For many birthing people, just having their partners by their side, offering a calm touch and encouraging words, throughout the entire experience is the most important thing. Regardless of who is in the room, what they are doing, and what role they are playing, nobody can replace the love and support you have to offer. The professionals may know birth, but YOU know your partner. You have the power to encourage peace, relaxation, and calm like no other.
While you’re in the early phases, do whatever you can to help your partner relax and feel comfortable. You will probably instinctively know how to do this better than anyone else would, because you know them best. If you are planning to go to a birth center or hospital, you will want to have an idea of what tools you have in your tool box and which ones will be helpful to use at home so that you can make the most of the early labor phase. This will help you to feel confident and prepared to provide support until it is time to transition to the place where you’ll be birthing.
While every birth looks different, and there’s no manual that we can apply to every birthing person and how their labor will begin or unfold, here are some general guidelines of the phases and stages of labor and some things you can do during each phase. You have what it takes to be the support that your partner truly needs. Believe in yourself and believe in your partner’s ability to birth. Remember to breathe and center yourself throughout. You got this.
First Stage (Labor)
Early phase
If it is nighttime when the surges begin, encourage sleep/rest if possible. It’s important to conserve energy & strength for the long haul. Missing out on a whole night of sleep before things begin to pick up isn’t ideal. This goes for you too. If you can ignore these early surges and either go about your day or go back to sleep, that’s preferable. Don’t put your energy and focus into timing the surges until they are coming in a regular pattern and become more intense.
Encourage nourishment & hydration throughout.
Watch a lighthearted movie or comedy. Offer they sit on the birth ball while watching.
Set up the T.E.N.S. unit and get the hang of it while it’s early.
Stay positive. Provide reassurance and words of affirmation and love.
Encourage upright positions, restful positions, and ones that feel the best.
Take a short walk if they are willing and able.
Encourage bathroom breaks every couple of hours.
Cuddle and connect. Massage. Anything that feels good will encourage oxytocin.
Warm up the rice sock if they complain of discomfort in their lower back/hips.
Make eye contact and smile… Send good thoughts, energy, and love to your partner and baby.
They may begin to become more vocal as a way to cope. This is normal.
Remember to breathe, and stay calm yourself. If you are experiencing anxiety, call your midwife/doula for advice.
Handle Logistics for other children and/or pets.
Have everything by the door and ready to go. You may have a chance to run things to the car later. You may not. Push the passenger seat back in case they prefer hands and knees for the ride. They may also want to ride in the back seat on their hands and knees.
Have a towel and plastic bag ready for the car ride in case waters release and for nausea.
Encourage a shower before leaving, especially if you’re trying to stay home as long as possible in the early phase. This will provide comfort and prevent you from arriving at the hospital or birth center too early.
Active phase
If you are birthing outside of the home, try to stay home as long as possible. It’s usually time to leave when surges are 4-1-1. This is a general guideline but means that surges are coming every 4 minutes (from the start of one to the start of the next), and they are lasting a minute, consistently this way for at least an hour. There is often a feeling that they are “in the zone” and no longer as talkative and interactive as they once were, even between surges. They may not be speaking in full sentences anymore, and they seem to have gone deeply inward. We call this “Labor land.” Labor land is a result of the body’s cocktail of oxytocin and endorphins which flood the body with pain-relieving and relaxation hormones.
If you are unsure, call your midwife/doula. This is only a guide. Sometimes, especially for first-timers, surges can be 4-5 minutes apart for a longer period of time, and it still be the very early phase (too early to head out.) Watch out for emotional signposts and shifts, and other signs, not just numbers.
If/when you set off to the birth center or hospital, do so calmly. Frantic rushing energy can feel unsafe, cause adrenaline release, and even slow things down. Continue calm positive encouragement during the ride, and get the doula on speakerphone if that would be helpful so that you can be relaxed, and concentrate on getting to the birthplace safely.
If you are birthing at home, this would be around the time that you call your doula, and your doula comes to join you, (or your midwife if you are having an assisted home birth.)
Encourage position changes every 20-30 minutes (every 4-5 surges.) They will usually naturally change positions on their own, but we can guide them gently if they appear to be sitting/lying in one position for an unusually long time. Movement is important for the baby’s descent and rotation through the pelvis.
Use a gentle touch and/or firm massage on the shoulders, arms, legs, and lower back. This releases oxytocin. If they don’t redirect us, that usually means what we’re doing is ok/working.
Encourage bathroom breaks every hour or so, spending extra time on the toilet to encourage progress (we call the toilet dilation station.) Backward sitting with a pillow to rest is also a great idea.
Maintain hydration with liquids such as coconut water, and other electrolyte drinks. Sip-surge-sip.
Slow dance and sway with them. Hold their weight for them if they’re tired.
Double Hip Squeeze may work really well now.
Vocalization (moaning, groaning) may increase. This is a great sign.
Encourage them to breathe slowly by modeling slow audible breaths - especially if they begin to hold their breath or hyperventilate.
Provide firm counter-pressure on/around the lower back and hips during surges. They will usually notify us as to what feels good and what doesn’t, don’t worry!
If they begin to do things repetitively to get through a surge, they may have found their “ritual.” This is a good thing. Even if what they are doing seems unusual.
Keep their lips and mouth moist by offering sips of a drink and lip balm.
Provide reassurance on how well they are coping through surges. Remind them of their strength.
Microwave the rice sock for 45-90 seconds and place it on the lower back. (You can hold it on softly, with counter-pressure, or tie it on with a scarf or Rebozo.)
Talk if they find that helpful, or remain quiet and use hushed voices to encourage calm.
Encourage a bath or shower when things begin to become intense. Set up their favorite music or Hypnobirthing tracks to listen to while they’re in there.
Once the surge pattern has been consistent, getting closer, longer, and stronger, and your partner is well into “labor-land”, it is time to leave for the birth center or hospital. Nausea, bloody “show” when wiping, feeling like they have to go #2 consistently (not just during surges), bearing down during surges, grunting at the peak of a surge, and waters releasing are good signs that it’s time to head out.
Transition
They may begin to experience surges every 2-3 minutes, or that don't seem to fully subside or have much of any noticeable rest between. They may be feeling constant rectal pressure. They may ask when this is “going to be over?” They may also begin to say that they cannot do it, become weepy, and/or cry out for help. They may start to become very nauseous or vomit. Some may start to ask for medication even when that isn’t actually what they want. This is a sign that birth is likely imminent and this can be an overwhelming time that calls for extra support and reassurance. Many people will appear to “come back” from the faraway labor land place they were in, and it can be jarring to their senses due to a normal, purposeful adrenaline spike. At this time — it is likely that you are already at your birthplace, or at least on your way.
Hold them up if they seem to become unstable on their feet.
Offer them to kneel on the bed, either on their hands and knees or over the Birth Ball for support.
Stay/sit right by their side. Hold them if they need this. Hydrate.
Remind them that feeling intense pressure is normal and that means the baby is moving down.
Encourage “low” sounds (by modeling) if the moans become high-pitched squeals or screams.
Breathe slow (model audibly & visually) with them. Hydrate.
Offer love, safety, praise, affirmation, & encouragement.
Help/remind them to take their rest between surges.
Keep your hands on them unless they express otherwise.
Tell them to focus on your face or another focal point if needed.
Help them anticipate the next surge and model a slow cleansing breath before it begins.
Your partner may begin shaking and/or vomiting. This is normal, and you can assure them of that.
Tell them that you know they can do this if/when they say they can’t. (Most say that at this point.) “You ARE doing it!”
They may begin to make “grunting” sounds during a surge. Encourage them to trust their body as it begins to bear down on its own. (F.E.R.)
Help them to get back up on their hands and knees after a cervical exam (if they have one to check dilation), if they plan to push in an upright position utilizing gravity. (Upright is usually best.)
Remind them that they are safe, that you are by their side, and that you’re going to meet your baby soon!
Second Stage (Pushing)
They may express that they feel overwhelming pressure and begin to make “grunting” sounds during transition, which turn into bearing down as the body begins to push on its own during each surge. Encourage them to trust their body and that they push in a way that feels most effective and comfortable for them. They may express some fear around pushing, and need some extra help with grounding themselves and focusing again after an intense transition. Sometimes surges will completely stop for a “rest and be thankful phase” and to gather energy before the body is ready to push. This is normal. Encourage rest, calm, and privacy if this happens. Remind them that they are strong and that they get to meet baby soon.
Help them to get comfortable and in a supported position. Encourage upright pushing positions for use of gravity.
If they appear to have surrendered to their body’s urge to push and are going with it, we hold space and support them in trusting that. We protect the moment and tune in to their needs intently.
If they appear to want direction with pushing, remind them that we’re here to help. We follow their lead. Low voices and calm energy will be key for most. Yelling push or asking them to hold their breath and bear down is rarely helpful unless they are medicated. If they appear to need assistance, we can inquire as to what they might feel is helpful — would they like the doula to guide them? The midwife? Both? Oftentimes too many voices can be overwhelming, so we check in about this if necessary.
Place ice-cold rags on their forehead and the back of their neck if they would like. Switch out for new cold ones every 2-3 minutes.
Continue with encouragement and reassurance.
Remind them to relax their jaw, and shoulders, if you notice they are tensing.
Encourage rest between surges.
Continue to be on standby with hydration and a cold rag.
Your partner may express several different emotions and/or apprehension about pushing. Bring them back to their breathing and remind them that they can do this. They are close.
It can be intense to watch your baby emerge, so if you feel woozy, take a deep breath and look away for a moment. Sit down for a minute if you need to. Take a sip of cold water or go splash your face.
If you are offered to help catch the baby or want to… you will be guided on how to do so.
Let them know if/when you start to see your baby's head. Offer they touch baby’s head if they wish.
Once the baby is born, take a moment to process and celebrate!
If birthing in the hospital, you can promptly remind the providers about delayed cord clamping if that is your wish. If you don’t remind them, they may prematurely cut the cord within 30-60 seconds.
Congratulations!!
Third Stage (Placenta)
After the baby has been born, the placenta must be birthed. This usually happens between 10-30 minutes of the baby being born — but it may happen sooner or it may take longer. At this point, the baby has not yet received all of its blood from the placenta, so delaying clamping the cord for 2-5 minutes is ideal. You may want to cut the cord. After the cord has been clamped with two clamps, you will be guided on where to cut between these two clamps using scissors. The cord is tougher than it appears and sometimes takes more than a little snip. Although cutting the cord is something they may offer, you don't have to do it if you’re not comfortable. You can say “no thank you.”
Stay by your partner and/or baby’s side.
You may need to provide encouragement and support as the placenta is birthed.
The placenta is an amazing organ, but you may not be interested in seeing it and that’s ok.
Sometimes stitches are needed to repair any tearing, and you may find that you want to stay up at the head with your partner and baby to provide support.
If your partner is unable to hold the baby while birthing the placenta or receiving any needed stitches, you may want to hold your baby skin-to-skin.
Take this time to bond and rejoice that you have all made it through such a transformative event.
Continue to offer hydration and nourishment as necessary.
Offer encouragement during the first latch, and “golden hour” which is skin to skin for an hour while imprinting on one other.
Any non-urgent suturing and/or newborn exams & procedures can wait — so that the golden hour, newborn instincts, first latch, and first family moments are not interrupted. You may have to encourage the team to give you your time unless there’s an urgent or time-sensitive matter that needs tending to.
Your baby will be imprinting on your face as well and will recognize your voice. Say hello!
Take pictures of your partner and baby, and ask someone else to take a picture of you all.
Lean on all of the members of the birth team. You’re all in this together and you’re truly a team. This may seem like a lot to remember — but in the moment you will remember the basics of support. And you won’t be alone. If there’s anything that you need, please talk to your provider, nurse, and/or doula. Ask questions. They have your back! And remember to take care of yourself as well… Don’t forget to snack and hydrate when you can. If you feel woozy at any point, have a seat and give yourself a minute, and some grace. You’re going to do great!
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