Module 2

Your Role as Partner in VBAC

The image of childbirth has long featured a solitary birthing mother, enduring the pain and process alone. Thankfully, that image is being replaced by a more accurate and empowering one: a mother supported by an active, engaged partner. The role of dads and partners in childbirth is undergoing a crucial shift, moving from passive bystanders to active participants, ready to provide emotional, physical, and informational support.

From "There for Moral Support" to Active Listeners and Cheerleaders

Gone are the days of dads pacing anxiously outside the birth room. Today's partners are present, engaged, and attuned to their partner's needs. Active listening is key, offering a safe space for mothers to express fears, anxieties, and joys throughout the birthing process. A gentle touch, a reassuring word, and positive affirmations can work wonders in boosting a mother's confidence and strength.

Beyond Back Rubs: A Massage Maestro and Comfort Curator

Physical support in childbirth goes beyond the traditional back rub. Partners can learn massage techniques specifically designed for labour, applying targeted pressure to relieve muscle tension and discomfort. Counterpressure, holding firm against certain points, can also offer significant pain relief during contractions. Creating a calm environment is another crucial form of physical support. Dimming lights, playing soothing music, and maintaining a clean, clutter-free space can make a world of difference in promoting relaxation and reducing stress.

Knowledge is Power: Navigating the Labour Landscape

Understanding the stages of labour empowers partners to provide informed support at each phase. Early labour might call for quiet companionship and distractions, while active labour demands active engagement, helping with positioning, breathing techniques, and advocating for the mother's wishes. Transition and birth require unwavering emotional support and encouragement, celebrating every milestone reached.

Calming the Waves: A Breath of Fresh Air in Pain Management

Relaxation and pain management techniques are invaluable tools for both mothers and partners. Guided breathing exercises, focusing on slow, deep breaths, can slow down the heart rate and promote relaxation. Visualisation, conjuring up calming images or memories, can help shift focus away from pain and towards positive reinforcement. Aromatherapy, using essential oils known for their calming properties, can also add a layer of soothing comfort to the birthing environment.

The changing role of dads and partners in childbirth is more than just a trend; it's a revolution in how we understand and support families. By embracing these active roles, partners become invaluable allies in the birthing journey, fostering a positive and empowering experience for both mother and child. Remember, every birth is unique, and the best support comes from open communication, respect for the mother's wishes, and an unwavering commitment to creating a loving and supportive environment.

Physical Support for Your Partner During VBAC: Massage, Counterpressure, and Creating a Calm Environment

As a birthing partner, your physical support can be invaluable to your partner during their VBAC (vaginal birth after caesarean) journey. Here are some ways you can provide physical support through massage, counterpressure, and creating a calm environment:

Massage

  • Focus on areas that feel tense or sore: Ask your partner where they feel discomfort and tailor your massage accordingly. Common areas include the lower back, hips, thighs, and feet.

  • Use firm, steady strokes: Gentle, soothing strokes can be calming too, but during labour, your partner may appreciate deeper pressure that provides relief from contractions.

  • Try different techniques: Experiment with kneading, circular strokes, and gentle compression. Pay attention to what feels good for your partner and be sure to stop if anything feels unpleasant.

  • Offer aromatherapy: Certain essential oils like lavender, clary sage, and frankincense are known to promote relaxation and pain relief. Use a diffuser or dilute the oil with a carrier oil for topical application.

Counterpressure

  • Apply steady pressure to specific points: During contractions, applying firm pressure to specific points on your partner's back, hips, or sacrum can provide relief and help move the baby down the birth canal. Ask your partner or a childbirth educator for guidance on specific points.

  • Support their body weight: Help your partner change positions during labour. You can support their weight as they stand or kneel, lean against you, or squat.

  • Hold their legs firmly: During pushes, holding your partner's legs open and steady can offer crucial support and leverage.

Creating a Calm Environment

  • Dim the lights and light candles: Soft lighting creates a soothing and intimate atmosphere.

  • Play calming music: Choose music that your partner finds relaxing and uplifting. Avoid anything too fast or loud.

  • Use essential oils: As mentioned earlier, essential oils can promote relaxation and pain relief.

  • Maintain a quiet space: Try to minimise noise interruptions as much as possible. This includes your own talking, phone calls, and any outside noises.

  • Offer words of encouragement: Be your partner's cheerleader! Offer positive affirmations, reminders of their strength, and words of love and support.

Additional Tips

  • Stay informed: Learn about VBAC and the specific challenges your partner may face. This will help you better understand their needs and provide informed support.

  • Respect your partner's wishes: Ask your partner what they want and need from you during labour. Be flexible and adjust your support based on their cues.

  • Take breaks: Supporting someone in labour can be physically and emotionally draining. Take breaks to hydrate, rest, and recharge.

  • Trust your instincts: You know your partner best. If something feels wrong or you have any concerns, don't hesitate to speak up to the midwife or doctor. And tune in to your partner, check how she is going if you are concerned.

Remember

Your presence and support can make a world of difference for your partner during their VBAC journey. By offering physical comfort, emotional encouragement, and a calm environment, you can help them achieve the VBAC birth they desire.

Here are some additional resources that may be helpful:

If your partner is planning a VBAC (vaginal birth after cesarean), you play a crucial role in her journey. This section equips you with knowledge, rights, responsibilities, and options to maximise her comfort and facilitate a positive birth experience.

What to Expect in the Hospital?

Labour monitoring: Expect continuous foetal heart rate monitoring and regular cervical checks.

Pros of continuous foetal heart rate monitoring and regular cervical checks for VBAC labour:

Increased Safety

  • Early detection of foetal distress: Continuous monitoring can pick up subtle changes in the baby's heart rate that might suggest distress, allowing for earlier intervention if needed. This relies on perfect recordings and constant observations of the medical staff. They won't see changes instantly if they are only checking it every 15- 30 minutes.

  • Monitoring labour progress: Consistent tracking of contractions and cervical dilation helps healthcare providers assess the progress of labour and identify any potential stalls or slowdowns.

  • Improved communication and decision-making: Continuous monitoring provides information about the current status of labour to both the healthcare team and the birthing woman.

Reduced Anxiety

  • Reassurance for the parents: Knowing that the baby's well-being is being closely monitored can significantly reduce anxiety for the birthing woman and their partner.

  • Early identification of potential complications: Prompt detection of any issues can prevent them from escalating and causing unnecessary worry.

Other Advantages

  • Documentation for medical records: The data collected during monitoring can be valuable for medical documentation and future reference. Important in legal proceedings.

Cons of continuous foetal heart rate monitoring and regular cervical checks for VBAC labour:

Increased Medical Interventions

  • Over Intervention: Over-reliance on monitoring data can lead to unnecessary interventions if findings are misinterpreted or normal fluctuations mistaken for problems. This can disrupt the natural flow of labour and potentially increase the risk of complications. Research suggests that continuous CTG monitoring does not improve maternal and foetal outcomes but does increase the incidence of foetal distress.

  • Discomfort: Constant pressure on the belly from monitoring and the pain often associated with vaginal exams can cause adrenaline to be released. Oxytocin release is inhibited in the presence of adrenaline potentially slowing labour.

  • Foetal scalp stimulation or internal foetal monitoring: If concerns arise based on the monitoring, additional interventions like scalp stimulation or internal foetal monitoring might be recommended, which can be uncomfortable for the birthing woman and can restrict movement. The Foetal scalp monitor is a wire coil screwed into to present part of the scalp, this of course carries its own risks, especially if the baby is presenting face first and this is undetermined.

Reduced Mobility and Comfort

  • Restriction of movement: Continuous monitoring often requires equipment that can limit the birthing woman's ability to move freely during labour, which can hinder the use of comfort measures like birthing balls and water immersion. Even standing and rocking can dislodge and hamper the readings. Yes, even the wireless ones. This can mean long periods with a midwife holding the equipment to the belly to pick up traces, interrupting the natural flow and movement of the labouring woman.

  • Increased discomfort: Regular cervical checks, while generally brief, can be uncomfortable and disruptive to the labour process. At times vaginal exams can be triggering for some women especially if they have a history of assault.

Psychological Impact

  • Increased anxiety and stress: Focusing too much on monitoring data can elevate anxiety and stress for the birthing person, potentially slowing down labour and negating the benefits of a low-intervention approach. Everyone watching that machine and not watching the woman means other signs can be missed.

  • Loss of control and trust in the body: Some birthing women feel that constant monitoring diminishes their trust in their body's natural ability to birth, hindering their sense of empowerment and control during labour.

Additionally, consider exploring alternative monitoring options like intermittent auscultation (listening to the baby's heartbeat with a stethoscope).

Remember

It's important to weigh the pros and cons carefully in discussion with your healthcare provider to determine the best monitoring approach for your individual VBAC journey. Your preferences, risk factors, and the specific details of your situation should all be considered to make an informed decision.

  • Pain management:

  • Options include epidural, nitrous oxide, movement and massage. Support your partner by understanding her preferences and advocating for her choices.

  • Foetal movement monitoring:

  • Be prepared for additional monitoring if necessary, like CTG scans. These are not always evidence based and are often used towards the end of the pregnancy to check the size of the baby. These size estimations are notoriously incorrect as they can be up to a kilo out. Getting the “big baby card” is common in VBAC journeys and should be considered with caution. Please also remember that big babies can be born vaginally without complications, even by small framed women. The internal diameter of the pelvis can expand up to 30% during birth if the woman has freedom of movement through her pelvis (upright positions help here). This measurement can not be determined prior to labour and birth as it occurs in conjunction with the baby’s descent. Stay informed and ask critical thinking questions to alleviate anxieties.

  • Possible scenarios:

  • Understand that labour may progress quickly or stall. Be adaptable and offer emotional support as situations evolve.

  • Emergency C-section:

  • While most VBACs are successful, be aware of the possibility of an emergency C-section. Stay calm and provide reassurance if needed.

Your Rights as a Support Person

  • Presence: You have the right to be present throughout labour, birth, and recovery.

  • Decision-making: Advocate for your partner's informed choices and participate in birth plan discussions.

  • Information: Ask questions and clarify any doubts you or your partner have. Knowledge empowers both of you. Remember if you can't explain it to someone else you don't fully understand the answer.

  • Respectful care: Advocate for your partner's comfort and respectful treatment by medical staff.

  • Communication: Assist your partner in communicating her needs and preferences effectively.

Your Responsibilities as a Support Person

  • Emotional support: Provide unwavering encouragement, comfort, and reassurance. Be her rock throughout the birthing process.

  • Physical assistance: Assist with positioning, fetching supplies, and offering massages or pressure relief.

  • Advocacy: Be your partner's voice when needed, ensuring her decisions are respected.

  • Staying informed: Learn about VBAC, understand potential challenges, and be a reliable source of information for your partner.

  • Self-care: Prioritise your own well-being to be a constant source of strength and support. This is where a Doula comes in handy.

Your Options for Enhancing the VBAC Experience

  • Birth plan: Create a written plan outlining your partner's preferences for labour, birth, and postpartum care. Discuss it with your healthcare provider.

  • Doula: Consider hiring a doula for additional emotional and physical support during labour, birth and early postpartum.

  • Relaxation techniques: Encourage your partner to practise breathing exercises, visualisation, and other calming techniques to manage discomfort by learning about it and doing it with her.

  • Movement: Facilitate movement and position changes during labour to aid progress and promote comfort.

  • Positive affirmations: Shower your partner with words of encouragement and remind her of her strength and resilience. Most importantly of all tell her how much you love her, how beautiful and powerful she is and that you are with her every step of the way.

Remember

Communication is key. Talk openly and honestly with your partner about her fears, expectations, and preferences. Be her anchor throughout this journey, and together, you can create a positive and empowering VBAC experience.

Here are some additional resources that may be helpful:

By understanding your role, rights, and options, you can be a powerful force in supporting your partner's VBAC journey. Remember, it's about supporting her choices and creating a positive birth experience for both of you and your new arrival.

Note: This information is for educational purposes only and should not be interpreted as medical advice. Consult with your healthcare provider for personalised information regarding your VBAC journey.

Stages of Labour: Informed Support for Each Phase

Stage 1: Latent Phase (Early Labour)

  • Duration: Hours, even days, before active labour begins.

  • Signs: Intermittent contractions, mild cramping, cervical changes.

  • Support: Encourage rest, relaxation, and normal activities. Be a calming presence and provide emotional support. Help with distractions and light tasks. This is the phase we don’t give a lot of of energy to, if it doesn’t demand energy don’t give it any.

Stage 1: Active Phase (Active Labour)

  • Duration: 6-12 hours on average. 1 cm per hour is not the rule, it's an average.

  • Signs: Regular, strong contractions increasing in intensity and frequency (every 3-5 minutes). Gradually becoming consistent and longer, however this is not always the case, it doesn’t mean labour is not progressing.

  • Support: Offer comfort measures like massage, counterpressure, warm or cool compresses, and position changes. Help manage breathing techniques and relaxation practices. Be an advocate for VBAC preferences and choices. THis is the phase for you to really step up and support your partner.

Stage 2: Descent and birth (Evacuation Phase)

  • Duration: Minutes to hours depending on individual factors.

  • Signs: Intense urge to push with contractions. Baby descends through the birth canal.

  • Support: Guide and encourage breathing techniques. Offer emotional support and reassurance. Provide counterpressure and hold positions as needed. Help maintain a calm and focused environment. Don't yell at her to push, remind her that you love her. The body with have her push as and when it needs to. Coached pushing for the sake of being 10 cm dilated is not evidence based practice. Remember the 3 PPP’s, Patience Protects the Pussy, this is the time to go slow and allow everything to open up.

Stage 3: Placental birth (Afterbirth)

  • Duration: Minutes to hours after birth.

  • Signs: birth of the placenta and membranes.

  • Support: Offer warmth and comfort. Encourage skin-to-skin contact with the baby. Assist with breastfeeding if desired. Monitor for and report any unusual signs. This is a time for quiet and peace, often referred to as the golden hour. This is not when you start ringing people. This is a significant part of birth and bonding and the lights should remain low and the atmosphere calm and respectful.

VBAC Considerations

  • Monitor for uterine rupture: Be familiar with signs like sudden intense pain, vaginal bleeding, or foetal distress. Inform healthcare providers immediately if you suspect any issues.

  • Respect maternal choices: Support the birthing woman's decisions regarding intervention or caesarean section if necessary. Prioritise her physical and emotional well-being.

  • Maintain positive communication: Encourage open communication with the birthing woman and healthcare providers to ensure informed decision-making throughout labour.

Additional Tips

  • Attend childbirth education classes with your partner to learn more about labour and VBAC. Calm birth or Hypnobirthing classes can be very helpful.

  • Pack comfort items like massage oils, music, blankets she is familiar with, and birth affirmations.

  • Be prepared for unpredictable situations and stay flexible. If you carry fears and trauma of your own then seek the support of a birth trauma therapist to address them before labour.

  • Most importantly, offer unwavering love, support, and encouragement throughout the VBAC journey.

Remember

Every VBAC experience is unique. By understanding the stages of labour, tailoring your support to each phase, and prioritising the birthing woman's needs and choices, you can be a valuable partner and contribute to a positive and empowering VBAC birth.

Relaxation and Pain Management Techniques for VBAC Birthing Partners

As a birthing partner during a VBAC (Vaginal Birth After Caesarean), your role extends beyond physical support. Creating a calm and soothing environment and guiding your partner through relaxation and pain management techniques can be invaluable. Here are some effective techniques you can employ:

Guided Breathing

  • Deep abdominal breathing: Encourage your partner to inhale deeply through their nose, expanding their belly, and exhale slowly through pursed lips. This activates the parasympathetic nervous system, promoting relaxation and pain relief.

  • Paced rhythmic breathing: Guide your partner to match their breaths to your or calming music. Inhale for a count of 4, and exhale for 6. This rhythmic pattern can distract from discomfort and induce a sense of calm, also helpful for sleeping.

  • Visualisation breathing: Encourage your partner to visualise their breath as a calming colour or image entering their body with each inhale, washing away tension and discomfort with each exhale.

Visualisation/imagining

  • Safe haven visualisation/imagining: Guide your partner to imagine a peaceful and serene place, like a beach or a forest. Encourage them to engage all their senses – the sound of waves, the warmth of the sun, the scent of pine needles. This can provide a mental escape from discomfort.

  • Positive affirmations: Help your partner repeat positive affirmations, such as "I am strong and capable," "My body is designed for birth," or "Each contraction brings me closer to my baby." Positive self-talk can boost confidence and manage anxiety. Heck if you can't remember those, just tell her she is beautiful, she is your world and that you love her. This goes a long way.

  • Guided imagery: Lead your partner through a narrated journey, describing a calming scene and inviting them to imagine themselves interacting with it. For example, visualise walking through a meadow, picking wildflowers, and feeling the gentle breeze on their skin.

Aromatherapy

  • Essential oils: Certain essential oils, like lavender, clary sage, and chamomile, possess calming and pain-relieving properties. Use a diffuser or dilute the oil with a carrier oil for topical application (avoiding the belly and breasts).

  • Scented compresses: Soak a washcloth in warm water with a few drops of essential oil and place it on your partner's forehead, temples, or neck.

  • Candles and incense: Scented candles and incense can create a calming ambiance and fill the air with soothing aromas. Choose natural fragrances over synthetic ones. Make it easy to take the scent away if she doesn’t like it anymore.

Remember

Individual preferences: Every birthing woman is unique, so tailor these techniques to your partner's preferences and what resonates with them.

Practice beforehand: Familiarise yourself with these techniques before labour to guide your partner confidently during the big day.

Open communication: Encourage your partner to communicate their needs and preferences throughout labour. Adjust your support accordingly.

By incorporating these relaxation and pain management techniques, you can guide your partner to manage discomfort and navigate their VBAC journey with greater ease and confidence. Remember, your presence, support, and belief in your partner's strength are invaluable throughout this special experience.

Welcome to the "Supporting Your Partner in a VBAC" quiz! This interactive tool is designed to educate and empower individuals supporting their partners through a Vaginal Birth After Cesarean (VBAC). Through a series of thoughtfully curated questions, you'll explore the best ways to offer physical, emotional, and practical support during each stage of labor. From understanding the nuances of different labor phases to implementing relaxation techniques and the safe use of aromatherapy, this quiz offers insights into how you can be a nurturing and informed presence during this pivotal journey.