How to be a Supportive Labor Partner

Birthing partners can be literally ANYBODY that you want them to be. While traditionally, a lot of pregnant individuals will bring their spouse as their birth partner, some people don't have a spouse. The reason why is irrelevant, the biggest thing is that you were chosen to help support them on one of the hardest and most magical days of their life.

So.......

Husbands, wives, partners, mothers, sisters, friends, whoever you may be...listen up. You are not the center of attention in the room right now. No... that would be the one having the baby.

And rightfully so. She just spent 9 months growing this human from scratch, and now has to go through a laboring marathon to bring this baby earth side.

While she may not need your physical help in birthing this baby, she does need your support in more ways than one. Your job is to be the Support Person. The Birth Partner.

Is labor fun? Depends who you ask. It definitely is incredibly hard work and takes a huge toll on your body. And going through it alone would be terrifying. There are quite a few things that you can do as the Birth Partner to help take some of the stress off your person's shoulders.

Their focus should be on labor. Contractions are painful and distracting, and even if she has done a TON of preparation for this day to help her cope while in labor, she still needs to focus. Which means your job is LITERALLY everything else.

Your probably thinking, "Great, except I've never done this before.... What should I even be doing?"

Great question! There are many things you can do, and also shouldn't do, to be a supportive birth partner. The biggest thing to remember, is that every person in labor is different and wants different things. So discussing these things with your partner before labor has started is encouraged. This is where birth plans come in handy! It helps your partner and the medical staff that are working with you while you are in labor. But for someone who has never been in labor before, they may not know what they like and/or dislike. So continuing the conversation in labor is also important.

Anyways... Let's get into it!

**DISCLAIMER. I USE THE TERM "WIFE" AND "HER" FREQUENTLY IN THIS ARTICLE TO REFER TO THE INDIVIDUAL IN LABOR INSTEAD OF WRITING OUT ALL POTENTIAL NAMES AND TERMS THAT COULD BE USED TO REFER TO THE INDIVIDUAL IN LABOR SO AS NOT TO CONFUSE WHETHER I AM TALKING ABOUT THE SUPPORT PARTNER OR THE LABORING INDIVIDUAL. PLEASE KNOW THAT I UNDERSTAND THERE ARE MULTIPLE NAMES AND RELATIONSHIPS THAT ARE USED TO REFER TO THE INDIVIDUAL IN LABOR. I AM NOT ONLY REFERRING TO WIVES WHEN I USE THIS TERM.

Be in Charge of Supplies

You're going to have to be the leader in one department of labor. Your wife, partner, sister, daughter (whoever) may be running the show, but one area they shouldn't have to focus on, is anything that has to do with getting to the hospital with all the supplies.

Have they probably had all the bags packed and ready to go for weeks? Maybe. But, it is your job to know where the bags are, make sure the car is full of gas, and that you have any necessary papers you may need at the hospital (insurance, health care cards, birth plan etc.). If your wife is having a homebirth, I would STILL know where these things are. Anything can go wrong at anytime, and it's important that she doesn't have to worry about this extra step.

But even in a homebirth, you should know where the important homebirth supplies are located; towels, blankets, pads, dryer, garbage bags etc.. That's your job. Not your wife's.

Warm Bath or Shower

Turning on the bath, filling it up and warming up the shower. Try to imagine what your wife wants before she wants it. This is why discussing her birth wishes prior to labor are super important.

Water can be super helpful for individuals in labor. Submersion in labor, or even water on the back can be an excellent natural pain relief in labor.

Help your wife into the tub or shower, and then stay with them if they wish. Some people like to labor alone, others want you right beside them. Feel the situation out, and see what best suits your wife. Rest assured, if she wants you to leave her alone, she will likely tell you.

**Check with your particular hospital if there are tubs, showers, or both so that you know what to expect when you get there. Also, if your water is broken, talk with your provider prior to submerging in water due to the risk of infection.

Offer Lights Snacks and Water/Electrolytes

As your nurse, I will always offer you a glass of water and ice chips when you're in labor, or I will just bring it. It's important to stay hydrated while in labor.

However, partners, you can take over this job from the nurses! I personally encourage my patients to eat when in labor. Nothing big and heavy, but light gentle snacks.

I know, "My Doctor said I'm only allowed clear fluids while in labor". This statement is based off of old beliefs and the potential risk of going to a c-section. They recommended no food in labor to decrease the risk of aspiration during surgery.

However, have you ever seen ANYBODY run a marathon on an empty stomach? Do they stop and grab light snacks on the way? Sips of water throughout? Energy packs? OF COURSE NOT. Because they would likely pass out from low blood sugar and dehydration and end up very tired and have more difficulty recovering.

You need energy in labor! You need FOOD. You need ELECTROLYTES. Your hospital may have a "rule" about no eating in labor. Personally, I would just ask to sign a risk agreement and say that you are aware of the risks and choose to eat in labor.

Bring light snacks that will give you energy; granola bras, nuts, protein balls, dried fruit, trail mix, pretzels, coconut water, crystal light packs, electrolyte drinks etc. Partners.... DO NOT EAT ALL THESE BY YOURSELF. Yes.... I have seen this. Your job is to offer them to your wife if she hasn't eaten in a while. Keep in mind, lots of individuals get quite nauseous in labor. So if they don't want to eat, offer them some juice or electrolytes to keep their blood sugar and energy up.

Movement

Moving in labor is highly encouraged, even with an epidural. Movement shifts the pelvic bones and allows for baby's head to move lower and dilate the cervix. Encourage her to move when she has energy.

Yes, your wife will want to rest. And that is ok. But movement can help not only with progression of labor, but also pain.

Walk with her by her side in the hallway. Hold her hand if she wishes, bring her water, hold her phone for music. Be her person.

Rock and sway with her. Rocking movements from side to side are a very common laboring position that individuals revert back to. Usually, they will bend forward with their arms rested on a bed, or couch, or wall and gently move pressure from one foot to the other in a rocking motion. Stand behind her, with your hands on the outsides of her hips. You can either support her and rock with her or provide counterpressure for her.

Walk stairs with her. If your wife's labor stalls out, a lot times we will recommended curb walking or stair walking to help shift that pelvis. Walk with her on the stairs or the curb for support.

Breathe

I've seen it time and time again; people in labor ALWAYS forget to breathe at some point, or they breath too fast. One thing I have found that really helps, is talking in a calm voice of encouragement, reminding them of their strength and that they CAN do this, and demonstrating how they should breathe.

Labor is intense, and it is so easy for your wife to get distracted from what she is doing. Being that support for her and gently reminding her to breathe can be so beneficial. Sit beside her while she is in the bed, bring a chair and sit in front of her while she is on the ball, stand behind her while she is rocking, kneel beside her when she is in the birth pool or on all fours.

Don't tell her to "Breathe slower" or "calm down". Trust me, that won't work. Speak gently. Say things like, "You are so strong", "You can do this", "Remember your breathing", "Breathe with me". The important thing is for you to stay calm. Bring her back down to that calm level she knows she can be on. And if she yells, don't take it personally. Stay with her, and keep calm and keep breathing. Rub her hands with your thumb. Silently remind her you are there.

Counter Pressure/Massage

There are certain pressure spots that can be pressed while in labor that have been proven to decrease pain during a contraction. It's known as counter pressure, and it works by tricking the brain into the thinking the pain is less than it actually is. It's called the Gate Control Theory of Pain, and it suggests that the pressure can "close the gate" in your brain to the pain signals, and significantly reduce the perception of pain.

It's effectiveness is different for each person, but by understanding the techniques, you can use them on your wife while she is in labor and see if they have a positive effect on her ability to cope.

There are three main maneuvers that we frequently use on our patients during labor:

1. Double Hip Squeeze: This technique is most effective when the patient is on hands and knees or standing and you are behind them. You will place a hand on either side of their hip, palms facing in at the top of their femur, right about where the bend in their hip starts. During a contraction, you will press in on both sides towards the middle of her body. At the end of the contraction, slowly release. This technique can be tiresome on your arms if she needs you to do it with every contraction for a long period of time. So swapping with a nurse may be needed.

2. Sacral Pressure: This technique works wonders with back labor, and again, you need to be behind your wife to complete this maneuver. She can be standing, squatting, hands and knees or side-lying. Take the heel of your hand or your fist and place it on the lower part of her back, just above her tail bone. During a contraction, you are going to apply pressure with your heel or fist and push in towards her belly button, as hard as she can tolerate. At the end of the contraction, slowly release.

Image above belongs to Resolute Physical Therapy (click me)

3. Knee-To-Hips: This technique is my go to counter pressure method when the laboring individual has decided they are ready for that epidural. Epidurals don't kick in instantly, they take time to work effectively, and the patient has to be in a semi fowler position for the epidural to take

Image above belongs to EIRMC (click me)

effect, which can be EXTREMELY painful in full blown labor. So to do this technique, have your wife bend her knees up while on the bed. You will place the heels of both just below her knee cap. During a contraction you will push on her knee towards her hips, as if you're trying to push her femur bone further into it's socket. You can also do this technique when the patient is getting their epidural sitting at the side of the bed. Just be mindful of the anesthesiologist while they are performing the procedure to not move the patient.

Sit with Them

Like I said before, your wife may want you right beside her, and she may want you far away. But even just being in the room can provide her comfort. You don't have to say anything or do anything, just knowing that you are there can provide her comfort and calmness. Keep your focus on her.

Provide Words of Affirmation

Some people respond really well to being reminded how well they are doing and how capable they are of something. In labor, it's really easy to forget and start to doubt yourself. If she has Positive Birth Affirmations chosen, recite those to her during the contractions; low, calm voice, reminding her of what she is capable of. If she hasn't chosen any, there are still things you can say to remind her: "You are strong", "You can do this", "Your body is powerful", "Each wave brings you closer to your baby", "I'm so proud of you".

Water, Ice Chips, Cold Cloth/Hot Blanket

Your wife is working HARD to bring this baby into this world. She is going to get tired and likely quite warm. Ice water, ice chips and a cold cloth to the back of her neck or forehead will work wonders to bring her comfort.

One tip is to ask the nurse for a bowl of some sorts to fill with ice water. And yes, put actualy ice cubes in the water. That way you can continuously keep the making the cloth nice and cold at all times. On the other side of things, if your wife gets an epidural, a common symptom is feeling cold due to the medicine moving down her back. Warm blankets will provide great comfort at this time.

Encourage Position Changes

Usually, your wife's nurse should be the one to initiate the position changes in labor. Movement is the key to labor progression. I life to suggest that my patient changes position every 30-60 minutes. But this is something that you can pay attention to as well. Especially if she is adamant about laboring in a certain position. Gently remind her that she has been in one position for a while and ask if she would like to try something different for a bit. She may refuse and yell at you.... that's ok.

You can also let the nurse know if your wife has told you that she wants to labor in a certain position. We will help her try that position and see how she copes with it.

Balance is also really important. Whatever you do on one side, it is recommended to do on the other to keep the body in balance and alignment. So if your wife has been laying on her right side for 30 minutes, it's important that she try to lay on her left for the next 30 minutes.

Be Their Advocate

Labor is not the time for you to be overly concerned about everyone else's feelings and comfort. Your wife is priority number one, and it is your job to make sure that if she has dreams and plans for her labor, that you do your best to help her reach that goal. That's where birth plans REALLY come in handy.

I'm not saying you have to be mean and ignorant to the staff (unless they are that way to you, in which case, please report them). But be assertive, not passive.

I remember a patient I had one time who brought the most beautiful, in depth birth plan, and wanted all her nurses to sign it after reading it. For both the memories and to ensure everyone knew her wishes. Every time someone new walked in that room, her husband made SURE that they saw that birth plan and read it. His job was to make sure that everyone was on the same page. It worked BEAUTIFULLY. So partners.... that's your job.

Calm the Environment

Hospitals have a tendency to be the most overstimulating environment ever; the walls and blankets are sterile white, the lights are bright, the speakers are loud, the staff is loud... Nothing about it says "Calm warm inviting space to have a baby". Make it comfortable for her. Turn down the lights, play some calming music, close the labor room door, request that minimal people come in the room to decrease distractions. Warm yellow night lights provide a calm sensation. You may be able to bring some form of aromatherapy, but double check your hospital, as some places have policies against certain smells.

It may not seem like you play a huge role, and it might feel like there is no real reason you are there. But I promise, she has chosen for you to be there for a reason. Make her feel like she made the right choice.

Hopefully some of these tips can help you out in the labor room. Until next time!

-Nurse Bai