Pregnancy and birth: what every partner needs to know

Pregnancy and birth has never come with more information, opinions or expectations. NHS consultant and author Dr Lorin Lakasing explains how partners can help cut through the noise, ask the right questions and support mothers when birth doesn’t go according to plan.

For those wanting to start a family, a positive pregnancy test should be welcome news. But today’s mothers-to-be face a bewildering amount of information and controversy around pregnancy, childbirth and motherhood. Partners have an important role to play in helping navigate those uncertainties and maintain a balanced view of the journey ahead.

When pregnancy meets the internet

Previous generations relied largely on midwives, healthcare professionals and charitable organisations for advice. Today’s parents also have the internet, where it’s remarkably easy to disappear down an unhelpful rabbit hole.

Some mothers become committed to so-called “natural” birthing philosophies promising an ideal experience; others, alarmed by accounts of labours that have gone wrong, request an elective Caesarean section.

Neither choice is necessarily as simple as social media can make it appear. Mothers planning to labour at home or in a birth centre may overlook the possibility of needing to transfer to hospital, while those choosing a Caesarean can underestimate the recovery involved.

This is where a partner can be invaluable: not by telling a woman how she should give birth, but by helping her look beyond the loudest voices and seek reliable, personalised medical advice.

When technology changes the picture

Modern pregnancy care also gives us access to information previous generations simply didn’t have.

Everyone is delighted to see their baby on an ultrasound, hear a heartbeat or discover the sex. Far fewer parents are prepared for the conversation that follows when a scan suggests a genetic syndrome, brain abnormality or heart defect, or that a baby isn’t growing as expected.

Technology can also complicate decisions during labour. Continuous electronic fetal heart-rate monitoring, for example, can increase the likelihood of interventions such as instrumental delivery or Caesarean section. Some mothers therefore opt for intermittent monitoring, but may not fully appreciate the trade-offs involved.

Clinical guidelines necessarily allow room for interpretation. The difficult question for families is how much uncertainty they are comfortable accepting.

Rethinking risk around pregnancy and birth

Historically, pregnancy and childbirth carried much greater risks for mothers and babies. As screening, laboratory testing, imaging and medical intervention improved, our expectations changed too.

Survival is now largely taken for granted, while modern conversations increasingly focus on the experience of pregnancy and birth.

That creates a difficult tension. We may want birth to be treated as a natural physiological process with minimal intervention while simultaneously expecting modern maternity services to prevent every poor outcome.

When something does go tragically wrong, inquiries often hear that parents believe earlier admission, additional monitoring, more scans or earlier delivery might have changed the outcome.

Maternity services unquestionably need to address their shortcomings. But families also need honest conversations about what medicine can and cannot guarantee, and about the potential consequences as well as benefits of the choices they make.

Your role in the room

For fathers and partners, one of the most useful things you can do is accept that pregnancy and birth contain uncertainty.

Start with the practical stuff. Think about the financial impact of becoming a family, understand maternity and paternity leave and pay, organise care for older children and resist the extraordinary amount of marketing aimed at convincing new parents they need to buy everything immediately.

After the birth, doing housework, dealing with visitors and simply noticing what needs doing can make an enormous difference.

Emotional support doesn’t necessarily mean agreeing with everything your partner says. Information from social media and the internet varies enormously in quality. If she’s becoming anxious or preoccupied with a particular approach to birth, encourage her to discuss it with the healthcare professionals who know her individual circumstances.

Most importantly, remember that circumstances can change.

A birth plan that made complete sense at 36 weeks may no longer be appropriate once labour is underway. You can help by asking questions, making sure information has been understood and ensuring your partner’s concerns are clearly communicated.

That isn’t about trying to second-guess doctors or midwives. It’s about being informed enough to ask: What has changed? What are our options? What are the benefits and risks? What happens if we wait?

When difficult decisions need to be made, a calm second pair of ears can be enormously valuable.

Don’t forget yourself

Becoming a parent is a major adjustment for partners too. Unlike the person carrying the baby, you haven’t had months of constant physical reminders of what’s coming. Sometimes new parenthood can feel as though you’ve been catapulted onto another planet.

When possible, maintain connections with friends, interests and the parts of life that existed before the baby. Take turns protecting a little time for yourselves and, if childcare and finances allow, occasionally go out together and challenge yourselves to discuss something other than nappies, sleep or feeding.

Pregnancy and childbirth inevitably involve uncertainty, difficult choices and sometimes outcomes nobody wanted. Maternity services have shortcomings that urgently need addressing, but no healthcare system can remove every element of risk.

For partners, you don’t need to become an overnight obstetrician. Being informed, asking useful questions, supporting your partner and helping ensure her voice is heard may be some of the most valuable things you can do.

Know your rights: Martha’s Rule

Martha’s Rule gives patients, families and staff a way to request an urgent review from a different medical team if they are worried that a patient’s condition is deteriorating and their concerns aren’t being acted upon.

It was introduced following the death of 13-year-old Martha Mills, whose mother, journalist Merope Mills, campaigned for change after concerns about her daughter’s deterioration were not escalated.

The scheme has since been expanded, including into maternity care, an extension supported by campaigners including Louise Thompson following her own traumatic birth experience.

For partners, the takeaway is simple: if you believe something is seriously wrong and you don’t feel concerns are being heard, know that there is a formal escalation route available.

About Dr Lorin Lakasing

Dr Lorin Lakasing is an NHS consultant in obstetrics and fetal medicine with 30 years’ clinical experience in maternity care.

Her latest book, Delivering the Truth: Why NHS Maternity Care Is Broken and How We Can Fix It Together, examines the stories behind the headlines and the competing pressures within maternity services, and considers how safer, more effective care might be achieved.