Hey, I promised some of you lovely ladies I would post up the notes I made from mine and DH's meeting with a doula. Sorry it's taken a wee while but I've typed them up now and hope some of you may find them useful. As these are my notes, they're a little bitty in places and it does mean this is a super long post (sorry). Hopefully there is something interesting for everyone here. I have to say she was unbelievably great and really made DH and I feel comfortable about all our choices. She made no judgements whatsoever about anything we decided and was really supportive about decisions regarding pain relief (I'm kinda open to anything as I have no idea how it will feel!). The advice was really practical and honest for us both and DH has really gotten on board with the advice for birth partners. So here goes: Stages of labour Pre-labour (latent phase) women tend to be very excited during this stage First stage this is when labour is established, contractions are 3 or 4 in 10 minutes and last around 60 seconds. This is generally when you are around 4cm dilated Transition (around 9 10 cm dilated) this is when the body begins to build towards pushing this is often the point at which women feel they can not do it, swear and get upset. Other signs are feeling shivery and the beginning urge to push. Second stage The pushing begins and the baby is born. In midwife led units they may often wait longer for a woman to feel a very strong urge to push before they encourage her to do so. This can be very tiring and try not to be disheartened if you feel the baby coming out and then after each contraction going back in a little bit again. This is natural and you are still doing a good job and getting the baby where they need to be. Third stage the delivery of the placenta. This can be done physiologically can take anywhere from 5 minutes to 1 and a half hours, you can allow the cord to finish pulsing before it is cut in this case. It can also be medically managed with an injection into the thigh after birth. In this case the cord must be cut immediately. There are certain situations in which a medical management is necessary and the medical team will inform you of this if you had originally opted for a physiological third stage. Notes for Birth Partner During labour the most active part of the body is the brain secreting hormones - Oxytocin is the most important and allows better contractions this is released by primitive brain structures. Inhibitions during birth originate from the thinking part of the brain oxytocin is inhibited and adrenaline is raised. (Adrenaline can out the braks on labour) When a woman is allowed to go through labour without being disturbed she can shut herself off from her surroundings and feel free to do what she needs to (scream, swear, position herself as she wishes). All of these allow her to engage with the primitive part of the brain and detach from the thinking part which inhibits this natural response. It is the job of the birth partner to safeguard the woman and allow her to remain in this state. They can do this through: Language try to avoid direct questions. If you think your partner needs water for example, get some and simply offer it to her. Light try to keep lighting dim. Bright light stimulates the brain and can make a labouring woman feel very vulnerable. At home turn off lights and close curtains. In the hospital ask to dim the lights if possible. (think of when animals give birth daytime animals tend to do this at night) Dont stare try not to observe the woman, give her the privacy she needs to focus on what she is doing and to feel safe in her environment. You can still be with her but try sitting behind her or in the corner of the room. (again think of the above example of animals they often tend to remove themselves and give birth alone) Feeling safe anything that may be interpreted through fear or concern will stimulate adrenaline. Help your partner to feel safe and reassure her throughout General notes for the birth partner If this is your partner or husband - remember labour does not need to be fixed. There is nothing you can do to fix it for your wife or partner you simply need to support her Dont go to the hospital too early you are only moving the perceived problem to another environment. The longer you stay at home in the early phase the more comfortable she will feel if your partner is still smiling when you look at her she is still excited and you can stay at home, when she stops smiling, this is when the serious part of labour has begun Be her gatekeeper during contractions keep everyone quiet and try to make sure the environment as much as you can is conducive to labour. You can also gently ask professionals to wait to discuss something until she has finished a contraction. (make sure you are aware of the birth plan and specific wishes) Between contractions give her lots of encouragement and support even if the labour is not going your way on the day, keep up the love and attention and try not to panic her. Enjoy the experience the medical professionals are there to maintain the safety of both her and the baby your job is to support and comfort her. Other tid bits and tips (this is completely from memory!) Try to use as active birth position as possible (if you have an epidural this might not be possible). Remember to use gravity to your advantage (for example it is much more difficult to have a bowel movement laying down!) wriggle your bum between contractions, hang on something higher than waist height and sag or squat when pushing or go on all fours. Think about whether you want to be offered pain relief or you want to ask for it. Labouring women are vulnerable and although she might herself feel like she is coping and doing well, if someone around you then suggests she should perhaps have pain relief she may begin to doubt herself and her ability to cope with labour. The end result is the same if asked for by yourself or offered by someone else. In an ideal situation, the baby should stay on the mothers chest for around an hour after labour as it regulates heartbeat and temperature. You can ask for the MW to do their weighing etc. later. If the mother is unable to do this for some reason (e.g. surgery, health, or feeling too shaky) then the next best thing is skin to skin with the father he can remove his top or pop the baby underneath it. This is obviously in an ideal situation and there are reasons why this might not be possible because of birth complications so dont worry if you cannot do this. If you are breastfeeding, try to do this as soon as possible after birth (it will also help if you are having a physiological third stage) If things dont go to plan on the day, dont worry. You are still doing a wonderful job and the most important thing is the health of you and your baby. Accept the new situations if and when they arise and do not feel guilty about anything that may arise dont be afraid to ask for pain relief if you need it, reassurance or to shout or make noise. If you have a c-section instead, feel happy that you have done a wonderful job and you will both be safe. You cannot fail in labour and should feel empowered by any decisions you need to make.