Birth Partners & 2nd Babies

The birth partner, most often the baby’s father, has a significant impact on the birthing mother.  Many times, the influential behavior of the birth partner is just as significant as the care provider, yet typically much less informed and research-oriented than the mother.  This can create a variety of issues with the perinatal period, particularly the birth environment.  Many times, the influence of the birth partner with 2nd (or subsequent) babies is even stronger than with first babies, most often due to issues that arose during a first birth (that could often be avoided with better care and a more compatible birth environment).

Fathers have a unique, and incredibly valid, approach to the birthing time.  They not only care deeply about their unborn child, but also about the woman they love and cherish.  With the continuing cycle of iatrogenic (provider-caused) complications resulting in far from biological birth stories, dad’s protective urges come on strong during pregnancy and birth.  This is one of the biggest reasons dads need to be involved in perinatal education and every part of prenatal care.  When meeting a care provider, dads need to be informed and they need to ask questions.  When a father says “I don’t care about that baby book” – there is a part of me that feels they aren’t taking the responsibility needed for their child.  Who doesn’t want to know more to make better decisions?  If fathers are worried about their babies and significant other, they should no doubt take the time to learn how they can help them and make them safer.  Sounds like common sense, huh?  Partners need to take the time to discuss the importance of the birthing experience with one another, and lay their fears out on the table.  This is the start of communicating the importance of birth.

Dads often don’t grasp the extreme impact a birth experience will have on the mother (or even themselves).  They don’t experience the birth the same because they don’t get the same flow of hormones or physical feelings like the mother, and for this reason, EB does not promote specifically dads being a coach or main birth partner.  First of all, mothers hardly need to be “coached” by anyone, if the birth environment is supportive of biological birth, and having someone who fears the situation be the main support is not conducive to a safe situation.  We believe the dads can have a tremendous positive presence on the birth, even without being actively involved, and some dads are the best support a mother could ask for.  However, because of a woman’s unique ability to relate to the birthing mother, we suggest mom selects the main birth partner because of what they will bring to the birth, not who they are (i.e. the father simply because someone thinks they *need* to be present), and this may be in the form of a doula, a sister, or other close friend, and yes – sometimes the father.  This relieves the performance stress off of dad, allows mom to be properly supported, and lets dad experience the birth in a much more positive way.  Dads are affected by the birth experience very similar to how mothers are affected.  Depending on the method of birth, and his involvement, it will impact his view of the mother, his relationship with his child, and most definitely affect the way he understands biological birth. 

The most significant impact I see from dads are on care providers and birth locations – some of the two most important aspects of the birth experience.  These two things will have an incredible affect on what happens to the mother and baby during the entire perinatal period.  Her quality of prenatal care, her ability to birth biologically, postpartum routines, breastfeeding experience, and overall health and well-being.  Mothers, wanting their partners to have a direct involvement in decision making, as they should, will allow their birth partners to decide their birth experience simply from allowing their birth partners to have a big say in who attends their birth and where they give birth.

Let’s say mom wants a midwife-attended home birth.  Dad doesn’t know much about birth other than “it is scary, painful, and not necessarily safe” and “so and so had to have a cesarean” so he feels they *need* a surgeon [OB] to attend the birth and all medications readily available.  He hears even less positive stories about birth than Mom does, so his fears continue (or even increase) while mom may be reading and listening to even one or two positive birth experiences.  If this is a 2^nd time dad, his strong opinions most likely come from the previous birth experience.  Mom “needed” an epidural.  Mom “needed” to be induced.  Mom “needed” a cesarean.  But you REALLY need to understand the course of your labor to see why those things happened.  If Dad isn’t up on his research, he continues to hear the typical pregnancy “expectations” instead of how they can positively affect the birthing experience.  And, if he isn’t so interested in a childbirth course, he’s not going to listen to very much of the information being given (which is one reason why a variety of teaching techniques can be so valuable).  I see a continued pattern of the dads that have a strong opinion about care providers and birth locations – being the same dads that have researched little or haven’t taken much time to listen to the mom’s wishes and perinatal needs. 

Why?  Well, it really comes down to communication, and it also comes down to human rights.  I’ve been in those shoes.  I was in that place of having a birth partner who was not OK with home birth or a midwife.  My husband didn’t want to read anything, didn’t want to attend a childbirth class, and thought all of it was a bit ridiculous, actually.  Did he attend class?  Yup.  Did he read any books?  He skimmed through one.  Did he go to prenatals?  When he could get off work.  But, ultimately, speaking about the importance of this birth experience and all the things I needed to avoid (unnecessary interventions and the temptation of an epidural – which never even crossed my mind during labor, by the way) was what allowed him to give up a little of his “control” and be understanding of my needs. 

One thing that benefitted me was he had seen animals being born before, and figured human birth would be somewhat similar – he didn’t fear natural birth, but did doubt my ability to handle it.  I recall having severe back pain during my first pregnancy (that I should have seen a chiropractor for) and was bawling my eyes out unable to walk to the bathroom – and his response was “If you can’t even handle back pain, how are you ever going to be able to handle natural birth?”  The only thing that allowed me to have the birth I wanted was the fact that I stood up for myself.  Basically, it was MY body and since I was the one researching and learning and becoming uncomfortable with my chosen OB-attended situation [during my first birth], I was the one that had the right to make the important decisions.  Why on earth would I let someone make such an important health decision about myself and my child without having much interest to read, research, and learn?  Had I not had that perspective, my birth would have gone MUCH differently.  I would have had a cesarean. Period.  I switched to a midwife-attended home birth, and my husband’s response was “well, ultimately it is up to you – and I know you’re going to do what you want anyway.”

You’re dang right it is, and absolutely I will.  My body.  I don’t ask your advice on who to attend me when I poop – and birth is really that normal.  Do things happen?  Sure.  But, you know, things can happen when you poop, too.  Do some people need to transfer?  Absolutely – and I want a care provider to watch over me who is so attentive and understanding of biological birth that they know exactly when that transfer is necessary.  In fact, quite a few moms get poor care, damaged bodies, and negative birth experiences with all the surgeons and medical needs right at their bedside.  Why?  Well, if this care provider you trust so much to attend this “unsafe birth” only comes in 5 minutes before crowning – how on EARTH will they ever really know what’s going on?  You’re trusting an L&D nurse to attend you – not an obstetrician.  Think about who you’re really hiring.  Midwives are typically more trained than L&D nurses – especially L&D nurses who’ve never experienced biological birth (which most of them are in this situation). 

Moms, you need to stand up for yourself.  If you want a specific birth experience, it is your responsibility to do what is necessary to create that environment.  “But, it is his child, too.”  Yes – it is – and we all want what is best for our children, no?  Make sure you’re getting your information from quality sources so that your fears don’t mask the truths.  Dads/Partners can have a tremendous positive influence on the birth experience – but if they want the opportunity to make such important heath decisions, they need to be as actively involved in the research and understanding as mom.  Birth is a human rights issue – and it is about the only “feminist” issue I stand strong on because uninformed persons (whether by choice of not wanting to listen or research, or by simply only hearing horror non-normal birth experiences) are what continue to cause the far from biological birth experiences everyone in western culture is so accustomed to.  Parents, do your research.  Mothers, have faith in your bodies, communicate, and do not give up your rights.  Ultimately, this baby is growing within your body, and you have the responsibility to make the decisions for this child.

This goes for any birth location and with any care provider.  By all means, communicate with your birth partner.  But, if you’re entirely on different pages – or even in a different book altogether – don’t simply give up.  Your needs are important, and ultimately you are the one birthing.  If you’re not comfortable in your current situation, only YOU can change it.

Still need some tools for convincing?  Check out these statistics on home vs. hospital birth at Citizens for Midwifery:

Home vs. Hospital Statistics

Home Birth Prep

Planning for a home birth is exciting!  There is very little you have to do to prepare for a home birth – and essentially, you don’t need any extras – but it is a good idea to have a birth kit ready for your birth team to make things easier and more comfortable.  Every midwife has their own preference for what they routinely use at each birth, but if you’re unsure or preparing an unassisted birth, the following are the basics you may want to consider:

From about 37 weeks on, you’ll want to keep your house tidy, particularly around the expected birth area.  This is so attendants can maneuver easily (especially without disturbing mama).  Birth is not meant to be sterile, but putting a little feng shui into your home can help with positive birth and postpartum energy.

You’ll also want to prep your bed with some type of waterproof liner.  Shower curtains work great for this.  You’ll place a fitted sheet on your mattress, overlay the shower curtain, and then another old (one you don’t care to get soiled) fitted sheet on top.  This is so any birth liquids can be easily removed after the birth, discarded as you wish, and you have a freshly made bed in a matter of seconds.  Some moms prefer an older sheet on the bottom as well so there are little worries about postpartum bleeding.  You may even add a waterproof crib mattress under your side of the bed for this reason.

Other items to have in an easily accessible location include:

• 1 Dozen Underpads (Chux pads) for catching fluids during labor/birth
• Sterile Bulb Syringe for suctioning baby if needed
• Thermometer
• Sterile shoe laces or cord clamp (note that if the cord is actually left to top pulsing, or you’re planning a lotus birth, a clamp is not necessary)
• Scissors to cut the cord
• Roll of paper towels or 3 dozen gauze pads
• 2 dozen towels/wash cloths (great for cooling mom’s forehead, wiping up fluids, counter pressure on the perineum…etc.)
• Large bowl (that you can squat over) to catch the placenta
• Flexible straws (you have no idea how beneficial this can be when mom needs to stay hydrated and can’t concentrate on holding a cup!)
• Emergency numbers & map to nearest hospital near the phone – just in case
• Peri-bottle in case of any perineal tears for postpartum
• Box of Depends or Box of hospital-sized or overnight sanitary napkins & mesh panties (mesh panties aren’t necessary, but they’re super easy to clean and dry really fast). 
• Flashlight with extra batteries (for perineal inspection after birth)
• Healthy foods on hand for mama and the birth team (don’t forget freezer foods for postpartum)
• Antiseptic soap (like Dial) for washing up for hands that may be near the perineum.  Your midwife may also want a few sets of sterile gloves.
• Medicinal Herbs such as peppermint in case mom has trouble urinating, or comfrey leaf for postpartum sitz bath (comfrey leaf can also be added to water on a sanitary napkin, and frozen, which helps soothe the perineum and vagina postpartum).
• Birth Guide for Home (this is often more for cultural reasons in a home birth setting rather than advocacy, but don’t be afraid to write down your wishes just to make sure your birth team knows what you’d like throughout labor and postpartum).
• Birth Guide for “In Case of Transfer” and a small bag packed with overnight clothes, toiletries…etc. for you (your birth partner) and the baby.

Many of these items can be found in your local big-box store, but there are also some great places online that make purchasing birth kits super easy.  Your midwife may also be registered at one of these sites where all you need to do is search their name and purchase their birth kit with all the things they prefer to have nearby. 

These include:

• In His Hands
• Baby Birth & Beyond
• Precious Arrows
• Everything Birth
• Cascade Birth Supplies

There are many places, and by simply searching “birth kits” on the internet, you can find a lot of options.  You can get a variety of extras from these places as well such as foot printing kits, blood typing kits, and other keepsake items like birth certificates and baby clothes.

Some other comfort items – similar to what you would take to a hospital birth – include:

• Hair bands/barettes
• Comfortable birth clothes, robe, gown for postpartum
• Breath mints for birth team
• Ice chips/Popcycles/Lollipops/hard candy
• Chap Stick
• Tennis ball/massage rollers/lotion/oil
• Rice-filled s0ck to warm/cool mom’s back…etc.
• Charged camera, film, video camera, batteries, extra tapes
• Nursing bra
• Nursing pads and/or cloth diaper inserts
• Receiving Blanket
• Warm baby clothes
• Car seat properly installed & checked
• Full tank of gas in your vehicle

The best thing is to check with your midwife and see if there are specifics they prefer, and why they use each item.  But this is a great basic list of items beneficial to a home birth.

Additionally, consider the following: 

• Esali Birth’s Perinatal Pocket Guide which has a lot of tips and tricks for labor and birth (whether in a home or hospital) and is an excellent quick reference during the entire perinatal period.
• You may also consider Dr. Gregory White’s Emergency Childbirth that goes over emergency situations should you be planning an unassisted birth (and don’t have professional help for emergencies) or in a situation that you may need to access quick emergency information.

Be sure all of these things are all in one, easily accessible location, and happy home birthing!

Walk Proud

For years, “kegeling” has been widely promoted in the birthing world as a highly effective and crucial prenatal exercise.  Less focus is placed on abdominal and back strength because, seemingly, the abdominal and back muscles are not used to birth the baby.  However, this is rather far from the truth.  Having poor abdominal tone throughout pregnancy will cause many more physical discomforts for mom throughout pregnancy, and can more directly affect baby’s position and rotation through the pelvis.  Equally, it is possible to “Kegel” (that is, strengthen the pubococcygeous muscles) incorrectly, or too much, and create increased and unnecessary tension, when what mom really needs is to learn the ability to relax the muscles of the birth canal, not contract.  This can result in a longer and more difficult birthing stage, just the opposite of what the “Kegel” exercise is promoting.

First of all, our bodies are just as strong as they need to be to do the job they were designed to do.  Yes, it is true that most of us sit and are inactive much more than what our ancestors were, resulting in varied body shapes, so low-impact daily physical activity is an optimal addition to your daily routine.  Do you need to bench press or run marathons?  Absolutely not.  Our bodies were designed to work in fields, hunt and gather food, tend to household chores, and birth babies.  The tone necessary to birth our babies was created from our regular daily chores and tasks.  Do we know of more beneficial practices now than what people did hundreds of years ago?  Of course – but lets put our modern practical knowledge to use where it is necessary and understand our body’s design before promoting the necessity of something.  Contrary to many’s beliefs, our bodies really haven’t evolved over the past hundreds of years, and are still designed (brain and all) to do what they were meant to do from the beginning.

One of the important things to understand is that our pre-pregnancy health directly affects our prenatal and postpartum health.  This goes from nutrition, to emotional well-being, and physical health.  Someone who is in less than optimal health in the conception phases will likely have a more difficult time obtaining pregnancy, and more discomforts throughout pregnancy.  The 3rd trimester is clearly not the time to start getting healthy – before you get pregnant is, although if you didn’t start prior to pregnancy, you can alleviate some discomforts by starting at any time. 

Before pregnancy, you want to start the habit of eating healthy and incorporating low-impact physical exercise into your daily routine.  These are not small steps to take once in your life, these are life changes that will benefit you forever.  The nutrition you put into your body affects how your body utilizes each part of the food – so choose wisely.  Additionally, as we grow older, and sit in front of our computers and TVs, our posture slumps, our pelvis tilts incorrectly, and our muscle tone diminishes.  All of this causing some of the most widely-known discomforts of pregnancy – back pain.

Back pain, like many other pregnancy conditions, is not a symptom of pregnancy.  It is avoidable, treatable, and likely indicates that mom needs to focus on the physical strength of her abdominal and back areas.  Having poor posture results in the back bowing, the buttocks overly protruding, and the belly hanging low which pulls on the anterior part of the body and causes increased strain on the back.  The shoulders likely slump forward, and an extensive curve results in the body.  Over time, this poor posture actually results in difficulties standing upright correctly because the wrong muscles have been toned, and your body is being pulled in the wrong directions.  You try to stand up straight and tuck in your butt, and you feel like you’re working out rather than just naturally standing tall.  Once you’re in the 3rd trimester, all of this can be difficult to fix and you’ve already hit the point of unnecessary physical discomfort.  The sooner you start correcting your posture, the easier things become.  Fix this before pregnancy, and you’ll likely experience little physical discomfort.

When this poor posture results, your pelvis tilts incorrectly which causes the baby to fall in a variety of unfavorable positions, and more importantly may be unable to tuck his chin for an easier birth.  When the baby tucks his chin to his chest, the narrowest part of his head presents through the birth canal creating an optimal setting for rotating through the inlet and outlet of the pelvis, and molding through the birth canal.  If the chin does not tuck, the baby may have difficulties rotating or present brow or face-first resulting in a less than optimal birth.  For instance, a longer labor, a longer birthing (pushing) stage, and more risks for tearing.  If you’re not under the care of a loving, supportive, and patient provider – then you’re adding more difficulties to the situation as you may not be given optimal settings to birth a baby presenting in this manner.

Postpartum posture correction can be even more difficult to correct.  If you’ve went throughout pregnancy with poor posture, you’re likely to take longer getting back into a pre-pregnancy physical shape and also cause more discomfort during breastfeeding (and even simply holding your baby).  Healthy abdominal tone prior to pregnancy and throughout will allow you to feel less discomfort during postpartum as your organs are moving back to their original locations.  This abdominal tone helps you to avoid that feeling as if your insides are going to fall out after the baby has been born.  Likewise, a healthy posture will allow cesarean recovery to be easier.  During breastfeeding, a mother who has developed the habit of slouching forward may experience increased back pain as she leans towards her baby to breastfeed.  Additionally, latching the baby on to the breast may become difficult as it is more effective to bring the baby towards your breast, rather than reaching towards your baby.  Sitting upright and having the proper muscle tone to support your back (and likely enlarged breasts) will be valuable to an extended breastfeeding experience.

Kegeling does little to help all of these factors during the perinatal stages.  Does kegeling tone the pubococcygeus muscles?  Possibly, but often in a way that tightens the muscles rather than making them efficient.  When kegeling, you’re not only contracting the PC muscles, but you’re also contracting the muscles of the birth canal as well.  This can result in tissue that is tight rather than flexible and able to be relaxed.  Your uterus involuntarily contracts during labor, and needs no assistance to birth the baby.  Only an overwhelming urge may assist your uterus during the birthing stage, but this is an instinctual reaction and one that doesn’t need a tight birth canal.  In fact, just the opposite is true; learning to relax the PC muscles results in an easier birthing stage.  Contracting the muscles causes them to squeeze, which makes the birth canal smaller.  We want to achieve a relaxed muscle state so the baby can easily move through the canal and vaginal and perineal tears are reduced.  Ultimately, if you’re not experiencing incontinence, your PC muscles are toned just fine.  And posture exercises actually do more for avoiding incontinence than do kegel exercises which you can read about here in this great post on why kegeling is not an optimal exercise.

A very simple way of toning your abdomen, back, and butt, is to simply remember to “walk proud.”  If you can remember that when sitting or standing, you need to sit up straight, tuck your buttocks, and keep your chin up then you not only tone the muscles in the correct manner, but you also feel better about yourself.  Getting into the 3rd trimester, you can remember that waddling is also not a symptom of pregnancy.  If you’re waddling, you’re likely not walking tall and concentrating on those necessary muscles to tuck your butt and hold in your abdomen.  So, the sooner you start, the easier your pregnancy and birth will become.  There is never a better time to start getting in shape and preparing for your birth.

Local or Online Perinatal Classes?

First and foremost, a parent’s decision should not be whether to take a class geared towards perinatal education, but which class should be the selection.   There are unlimited options for learning about the perinatal period – a different style and format to fit every personality.  Independent education is the optimal choice as the instructors are not limited on options and regulated by hospital or practice protocol.  In other words, in an independent course, students should be able to receive the pros and cons to perinatal choices rather than going through a “what to expect” checklist.

A lot of prospective students ask me what the better option is as far as Esali Birth courses – online or local (and don’t forget webinar).  There are also misconceptions about online courses in that they’re not complete.  Well, it really depends on your personal situation and what you’re looking for out of the class, and EB online classes are almost identical to our local course – specifically to allow our students the ability to choose and fit a quality course within their modern lifestyle.

Some of the benefits of a local course include getting to interact with other couples.  You get to hear their thoughts, their wishes, their fears, their experiences, and their questions.  You get a chance to get away for an evening to focus only on you and your baby.  You get to interact with spontaneous discussions that spark interest and thought.  You have instant contact with the instructor for any questions.  You get commentary feedback during videos and you rely less on reading material.  You have the ability to create a bond with other parents who are having children close in age to your child.  The local course also includes the complete online course, so you get the benefits of both – which is also great if you have to miss a class or two during the 10-week series (plus review until you birth your baby).

In an online environment, you have the ability to “attend” class whenever it is convenient for you and your birth partner (and the rest of your family’s schedule).  You can enroll anytime and have instant access to your course – there are no materials that need shipped, no extra costs or downloads necessary for software or materials.  This is a very “green” option for perinatal education – modern technology being utilized for today’s modern parents – while not skimping on quality of content.  (Note: the complete online series is available in a mailable CD format should someone have limited or no internet access on an as-needed basis).  You are able to review course sections multiple times in a self-paced format, and have this available until you birth your baby.  You are granted unlimited phone and e-mail support for any questions which means you may need to write down your questions as they come up, but you’re still able to interact with the instructor.  You may require a little more self-discipline to be sure to go through the course, but all the information is the same in the local course as the online environment.  The main sections include the same “seminars” as the local course, so you even have the option of listening vs. reading everything.  It is not a complete work-book setting; there is a combination of reading, watching videos, listening to seminars, and providing feedback.  There are a few videos that are shown in the local series that are not available in the online format, but alternative options are chosen, and there are a lot of additional videos and supplemental articles available in the online course (which is also one of the benefits of having the online courses available even for local students).  You can also interact with others on the EB Community Forums.  You will need to print any handouts vs. getting them in a packet like in the local course – but all the information is there (and the online course is a lower cost option).  You do have the option of taking the full online series, or attending one or two sections if you’re simply looking for a review or to supplement another course.  We also have a Breastfeeding Basics seminar (included in the standard series) that is available if you’re just looking for breastfeeding information. 

Then, there is the webinar option.  The webinar is a 6-week series covering all the major topics.  We “meet” at a scheduled time weekly through an online conference program and talk w/ a headset (or over the phone).  We go through the same seminars as the local and standard online series and discuss just as we would in a local course, only we are not face-to-face.  Webinar students are also given access to the complete online course as a supplement for the other classes and for review until you birth your baby.  The webinar sort of gives parents the best of both.  You get to interact with other couples and the instructor in real-time, but don’t have to leave your home.  You do need to schedule time weekly to attend, but you have the ability of reducing gas costs and not needing as much time getting to and from class (especially if work is a conflicting issue).  And, just like with the standard online series, you can attend anywhere there is an internet connection – so anyone wanting to take an EB course has the ability.

So how do the various courses add up in terms of cost? 
A local 10-week EB course is $150/couple (plus gas to class each week).  A 6-week webinar series is $125/couple.  The complete online course is $100/couple.  For local and webinar series options we offer a $25 early-registration discount (if registered at least one month prior to the start date).  We offer Military, Single-Mom, and Teen discounts for all our series options as well. 

So with an online Esali Birth course, it isn’t like reading through various bits of information on the internet.  This is not a “Google” education!  You’re getting a walk-through of perinatal education – the important information, and the same information as with our independent local course option.  It is the face-to-face connection that differs, and every parent varies on what their personal needs are.  Some moms are not comfortable learning in a small group setting.  Some moms need the one on one attention of phone and e-mail conversations.  Some dads are more likely to attend if they don’t have to sit in a small group setting as well.  Many parents have schedule conflicts that either don’t permit them to take local courses, or only give them the option of a crash course or hospital-based series lacking quality and content.  Don’t miss out on quality education because of cost, location, or limited “methods” in your area.  You have options right here, and we would love to help you begin your journey to a beautiful birth experience!  Check out our free sample course at EB Online.