Birth Companions

SUPPORTING THE MOTHER DURING AND AFTER LABOUR partners, husbands, mothers, friends.
If you have been asked to accompany a mother during her birth, this information is for you!
You can play an important and very special role. Mothers who have birth companions have easier and less stressful births. Generally, they also have fewer complications. You can help a mother have a healthy and happy birth experience. You have been chosen to share in a very special event in the mother’s life.

This leaflet gives practical suggestions about preparing for the birth.
“I was so afraid to be with my daughter in labour. I didn’t want to see her in pain. But, i am proud now that i did it. It made a big difference that she wasn’t alone. I was there for my grandchild’s first breath.”

What is a birth companion?
A birth companion is someone who the mother trusts. The companion helps the mother to prepare for the baby’s birth and is with the mother during labour. The companion provides support, helps to keep the mother comfortable and calm, and is someone who can speak up for the mother’s rights if she cannot.
A birth companion can be:
• the mother’s partner
• the father of the baby
• a family member
• a friend

Some women may be able to have a doula as a companion: a doula is a non-medical person who has training to support women and their partners during labour. Ask a health worker at your facility if doulas are available.

Before the birth
Try to go with the mother to some of her appointments at the MOU/hospital before the birth.
• Ask the midwife or nurse for a letter stating that you will be the birth companion. When you arrive for the birth, show this letter with your ID book to the health worker, security guard or any other staff on duty.
• Find out where the mother will be during active labour and delivery. Find out where the bathrooms are. Ask whether the facility works differently if you come at night.
• This is an opportunity to ask any questions you have about the birth. It is important that you are calm and prepared on the day of the birth so that you can provide the best support for the mother.

It’s okay to ask questions
You could help the mother prepare for her trip to the MOU or hospital, for example:
• Arrange for transport (ambulances should only be called for an emergency).
• Help the mother think about who will help with child care or other tasks at home while she is away.
• Help the mother prepare her hospital bag (the ‘Safe Birth’ information describes what should be in the bag).
• Take water, Rooibos tea and small snacks for the mother, such as pieces of fruit, nuts or crackers.
• Make sure the mother can contact you when the time comes to go to the MOU or hospital.
Ask the mother what she wants you to do during the birth. For example:
• If she needs a Caesarean section operation, does she want you to be with her?
• If she needs to be transferred to another hospital, what would she like you to do?
• If the labour is long, who else can be a birth companion so that you can take a break if you need to?
Don’t forget to look after your own needs. Take some food, water or juice for yourself.

During the birth
• During the early stages of labour, you can keep her company and help her to pass the time.
• It is your role to be there for the mother, but the birth companion should not be in the way of the staff. Ask the mother and health worker where you should sit or stand, usually at the top end of the bed.
• Help the mother to drink fluids during labour.
• Encourage her to move around, walk slowly in between contractions or change position if she wants to – walking and shifting into different positions during labour can help relieve pain and speed up the labour process. It’s okay for her to rock, moan or squeeze a pillow if that helps her.
• Rubbing the mother’s back or massaging her shoulders during labour can help relieve her pain.
• Help the mother relax with deep, slow breathing. Keeping her breathing regular can help the mother stay calm, and help her control pain during contractions. However, it can be hard for her to keep her breathing regular. Encourage her to keep breathing. It is better for both her and her baby.

Breathe with the mother and help her keep count of her breaths.
Breathe in through your nose while you slowly count to three.
Breathe out through your mouth while you count to four.
The mother may find it helpful to make a sound on the out-breath, such as
“oooooooh” or “aaaaaah”.

• Between contractions, give the mother sips of water to prevent her mouth from becoming dry.
• Remember to drink water too.
• Encourage the mother with kind, positive words and try to keep your voice calm when speaking to her. Don’t be upset if she does not want to talk to you or if she seems rude or angry. Women in labour are in extreme pain, are sometimes afraid and may not react in their usual manner. Speak softly and say “you’re doing great” or “breathe”. Pay attention to see if this is helping her. You may notice that it is better to connect with the mother without talking.

Be aware of the mother’s rights
The mother may not be able to speak up about her needs during labour. Try to be aware of her rights, and take action if they are not being respected.
For example:
• Does she have enough privacy? Is there a screen or curtain between the beds?
• Does she need pain relief?
• Is a health worker treating her roughly or unkindly? If so, speak with the health worker in a calm, to the facility champion or authorities.
• Sometimes procedures are done which are unnecessary (e.g. shaving the mother’s pubic area or performing an enema). If you, or the mother, are unsure of the procedures being done, ask the reason for it.
• Does the mother have any cultural or traditional routines she wants (performed) during the birth? If so, explain to the health worker what these are so that she can be aware and support you in respecting the mother’s wishes.
Are you or the mother unsure of anything? It is okay to ask questions. Sometimes asking questions like “What is that for?” or “Is the baby okay?” can reassure the mother.

After the birth
Does the mother want to keep her baby with her after birth?
• Unless there is a medical reason not to, it is good for mothers to have their babies on their chests, skin-to-skin, immediately after the birth.
• This helps a lot with bonding and breastfeeding.
• The milk for the first 2-3 days is greyish and watery. It is very useful for the baby’s ability to fight infection.
• Does the mother want you to stay with her after the birth? Does she need help to:
– call family, friends or anyone else after the birth?
– go to the bathroom or wash?

How you can help when things don’t go as planned
If the mother needs a Caesarean Section operation:
• Find out if she wants you to be with her.
• Most Caesareans happen under a spinal anaesthetic. This is safer for the mom and the baby and allows a companion to be with her during the birth. She may feel pulling and pushing, but will not feel pain.
• Sometimes, a mother may be disappointed if she was planning a natural birth. Encourage her and praise her as much as possible, and give her the chance to talk about her feelings. It can also help to bring her baby to her as soon as possible after the birth.

If the mother experiences a stillbirth or her baby dies:
• Sometimes, tragedies happen. You can help the mother deal with this very difficult situation. The way it is handled can be very important for the mother later on.
• You can suggest that the mother spends time with the baby in private, to dress or hold the baby, and to say goodbye. Sometimes, a photo, lock of hair or foot print helps for mourning and memories later.
• Does the mother have questions for the health workers? If so, you can help her find someone to talk to.
• Find out if there are any support services for the mother, such as a counsellor or social worker. If there is no one available, ask your health worker for a referral.