Birth Partner | For Everyone at the Birth

Source: *Why Did No One Tell Me This* — Natalia Hailes and Ash Spivak

The Birth Partner's Central Job

You cannot be in labor and simultaneously track what's happening in the room. The laboring person is working too hard for that. This is where the birth partner earns their place. Your job is not to absorb every medical detail yourself, but to make sure decisions are not made without your partner's actual understanding and consent. You are there to slow things down when slowing down is what the moment calls for. You are there to keep the environment supportive, to hold logistics, and to be the voice when your partner cannot be their own.

Stay off your phone. Help them stay distracted through early labor. Try to keep your own cool, because if you look scared, they will feel scared. Don't talk to them during contractions. Wait until it's done, then speak.

Rights in the Birth Room (What You Are Protecting)

Three rights apply to every birthing person, regardless of setting:

**The right to bodily autonomy.** No one touches your partner's body without permission. The baby is legally part of their body until born. No exception.

**The right to fair and equal treatment.** Regardless of race, age, religion, sexuality, or any other factor. If your partner is being treated differently than a standard patient would be treated, name it.

**The right to informed consent and refusal.** This is the most active one. Before any procedure, any medication, any intervention, the provider is legally required to walk through three steps: inform (give objective facts and evidence), advise (share their personal recommendation), and support (respect the decision, even if it goes against their advice). Signing a hospital admission form does not waive this right. Every new procedure requires fresh consent.

If at any point you feel those rights are being violated, you can ask for a new nurse, a new doctor or midwife, or ask to speak to the hospital administrator or patient ombudsman.

B.R.A.N.D.: The Tool for Decision Moments

When something is being recommended and there is pressure to decide quickly, this acronym keeps the conversation structured. Use it yourself or use it to help your partner work through it.

**B** - What are the **Benefits**?

**R** - What are the **Risks**?

**A** - What are the **Alternatives**?

**N** - What happens if we do **Nothing** (or wait)?

**D** - Do we have time to **Decide**?

That last question matters more than people realize. True emergencies are rare. In most cases where an intervention is being recommended in labor, there is time, even if the room doesn't feel that way. Asking "do we have time to decide?" resets the pace. It reminds everyone in the room that consent is not a formality.

A companion move: ask for five minutes alone. Even if the answer feels obvious, the pause allows the laboring person to go inward without someone waiting on them for an answer. It also gives you and your partner a moment to discuss without pressure. Simply taking that moment to confirm you are both genuinely on board can matter a lot when your partner looks back on the experience later.

Understanding Interventions (So You Can Help Navigate Them)

Interventions are not inherently bad. They save lives. They also help labors move through stuck spots. The problem is when they are administered without real informed consent, or when one leads to another in a chain that wasn't fully understood when it started.

Hailes and Spivak describe it plainly: most interventions come in packages. An epidural comes with an IV, continuous monitoring, a blood pressure cuff, a pulse oximeter, and a bladder catheter. That is not a punishment. That is the standard safety protocol. But knowing it in advance means your partner is not blindsided by it when they're already exhausted and in labor. A useful question before agreeing to any intervention is: "What else does this intervention come with?"

Getting one intervention does not guarantee others. But it does increase the chances of needing them. Getting Pitocin increases the chance of wanting an epidural. Getting an epidural increases the chance of needing Pitocin if labor stalls. This is not cause for alarm. It is information. Knowing the potential sequence helps your partner make choices from a clear place rather than from fear of the next step.

The goal, as the book frames it, is that things are happening with and for them, not to them.

When a Cesarean Is on the Table

"Emergency C-section" is a phrase that gets used much more broadly than it sounds. Most unplanned cesareans are not true emergencies in the medical sense. They are decisions that arise during labor without having been scheduled in advance. True emergencies, where the surgical team moves immediately without time for questions, are rare.

In most unplanned cesarean situations, there is time to ask:

What specifically is the concern right now?
What are the risks of this surgery for my particular situation?
What are the alternatives?
What happens if we wait a short time?

If it is a true emergency and the room moves fast, your partner will still be asked to consent. This is one of the reasons trusting your care provider before labor matters: if a real emergency comes, you want to be able to move with them, not feel like you have to fight them at the same time.

For partners entering the OR: you will likely arrive after the birthing person has already been positioned and prepped. It can be visually overwhelming. Take a breath before you walk in. If you need to step out briefly, that is fine. Better to step out than to pass out.

Continuous Monitoring vs. Intermittent Monitoring

This is worth knowing because it often comes up without much explanation. Continuous electronic fetal monitoring is standard practice in many hospitals, but it is not evidence-based for low-risk pregnancies with no interventions. ACOG, AWHONN, and ACNM all recommend intermittent monitoring as standard for low-risk labors. Continuous monitoring in low-risk pregnancies does not reduce perinatal mortality and is associated with higher cesarean rates and more assisted deliveries.

True intermittent monitoring, as defined by ACOG, is listening to the baby's heart for one minute every 15 to 30 minutes during active labor, and one minute every 5 to 15 minutes during pushing. Not "on the monitor for 20 minutes every hour," which is common in many hospitals but is not the same thing.

If your partner is low-risk and wants intermittent monitoring, they can ask for it by name and point to ACOG's own guidance if the conversation requires it.

Things You Do for Them in the Room

The coping cheat sheet from Hailes and Spivak is written as much for the support person as for the laboring person. Here is the partner's portion in plain terms:

Help them stay distracted through early labor. When they cannot be social anymore, that shift is a signal: things are moving.

Between contractions, offer massage, light touch, or just presence. During contractions, be still and quiet.

Learn the hip squeeze before labor. It works: pressing firmly inward on the back of the hips during a contraction creates more pelvic space. Do not shift position or remove your hands during a contraction unless they ask you to.

Watch their feet and shoulders. When people are uncomfortable, they tend to rise onto their toes or hunch upward. A gentle hand on a foot or shoulder brings them back down.

Remind them of the five-minute rule if a decision needs to be made and they seem overwhelmed.

Do not complain about being tired. Do not eat in front of them.

Let them know, repeatedly, how powerful they are. And how loved.

After the Baby Is Born

If your partner is particularly emotional on days three through five postpartum, remind them this is when mature milk comes in. The hormonal shift is real and not a sign that anything is wrong.

Take over baby duties when you can so they can rest. Manage family members who are overstaying or creating stress, especially if they are your family.

Encourage them to keep relying on their support team. Help them remember the postpartum period is temporary.

And keep telling them what you told them in the birth room. That they are powerful. That they are loved.