Birth from the father's perspective

Many new moms share their birth stories online, for others to learn from, for support, or for any number of other reasons. I haven't seen many new dads do the same thing, but I think we should. Childbirth is obviously primarily the birthing parent's experience, but for birth partners it can be stressful and difficult so it would be valuable to have more stories from their perspective. If more fathers share their experience as the support person for a birth, we can build a body of knowledge for other new dads to learn from and normalize talking about the whole range of experiences we have during the birth of our children. In this post, I share, with my wife's permission, my perspective on the story of our son's birth.

My wife Megan^[1] and I were both apprehensive about birth, between the physical pain for her and the many unknowns involved, so we wanted to be as prepared as possible. The OB practice she went to offered a group prenatal care program run by a couple of the midwives which combined regular pregnancy visits with education around pregnancy, childbirth, and newborn care. It was a great program based on March of Dimes' Supportive Pregnancy Care. I knew I needed to be prepared for labor and birth so I could support my wife in an active way, so when the midwives facilitating the group sessions recommended The Birth Partner, I ordered it the same day and started reading. This book is one of the best resources I have ever read. It is so densely packed with information but still approachable and easy to read. It helped me understand what's normal in labor and ways to support my partner in labor along with common issues and interventions. After reading it and going through the childbirth education I felt as prepared as I could going into the big event.

Megan's birth plan, informally, was to aim for a low intervention birth. Knowing interventions beget interventions, the goal was to labor at home as long as possible before going to the hospital and trying to use pain management techniques as long as they were still effective. She was open to an epidural, but wanted to delay it as long as she could. My role in this plan was to assist with pain management by helping with supportive positions, rhythmic breathing, and talking through the plan as labor progressed.I did as much learning as I could to prepare for this role and we were both feeling reasonably confident.

As far as low-intervention goes, nothing about our son's birth went according to plan. Her water broke in the early morning around ten days out from the baby's due date. I frantically finished some tasks getting the nursery ready and did some last minute cleaning before we called the OB's office for instructions. Because contractions hadn't started yet, they wanted us to wait at home to see if labor progressed during the day and to call again after 12 hours. We both worked a full day, which was just surreal. It felt like everything was happening and the baby was coming and I needed to finish transition plans to be out on leave, but at the same time there really wasn't much going on. My wife had a few contractions during the day, but nothing consistent or progressing. As we neared the end of the work day 12 hours had passed, we called again, and were instructed to come into the hospital for her to be checked out.

The difficult thing with the water breaking before contractions start is it's the wrong order. Once the water breaks, there's a higher risk of infection which gets worse the longer you go before the baby is born. Because of this, the water breaking starts a timer in most practices which, if labor doesn't progress on its own, ends in induction. We got to the hospital and in triage they confirmed her water had broken and we were being admitted for an induction. Although this was the expected outcome and we'd had the whole day to get used to the idea, it was still a disappointment. For me, the issue was the immediate departure from the labor and birth she wanted. Our plan went out the window and we had to adapt. Right after we got into the labor and deilvery room, they started her on misoprostal (also called cytotec), which is used to ripen the cervix before starting pitocin to move contractions along. She started on that and we tried to get a little bit of sleep before labor progressed more.

We did not get much sleep because contractions started getting stronger and coming more frequently. We were ready to manage them with rhythmic breathing, counterpressure, slow dancing, and pacing back and forth across the room. Through this stage, I felt pretty good. I was tired and I knew we had many hours to go, but I was remembering what I needed to do, she was managing the pain well, and it felt like labor was progressing. We wanted to avoid the pitocin as long as possible in the hope the misoprostal would be enough to get labor going because pitocin often causes contractions to ramp up much faster and become stronger than they would from an unaugmented progression of labor. This makes them significantly more painful and can be more difficult for the baby to tolerate. The doctor decided against a second dose of misoprostal and to start pitocin. She was okay with us pushing it off another hour to see if contractions sped up on their own, but unfortunately that didn't happen and the timer had run out; we needed to start pitocin.

We had heard pitocin would make contractions more painful, but it was something else entirely for her to experience and me to witness. The difference was immediate and it was massive. The pain management techniques we were using suddenly didn't touch the pain she was feeling and the contractions got so much closer together so she never got a real break. After the first few contractions, the pain got so bad she started crying during the ramp-up on each one. Watching the person I love the most in the world in so much pain and knowing I couldn't do anything about it was one of the most difficult things I've ever experienced. When she cried out I couldn't help crying myself but I knew I couldn't let her see that. I was her support person and I needed to project calm and confidence so she knew I had her back. I didn't want seeing me breaking down to make her lose her strength, so when I started crying I turned my head away so she wouldn't see.

She had been open to getting an epidural when she needed it, and the pitocin contractions made it abundantly clear that she needed it. It was the middle of the night, labor was not progressing quickly, and she needed to get some sleep to avoid exhaustion and burning out. We talked and she decided to try to push through two more contractions before making the call, and in the end made the call to get an epidural. The anesthesiologist came maybe 20 minutes later to get the epidural placed. It's important to sit still while the it's being placed and she did an amazing job managing the pain through the whole process. The medication started flowing and her relief was immediate, about an hour after starting the pitocin. I was so proud of her for how well she managed the difficult changes in labor and I was so proud of her for making the decision that getting an epidural was what she needed. With the pain under control for the moment we were both able to get some sleep.

The next few hours were uneventful, but it was clear labor was progressing as we needed. At the nurses' shift change, the nurse we had overnight thought we'd meet our boy around 10 and the new nurse coming on expected a little later, just after noon. Shortly after the shift change we hit a rough patch. While changing positions, Megan's IV tube got caught between the bed rail and the nurse's clothes and was ripped out of her arm. The nurse was very upset and we tried to reassure her it happens and it wasn't a big deal, but she replied, "No, it really doesn't! I've never had that happen before." Luckily the IV came out cleanly and didn't do any damage, but it was not easy getting it started again. Three different nurses came in to try to place a new IV in her other arm, but none could find a suitable vein. Eventually the IV team needed to be called and they were able to get a new IV started. Unfortunately, it had been over 30 minutes without pitocin flowing, so she needed to start from the lowest dose and ramp up again. This was a tough situation, but thankfullly the interruption didn't slow down labor too much.

Pretty quickly it came time for Megan to start pushing and we shifted into that mode, which is completely different than managing earlier stages of labor. Because of the epidural, she wasn't necessarily going to feel the urge to push so the nurse suggested directed pushing, where she called out a count to ten three times during each contraction with a breath in between. Thankfully, my wife could still feel the contractions enough to know when they were coming and when she needed to push. I got to help with positioning and talking her through the pushing. At one point, the nurse was away from the bed when a contraction started, so I took over the counting. When the nurse came back, she thought it was a great idea for me to take over so I got to take a more active role and coach my wife through the pushing stage of her labor. That was an unexpected wonderful experience. It felt like I was doing something useful to help bring our son into the world, which is something I'll never forget. The pushing stage was long and difficult because the baby descended quickly but was making slow progress, but my wife was absolutely incredible. Every time it looked like it was too difficult or she was too tired, she found even more in her and kept going. From the time I could see my sons head the mood shifted and it felt like he was almost here.

After two and a half hours of pushing, almost sixteen hours since we arrived at the hospital, our little boy Jacob^[2] joined us and went right to his mother's chest. We heard his yell immediately, nice and strong, and he opened his eyes and looked at Mom soon after. I bent down to say hello to him and introduce myself as the weirdo who talked to him for the last few months on the inside. As soon as I started talking, he turned his eyes and looked at me. It was an incredible experience to witness my wife give birth and be a part of his first few moments in the world. I keep going over those memories in my head with awe and I'll cherish them forever.

Almost nothing went according to plan, but we adapted as necessary and went home with a healthy, beautiful boy. I've had issues with being physically out of it in stressful situations, so I had been worried about being that father who puked or passed out or otherwise couldn't help. We had joked beforehand that I needed to make sure I didn't add another patient to the mix, but that didn't happen and I was so happy I was able to keep calm and channel the stress into focusing on helping her. My preparation was so useful because I felt like I knew what to do as the situation changed and I understood the medical interventions which came up. Preparation made me feel like I could adequately support my wife and fully realize my role as her birth partner. Being a part of her birth experience was unlike anything I've ever experienced and made me feel ilke I was on the right path to being a good father.