Labor and Delivery — A Dad’s Pregnancy Perspective
If men had to give birth, the labor and delivery process would be much more comfortable. Perhaps women can withstand more pain or they are more willing to suffer in silence. Regardless, there must be a better way. The following explores some of the issues and potential solutions from a dad’s perspective. None of it is intended as medical advice.
“This Ain’t Vacation”
When we arrived at the hospital recently for the birth of our son, a valet greeted us and took our car. We were off to a promising start. My wife and I had tried to pack light. There were no roller suitcases in tow. We had a duffel bag with clothes, a second (smaller) bag with snacks, and a few pillows, including the snake-looking one that divided our bed ever since my wife’s second trimester. One of the nurses who ran the hospital’s birthing class had warned, “This ain’t vacation. You don’t need to look like you’re arriving at the airport.”
We did need to prepare to stay a few nights though. Do not be like me and fail to pack more than one sweater. Hospitals are cold. If mom has a Caesarian section (C-Section), you will have to stay a few extra nights.
In our case, my wife was being induced, so our arrival was more akin to checking into a hotel. We were not speeding down the interstate to avoid an in-car delivery. Thankfully. A major downside to induction, however, is the lengthy process. It takes much longer from beginning to end as opposed to natural labor, where the birthing process is well underway when you arrive at the hospital.
The natural labor process had sounded too painful and risky to us. The hospital tried to sell it as “ enjoying the beginning phases of labor in the comforts of your own home.” I’m not sure who finds it comfortable to bend over and contract in pain with no doctors or nurses around. Maybe those people exist somewhere. Let’s be honest — insurance companies would prefer not to pay for moms to be in the hospital any longer than medically necessary.
We were also concerned that if we timed our drive to the hospital incorrectly once labor had started, we could get stuck — bad traffic, car breakdown, car crash, etc. Most of these disaster scenarios were admittedly extremes, but those events always seem to occur in the most stressful moments. In light of those considerations, when the doctors gave my wife the option of induction, we jumped for it.
Nobody Eats or Sleeps
At the hospital check-in, they forced me and my wife to separate. Other hospitals may handle this differently, but I would have thought that during a stressful experience like labor and delivery, you would want the caretaker or support person by the patient’s side at all times. When my wife was settled in her room and they called me up, I entered a space that was more than sufficiently sized for both of us. While they understandably do not want the support person getting in the way, leaving the future mom to settle in alone did not seem necessary.
Our check-in time was at 8 AM. Thankfully my wife was allowed to eat breakfast in advance. The general rule from the doctors was that she could snack on light food up until receiving the epidural (no egg mcmuffins, moms). After that, she would be limited to a diet of ice chips, clear liquids, and everyone’s favorite, jello. The nurse who initially took care of her showed me a small snack area at the center of the maternity ward. It had a coffee machine where you insert one of those packets and it automatically brews sub-par coffee. No milk or cream options. The food consisted of yogurt and not much more.
This was the extent of the food for an induction process that was supposed to last for some 24 to 48 hours. What would happen if my wife did not have me there to be her runner and grab food? How was she supposed to endure the arduous journey of labor and delivery over 24 hours with only yogurt to fuel her? Let’s just say if men had babies, the snack bar would be a buffet.
As we worked toward the epidural, my wife was fairly mobile. She could get out of bed with help from me and the nurses to walk around the room and go to the en suite bathroom. Once she received the epidural though, it was catheter time. Her movements would be restricted to her bed. During this time a steady stream of nurses, doctors, residents, and medical students flowed into the room. Each one had to do their own assessment, despite the fact most of it was already covered in my wife’s chart. This often involved poking, prodding, and probing some of my wife’s most sensitive areas.
This attention continued well into the night. They promised that once she received the epidural, she would be able to get at least a couple hours of rest, but that proved not to be the case. People continued to flow in. As a result, my wife never rested once, apart from a few minutes where she tried to close her eyes here and there. How do they expect moms to be energized for delivery if they do not respect her time for rest during the birthing marathon? Especially in today’s sleep-obsessed world. Men would probably receive designated nap times if they gave birth.
With regards to the people flowing in, almost 90% of the time they were not “doctors.” Most were residents, some more senior than others. I’m all for the apprenticeship programs in hospitals, but when a resident is telling you that a C-Section will be necessary, at a minimum the doctor should be present too. Law firms would not let a junior associate make closing arguments in a multimillion dollar case. Medical decisions that have lasting effects on people should be no different. Would men receive this same level of treatment if pregnant? I think not.
Invasive Labor and Delivery Procedures
Not enough people realize that a C-Section is abdominal surgery. My wife gave birth a little over a week ago as of this writing, and she is still recovering. Leading up to labor and delivery, so many people — doctors included — explained how a C-Section may be required and is a viable option. They spoke about it casually. It sounded as easy as a snap of the fingers. Given the invasiveness and consequences it can have for future pregnancies, it should really only be an option of last resort. The recovery time is significant and the “softer” complications are not well-disclosed.
Any legitimate doctor will disclose the health risks of the procedure, but nobody detailed the trouble my wife might have breastfeeding immediately after the operation, let alone caring for a newborn while still recovering from major surgery. Doctors are understandably focused on mom as a patient, not as a mother who will likely be the primary caregiver of a helpless infant post surgery. My wife is still having trouble resting our son on her stomach for breastfeeding. I cannot begin to imagine the infrastructure that would be in place if men had to undergo C-Sections.
Another operation my wife had to undergo as part of the induction process was the insertion of a Foley balloon catheter. They basically force a catheter into the uterus to promote induction. No painkillers or anesthesia are used. I don’t think I’ve ever witnessed my wife in as much pain. The labor and delivery process in comparison appeared far easier. If a man had a similar procedure done on his penis, the whole world would know about it. There must be a way to make this process less painful and uncomfortable.
The Unenviable Support Person
The support person process demands reform too. There is no defined role — regardless of whether you are the future dad, current partner, grandma, grandpa, whoever. Your job is basically to sit there, provide emotional support where possible, and make sure you don’t become the third patient. Seriously guys, don’t faint.
It is a helpless task. I felt like I was watching a theatrical performance where mom and baby were the stars of the show, doctor’s were the supporting cast, and nurses and medical students, the stage crew. The support person is generally included every step of the way, from entering to exiting the hospital. Although I was included, I felt like I was an audience member who was part of the play, but never told his role.
For example, when my wife had the Foley balloon inserted, I stayed back as everyone huddled around my wife — residents, nurses, and medical students. When my wife cried in pain, a nurse barked at me to come over and comfort her. Does everyone know they can stand by the bed next to mom during these procedures?
At another point, a nurse snapped that I was sitting on the “wrong side of the bed” and that they would need the space in case of an emergency. I was feeding my wife ice chips as her labor intensified. It wouldn’t have taken much to move. Again, I was confused about what I could and couldn’t do. Each nurse also seemed to have their own set of rules.
Once my wife made it to postpartum, they brought us (and our baby!) to a different unit of the hospital. My presence became even more of an issue, however. Not all of the rooms were equipped for support persons. I had to sleep in a chair the first night. The room they initially put my wife in was a double room, meaning my wife would have to share it with another patient as needed. Fortunately, we didn’t run into that issue until the next day, but apparently I would have had to leave had that happened. The nurses were able to accomodate us the next night with an individual room, but the entire arrangement shocked me.
Here was my wife fresh out of surgery with the newest of newborns, and they would have asked her support person to leave if she had to share a room. Worse yet, the hospital would have discharged her the next day had she not had a C-section. Parents — particularly new ones like us — need more time in the hospital. Many are not qualified for the job of parenthood, ourselves included, which creates unnecessary risk for the baby.
For what should be a family-focused and inclusive support process, giving birth and recovering can be very isolating. It’s no wonder postpartum depression is such a concern. The current structure risks stripping moms of their support system when they need it the most. I find it hard to believe that men would be treated similarly if they were the patients in the birthing process. And it’s not because women make more natural support persons.
Breastfeeding Is Anything But Basic
Another area where the hospital fell short was with breastfeeding. The prevailing guidance and literature compels most women to try breastfeeding their babies from the start. Most people make this seem automatic. As if all babies naturally latch onto their mothers the first time and the milky rivers of Babylon flow from mom’s boobs.
Let me tell you as an objective observer — breastfeeding is hard. Not every baby latches immediately. Ours didn’t. There is a learning curve for both mom and baby, and the curve can be steep. The hospital may try to set you up with lactation consultants, but the transition to these individuals seems very informal, as they aren’t doctors or nurses and will often come directly to your house. Most likely, you will have to file claims with insurance separately for their services. Most providers do not cover them. And if you do get one, make sure they are appropriately certified.
So if mom struggles to breastfeed in the beginning, she is basically left to her own devices. Our pediatrician told us we need to switch to formula if it doesn’t work. The baby needs to eat after all. While there is intense focus on delivering the baby, the best way for sustenance is effectively an afterthought. There is a massive divide between labor and delivery, and actually caring for your baby postpartum. Unfortunately, most women fall into the crack without any idea of where to turn for help.
The Labor and Delivery Process Demands Improvement
In conclusion, the labor and delivery process should be and can be made much more comfortable for moms. It is shocking the pain and misery women must go through from labor to delivery in the 21st century. I asked myself a few times how they managed a few hundred years ago. The death rate from birth may be significantly lower now, but a few minor comforts and improvements could go a long way. Whether it’s more food during the process, more direct communication and coordination by decision makers (i.e., doctors, not residents), a defined role for support persons, and a smoother postpartum transition to motherhood, improvements in any of these areas would help. Our moms deserve it.