I was training to be a doula until I turned towards nursing instead. I still attend births for friends as a doula. Just attended a home birth 3 mos ago.
Your daughter needs to prepare for birth and know what to expect, otherwise she will be lost. Of course we can't always know ahead of time what will happen, but she need to be educated with her rights and the options (barring emergencies) that she has. You can do a search on "birth plans" and find some blank forms to go over with her. Like does she want to do natural, or have an epidural. If she wants an epidural, does she want to get it right away or does she want to wait and see if she needs it?
Assuming she goes into labor without being induced, and assuming the baby is not breech for a csection, here's some advice to make things go smoothly.
1) Don't head for the hospital until the contractions are strong enough that she can't bear them anymore. She has a better chance of not having labor stall if she waits. Women are generally more comfortable at home, they can relax and feel safe. Once they get to the hospital it's not a familiar environment. If the hospital is full and she's still in early labor, she may have to wait in triage for a labor room. If she arrives and is in active labor she will get a room faster. Triage is NOT comfortable, although the nurses try to make it as comfortable as possible. It's just not very private and the beds don't adjust.
2) Have her change positions and get up and squat and hang over the side of the bed, whatever she feels comfortable doing. The baby moves down best with active movement because it has to twist and turn on the way down. If mom is on her back the baby has a harder time coming down as effeciently. If she has an epidural in place and can't move around, you can ask the nurses to help turn her from one side to another every hour or so. It will sorta achieve the same thing.
3) The longer she waits for the epidural the less chance of needing pitocin to get labor moving when/if it stalls. Ideal is between 4 and 7 cm. After 7 the labor usually moves so fast that they won't put one in. It depends on the hospital and the doctor.
4) Make sure to take care of YOU and same with her husband. The labor may be long or short. You will probably not want to leave her side to get food so be sure to have a bag packed with stuff for yourself: a sandwich, fruit, granola bars, drinks. Pack some for her husband, too. He won't remember to do it himself.
Bring a sweater or long shirt that you can put on and take off. Often the labor rooms are cold so the laboring woman is more comfortable, but everyone else freezes their rears off. Bring loose pants, and it might not be a bad idea to bring a spare tshirt and pants just in case you get blood or baby poop on you.
Bring a camera and extra batteries and film. Pack chapstick both for you and for her, and breath mints for you and her husband. Bring a card game or other things that she might enjoy doing if she has an epidural and wants to pass the time. Magazines, etc.
5) If she wants to breastfeed, call ahead to La Leche League and get the name of a good Lactation Consultant that you can call even from the hospital if she's having trouble getting started. The hospital LC may or may not be on duty that day (or night). Also study up on proper latch techniques so you can help her get started. www.breastfeeding.com
has plenty of info. Sometimes it helps for someone else to hold the baby's head and her breast to get it latched on right the first few times. She will be tired and it's hard to see from her angle if the latch is good or not. No bottles in the hospital, no pacifiers. If the baby needs to be supplemented with formula, have them syringe feed instead.
6) It's her right to pull the baby out if she wants to. Tell the doctor ahead of time and he can help her deliver it. It's an awesome experience! I did that with my last one. It's also her right to delay the cutting of the cord until it stops pulsing. There are some benefits to doing that. She can refuse an episiotomy if she wants, or tell them she only wants a small one if necessary and let her tear the rest of the way. Sometimes it helps to have one to get the tear started in the right direction. Other times they are routine but totally not necessary. It's her husban's' right to go with the baby to the nursery for all the newborn tests and to give the first bath.
7) During the pushing stage, tell her to push slowly and wait for the skin to stretch. The OB should guide her in this. If she doesn't feel the urge to push her epidural can be turned down or off during the last stage.
8) If she needs a csection, it's her husband's right to be in the OR with her. However they may not allow more than one person. If that's the case, ask to be outfitted with scrubs
, too. You can wait outside the OR doors and when the baby is born, her husband can go with it to the nursery and you can step right in and be there next to her while she's being sewn up and offer your support. Or you can go with the baby to the nursery and he can stay. Have a plan of action in place.
9) If she has a natural childbirth with no drugs, tell her two things: relax the jaw, and low moans. You may have to moan a bit with her. If she starts having high moans and screams it will tense up her whole body and the birth will stall a bit. Low moans and a loose jaw will keep her more open for birth. If she is not having an epidural she needs to get up and move. It is her right to get out of that bed. If they tell her they need to monitor her, they can do it by hand every few minutes as needed. She doesn't need to be constantly strapped to the machines.
10) Be kind to the nurses and doctors.
Realize they are doing their job. If there is something that you feel must be advocated according to your daughter's wishes, a kind work works better than orders. I'm sure you knew that already, but as a doula-support person I have found that some nurses are all for labor support and advocates and some feel threatened by them because they often will fight the care that the nurse is supposed to do for that patient. Best is to remind your daughter of her wishes so she can tell the nurse directly.
Well that's all I can think of for now! Good luck and I hope it's a wonderful experience for everyone!!