Coaching my daughter in childbirth

SmilingBluEyes · Jul 26, 2006

Please, please oh please, tell her to forget everything she has seen on Baby Story and those other shows and keep an open mind. HONESTLY that is my best advice. Some people take those shows way too much to heart and are disappointed their birth experiences are not like those captured in 10 minute segments of a television show.

If she has not had childbirth preparation, she should try to get this.....whether she plans an epidural or not, being prepared is so much better than not. IF she has no time or as you say, inclination, for classes, have her check the local library or book store for some good prepared childbirth books and DVDs.

Other than that: Just be there for her. Many women have, as their greatest fear in childbirth, abandonment issues. Being there for her is so helpful, even if you don't feel like you are "doing much", you will be, just by advocating for her.

GOOD LUCK and congratulations on the impending birth of your grandchild. I wish you all a wonderful and safe birth experience.

mommy2boys · Jul 26, 2006

I'm not a nurse yet but I had both of my boys w/o taking any classes. (I was on bed rest w/ both of them and couldn't get to any classes). My DH, mom and sister were in there w/ me and the best thing that they did for me was to listen to me. My mom rubbed my hair, my sister helped me breathe and relax and my DH stayed out of the way.

I think that both of my deliveries went well considering I couldn't get an epi because I went to fast. It was nice to have my family in there to help me. My only suggestion is to listen to her, both verbal and non verbal. She will let you know what to do for her. My mom said that I would rub my head on the pillow if she wasn't doing it hard enough and my sister found out really fast to tell me when the contraction had peaked,she told me after that half the time she was lying (the contraction was still climbing) so that I would relax.

Good luck and congrats on the soon to be new baby. I wish all of you a happy and healthy delivery.

Erin

SC RN, RN · Jul 26, 2006

Mothers can be a wealth of information and support for laboring patients ... as long as you are there for HER, you will be fine. That being said, the majority of problems with moms coaching daughters is when the moms say "well, I never thought it was that bad" or "I didn't need any pain medication and my labor was 3 days long and I pushed for 4 hours" and so on. I'm sure you won't say these things but be careful to not insinuate anything about your labors on to her labor. This is true no matter who the support person in the room is ... the patient just needs to be supported through HER feelings, HER labor and HER experience.

Best of luck to you ... and hopefully the bf will pass out and you and your daughter can have a wonderful experience together! :lol2:

Retired R.N. · Jul 26, 2006

Whatever else you do, PLEASE do not tell her to start pushing too early, because it doesn't help a bit and wastes a lot of energy. It will be much more effective if she takes advantage of the time between contractions to rest and try to relax. This saves her energy until she really needs it. Your daughter will tell you when it's time for her to push!

ladytraviler · Jul 26, 2006

I coached both of my daughters in childbirth. It is an experience I will never forget. Used different techniques for both of them. Visualization for one and light massage for the other. I let it be know to the nurses (I worked there a long time before)that I was mom not nurse. I was my daughters advocate. I was also the gate keeper for her and my husband enforced it. It was their day and they directed. I would not have missed it for anything.

AmericanChai · Jul 26, 2006

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!!

SilentfadesRPA · Jul 26, 2006

hello and congradulations on being a soon to be grandmother. it is great that you could seperate your ambivilent feelings about this situation and be present for your daughter and her partner.

i did 5years in a private practice of ob and became a lamaze instructor. in the practice we had several younger girls and some women who did not want or could not attend a lamaze preparation.

i did searching for reading material to help prepare them and thier partners,. i came across a great video about lamaze and childbirth.

it was hosted by patty duke austin. she presented childbirth and lamaze in a manner that was very calming way that patients were able to adapt many of the lamaze techniques and information.

ms. duke empowers the mother to have control along with ideas and comfort measures the partner can provide. various methods are demonstrated ie breathing techniques, imagery, and touch. this may very well assist your daughter and you to view it together.

does anyone remember "the patty duke show" ? well this video (in my opinion) was pattys redemption for allowing and staring in that. i just looked it up and the name is --

"the lamaze method: techniques for childbirth preparation"

i used the video for five years in situation like your daughters and got great feed back on it. as well i did a search and it is still available via ebay. i wish you all the best -- sounds like the baby has a great start in this world with you being there to help.

marc

CEG · Jul 26, 2006

I would recommend that she stop watching those childbirth shows because they are unrealistic- it compresses hours into minutes. I also think they must have a 90% c-section rate. I am so tired of hearing "the baby is so big I need a c-section" then welcome the 6 pound baby.

Off my soapbox, as long as she is reading she should be well prepared but having a childbirth class is usually really helpful. The teacher will bring up things she may not have read and it gives you a chance to practice. She can also meet some other mommies to be. If you can go to one with her that would be even better. Independant instructors can be good because they don't have to cater to a particular doctor or hospital's standard practices. A tour of the hospital where she plans to deliver is a good idea because you will know what to expect and the practical things like where to enter the hospital at night (bypassing ER is great if you can do it).

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. !

I don't want to hijack the thread, but everyone has their own opinion on episiotomy and I will add mine to this comment. If you have an episiotomy and it extends it will tend to be worse than the tear alone would have been. It will also not tear along a natural weak spot in the skin but through the skin and muscle of the doctor's choosing. The majority of severe tears are related to operative deliveries and episiotomy extensions. I would recommend leaving well enough alone unless there's an emergency.

"Husband Coached Childbirth" by Susan McCutcheon is a slightly wacky book with men in short shorts coaching their naked wives through labor but gives a long list of great labor support techniques with photos and instructions. I would really recommend it, especially if she wants to go without the epi. Also, if she plans on having an epi ensure she knows it will not be pain free- labor needs to be well-established so she will need some coping techniques.

If your daughter plans to breastfeed you may need to advocate for her. Some hospitals are not very supportive of breastfeeding.

Best wishes to grandma and mama!

mleern · Jul 26, 2006

Hi, Thank you all so so so much for this great advice. It's exactly what I was hoping for!

AmericanChai · Jul 26, 2006

I don't want to hijack the thread, but everyone has their own opinion on episiotomy and I will add mine to this comment. If you have an episiotomy and it extends it will tend to be worse than the tear alone would have been. It will also not tear along a natural weak spot in the skin but through the skin and muscle of the doctor's choosing. The majority of severe tears are related to operative deliveries and episiotomy extensions. I would recommend leaving well enough alone unless there's an emergency.

I agree with you. I totally depends on the angle of baby's head and where the mother looks like she's going to tear. But sometimes it's better to get a tear started in the right direction rather than have her tear upwards or something. It's sooo hard to make that judgement call and I'm glad I don't have to make it. I usually suggested to my clients that they not get cut at all unless it's an emergency and they need to get baby out fast. But some doctors will insist on cutting and if that's the case a small cut is better than a big cut. With my last baby everyone was sure I would tear along my old episiotomy scar and I didn't. I tore just a bit to one side b/c baby's head was coming out crooked and I did not need stitches. I was soo relieved.

On the other hand I had one client (10 pound posterior baby) who tore upwards and downwards too and it was a very rough recovery for her. I feel that if she had had a cut in the right direction it might have saved her a lot of healing time. But of course we didn't know until the tearing happened how bad it would be. She was very firm about no cutting at all and her decision was respected.

I'll end on the note that I'm glad these procedures are there when needed, but I think many doctors use them far too often. :)

Doula4Nurses · Jul 27, 2006

I am a Doula also. You have already received some great advice, but I would like to recommend that you get and read The Birth Partner by Penny Simkin. It's excellent! It's great to read beforehand, and it's also good to take into the labor room with you, as it is organized to be used as a quick reference tool. For that matter, one can't go wrong by reading anything by Penny Simkin. Good luck with attending your daughter's birth of your grandchild; what a blessing it will be for you both, I'm sure! :)