Jan
20th

THE ROLE of COACHES in HOSPITAL DELIVERY of BABY

Files under Pre-birth | Posted by admin

Since the time my daughter delivered our first Grandchild, I have realized that things have not really changed very much since she was born! Birth is still birth!

 It is still necessary and truly helpful to attend good, recommended prenatal classes for both you and for your spouse. If your spouse is reluctant to be present at the birth of your baby, ask trustworthy family member or friend to act in the role of Coach for you during the labor and birth of your baby and to attend the classes with you! Information is a valuable and necessary tool to a new “mother and father to be” and is available through your Public Health Unit as well as through advertised private birthing classes.

 The different experiences or problems couples have shared together can be resolved through a problem solving approach with the help of other moms, Professionals and research on the Internet or in published articles. But there

can be some unanticipated problems that are not prepared for in advance as the parents may be unaware that there is a problem.

 Coaching versus Visiting is one of the sensitive problems you may encounter. As an RN, a Mother and now a Grandmother, I was asked to be present as a Coach at my Granddaughter’s birth. My son-in-law and I worked tirelessly to make our “mom to be” as comfortable as possible, wanting to be able to help more but at times being at a loss as to what to do except just be there for her. This was a first baby. Having a baby is hard work! The second time around, you will know what to expect, what worked for you and how you will react to the experience.

 I admit that I felt very fortunate that I had been an RN on the birth of our first baby, although, when the baby is your own, it can be a little difficult to be objective! I was privileged to be present during the birth of my Granddaughter, with Daddy, as part of the Coaching Team, just in case I was needed to help Daddy out if he felt squeamish, and I must admit it was a thrilling experience! By the way, Daddy did an absolutely great job! And he did the right thing by admitting he was squeamish!

 When my babies were born (at that time we were taken to a delivery room from the labor room), my husband sat in the corner of the delivery room feeling ill and miserable while I anxiously watched him while trying to push our baby into the world with no Coach there for me except the Nurse and Doctor. He was helpful during the labor, however, and he had gone to prenatal classes with me, but some people just don’t have the “stomach” for certain experiences and I wish I had been able to have had another Coach there for support! An alternate “just in case” is truly a wonderful opportunity to be given, as none of us know how we will react to given situations and even repetitive experience can fail to reverse this problem.

 My husband felt terrible. I felt badly I had put him through the reaction but at the same time, I had no choice but to go through with the job at hand. That was the reality! He had missed a couple of prenatal classes and one was the film of a woman giving birth. Daddy needs to be prepared but he needs support too. That’s where an alternate Coach is a real bonus.

 The Mother-to-be is asked, prior to the birth of the baby by the Hospital, to register 2 people to be with her as Coaches, in the area in where we reside. This does not mean that if one of the Registered Coaches leaves the room, that another Unregistered person can take the place of the Registered Coach. This rule is made by Hospitals for a reason and ensures that the Mom has privacy without having to worry that another family member or friend is going to visit her during her labor.

 She is generally not at her best! She is working hard and she does not need visitors or spectators while she is doing her hard work. The last thing an expectant mom is labor needs is to have someone she does not want to see in the room. Her dignity is pretty much gone by the time she enters the hospital and she needs that last little piece of control to preserve what dignity she has left! Her backside may be exposed, she may be vomiting or trying to sleep or she may be undergoing an exam to check her cervix! She may be having a catheter inserted, she may be crying and she may be bitchy! She is trying to concentrate on her breathing to control the pain that is a natural part of childbirth.

 It is the job of the Coaches to advise family and friends of the Hospital Rule and to insure that the rule is maintained. My daughter had asked me in advance to promise her I would not to allow anyone into her room with the exception of her husband and myself. This is not always an easy task, as on occasion, people who are anxious and care about the mom wish to offer their emotional support and attempt to come down to the room unaware of the Hospital rules.

Coaches are warned by Hospital staff that the Hospital has a policy which the Coaches are responsible to insure. The Nurses are busy on an L&D floor and want the hallway free to allow Moms to walk while they are in labor and to transport babies being carried from birthing rooms to the Nursery to be safe from infection.  Mom is at risk for infection once her water breaks, and the minimum number of people in the room, good hand washing and doing exactly as told when the Nurse asks for assistance to help her when a sterile procedure is required. The Coaches are there to work, not to be spectators. The birthing rooms are not large and in the case of an Emergency, too many people in the room could prohibit staff from being able to do their job.

People who choose to wait 12 hrs in an uncomfortable Waiting Room would actually be better off staying at home in comfort and waiting for a phone call. In the event that people wish to stay in the Waiting Room, one Coach should go to the Waiting Room often, to update the anxious supporters, at least every half hour to hour to report on her progress and reassure family and friends that everything is going well. Again, this is a big help to the busy nurses who may not even have your Mom as their patient  and may not be aware of your mom’s status should a family member or friend come to the Nursing Station. Protect the mom from anxiety and embarrassment! That is another part of your job as a Coach.

The Coaches both need to attend Prenatal Classes with the “mom-to-be” or have the knowledge and experience to be a productive support to the mom and not be there as a Spectator. Being a Coach is hard work!

 The Coach needs to be knowledgeable, patient and willing to administer endless backrubs, massages and hold the mom as she wretches over the toilet.

Mom will make the choice to agree any medication offered to her during childbirth. This choice is totally hers to make. There are medications available that will not hurt the baby and will not cross the placental barrier. Mom will probably be offered an injection of Demerol and Gravol to assist her with pain and nausea. This injection works especially well if Mom sits in a warm shower following the injection. One of her Coaches will need to be with her should she feel drowsy. My daughter could have sat there in the shower for hours!

Should the Mom opt to have an Epidural Anesthesia to give birth, Mom will need to be restrained by a Coach for the epidural needle insertion during an Epidural block, just in case she has a contraction, which is likely at that point. My son-in-Law could not “do the needle thing” and that was fine. I was the Coach with my daughter while the Epidural needle was inserted, holding her in a fetal position and not allowing her to move.

 The Mom should have an idea if she wants to have an epidural before giving birth, but not be afraid to change her mind should the labor be more than what she anticipated to be able to handle. Keep an open mind when you go into hospital. It is ok to decide you DO want one. No one is going to point to you as you walk out of the Hospital and say,” That’s the woman who didn’t have an epidural!!!”

My daughter was not going to have an epidural either, but I recommended that she keep an open mind, just in case. It would be her choice and hers only. She was afraid of the side effects of an epidural; that she would be paralyzed. This can happen but is very rare. The important thing to remember is that you MUST NOT MOVE even if you are having a contraction when the Epidural is inserted and the Coach holding you must hold you in place, with encouragement and talk you through the contraction with reminders you must not move. The Anesthetist will talk to both Mom and Dad prior to inserting an Epidural and will speak to you of side effects and answer any questions you might have.

 Once the Epidural is taking effect you cannot get out of bed as you will have no feeling in your legs. You will be catheterized to pass urine but you won’t even feel that. You may feel a sense of pressure when you need to void and your Coach will let a Nurse know. In some cases an Epidural is not as effective as hoped but it still helps the mom to withstand the pain of delivery.

 My daughter decided that she would have an epidural when she was about 2-3cm dilated as she was tired and vomiting and having difficulty coping with the pain. This was a little early as an epidural can slow down the contractions, but the Staff was made aware she wanted to have one…a change of heart. A drug to increase the contractions while you have the epidural in place may be used to stimulate the contractions that move the baby down the birth canal, but you will not usually feel them with an epidural, except for pressure in your abdomen. If you do start to feel pain, let your Nurse know. The medication with the Epidural is a continuous drip but sometimes an occasional extra bolus may be required. My daughter would not hesitate to have another one next time!

 I, myself had an epidural with my first child which worked so well I was awakened to deliver our baby! However, I was too far dilated with our second child and there was no time for an Epidural. I was given a gas mask to inhale blessed “laughing gas” and ended up with a bruise on the bridge of my nose as I refused to give the mask up even after the delivery and had it held tightly against my face to the point it was wrestled away, finally! Unfortunately, today, this is not generally an option due to fear that the baby will be sleepy after birth.

 The Coaches will also have the responsibility to hold Mom up in the bed at her legs and back so that she can push more effectively once the baby has moved far enough down into the birth canal to be pushed out. The Doctor is seated at the foot of the bed with a Nurse in attendance. The Mom is offered a mirror to be set up at the bottom of the bed so that she can watch the birth of her child.

 My daughter politely declined as all she wanted to do at that moment was “get the baby out!” Once she had pushed the baby’s head out, I asked my daughter if she would like to look down to see her baby and she reacted with amazement at the tiny head and face and renewed her pushing with a renewed vigor! The remainder of our little girl was out in no time!

 Everyone in the room is full of awe and wonder as the baby is placed in the Mother’s or Father’s arms! It is a very emotional moment. A moment of pride, joy and love! A wonderful time to capture this treasured occasion on film.

The baby is then taken by the Nurse to be weighed and cleaned up and drops are instilled into the baby’s eyes. The mother knows she has done a good job and the Coaches are happy they could be of such help! What a high there is in that room!

Once the Nurses give the ok, the friends and relatives in the waiting room are allowed into the room to see the baby. In some hospitals, due to infection control issues, this is not allowed until the Mom is comfortably settled into her own room with her baby.

Usually Dad will be the primary Coach but do consider an alternate Coach in addition. Both Mom and Dad need support during this very exciting time and I was truly exhilarated to be a working part of my Granddaughter’s birth and shall never forget it!

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