Labor and Delivery Preparation: Partner Engagement and Physical Support
Often when we think about labor and delivery preparation, we only consider the birthing person. But there is so much support that a birth partner can provide. It is also important to remember that a birth partner WANTS to feel engaged and empowered during birth. Partners can play a vital role in pain modulation, mental support, advocacy, and planning and processing.
Rules of Labor
There are two primary “Rules of Labor” that I learned from my dear mentor Ann Croghan.
No talking during contractions.
Contractions are a time for the birthing person to stay centered, focused and in their body.
Between contractions in the appropriate time to check in in the following ways:
How does this position feel?
How was my hand placement?
How was my pressure?
Please drink some water.
It is important to note that this is also the appropriate time to gently recommend a position change. If a position has been sustained for > 1 hour and no dilation or progress has been made, it is time to change positions. However, sometimes making this transition can feel impossible to a person during childbirth, so be gentle and firm.
No creepy touch.
Any time we put our hands on a birthing person this touch should be firm and intentional.
No light stroking.
The remainder of this blog will be dedicated to how to place hands on a birthing person to help lessen their pain or optimize the outcome of their stage.
Brain Confusion
The best way to modulate pain during a contraction is to distract the brain away from the pain. The 2 best ways to do this are with deep pressure and joint approximation.
Deep pressure
This can happen anywhere on the body.
The best places to offer deep pressure is along the spine. This can be done in any position during labor or delivery.
See picture 1
Joint approximation
Pushing a bone into its socket, or bringing bones toward each other, will awaken the proprioceptors in that joint (the receptors that tell our brain where our body is in space) and take attention away from pain receptors.
Picture 2 demonstrates 1 hand on the scapula and the second hand bringing the upper arm bone into the socket.
Picture 3 shows birth parter in a wide stance, stabilizing the sacrum and leaning body weight into femur, pressing the thigh bone into the socket. (Good body mechanics for partner are KEY!)
Picture 4 demonstrates pelvic approximation in sidelying, pressing the top of the pelvis into the bottom. Picture 1 and 2 show this being performed as a hip squeeze using the knees.
Tailbone Mobilization
Pressing on the tailbone is a nice way to facilitate opening of the pelvic inlet (top of the pelvis) during labor, and the pelvic outlet (bottom of the pelvis) during delivery. Please refer to the previous blog post on labor vs. delivery positions.
During labor: the palm of a hand, skin-to-skin, should be placed on the sacrum, just below the underwear line. The tailbone should be drawn down as the birthing person tucks the tail and round the spine.
See Picture 5
During delivery: the palm of a hand, skin-to-skin, should be placed on the sacrum, just below the underwear line. The tailbone should be drawn up, toward the upper back, to open the pelvic outlet.
NOTE: This is an incredible release for back labor, or severe back pain during contractions.
See Picture 6
Hand Squeezing
Finally, it can be very helpful to have a birthing person squeeze your hands as hard as possible during contractions and pushes.
It is much harder to kegel when you are also putting energy into squeezing the hands.
You may also use one hand to squeeze, and the other hand to help facilitate leg position, especially if an epidural has been onboarded.
Note Picture 7
Stay connected
Personal connection is the best way to help the birthing person stay in the zone.
Skin to skin is an amazing tool.
Rocking, dancing, singing, anything rhythmic can be grounding.
Help them stay in their breath by breathing yourself.
