Warning: I’m not embarrassed by bodily functions and I’m not grossed out by birth. If you are either, stop reading now – unless you’re an expectant father – in which case, suck it up you wuss – you need to know this stuff!
First rule: if she wants medical care – you get some.
Second rule: If the pregnancy has been abnormal, or something just seems “wrong” call 911.
Here’s the big question: Do you need a doctor during the childbirth? Answer: If everything is normal – NO. In fact, when my wife teaches birth classes, I often sit in. Many of her clients are second time mothers who had a bad experience with their first birth. The bad experience almost always goes like this – so often that I’ve coined it a “snowball birth” because one step inevitably leads to the next and the whole mess gets bigger as it rolls downhill. 1) Doctor induces labor for no good reason; 2) Doctor gives epidural; 3) Mother fails to progress to Doctor’s satisfaction; 4) Doctor gives mother a drug to make her contractions stronger; 5) Mother can’t push effectively (usually a side effect of the epidural); 6) Doctor tells Mother she needs a C-section; 7) Mother feels like a failure and Doctor leaves for his golf game.
The whole process happens because the baby isn’t ready to come yet.
Also – most mothers who have had a “modern” birth – those with epidurals and doctors - will still tell you how much it hurt despite the epidural and often have complaints about the doctor being rough or rude or even threatening…e.g., “if you don’t push, I’ll need to use suction.”
When you talk to a woman who had a natural and uneventful childbirth – no drugs and a midwife, they rarely talk about pain…usually it’s pressure. There are medical reasons for this that involve memory hormones. Remember that blinky thing in Men in Black that erases memory? The body has a hormone that does the same thing for pain memories. If you have an epidural, it never gets triggered.
If you’re normal and healthy – go with a midwife.
But what if it’s an emergency – it’s going to happen at home and no one can come and help…
Okay…so hypothetically speaking, let’s say you’re about to have the baby at home and without the help of a midwife. The pregnancy, up to this point has been normal and healthy. Now what?
Even if you aren’t planning to deliver unassisted at home – remember that the baby may not have gotten that memo.
Supplies:
- You need to own this book, have read it repeatedly, and have it handy. Get the book and read it. Yes, I’m aware it’s the 1958 version. I promise, the process hasn’t changed since then.
- You need something to clamp or tie-off the cord. I’ve used dental floss and cord clamps. I highly recommend the cord clamps. You can buy them here. You’ll want to order those ahead of time. You need at least two. People have used clean, unopened packages of shoelaces as well. Again, I recommend the clamps.
- You need lots and lots of clean towels. We used beach towels. How many do you have? You need more.
- You need a bowl to catch the placenta in.
- You need tissues. It’s quite possible she’s going to poop during labor. If she does, she probably didn’t intend to and she probably won’t even realize it happened. It won’t be very much. Just grab it with a tissue and put it somewhere out of the way. You don’t want it touching the baby and there is no need to embarass mommy.
- You need a sharp pair of scissors and a way to sterilize them. Alcohol works. There will be no hurry at this point.
Process looks like this:
She’ll have contractions. They may be fast coming, or not. They may be hard or not. They may be regular or not. I know the movies say that they’ll be regular, fast coming, and painful. They’re movies – not reality. On a related note, the water may not break until well into the process of birth. Occasionally, babies are born with the water in tact. Don’t count on the water breaking to be a sign – that’s just in the movies.
First things first: what’s your job? You are whatever mama wants and needs. You make mama comfortable and hydrated. You do not complain about your problems and you don’t share your fears with mama. You are strong when she is not. You are soothing when she needs to be soothed. You just need to help get mama to the point where her body takes over, then you catch.
If you need to time the contractions, that’s fine. Do it discreetly, and don’t give mama reports. Above all, don’t tell mama she’s having a contraction or when one is about to happen. It’s fairly likely that she already knows.
Watch mama…she’s likely to go through some telltale stages (these can last for more than 24 hours or be over in less than an hour):
Nervousness, insecurity, a sense of “I’m not ready” – I’m still talking about mama here, not you – focus! These are all signs of early labor when they’re coupled with contractions. She’ll likely be talking to you through her contractions…that’s because they’re still mild. Have her rest, use the bathroom, and drink water. Maybe eat something. If that doesn’t stop the contractions, this is probably the real thing. It could be 24 hours or 20 minutes. It’s up to baby. Your job it to keep her as calm as possible, comfortable, moving, and hydrated. Help her walk around. Close the blinds, lower the lights - if she wants soothing music, now is the time, wash your hands very well. Gather your supplies – especially the towels.
There is also a period of emotional swings, if contractions were regular before, they may get irregular during this period. That’s normal. This is a transition period. Contractions will get more intense. She’ll likely stop talking during the contractions – you should too.
Unless she tells you otherwise, keep touching her – gently, soothingly. Look for areas that are tense and help her relax them. Tell her she’s doing great. Tell her you love her. Tell her you find her amazing. Things like “you’re hardcore,” “you’re a trooper,” and “no pain, no gain” are probably ill-advised. When the contractions get to the point that she wouldn’t move out of the way of oncoming traffic when she’s having one – you’re in the real deal.
At some point around this time, she’s going to shed her modestly – and likely her clothes too. That’s why I had you shut the blinds earlier. Keep her drinking water between contractions.
Now you should be watching/listening for a few things: 1) grunting; 2) clenched muscles during contractions … the same ones you clench when you’re trying to have a bowel movement; and 3) her saying “I feel like I need to poop.” All of these are signs baby will be arriving very soon.
Then you’ll go into the final stage – and men tend to want to say “PUSH!” She won’t have a choice but to push. Pushing makes things feel better. Her body will compel her to push. This is not a 30 second process. Our first child required more than 4 hours of pushing. Keep her hydrated.
In the movies (and at hospitals) they put mama on her back with her legs up. They’re stupid. Nothing could be less helpful. That position doesn’t use gravity to help and it makes the opening narrower. Have her get on all fours, or better yet in a standing squat. That opens the canal and helps baby come. It makes it harder for you to “catch” – and that, by the way, is why docs put mom on her back. Keep your hands properly positioned…babies can come out fast and you don’t want the baby’s introduction to the world to be a thump onto the floor.
The water will break at some point if it hasn’t already – look at it. If it’s dark or brown, you may have a problem – but you already know that because you read the book, right? Normal is slightly less than clear with flecks of white stuff that looks and feels like lotion floating around in it.
If you see ANYTHING other than a head coming out first, call 911.
Crowning – the part where the head is coming out of the opening – can be a tough time for mom. For dad, it’s tough to look at – but get over yourself…she needs you now more than ever. Believe me, everything will go back to normal after a few weeks. Try to help her push baby out gently – too fast and you could have a serious tear. In the end, the baby will come out however it wants. But you can try.
Follow the book’s directions on clearing the mouth and checking the cord.
After the head comes out, the rest will follow quickly. Catch! Your baby is slippery, small, and may come out with surprising force. Don’t drop it. DON’T pull it out and DON’T yank on the cord.
Put baby on mama’s belly, cover it with towels or blankets and get ready to catch the placenta. Mama will feel it coming. She can be on her back for this part.
Keep your hand up and keep the bowl in place. This can take up to 30 minutes, but when it happens it will go quickly. This is the messy part. It’s also the gross part. Catch the placenta in the bowl.
You should expect about a cup of blood during this process. That’s easy to say because a cup doesn’t sound like much. It looks a lot worse than it sounds when it comes from someone you love.
Once the cord has stopped pulsing and goes limp, clamp the cord about an inch or two away from baby’s navel and then about an inch further than that.
Sterilize your scissors and make the cut.
Mama will be shocky…make her warm and comfortable. Hydrate her. Orange Juice is good. She’ll be pale and shaky. She may alternate between being hot and cold. Keep her warm. She’ll still be leaking blood for awhile. Don’t make her move until she’s ready – that could be hours. Be ready for her to faint – you need to have hands on her at all times if whe’s walking.
At some point, she’ll need to pee. That can be really difficult for a newly un-pregnant mama. Something that makes it easier is a thing called a peri-bottle. Basically, it’s a little bottle that you can fill with warm water and mama can squirt herself down there after peeing.
Big, thick pads for her nether regions are important here. She’ll still have some blood coming out. These look like giant maxi pads and she’ll know what to do with them – you are still actually speaking to her aren’t you? She’s a human being after all! Some people even soak them in various herbal solutions and freeze them beforehand to use them as cold compresses – just beware of freezing the actual skin. Or you could buy perineal cold-compresses.
Seek medical care if available. Unless something seems wrong, there’s no real hurry here. We didn’t even go to a midwife until 4 hours after our third child was born and that wasn’t really a hurry.
The main concerns are baby’s breathing (usually indicated by color), overall health, and whether mama is doing alright post-partum.
Nothing I’ve said here is to be construed as medical advice. You need to consult a professional if possible. These are just tips from my experience with my kids – all of whom were born healthy and without any serious complications. I’m very lucky.