Partners

Holy Snow Day, Batman!

I’m on call and snowed in here in Brooklyn.  Of course, babies don’t take snow days, and I’m slightly excited by the idea that I may have to rush out and brave the snow to get to a birth.  I love a good challenge!

I came across this article about Postpartum Depression in fathers in the NY Times and it got me to thinking more about Partners in labor.  Partners – who I define loosely as husbands, fathers, same-sex partners, friends, lovers, or whoever is close to the mother and attending the birth — play a very special and important role that is distinct from what we do (or can do).

Throughout my training, I have tried to stay attuned to what I can do to support Partners during a birth.  Partners have a profound impact on a mother’s labor.  And I feel that a birth can be (should be!) a profound experience for partners, as well.

During the last birth I attended, the mother became panicked as the baby crowned.  We were all cheering her; the midwife was giving instructions, the other birth attendant and I encouraging her, and her partner was by her side.  In her moment of confusion and fear, her partner stole the show and said “Look at me.  You are going to be fine.  You are doing a great job.  You are so strong.  Look at me.  I love you.”  She kept her focus on him for the rest of the birth, and it allowed her to get right back on track and focus on the task at hand.  She changed in an instant and the trust she had for him in that moment allowed her to deliver her baby with relative calm.

That long-standing, loving, trusting relationship is not something we can (or should) recreate, and was so damn important in that moment.  This is why I think it’s so important to keep Partners involved and informed; they are absolutely crucial to the process.

Some ways I have learned to do this are:

– I frequently ask a Partner how they’re doing and check in with them.  I also give them encouragement as often as possible; I let them know when they’re doing a great job supporting the mother.  I remind them that their baby is coming soon to keep them motivated.

– If I’m doing something that the Partner could be doing, and if the Partner is standing around looking unsure of what to do, I will often hand over that cold washcloth, or move over and as them to take over.

– If a Partner is exhausted, I let them know that I can jump in and give them a break to get some rest or something to eat.  I remind Partners that they need to keep their strength up in order to be present for the pushing and delivery.  And I assure them that they will not miss the big event if they step away for a few minutes.

– I sometimes just excuse myself all together if I sense (or if they tell me) that a Partner would like to take the lead in comforting and caring for the mother.  I believe that birthing mothers and Partners deserve privacy if they want it.

– The midwife often gives Partners specific instructions on where to be, especially during the pushing, and I try to stay aware of these instructions to use in the future.  Usually, the partner is holding a foot, providing a stable hip for a foot to push against, or adjusting the laboring mother as she shifts.

I find that Partners who are involved in these ways have a much better, intimate experience than those who stand back and don’t take an active role.  What a powerful way to begin a journey as a parent!

It doesn’t surprise me at all that the events surrounding a birth have a physiological impact on fathers (or partners), too.  From the NY Times essay:

A 2006 study on marmoset monkeys, published in the journal Nature Neuroscience, reported that new fathers experienced a rapid increase in receptors for the hormone vasopressin in the brain’s prefrontal cortex. Along with other hormones, vasopressin is involved in parental behavior in animals, and it is known that the same brain area in humans is activated when parents are shown pictures of their children.

There is also some evidence that testosterone levels tend to drop in men during their partner’s pregnancy, perhaps to make expectant fathers less aggressive and more likely to bond with their newborns. Given the known association between depression and low testosterone in middle-aged men, it is possible that this might also put some men at risk of postpartum depression.

By far the strongest predictor of paternal postpartum depression is having a depressed partner. In one study, fathers whose partners were also depressed were at nearly two and a half times the normal risk for depression.

Testosterone aside, this is only more evidence that we are not only emotionally interdependent, but that the material of our bodies are also in conversation with each other.

Do you have any tips for labor attendants who want to support Partners?  Please leave them in the comments!

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