Dean is his daughter Charlie's birth partner (S5-ep3)

Most women choose to have someone to accompany them when they give birth, who is known as their ‘birth partner’. While your needs in childbirth will be taken care of by a midwife, it is a good idea to have someone else there to provide more personal emotional and practical support. Indeed, there is medical evidence that a woman labours more effectively and calmly if she is never left alone.

For many, the birth partner will be the person you are in a relationship with, for others, their own mother or a close friend. Society now expects partners to attend the birth, yet I believe very strongly that you should do what seems right for you as a couple, and no one should feel obliged to be a birth partner if they really don’t want to be. If your partner prefers not to be there for whatever reason, then that is entirely up to you and them. That said, they invariably remember the birth of their child as one of the most powerful moments of their life, and one that creates a unique bond between you as a couple.

Seeing someone that you care for in pain is always difficult for a birth partner. Whoever you choose, they will usually cope much better with this if, firstly, they know what is happening and, secondly, they can take steps to help you. Your birth partner should therefore inform themselves about birth by reading up on labour, Caesarean sections, the different types of pain relief and some of the potential complications, so that they feel confident about discussing any issues with the medical staff. They should also read your birth plan, if you have one, so that they know what it contains.

If possible, they should also attend antenatal classes (there is usually a specific, one-off session for partners if they are unable to attend the entire course) and tour the labour ward in advance so that they know what to expect.

If you are having a home birth, your birth partner should know where things are kept in your house and what the arrangements will be on the day. It is important, however, that anyone who is planning to be with you during labour understands that you can change your mind at any stage, and should not feel offended if, in the end, you decide to give birth without them being present.

The essential role a birth partner has is to act as your advocate when dealing with medical staff. During a labour that is progressing normally, you may be left unattended for short periods of time. If you become concerned that something is happening to you or your baby, your partner can ask for the help of the midwife or obstetrician, insisting if necessary, without being confrontational. You may not be thinking very clearly due to pain or fatigue, whereas they can ask questions for you about the situation and seek clarification if it is needed. In addition to being your advocate, your birth partner can see to your personal needs and provide emotional support.

For example, you may want physical reassurance by having your back massaged or your hand held (it is important that your birth partner learns how to massage you in advance, and doesn’t leave experimenting with different techniques until the day).

Some women don’t like to be touched during labour and prefer verbal reassurance and encouragement instead; conversely, you may not want to talk at all or prefer to focus on some background music. While you can, to some extent, talk this part of the role through beforehand, it is impossible to know in advance how you will feel, so your birth partner will need to listen to you carefully at the time in order to be able to respond effectively. They should be aware that your needs may change from one moment to the next: it is common for women to want their birth partners close to them for some of the labour and to push them away, verbally and/or physically, later on. It is important that your birth partner is prepared for this, to avoid any surprises and unintentional hurt.

Other birth partners

Some women also wish to be attended during the birth by an alternative medicine practitioner, such as an acupuncturist, a doula or another family member. While all maternity units allow you to have one other person with you, many cannot accommodate more than this, so check in advance what your hospital’s policy is.

If you have hired an independent midwife for a home birth and have had to transfer to hospital because of complications, she may not manage the actual delivery herself, but will be allowed to support the hospital midwives and manage practical issues, as well as reassure and encourage you.

Partner’s role on the day

In order to support the mother-to-be during the birth, you should:

  • encourage her, tell her how well she is doing and remind her to focus on her breathing in order to cope with the pain
  • maintain eye contact as much as possible, to enhance her feeling of security
  • be sensitive to her needs, which may change from one minute to the next
  • help her in practical ways: ensure she has a water bottle to hand, that her pillows are comfortable, that she is not too hot
  • accept that, although it can be minimised, pain is part of the birth process: you will not be able to take it away
  • maintain an atmosphere of calm and quiet wherever possible
  • stay fed and watered, but in a discreet way, and take regular, short breaks
  • keep your sense of humour, at least in the early stages
  • try not to let fear/distress/panic show: remain outwardly confident, positive and encouraging be prepared to seek medical help if you think it is needed
  • be assertive – but not aggressive – with the medical staff
  • seek further information or a second opinion when necessary
  • provide clear information and reassurance for her, and explain what the medical staff have told you.

Doulas

The word ‘doula’ comes from the Greek word for woman servant or caregiver, and it now refers to a woman who can be hired to offer support, advice and practical help to a woman in childbirth and the period after (and also to her partner, if required).

In effect, a doula ‘mothers’ the mother. Increasingly, in an age where women often do not have close family and friends living nearby, doulas are stepping in and filling the need for support during this important and emotional stage of a woman’s life.

Doulas don’t perform a clinical or medical role during pregnancy and labour, but they have had some training, have good knowledge of a woman’s physiology and are experienced in childbirth and the postpartum period. (Although it is not an essential qualification, most have given birth themselves.)

While they are there to support both parents, they can also be your sole birth partner if you so choose. It is best to recruit a doula via an agency, which can perform background checks and act as a mediator if there are any problems – this is important, as this is (as yet) an unregulated profession.

You should meet your doula sometime during your pregnancy – by the time you are 36 weeks pregnant, at the latest – so that you can discuss the help you think you would like and to make sure that you are going to get on.

During labour, a doula can offer advice on breathing and relaxation and different positions to help you cope with the pain, encourage and reassure you and help to explain any medical situation that arises. She encourages – though never pressurises – the partner to be involved and will remain sensitive at all times to what you both feel comfortable with.

Her aim is to help you feel supported in what is happening, so that the labour is something you look back on positively.

A doula can also be hired for the period after the birth – indeed, some women prefer them to be involved only once they have returned from the hospital. The length and type of involvement depends entirely on the specific arrangement between you but, generally speaking, the doula’s role will involve being of practical and emotional help to you as new parents. This means helping around the house, providing advice on breastfeeding and offering guidance and reassurance on all aspects of babycare. This could be a particularly valuable source of support if you are a single parent or don’t have a network of female relatives and friends on hand.

As a result of the doula’s help, many women find that they are better able to recover from labour and bond with their baby and that the postnatal period becomes more relaxing and enjoyable for both parents.

This is an edited extract from One Born Every Minute: Expecting a Baby by Dr Penelope Law (Quadrille, £20). Text © 2013 Dr Penelope Law.