Hypnobirthing, a little for the birth partner

A hypnobirthing birth partner supports the mother by understanding what happens during labour, knowing her birth preferences and becoming familiar with the hypnobirthing techniques she has practised. Learning about the stages of labour can also help a birth partner understand changes in the mother’s behaviour and know how to support her as labour progresses.

 

If you are the birth partner, understanding what labour may feel like can make it much easier to know how to help. Hypnobirthing often focuses on the person giving birth, although the birth partner has an important role in supporting the environment around them. The more you understand about what is happening during labour, and what the mother may need from you as it progresses, the easier it becomes to support her without continually asking what she needs.

 

One way I describe the first stage of labour is to imagine running up a long, steep hill when you cannot see the top.

 

You know you are going uphill and you know that eventually you will reach the summit, but you have no way of knowing exactly how far away it is. You have prepared for the run and you know what your body can do, yet the uncertainty around how long you will need to keep going adds another demand to an already physically demanding experience.

The First Stage

The first stage of labour can feel similar. The body is working hard as contractions gradually change the cervix, and the mother has to continue through each contraction without knowing exactly how long this stage will last. Even when labour is progressing normally, there is no countdown telling her how many contractions remain.

 

As the birth partner, it can help to really imagine yourself on that hill. Think about what you would need from the person beside you while you were using considerable physical and mental energy and had no idea how much further you had to go. Their presence, behaviour and communication could affect how manageable that experience felt.

 

This is one of the reasons I encourage birth partners to learn about hypnobirthing alongside the mother. When you understand what she is doing and why, you can recognise when she is deeply focused, help maintain the environment she has prepared for labour and become a useful part of her hypnobirthing practice long before labour begins.

 

 

 

The 4 Cs of Mental Toughness

In their work on mental toughness, Peter Clough, Keith Earle and David Sewell described a model based around four components: control, commitment, challenge and confidence. Although the model did not originate in hypnobirthing, I think these four ideas provide a useful way for a birth partner to think about their role during pregnancy and labour.

 

Commitment

 

For the birth partner, commitment means understanding what the mother wants for her birth and taking those preferences seriously.

 

Talk about the birth before labour begins. Learn why particular things matter to her and understand the hypnobirthing techniques she intends to use. If she has spent pregnancy practising breathing, relaxation or hypnosis, practise with her occasionally so that you recognise what she is doing when labour begins.

 

This preparation also means that you are less likely to need instructions from her at a point when she may want to turn her attention inwards and concentrate on labour.

 

Control

 

Birth contains plenty that neither of you can control, so it helps to understand the areas where you can have some influence.

 

During pregnancy, become familiar with the mother’s birth preferences and ask questions when you do not understand something. During labour, you can help communicate those preferences to the maternity team, ask for explanations when they are needed and give the mother the space to consider her options.

 

You can also take responsibility for practical aspects of the birth environment. If the mother knows that you understand what matters to her, she has one less thing demanding her attention while her body is working through labour.

 

Challenge

 

Clough’s model includes the way we perceive and respond to challenge. This feels particularly relevant to the hill analogy I described above.

 

Labour asks a lot of the body, and the uncertainty around how long it will continue can add to that demand. As the birth partner, you can help keep the immediate experience manageable. You do not need to continually remind the mother how much further she has to go or encourage her to think ahead to the baby. Often your role is to understand where she is now and help her continue using the hypnobirthing techniques she has practised.

 

Confidence

 

Your confidence matters too.

 

If you understand the physiology of labour, know the mother’s preferences and have practised hypnobirthing with her, you are more likely to feel comfortable in the birth room. That confidence can influence the way you speak, respond and communicate with the people around you.

 

You also know the mother in a way that the medical professionals in the room may not. You know how she communicates when she feels comfortable, what tends to help when she feels overwhelmed and how she likes you to support her. Bringing that knowledge into the birth room is an important part of being a hypnobirthing birth partner.

 

 

During Birth

Throughout the first stage of labour, the mother can use her hypnobirthing techniques alongside her understanding of what her body is doing to keep moving up that hill. As she reaches the end of the first stage, she enters the phase commonly known as transition.

 

Transition happens as the cervix approaches full dilation, shortly before the second stage of labour begins. For some women, this can feel like an intense point emotionally as well as physically. She has already worked incredibly hard and is getting close to the point where her baby will be born, while her body is still asking her to continue.

 

I remember a similar feeling when I ran the London Marathon. When I saw the 26-mile marker, I knew I was almost there. I could see the finish and knew I was only minutes away from it, yet I still had 0.2 miles to run. At that moment, those final 0.2 miles felt extraordinarily long. My body had already covered 26 miles and seeing how close I was to the end made me acutely aware that I had not quite reached it.

 

This is how I like to imagine transition. The mother has climbed almost all of the hill and the top is finally close enough to see. She may feel emotional, tired or unsure whether she can continue. If this happens, it can help the birth partner to understand that this change may be part of labour progressing. Your familiarity with the stages of labour can help you remain calm while she concentrates on what her body is doing.

The Second Stage

Once the cervix reaches full dilation, the second stage of labour begins. This is the stage in which the baby moves down through the birth canal and is born. The experience varies considerably between women and between births, but knowing that labour does not necessarily become steadily more difficult with every stage can be useful for both of you.

 

Eventually, you reach the top of the hill together and the baby is born.

 

There is still one more stage of labour. During the third stage, the uterus continues to contract and the placenta separates from the wall of the uterus and is delivered. Your role as birth partner continues here too, while the mother meets her baby and her body completes the final stage of birth.

 

 

What are the three stages of labour?

 

The hill gives you a way to imagine what labour can feel like. It is also useful for a hypnobirthing birth partner to understand what is physically happening during each of the three stages of labour.

 

The first stage of labour

 

During the first stage of labour, contractions help the cervix to soften, thin and open so that the baby can eventually move through it. The thinning and shortening of the cervix is called effacement, while its opening is called dilation.

 

Before labour, the cervix is relatively long and closed. As labour progresses, it becomes shorter and thinner and gradually opens. In a first pregnancy, the cervix will often begin to soften and thin before significant dilation takes place, although every labour follows its own pattern.

 

As labour becomes established, contractions usually become stronger and more regular and the cervix continues to dilate. Full dilation is approximately 10 cm.

 

Towards the end of the first stage, some women experience what we commonly call transition. This is the period I described in the hill analogy above. Contractions may feel particularly intense and the mother may experience changes in how she feels or behaves as her body approaches the second stage of labour.

 

The second stage of labour

 

The second stage begins when the cervix is fully dilated and ends with the birth of the baby.

 

During this stage, the baby moves down through the pelvis and birth canal. The mother may feel an urge to push as the baby descends, although this experience varies and there can also be a period after full dilation before active pushing begins.

 

Eventually, the baby is born and you have reached the top of our metaphorical hill.

 

The third stage of labour

 

The third stage begins after the baby is born and ends with the birth of the placenta.

 

The uterus continues to contract, helping the placenta separate from the wall of the uterus so that it can be delivered. There are different ways of managing the third stage, and your midwife or doctor should discuss the available options with you during pregnancy or labour.

 

Understanding these three stages gives the birth partner a clearer idea of what the mother’s body is doing throughout labour. When you understand the physiology behind what you are seeing, it becomes easier to recognise where she may be in the process and to support the hypnobirthing techniques and birth preferences you have prepared together.

 

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Reference: Clough, P. J., Earle, K., & Sewell, D. (2002). Mental toughness: The concept and its measurement. In I. Cockerill (Ed.), Solutions in Sport Psychology (pp. 32–43). London: Thomson.