How to Be a Supportive Birth Partner
Few people would agree that the day they projectile-vomited while wetting themselves in front of their partner was one of the happiest days of their life, but Laura Mallows, a first-time mother from Cardiff, Wales, is among them. Child labor and delivery can be a wild ride for the birthing person, and having the support of a loved one throughout can make for more than a good story.
"My mum and [partner] Ronnie were both by my side cheering me on throughout my pregnancy, and it really helped me believe I could do anything, and I did," Mallows said.
Research indicates people who receive continuous, strong social support during labor and delivery tend to have significantly better birth outcomes, such as shorter labor, reduced pain, less need for medical interventions, and improved emotional and psychological well-being, according to Ngocnu Rigby, a certified nurse midwife with UTHealth Houston and UT Physicians in Texas, and Kyler Elwell Silver, M.D., an OB-GYN in Dallas and assistant professor at the University of Texas Southwestern Medical Center.
Natalie Moss (they/them pronouns), a doula with Marillac St. Vincent Family Services in Chicago, agreed. Although birth is a natural process, it can be painful, daunting and sometimes quite scary, Moss said. Having someone to provide emotional and physical support, ask questions and advocate can help the birthing person feel more comfortable and in control.
"All human beings are mammals," they added. "We are pack animals. We need people with us there. So having someone there who's supportive, who's like, 'Yes, I know what you want for labor and I'm going to make sure that you get what you need,' it entirely changes that process."
"As a woman, there is nothing more powerful than having a partner listen to you and validate your wants as the one giving birth," said Kristjana "Kris" Hillberg, a mother of three in South Dakota.
Supporting a partner through labor and delivery can even bring couples closer together, according to Brandon Eddy, Ph.D., a therapist and assistant professor at Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas.
"One study I conducted was on the topic of husband involvement during pregnancy," he noted. "Every couple in the study mentioned the labor and delivery process. Many couples felt the experience brought them closer as a couple, largely due to sharing the experience and being able to rely on their partner for support."
On the other hand, a birthing person who doesn't feel supported during labor and delivery may feel isolated, alone and disempowered. According to Moss and Eddy, they are more likely to view their experience negatively and may feel hurt or emotionally distant from their partner. For some people, it may even be traumatic.
"Whether this is your first or fifth time giving birth, the experience of having a child is wrought with emotion and unpredictability," explained Jennifer Kowalski, L.P.C., a counselor at Thriveworks in Cheshire, Connecticut, who specializes in relationships. "While many mothers plan their births, the universe may have other things in mind for you, and having someone by your side who can provide comfort and advocacy is never a bad idea."
Taking the time to prepare
Whether you're a co-parent, spouse, best friend or relative, if you plan to accompany a loved one during birth, gathering information ahead of time can help you provide the support they need. Here are three strategies you may want to consider:
Take a class
"No amount of research, watching TV shows, listening to podcasts or other people sharing their personal experiences can possibly prepare you for a live childbirth," Kurt Hillberg said of his first childbirth experience with his spouse, Kris, who had given birth to her eldest, from a previous relationship, using an epidural. The couple's first birth together was also Kris' first time delivering naturally, making it a learning experience for both.
"The biggest mistake partners and pregnant patients make is assuming they know what is going to occur in labor," Silver said. "The more education, the better."
With that in mind, Silver and other experts strongly recommend a support person take a comprehensive childbirth course with their pregnant partner, especially if this is their first experience.
"Birth is a complex physiologic process that requires good education to be fully understood," she explained. "The partner should not expect to walk into labor and delivery and understand what is happening. A better understanding will make them a better support person, giving the pregnant patient a better experience."
Talk about needs and wants beforehand
Don't have conversations about wants and needs when a person is under intense physical and psychological stress. Silver and others recommend discussing wishes and plans before labor begins.
"There are so many ways to help," Silver said. "This will depend on the pregnant patient and the situation. Some people want touch and physical support, some prefer silence and space. It is best to have these conversations prior to arrival to L&D [labor and delivery at the hospital] and then be flexible once you are there."
"One of the easiest ways to get this conversation going is by creating a birth plan together," said Liesel Teen, R.N., a labor and delivery nurse in Raleigh, North Carolina, and founder of Mommy Labor Nurse. "This will allow you to get a feel for your partner's birth wishes and allow you to have an open conversation about the best ways you can support each other through this journey."
Accept things are out of your control
Witnessing a loved one in pain is heart-wrenching and it is understandable partners may feel anxious, overwhelmed or afraid. As a means of coping, some people might try to "fix" or control the situation, which isn't productive, according to Teen and Kowalski.
Teen recommended that if a partner feels anxious leading up to the birth, they should do their best to address this feeling ahead of time so they can focus on the birthing person's needs when the time comes.
"Anxiety develops when we try to control an uncontrollable situation," Kowalski said. "It is fine to go into labor and delivery with a plan but accept that you need to do whatever is best for the mom and baby.
"It's important to know in this situation that the pain is part of the process and every contraction is the body's way of delivering your child," she added. "It is probably one of the few experiences where the joy of the outcome is worth the measure of pain. It really is not helpful to try and fix the situation, as there is no solution. The best thing a birth partner can do is bear witness and give praise. Let the person who is enduring the pain and doing the pushing know that you are in awe of them and that they're doing a great job."
"The most challenging part for me was that I felt that things were, for the most part, out of my control," Kurt Hillberg recalled. "If something were to go wrong or there was some sort of unexpected complication that was going to come up, there was basically nothing that I could do about it. The entire experience is beyond humbling. You really have to be able to sit back and take the ride and roll with the punches as they come."
Tips for the day of delivery
You wait and you wait, and eventually, the day arrives. Here are seven pieces of advice that should put you in good stead as the best supportive birth partner:
Create a comfortable environment
Burt Webb, M.D., an OB-GYN in Scottsdale, Arizona, suggested creating a safe, relaxing atmosphere. Webb noted the specifics depend on the birthing person's preferences and location. For example, some people may want rock music and a crowd, while others prefer Tibetan singing bowls and a limited crew.
However, some general tips include ensuring the room temperature and lighting are agreeable and that the birthing person has comfortable pillows. Music and an essential oil diffuser may help, as can a tub with warm water for soaking. And hanging fairy lights or displaying flowers in the room can make it feel like the special occasion it is.
Access to fuel and hydration is also essential, provided the birthing person has their doctor's permission to eat and drink. Experts recommend providing ice cubes, water or clear soda, and snacks like low-sugar granola or protein bars, crackers and rice cakes, the latter of which can alleviate nausea.
Inflexibility is the second-biggest mistake partners make during labor, according to Silver.
"Things change during labor, and that's OK," Silver said. "The goal is always to have a healthy mom and baby. The partner should ask questions of the providers, express the patient's wishes and help the patient make a decision that is safest and best for both mom and baby. There are so many unexpected things that occur in labor and delivery; some exciting, some scary and some just not what people had planned. It is best to be flexible."
Unexpected things can range from minor to major, but a birth partner's response is essential.
"The pain was pretty intense," Kris Hillberg said. "Poor Kurt. I would feel immense heat during a contraction, asking him to turn the fan on. When the contraction passed, my body would go into shivering [convulsions], and I would yell, 'Turn it off!' He was by my side telling me how strong I was the entire time."
"[My partner] was an extremely good advocate for me, and the biggest part of that was knowing what my birth plan was and what I wanted out of that, but also not pushing me to stick to it when I changed my mind," explained Zoe Ayre, of West Yorkshire, England. "He was also really calm throughout, and at the pushing stage, he was a great cheerleader, and the moral support and enthusiasm he brought really helped me push through."
Help your partner change position
A birthing person might need help holding certain positions and may have to shift several times during labor, according to Teen, Rigby and Moss. A partner can help by, for example, supporting the birthing person's legs during pushing or steadying them as they get into a squat.
Not only can movement alleviate pain and pressure, but experts say it can promote relaxation and facilitate labor by shifting the pelvic bones, helping the baby travel through the birth canal. Upright positions, including sitting or squatting, are doubly helpful as they allow gravity to direct the baby down.
Medical providers should keep the birthing person and their support partner in the loop, but they may not explain everything for one reason or another. Moss said it's OK and encouraged people to ask questions, especially if something seems off.
"Don't leave the birthing person out," they said. "But if there are nurses, doctors, ask them questions, 'Hey, I noticed this. Is this OK?' That can be really helpful in relaying information to the birthing person."
Ayre recalled this type of communication as one of the most crucial tasks her partner did for her.
"He knew what questions to ask and probed the doctors to gather information for me when I probably wasn't in a fit state to ask those questions myself, and he gently queried with me whether I was sure about decisions to escalate interventions, such as asking for higher pain relief and then an epidural," she explained. "I felt incredibly looked after and supported by him."
Some childbirth professionals talk about the gate control theory of pain, a technique to alleviate discomfort during labor and delivery. The theory states that activating the nerves in a nonpainful way at the same time pain is occurring can block pain signals from reaching the brain, Rigby explained, adding that the nonpainful input closes the "gate."
"There is a limited amount of sensation that can go to the brain at once, thus, flooding the brain with nonpainful stimuli may prevent the pain from getting through," she continued. "Some ways the partner can help in labor include providing a warm bath for soaking, massaging the mother during contractions, assisting with sitting on a birthing ball, pressure point therapy on the patient's back or hands, and utilizing a heating pad for comfort. All these examples may help flood the nerves so the painful messages are interrupted."
Kris Hillberg recalled this was one of the more helpful acts her partner did for her.
"He was calm, collected, kind and willing to add pressure points or hold my hand," she said. "He was truly there and so helpful through the entire delivery process."
Teen noted the gate control theory applies to physical touch and other senses, too, including scent, taste and sound.
"Anything that the support person can do to distract the laboring woman, give her brain something else to focus on, can serve as an effective pain-coping technique for labor," she added.
As a support person, one of the most straightforward and helpful instructions you can give is to encourage your partner to breathe, according to Teen.
"Help her slow down her breathing by slowing yours down and breathing with her during contractions," she recommended. "Remind her to breathe and not hold her breath."
Intentional breathing ensures the birthing person and baby have enough oxygen, which helps the birthing person focus and bear through each contraction.
Practice relaxation techniques
It isn't easy to relax during one of the most important days of your life, particularly while experiencing tremendous pain. However, relaxing—to the best of their ability—can reduce a birthing person's discomfort and facilitate the birth.
"Remaining relaxed during contractions is one of the hardest things to do during labor. It's human nature to tense up when you feel pain, which is exactly what happens during labor," Teen explained.
Experts said there are several ways a support person can help the birthing person relax, from gentle reminders to soothing massage and meditation techniques.
Mallows credited hypnobirthing—along with the support of her partner and mother—with calming her nerves before and during her 30-hour labor.
"I am a massive wimp and hate blood, so when I found out I was pregnant, I had a slight panic until I reframed my mind with hypnobirthing," she wrote in an email, noting she and her partner took a hypnobirthing class together in preparation.
Hypnobirthing, made famous by celebrities like Meghan Markle, is a pain management and relaxation technique involving self-hypnosis. Research on its effectiveness has produced mixed results, but some reports, including a 2006 review of 14 studies, indicate it may have merit.
Feeling all the feelings
"The experience was much more intense than what I was expecting going into it," Kurt Hillberg revealed. "You can mentally prepare yourself for what you are going to see and hear during a birth, but no amount of mental preparation gets you ready for the emotions you are about to experience."
"When people are in labor, things get very emotional," Moss said. "Again, it's a natural process, it's a hormonal process, but it is also huge, and it can bring up a lot of emotions for everybody."
Often, the birthing person can't help but let those feelings out, they added, but it can be helpful for the support person to do so as well.
"Let those emotions happen because they will only bring you all closer together, and it will only make the labor and delivery process more beautiful for everyone if we can feel those feelings and feel them together," Moss explained. "Sometimes the birthing person just starts crying, like, 'Oh, my God, I don't know if I can do this.' And having a partner cry with them, hold their hands and be like, 'Listen, I know it's scary, but we're going to get through it. We're going to have this baby and it's going to be amazing,' that in and of itself can be so healing for everybody."