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A childbirth cheat sheet for dads-to-be

by JD Lasica Reviewed by the BabyCenter Medical Advisory Board

En espaol

One of the best ways to prepare for childbirth an eye-opening experience for most of us is to accompany your wife or partner to a childbirth education class. Almost all hospitals and birth centers hold sessions, and parents are usually given the option of attending two or three short evening sessions or one long daytime session. For me, the class was a great introduction to the big event, still several weeks off for us. We decided to attend a one-day childbirth preparation class at our hospital (Alta Bates in Berkeley, California) rather than attend an offsite class, where the emphasis is more likely to be on natural childbirth. I'll confess up front that I thought 80 percent of the class would be about breathing exercises. Not quite. We immediately hit it off with our instructor, Janaki Costello, a certified doula, childbirth educator, and board-certified lactation consultant. Here are the ten key lessons she passed along: 1. Recognize the onset of true labor Late in their pregnancy, most women will experience false labor Braxton Hicks contractions that may start out strong but taper off and then stop after a while. Look for these signs, among others, that your wife is experiencing the real deal: Her water may break, resulting in a trickle or a gush of fluid. When the amniotic sac (also called the bag of waters) breaks, 80 percent of women will spontaneously go into labor within 12 hours. Keep in mind, though, that contractions usually start before her water breaks. Persistent lower back pain, especially if your partner also complains about a crampy, premenstrual feeling. Contractions that occur at regular and increasingly shorter intervals and become longer and stronger in intensity. She passes the mucus plug, which blocks the cervix. This isn't necessarily a sign that labor is imminent it could still be several days away but, at the very least, it indicates that things are moving. 2. Know how to time the contractions Make sure your watch has a readable second hand, and time your wife's contractions from the beginning of one contraction to the beginning of the next. If they're eight to 10 minutes apart and last 30 to 45 seconds each, your partner is likely in early labor. Your doctor or midwife can help you make the decision over the phone about when to come in. As a general rule-of-thumb, if the contractions are less than five minutes apart, last a minute or more, and continue in that pattern for an hour, you should get to the hospital. But some situations call for getting to the hospital sooner, so be sure to talk to your caregiver ahead of time about what's right for you. 3. Don't get to the hospital too early Costello hit us over the head with this admonition: Don't head to the hospital the minute your partner goes into labor. If she's dilated to only 1 centimeter, chances are they'll send you home because you have a good ways to go. "Take a walk, go to the mall or a museum, hit the beach, catch a movie anything to help you take your mind off the contractions," Costello said. "Try not to fixate on the clock. If it happens at night, try to get back to sleep for a few hours." Easier said than done, says my wife. 4. Know what to expect during labor Forget those TV sitcom images where a woman goes into labor and a baby pops out by the second commercial. It sometimes happens that fast, but only rarely. For most, especially first-time mothers, labor is a journey, not an event. Bottom line: Don't expect this will be over in just a few hours. Every woman's experience is different, but it's helpful to understand that there are three distinct stages of labor:

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First stage The first stage really consists of three phases: Early phase. This phase typically lasts up to 14 hours or longer, although it's usually considerably shorter for second and subsequent babies. As labor progresses, the contractions get longer and stronger. Active phase. Often this phase lasts up to six or more hours, although it can be a lot shorter. You should be in the hospital or birth center by now or en route. Contractions are much more intense, last about 40 to 60 seconds, and are spaced 3 to 5 minutes apart. Breathing exercises, relaxation techniques, and coaching are all important now. If your partner is having trouble coping or she's not interested in a drug-free labor, this is when she might opt for an epidural or other pain relief. Transition phase. This phase can last anywhere from a few minutes to a several hours. It's here that your partner is most likely to swear at you like a truck driver. (Don't take it personally; even women who have coped well up to this point often "lose it" during the transition phase.) Contractions last 60 to 90 seconds and come two or three minutes apart. Second stage Pushing and birth. The second stage can last from minutes to hours the average is about an hour for a first-time pregnancy (longer if she's had an epidural) and ends with a moment that's made up in equal parts of relief and breathtaking beauty: the birth of your baby. There's a lot to think about during this phase: Do you want to record the birth on video? Will you want to cut the cord? (Be sure to remind your doctor or midwife if you do.) Does your partner want to try to breastfeed immediately after birth? If the doctor or midwife or labor and delivery nurse doesn't make sure that happens, you'll need to be ready to advocate for her. Third stage Delivery of the placenta. It's not over yet! This stage, which begins immediately after the birth of your baby and ends with the delivery of the placenta anywhere from one to 30 minutes later, is usually anticlimactic but necessary. Be aware, too, that your partner may get a case of the chills during this phase or feel very shaky. If that's the case, be ready to offer a warm blanket and to hold your newborn while she's regaining her strength. 5. Be an active participant Costello looked at the half-dozen expectant fathers around the table. "Remember, dads, it's your baby, too. You're a critical part of the process." In the days and weeks before your baby's due date, make sure both you and your wife are packed for the hospital, including a possible change of clothes, toiletries, and camera or camcorder, and other essentials. If you have a birth plan, you may need to let the labor and delivery nurses know about it (you should have already discussed it with your doctor or midwife). During early labor, remind your partner to drink plenty of liquids. Pour her a glass of nonacidic juice such as apple juice or pineapple juice, honey and water, an herbal tea, or just plain water to ward off dehydration. Offer her a bagel, yogurt, or something bland she might not get anything solid to eat at the hospital for many hours after the baby's birth. Finish packing. When you head to the hospital, drive carefully. This isn't the time for taking unnecessary chances. When you get to the labor room, stick around to provide comfort and support. "The transition stage is not the time to head out for a long lunch," Costello advised. Feel free to bring fruit or other snacks along if it's in the middle of the night. 6. Be an advocate for your partner The doctor or midwife and nurses are there to make sure your partner and baby do well during labor and birth. But you have a big role in helping your partner get comfortable and in communicating her wishes. You and she also have a big say in personalizing your room. When it's time to rest, soften the lighting. Freshen the smell by taking along aromatherapy balls, potpourri, or scented oils. Bring pictures and your own music. I found a portable CD player in the garage and packed some of my wife's favorite CDs. 7. Know how to play coach Take your cues from your partner. Some women love having a massage or having their hair stroked during labor. Others don't. And it may be hard to predict ahead of time what your partner will prefer. In any case, try to reassure her that she's doing fine and be ready to help in any way she asks. See more tips on how to be a great labor coach. 8. Be prepared

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We watched two videos of vaginal births and one of a c-section. All showed the messy, unglamorous side of labor. Don't be surprised if your baby's skin looks wrinkled or his head is molded into a cone shape, and, in truth, he doesn't even look like a baby. 9. Cut the cord if you want Today, most dads choose to cut the baby's umbilical cord in the first minutes after birth. "It's your right, but sometimes they forget," Costello said, "so make sure you remind your doctor or midwife." 10. Read further Costello recommended several books: The Birth Book (Little, Brown, 1994) by William and Martha Sears; Sheila Kitzinger's The Complete Book of Pregnancy and Childbirth (Knopf, 1985); Carl Jones's Mind Over Labor (Penguin, 1987); and Pregnancy, Childbirth, and the Newborn: The Complete Guide (Meadowbrook Press, 1991) by Penny Simkin, Janet Whalley, and Ann Keppler. And there's no substitute for exchanging questions or swapping tales with other moms-to-be and expectant fathers. The BabyCenter Community brings together expectant mothers by due date and provides a place for expectant dads to hang out. Contributing writer Joseph D. Lasica lives with his wife and baby in the San Francisco Bay Area.

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