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Info Centre - Supporting labour and birth

Supporting labour and birth

In the last 100 years, the culture of giving birth has changed dramatically. Women no longer always have one-to-one support from midwives who they can get to know, and who can give them continuous care during their pregnancy and birth. This can affect women’s confidence in their ability to give birth and is often a reason why birth support is invaluable.

Birth supporters however can be the constant presence which many women find invaluable. A birth supporter is someone who is on hand during the birth of your baby to give you anything you need – encouraging words, sips of water or maybe a snack, or just a quiet, comforting presence. They can also support you physically – massaging your shoulders (although during the birth, some women may decide they don’t want to be touched) or helping you into positions that you have practised in the lead up to the birth, reminding you to breathe slowly and calmly through contractions. They are on hand to listen and support you if you need to make decisions in labour; and they can ask your midwife questions to help clarify your options at a time when you may be pre-occupied with labour.

Who can be a birth supporter?

Fathers

Around 97% of fathers are now present at the birth of their children – a complete turnaround from the position 40 years ago, when fathers were not welcome in delivery rooms and often paced the corridors instead.

The vast majority of men describe being at their child’s birth as one of the most moving moments of their life. But it’s not like that for everyone and some men can feel concerned about being their partner’s only supporter. Equally, some women are concerned about their partner being there. Some don’t want their partners seeing them go through labour; others are worried about how their partner will cope. It is important to remember that there are alternative ways of being supported.

Generally, you can have more than one birth partner present for a vaginal birth (there may be restrictions if you are having a caesarean). Having two birth partners can ease the pressure on each of them – enabling them to go to the loo or take a break without leaving you alone.

Family members or friends

Women have supported other women during birth for thousands of years. For example, you could ask your mother or mother-in-law, sister, or a good friend (maybe one who has given birth herself) to support you. Whoever you choose, you need to know them well enough to feel really comfortable with them. Anyone who makes you feel edgy just won’t do. Professionally, you could choose an independent midwife or a doula.

Independent midwives

Independent midwives are usually self-employed and work alongside, but not as part of, the NHS. An independent midwife can provide all your antenatal and postnatal care, as well as being there for the birth. Most work with one other colleague or in small group practices to ensure that you always see just the same small number of familiar midwives throughout your care. They usually specialise in attending home births, but a few also have access to provide midwifery care in NHS hospitals, and most would accompany you into hospital as a supporter if you planned a home birth but needed hospital care during labour. The charges for their services vary from around £2,500 to £5,000. This sounds like a lot of money, but for the time they invest in your care, it’s not a lot for them to earn. See "Choosing an independent midwife" for more information.

Doulas

There are two types of doula – birth and postnatal – and some cover both areas.

A birth doula is there to offer physical and emotional support to you (and your partner) during labour and for your birth. They don’t do anything medical but are a continuous, reassuring presence. Most (but not all) doulas are mothers themselves and may or may not have done additional training. Those recognised by Doula UK will have completed an approved training course and will have de-briefed and reflected on what birth means for them. A birth doula will usually cost between £200 and £600. Postnatal doulas are there to support you at home after the birth – ‘mothering the mother’ so you can mother your baby.

Birth companions

The NCT will begin training specialist workers from autumn 2009 and will launch a new birth companions service in June 2010.

All NCT specialist workers will be allowed to train as a birth companions (who will perform a similar role to a doula, but concentrating on the period immediately around the birth) with some additional requirements for breastfeeding counsellors and postnatal leaders.  

The new service will be available for a fee for couples/mothers; it will also be available free of charge from maternity units who want a birth companion to support women from disadvantaged groups or those with special needs during labour and birth.

Whoever you choose to support you at your baby’s birth, it is important to remember that it’s your decision and that you will benefit from feeling as relaxed and confident as possible.

Thinking about your labour

What support would you like to have, and who would you like to have with you? Who will make you feel secure, relaxed and confident enough to concentrate fully on working through your labour?

These are the kinds of questions it may be worthwhile discussing openly and honestly with your partner. If either of you have any concerns, discuss the options, such as having a close friend, family member or doula to provide you with additional support.

Discuss also the kind of things you would and would not like your birth partner to do; the interventions you would consider and any fears or concerns that either of you have. Talking about these beforehand will help you to make decisions and avoid misunderstandings or underlying tensions during the birth.

This is a good excuse to spend time together. You can prepare for the birth by learning and practicing different techniques such as massage, visualisation, relaxation and breathing. Valuable advice and practical skills can also be gained from attending classes, such as the NCT’s classes, or active birth and antenatal yoga classes.

Tips for birth supporters 

  • Be aware of what is happening
  • Your confidence in the birth process will make an enormous difference 
  • Ensure a calm and comfortable environment conducive to the birthing process, dim the lights, play music, discourage unnecessary interruptions  
  • Be practical – is she really comfortable? How about a pillow under her head or knees? Can she reach her water bottle?  
  • Don’t talk too much during labour as she needs to focus.
  • Stay calm and keep your voice low to avoid disturbing her.
  • Understand the importance of being upright during labour and provide her with support to do so, such as holding her while she leans against you.  
  • Help her to cope with the pain by focusing on her breathing during contractions 
  • Tell her how well she is doing. Loving encouragement is what she needs now.
  • Accept her pain. Seeing somebody you love in pain is very difficult and it is very natural to want to stop the pain. Try to understand that in labour this response is not necessarily appropriate or even possible. 
  • Respect her. Tell her what is going on and if something is not going as planned, explain clearly what the staff recommend to sort it out. Remember that her consent is needed for every aspect of her care and treatment. 
  • Look after yourself. Take a short break every hour.

Support and further information

Those supporting a woman in labour might like to read ‘Guide to Labour'.

The NCT’s publication, ‘Happy Birth Day’, is a book that will instil confidence in every expectant mother, and help her to make the right choices for her throughout her pregnancy and birth. It is available from http://www.nctshop.co.uk/ for £16.99 or call 0845 8100 100.

To make contact with an independent midwife, call the Independent Midwives Association on 01483 821 104 or visit their website at http://www.independentmidwives.org.uk/ 

Doula UK (PO Box 26678, London, N14 4WB; http://www.doula.org.uk/ ) is the biggest network of doulas in the country, though there are a number of smaller organisations who may also be able to put you in touch with a doula.   


Page lasted updated 2009.