Finding the right labor support.
Heather wrote with some darn good questions. Her husband doesn't want to be in the delivery room. It'll be gross and he doesn't want to see Heather in pain. After some "discussion," she's talked him into being there but isn't sure he'll be much support. She's considering hiring a doula for labor support though she's planning on an epidural. Her doctor says the labor nurses at her hospital are great so Heather wonders if a doula is necessary. She's due on Christmas day and worries she'll get an inexperienced nurse without enough seniority to get Christmas off. Oh so many things to write about here, Heather. Dads? Doulas? Christmas? Where do I start?
Some Dads still yearn for the days when they were relegated to the lobby to drink from their flask, smoke cigars and wait for the announcement "you're a Father." Flowers in hand, they'd find their wife with fresh makeup and perfectly coiffed hair—not a speck of birth-goo in sight. All dad had to do was admire the fruits of her labor.
Yeah, right dudes. These days we expect you to be in the delivery room providing support and a certain amount of medical knowledge to get Mom through endless hours of labor. We expect you to hold her legs while she pushes, take perfect birth photos (carefully avoiding crotch-shots) and be a good sport about it all. No gagging or wincing and for God's sake, you'd better not faint. Got all that? Good. We don't want any slackers in the delivery room. Just kidding, guys. We know not every guy can handle the guts and glory.
Most guys are totally up to the job—even those who know the sight of blood drops them to the ground faster than a lead ball. Most fainters, whiners, wimps and weenies snap out of it once labor kicks in. They're into it. They clock contractions, remember every breathing pattern and are, honest to God, into it. Their wife/partner NEEDS them. Their baby needs them. She's depending on him to BE THERE for her. Most guys do it. Sure, there's some blood and guts but not as much as you'd think. We nurses are a tidy bunch and keep it as clean as possible. There's no rule Dad has to be down in the action zone. Up at the head of the bed is just fine.
But what if he totally doesn't want to. OK, fine. Your loss, buddy. Personally, I think Heather's smart to talk her husband into being there. That way, she won't resent his absence and he won't regret missing his child's birth. Chances are, once the show is on the road, her husband will be more supportive than they think.
So, what do I think of doulas? Some are great and some aren't. Some are knowledgeable, supportive team players. Their job is to support both parents (but not in a medical role), no matter how labor plays out. We all know that birth is unpredictable and birth plans change all the time. A good doula helps parents go with the flow, making changes as needed. I've worked with some wonderful ones. They're gifted at labor support, massage, breathing, positioning and listening. They're an information resource and sounding board for parents to bounce ideas off. They know when to step in and when to back off. They know the right questions to ask the medical staff so all players have the information they need to make decisions. These are the good ones.
Then there are the others. I've worked with some who have their own agenda; their own birth plan. They're adversarial, militant and argumentative. If mom originally planned an un-medicated birth, by God, that's what she's going to get, like it or not—even if she changes her mind or labor isn't going as expected. She's in the staff's face when they need to do stuff. She second guesses medical decisions, creating an atmosphere of distrust; an "us against them" attitude. I've had doulas who attend a few deliveries a year intimate they're way more knowledgeable than nurses who attend a half-dozen a week. That makes for a tough situation.
The trick is in hiring the right doula for you. If Heather wants one, she needs one who's supportive of epidurals. If she's got a good nurse though, she might not need a doula. Her husband, a girlfriend, sister or her Mom might be enough support. Labor support is a huge part of the nurse's job. We know how to nurture Moms through labor, help parents make decisions and get the job done. I've had couples that have asked their doulas to leave when they realized they didn't need her after all. Now, if Heather's doctor said the labor nurses were no-good, I'd say, get a doula.
For women who really want an un-medicated birth, having a doula or other support person with experience in labor-land is key. You want someone to keep you focused, calm and on-task with whatever labor technique you've practiced. Some techniques are pretty specific, like Hypnobirthing. Doulas are often great at keeping Dad focused as primary support person when he's stressed, tired or confused. I love when they do that— keep Dad as co-star of the show. I hate when they displace him.
As for the Christmas staff? I don't know how it works at Heather's hospital but at mine, we take turns working holidays. One year we work Christmas, the next -Thanksgiving. There's a mix of newbies and oldies. Plus, labor nurses get a lot of extra training and supervision before they fly solo. Labor and delivery is a high-litigation risk department. People sue if we mess up their babies. We don't let brand new nurses manage labors. We're a team and we watch out for each other. Even on Christmas.
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