Just for Dads – History and High Expectations in Labor and Birth

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Farrah Sheehan Deselle, MSN, RN, CLC, CCE (BFW)

Childbirth and Parenting Preparation, Education and Support Program Coordinator

Catholic Medical Center

In my work with families I am impressed by the courage of men to show up and be the best they can be in birth.  I am equally impressed by the courage of some men who express reservation at the assumption of their role in labor and birth.  Most couples come to birth without questioning that the father-to-be will be the main support person.  They often come with high and frequently unspoken expectations about his role.   Our culture has not done much (OK, not really anything) to prepare men for labor and birth, and for many men today, they are the first or perhaps the second man in their entire lineage of men to accompany and support a woman during birth! This is a big deal!

But, in our culture of high expectations and massive information overload, what are the expectations of dads-to-be in labor and birth? Are they realistic? How did they come to be?  And ultimately, how can men bring the best of who they are to the experience of labor and birth, for themselves, their child and their partner?

When we consider human history and the participation of men in labor, it has really only been occurring for a blip of time, and does not happen in all cultures around the world.  In fact, it is a very western phenomenon.  So what happened to welcome men into the team of labor support today?  Early in the 1900’s most births were still happening in the home, attended by midwives, women friends, and family members.  Fathers were supporting the home in farms and through other labor.  As medicine made its way into the birth process, women began delivering babies in the hospital.  In the 1930’s, ½ of American babies were born in the hospital and by the late 1950’s it had reached 95%.  

Initially women were alone, often sedated and in labor wards with other laboring women.  This left them without the centuries old tradition of a circle of female support in labor, but did not replace it with any other type of physical or emotional support.  Fathers-to-be were literally not allowed to be present.  Eventually men and women began to speak up and out against this exclusion, and especially during the 1960s and 70’s changed what had become the hospital norm. Fathers began to be present for birth, and became the one support person a mother-to-be had in a sea of brand new relationships with health care professionals, and often a myriad of medical interventions.  

I imagine the need for a circle of love and support in labor and birth to be so deep that it is probably in our bones.  After all, this circle of support was a part of how women birthed for centuries.  As we have come to know more about the physiology of birth, we can understand why women need love and support during labor and birth.  When a woman feels loved and supported, safe and reassured, she releases oxytocin, the very hormone responsible to contract the uterus and move the baby from her body and into the world.  Notcoincidentally, oxytocin is also the hormone involved in the process of creating a child: when skin is on skin, during kissing, lovemaking and orgasm.  It is the hormone released during hugging, the verbal expression of love, and when two people feel safe and secure in each other’s presence (including a mother and her newborn child).  

Who better to be present in birth than the very person who helped create this baby, or if not the biological father, than a person who loves the mother and will support her through this initiation into motherhood? But over the past 60 years or so, the expectation of the role of fathers-to-be in the birth room has developed, alongside men’s roles in domestic matters like raising children and caretaking the home.  The expectations of men attending and participating in birth can vary by their partners, and themselves.  In my work, I often find the expectations to be very high; that he will be there for every moment, provide physical and emotional support; that he will navigate the complex world of health care; will tactfully communicate with family and friends about visitation; will hold down the home and the hearth during the hospital stay;  will provide updates to nervous and excited family and friends on social media; will be physically, emotionally and sometimes spiritually present for the first moments, hours, and days after birth, guided by intuition and autonomic skills for what is needed by both mother and babe.  Phew! All of this on 48 hours of no sleep (an unwished for but often true experience of childbirth).

The expectations are so high, that fathers sometimes feel enormous pressure and worry that they will not get it just right in birth; that they will disappoint their partner; or that they will freeze, will not know what to do in a particular moment. The love, support and decision making responsibility that was generally provided by a group of women who could share the roles, has shifted to one individual who has never been in birth before and who’s life and culture did nothing to intentionally prepare him for the intensity of the experience.   Furthermore, the world is much more complex than it was in the early 1900’s and birth comes with many more “decisions” and nuances for this one individual to navigate, even with the best health care team available.

Kevin McKenney, a new dad whose son was born at Catholic Medical Center (CMC) last year and who took a Preparation for Birth class said of his experience in birth, “the most difficult part for me was seeing my wife going through such a painful and difficult experience and feeling like I couldn't do enough to help.” Kevin said that preparing for birth by reading, taking the class and talking with his wife about labor and birth helped him offer her the love and support she needed even when he wasn’t exactly sure what to do. Christine, his wife, says “the feeling of his complete attention, love and support is what got me through it all.”   Kevin says, “It did feel good to know that I was able to help her and that my role was both helpful and meaningful.”

One of the beautiful things about birth – and life – is that when we peel away all the layers of expectations and beliefs about the way birth should be we are left with the love and support that each and every moment needs.  We are left with the love that each moment offers us the opportunity to express. Indeed, this is the very medicine needed in birth.  What a man, what a father-to-be, has to offer the laboring woman, whom he loves, is precisely his presence and his love.  What he has to offer himself is a knowing that his love is just what she needs, even when he doesn’t know exactly what to do.  

As a dad-to-be, what can you do to help prepare yourself for labor and birth?

Talk with your partner about her expectations of you and share your expectations of yourself with her?

Talk with your partner about any worries you have about your role? And find out what her worries are.  Remember this is new for both of you.

Talk with other men in your life about what surprised them the most about birth, about themselves in birth?  

Learn about what women need in labor and birth by taking a class that helps you build your birth support tool box or reading about labor support (Birthing From Within by Pam England has a fantastic labor support chapter), or by talking to a woman who has given birth with a supportive partner. 

Practice supporting your partner before labor, by offering touch, massage and words of encouragement and support techniques to see what she likes.

Encourage and support her through words or actions when she is doing something to prepare for birth (like taking yoga, or practicing positions for birth)

Build your own coping strategies for the tough moments of labor and birth, by practicing breath work, mindfulness, or connecting with your partner and baby through touch or just being near each other.  

Check in with your partner about additional labor support for both of you, such as a doula, or if labor is very long (such as with an induction), a trusted family member or friend who can relieve you for a break without having to leave your partner alone.

Visit the hospital where you will give birth and ask about their expectations of your role as a labor support person.  With your partner, communicate your expectations of your role to the birth team.

At The Mom’s Place, our classes are developed using the Birthing From Within model (BFW) preparing parents in the body, mind and heart for the full range of childbirth experiences.  Our childbirth educators are nurses who work at The Mom’s Place and in our Special Care Nursery and have received training as BFW mentors.  If you want to learn more about our offerings or schedule a welcome visit, call (603) 626-2626 or check out our website www.catholicmedicalcenter.org/moms-place. 

Farrah Deselle is a Certified Birthing From Within Mentor and coordinator of Childbirth and Parenting Preparation, Education and Support Programs at The Mom’s Place at CMC. She teaches many of the classes and works at The Mom’s Place as a lactation consultant. She has a Master’s of Science in Nursing: Health Systems Leadership. Contact Farrah at: farrah.deselle@cmc-nh.org.