Thursday, February 19, 2009

Ask Busca: Dads and Doulas?

I think I'm going to start a new feature: Ask Busca. If you have a question related to childbirth, pregnancy, or breastfeeding, ask away, my friends! I'll work on getting an email address created for this purpose. In the meantime, here's the first "Ask Busca" post.

Fig asked:
My husband only wants the two of us to be present for our first baby's birth. (No friends or relatives or anything, just him, me, and the people who are delivering the baby.) So ... do you think I can convince him a doula would be one of the baby-delivery personnel? I have no idea what the dynamic is like in a delivery room. No idea what to expect. But here's what I know about my husband: he is extremely private. He doesn't like big fusses, or loud craziness, and he's very uncomfortable with profound emotions/pain. He also doesn't like to be bossed. I guess I just can't figure out how the husband and doula work together without the husband feeling a little bit weird. Am I worrying about nothing?
Busca's babble:

My husband and I had some of the very same concerns with our first pregnancy. We felt that we only wanted just the two of us at the birth. But God knew better. So he gave us Eve--my saint of a nurse, who was really basically a doula. I could NOT have done it without her help. I thank God almost daily that Eve was my nurse. But the truth is... most nurses aren't like Eve. So, most women labor alone with their extremely overwhelmed husbands trying, often futilely, to support them.

We talked a lot about this at our doula training. One of the studies we discussed (click here for the abstract) showed that 12 out of 20 husbands take on the "witness/observer" role in their wives' births. Only 4 out of 20 filled the "coach" role. The remainder were "teammates"--taking their lead from others' suggestions (which requires someone to actually be present to make those suggestions). We discussed how important it is for couples to discuss which of those roles the husband feels comfortable filling. Some men just aren't comfortable taking on the "coach" role, but so many women have the expectation that they will (or MUST) fill that role. Then they're disappointed when their overwhelmed husband can't be that support during labor. Some husbands plan to fill the coach role but find themselves blind-sided by the intensity of birth (think: deer in headlights).

It's completely OK for a husband to be a witness/observer if that's what he's comfortable being. He shouldn't be expected to be something he's not. Based on your description of your husband ("he is extremely private. He doesn't like big fusses, or loud craziness, and he's very uncomfortable with profound emotions/pain"), I wouldn't be surprised if he would be most comfortable as a "witness/observer." Birth (by its very nature) is a big, huge fuss! It is LOUD. It is intense and RAW and emotional and painful. It just is. And it's OK if he needs to withdraw from that intensity and just observe. It's totally OK.

BUT... if you're serious about wanting an unmedicated, non-interventive labor and delivery, you absolutely must have support. And a "witness/observer" will not be enough. And you can't guarantee that your nurse will be helpful. They're generally busy and overworked and used to the standard assembly-line approach to birth. I understand the desire to experience this sacred event privately. But I'm telling you now that, if I'd had any other nurse, I would have been cranked through the birth machine just like everyone else. I would have buckled, no question. Continuous emotional and physical support are crucial!

Here's a quote from one of the articles in our doula training binder:
"Women in labor have a profound need for companionship, empathy, and help. Those responsible for her and her baby's clinical well-being (doctors, nurses, midwives) even if capable of providing support, must give it a lower priority thatn their clinical duties, and in some cases, their personal needs (for breaks, sleep, and to go home). Labor support is so intense and demanding that few can do it forty hours a week. Some well-prepared partners are admirable labor support providers; most are not.

"Without a labor support person, the women's emotional needs will probably be unmet, and she will not cope nearly as well as she might with good support. Copstick, et al. (1985), found that women were unlikely to use techniques learned in childbirth classes beyond early labor unless their partners were trained and willing to help and coach them"
(Penny Simkin, "The Labor Support Person: Latest Addition to the Maternity Care Team," 1992).
I just can't stress enough how important continuous support is. If Eve hadn't been there to show my husband how to put counter-pressure on my knees or to suggest other ways he could help, he wouldn't have known what to do. And I wouldn't have known either. Eve had given birth without meds before. She knew how to help. She knew that the noises I was making were normal and OK. She reassured both of us. And she never made my husband feel uncomfortable. They worked as a team.

For more info, check out DONA's "Dads and Birth Doulas Brochure."


Fig said...


Liz Johnson said...

You rock my socks, Busca.

I like to think of doulas as being there for the dad just as much as the mom. I know Chris would've really liked somebody that he knew and trusted to ask things like "Holy crap, is that normal!?" or "Can I leave and get a cheeseburger?" And a lot of midwives have doulas that they work with and can recommend, so in a way, they can come as a "team"... both the midwife and doula together. There are going to be a bazillion other people around anyways (nurses, possibly medical residents, maybe an OB or two floating around), so why not have one more person "on your side"? No matter what, if you're delivering in a hospital, there are going to be at LEAST two other people (besides you and your spouse) there, so why not have one there to help him out, bring him pillows, and give him a burger break when he needs one?

The Roundy Fam said...

Love it... such a thorough answer and encouraging! :o)