • Many doulas have other useful birth skills such as aromatherapy and massage or hypnotherapy.

  • They are objective and can often advocate well. They are experienced at communicating your needs to health professionals, which means you can focus on birthing and not talking!

Cons

  • They cost money. Trainees cost no more than £200 but qualified doulas are usually more. Think in the range of £500 for antenatal visits, birth support and postnatal visits.

  • They won’t play an ongoing role in your child’s life, usually.

  • You won’t know them beforehand, though you do get to know them through antenatal visits.

Independent midwives

It may seem strange to mention independent midwives in an article about birth supporters, but some women do opt to hire one while continuing with NHS care. In this case the midwife becomes more of a doula, but an incredibly experienced and knowledgeable one. A woman opting for a home birth may opt out of NHS care with an independent midwife and not feel the need for any other birth supporter.

Pros

  • Experienced midwives who have attended lots of births.

  • All of the positives associated with a doula.

Cons

  • Expensive option, if you just want a doula. They tend to charge in the region of £2,500+ per birth.

  • Can be difficult to find. Thanks to overbearing government regulation, independent midwifery is a dying breed.

  • All of the cons of doulas.

Is it really important?

Choosing a friend or doula need not take away the role from the father. Women can have two birth partners in all hospitals and birth centres, and of course are free to have any number of people in their home. So you may decide to hire a doula who will advocate and look after both parents which then releases the father from the responsibility of advocacy in a field he may have limited knowledge about. This usually reduces his anxiety levels (and the mothers!) and allows him to spend his time looking after the mother. The mother won’t be left alone while he nips to the toilet, to get something to eat or make a phone call – all of these things which couples often haven’t thought about.

If the couple decide that the father won’t be present at the birth he can still support. He can be nearby, keep family informed of progress, fetch and carry, look after siblings, make sure there is enough food, fill up and empty birth pools and come straight in to meet the new baby and share this wonderful new experience and first precious moments.

Something I have learned during five years of teaching antenatal classes is that the vast majority of women don’t consider the importance of the choice of birth partner before they are in labour. The birth partner is such a vital part of the birth process that this decision deserves a great deal of thought.

A positive, supportive, intuitive and experienced birth supporter can make a huge difference to the process of labour. A woman will never regret spending time and energy finding the ideal birth partner.

 

Further Information:

Doula UK 0871 433 3103 http://www.doula.org.uk

Independent midwives 0845 4600 105 http://www.independentmidwives.org.uk

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