Victoria Armstrong, project on the role that massage can play in supporting fathers in the maternity period

I am an experienced massage therapist, confident in my skills but the Well Mother Massage & Pregnancy Diploma Course was about pregnant ladies, something about which I have limited professional and no personal experience. However, I knew that I wanted to explore an aspect of pregnancy even further from my field of understanding; to write about the fathers (rather, the non-pregnant parent, but referred to as ‘father’ for the rest of this essay); the parent whose body would not adapt and change to accommodate their growing baby, who would not experience the physical symptoms, the hormonal reactions, would not face the fear of their body releasing another life into the world. I wanted to write about those whose role society mostly relegates to that of spectator.

From the beginning, everything is about mom and baby, and the majority of the time the dad is left out once conception occurs. Dad becomes nothing more than support staff, not an active participant in the process.[1]

This assignment will explore the role that massage can play in helping and supporting the father during a transformative time in his life, with a particular focus on how it can enable him to bond with his baby.

All change please

While no one was looking, the very foundations of our society, our culture and our families have undergone a metamorphosis.[2]

Society has changed dramatically since the middle of the twentieth century, with scientific advancements occurring at lightning speed. Wonderful medical progression has brought the perhaps unfortunate tendency to medicalise pregnancy: the mother-to-be is now a patient, pregnancy a condition or illness, and labour a state of pain to be managed. Indeed, the popular BBC television drama Call the Midwife, based on the memoirs of former nurse Jennifer Worth, is set in the late 1950s, and highlights the dramatic shift in the attitudes towards the involvement of doctors, new drugs, new technology and the advent of maternity hospitals. Even the changes in the role a midwife plays during labour.

The wider social developments have led to a cultural shift, resulting in the commecialisation and politicalisation of nearly every conceivable aspect of human life, with conception, pregnancy, birth and parenting being no exception. There are now books, guides, classes, supplements, pillows, belts, clothes, travel systems; all of which are placed before the bewildered expectant parents, with an implicit pressure that to ignore, not buy, not take they may fail their unborn child. Today, the ‘typical pregnant couple’ will both work, the mother encouraged to do so for as long as possible into her pregnancy so that her maternity leave with her child might be as long as possible. One of my case studies was hospitalised with a-typical preeclampsia with 3 weeks still to work. Luckily as an NHS employee, they agreed that her hospital stay should count as sick leave and would not be deducted from her maternity leave. Pregnancy now seems to be a minefield of pressure and negotiations, and whilst some of the social advancements are wonderful (e.g. the advent of paternity leave), other developments have led to so much choice that confusion can reign. It is therefore perhaps providential that your ‘typical pregnant couple’ will now be facing these choices together.

Fortunately today, most partners are fairly demonstrative with their love and excitement during pregnancy. Much has changed since the days of pregnancy and birthing solely being ‘woman’s business’, and so partners feel they can happily and practically share in the responsibilities of parenting.[3]

Since the middle of the last century one thing that has really changed in parenting terms is the role of a father. Early episodes of Call the Midwife show an expectant father waiting downstairs, smoking and drinking whilst his wife is upstairs labouring with the midwives. Later in the series, and indeed towards the latter half of the twentieth century, fathers were typically found into the hospital waiting room, with only about a quarter of men in the UK attending the birth of an infant in the 1960s.[4] However, in 2012 a Department of Health survey of more than 80,000 new parents, which represents approximately 5% of the UK births, found that nearly 90% of fathers were present at the birth of their children[5].

Background

My case studies are four women at various stages of pregnancy, and unfortunately only one father-to-be was able to attend a couple’s session during my study. I have also worked with a number of other ladies during this time, including a number from very early in their pregnancies who will invite their partners to a joint session in due course. I also had several fathers-to-be amongst my existing clients and although their wives volunteered to be case studies, circumstances got the better of us and their babies arrived before we could do any work together. Each of these groups provided me with plenty of varied experience from which I will draw.

In this assignment, I will look at the three key stages a father-to-be will encounter, and will outline how I believe massage can help him develop a bond with his baby, easing him into his relationship with his child and his new role as a father. There are a number of exercises laid out in the Appendices that will develop the themes addressed.

‘A rough deal’

Once she becomes pregnant there is an inner directed, non-stop process underway. As men we will never know just what being pregnant is like for a woman.[6]

From the moment of conception to birth the mother-to-be is pregnant, even before she is aware of the new life inside her. From her first symptom, the physical reality of pregnancy makes itself clear to the expectant mother, but this isn’t the case for the father. Indeed, regardless of his research, dedication or involvement he will never be able to experience pregnancy in the same way, but he needn’t be a passive bystander. In fact, more often than not he won’t want to be.

Expectant fathers often want to be a different kind of father from their own. In particular, fathers today express a desire to be more actively engaged in caring activities, and to meet their children’s emotional needs (Twenge et al. 2003, Wild 2005)[7]

During pregnancy, the mother’s body is adapting to provide continued life and health for her whilst also providing the perfect environment for a new human to develop. From around week 7-8 the foetus is able to feel the mother’s movements as it develops a sense of touch, and a relationship forms through non-verbal communication before any other senses develop. In time, the mother is able to increase her awareness of the baby through its movements and reactions, routine, preferences and so forth, so that a physical bond develops.

But what about the father? What about his relationship or bond with his child? After all, we know that the role of a father has wide ranging effects on the health and wellbeing of a child:

Studies have shown that school-age children who have a good relationship with their dads are less likely to have bad behaviour or depression. Another study found a correlation between fathers’ participation in education and children who were more likely to earn high grades, enjoy school, participate in extracurricular activities and be less likely to fall behind. Early involvement by dads also reduced cognitive delays and increased cognitive growth.[8]

So what role might massage play in helping a father develop a bond with his baby, to help give him a good start and cultivating a ‘good relationship’? Particularly if ‘early involvement’ can have such an important role in the cognitive development?

Mathematical Magic …

The most important thing a father can do for his children is to love their mother ~ Hesburgh

Whatever a couple’s background prior to conception, whatever the history, circumstances or politics of their relationship, no matter whether the pregnancy has been longed for, assisted or a bolt from the blue, the one certainty is that their world has changed forever. Previously they found themselves in a state of known mathematical stability, the kind taught in a very basic way at school: 1+1=2.

At the moment of conception, even before they are aware of the shift in their reality, mathematical magic has occurred so that now 1+1=3 (or more!). Whether or not this is their first child, the relationship of the expectant couple will face many challenges – perhaps the greatest shift occurs during the first pregnancy, as they develop from a couple into the larger unit of a family. During this expansion, it is my belief that massage can play an important role encouraging intimacy, reinforcing and deepening a couple’s love, through a potentially turbulent time.

Each of us is introduced to physical life through the touch of our parents, the first and most essential way in which a mother and father communicate love to a child. Touch is also a fundamental means of communication between people.[9]

It is really important that with the announcement of a pregnancy and the impending addition of their child into the lives of a couple, that their love is not forgotten or forsaken.

I believe that through massage a couple can help each other through this transition. They can explore the physical changes of the mother’s body together; they can become aware of the way their attraction towards one another alters over time; how their connection with and understanding of one another develops and deepens. It can help provide a focus for the growth that they are undertaking, and provide a counterpoint to the changes and concerns they may have about their relationship moving forward, be they practical or financial.

However, this assignment is not about the role of the father in relation to the mother, as a partner, a lover, a friend, or any other role. Instead I am writing about the role of the father in relation to his unborn child.

What’s a man to do?

Once a woman reveals her pregnancy to her partner, and reality dawns for the man, virtually all fathers-to-be will ponder the same thing: “She is having a baby. What am I supposed to be doing?”[10]

Prior to my undertaking the Well Mother training, several of my clients announced their impending fatherhood to me. One had only just found out they were pregnant, and two were well into their second trimester. They were all first time fathers-to-be and used words such as “excited”, “thrilled”, “nervous”, “unsure”, “daunted”. There was a sense of uncertainty about where they could go for support as anxious fathers-to-be, perhaps not wanting to reveal their concerns to their partner for fear of worrying them.

The next time you meet an expectant dad, try this… take a moment to see and acknowledge that this man in front of you wants to be the best father he can be. And he may need support in getting there. What might get in the way will be the lessons he learned about being a dad as he grew up in his family, as well as our society’s, often low, expectations of men.[11]

None of these men were able to attend a partner session during my case study period, so I offered them the opportunity to discuss the impact their pregnancy was having on them physically and mentally during our appointments, which most agreed to. As well as having a physical impact, they typically opened up to discuss what they were experiencing, feeling and occasionally fearing too. I felt that being able to offer this opportunity for non-judgmental conversation, backed up with knowledge and understanding of the realities of their situation, took our sessions to a new level of massage therapy for them. So perhaps the father-to-be might be encouraged to investigate and invest in the self-care of organising occasional or regular massage during the ante-natal period. It doesn’t have to be with the same therapist the mother-to-be is seeing, but it would be beneficial if he were to see someone with Well Mother training, who will understand what he will be going through and how they can support him during this transition.

Antenatal

Historically, antenatal education has focused on the health needs of women and babies, without paying a great deal of attention to the role, influence or experiences of fathers during this important period of transition to parenthood.[12]

Whilst the social and cultural shifts of the late twentieth and early twenty-first century are seeing more and more men wanting to confidently take an active role in the growing, birthing and raising of their child, the support network is somewhat behind the times.

Research shows that the children of highly involved fathers often develop better friendships, have higher self-esteem, do better in education and are less likely to become involved in crime or alcohol and substance abuse (Flouri E 2005). However it is still widely recognised that fathers are not included in the same way as mothers during the antenatal period.  We know that 9 out of 10 expectant fathers attend the first scan but after that they are rarely invited to attend routine antenatal visits and when home visiting the midwife or health visitor will ask to see the mother before the father.[13]
References: Flouri E (2005) Fathering and Child Outcomes  John Wiley and Son Chichester

A woman’s role during pregnancy is quite clear. She goes from being a woman through a process to become a mother, through the physical growing of and birthing her child. Indeed a father’s role during pregnancy is equally clear as he goes from being a man through a process to become a father. Unfortunately, his role doesn’t have such a physical manifestation, which can make it harder for him to process the transition and to know how he can best prepare himself. Whilst a mother has a course of appointments to attend, classes she could take, exercises to physically prepare for the later stages of pregnancy, the labour and birth, the father doesn’t have any landmark scans, exercise recommendations, or nutritional requirements to consider in relation to his body. During pregnancy, his body and lifestyle can both remain untouched other than the acceptance, knowledge or denial of his impending change of status. However, more and more men are finding ways to come together with their partner to establish routines during pregnancy and after birth to become more involved. “A new dad can begin the nurturing parent-child relationship even before a baby is born. Some fathers who practiced talking to a child while it was still in the mother’s womb say their new babies recognised their voices directly after being born.”[14]

It is important to take the opportunity to engage with your new baby, while in the womb, and allow bonding to begin. You could get very close to your partner’s belly and speak to your child. You might even speak so quietly that only your child can hear … it will be your little secret together. Acknowledge the relationship that already exists between you. This early period is precious and endearing. Take time off work if possible, a day or afternoon here and there, to be with your partner and your child. Take walks, hold each other, and take time to connect. Speak about your new family and life together. Include your baby in these conversations.[15]

Talking directly to his child-to-be might be challenging for a father initially, but there are so very many ways a father-to-be can take steps to bond with his baby. Touch is a non-verbal means of communication that is available to everyone. The giving and receiving of touch is a very nurturing and nourishing experience. It can be as simple as stroking a back, holding a hand, caressing a cheek. A baby’s sense of touch develops at week 7 or 8, quite a considerable time before the mother might experience the sensation of her baby moving, typically between weeks 16 and 25. As each becomes aware of the presence of the other through touch, it isn’t unusual for a father-to-be to feel on the outside of an exclusive relationship, but it really does not need to be this way. Whilst the father will not immediately feel a kick of the baby as it moves, with encouragement to hold the mother’s abdomen to experience this sensation for the first time, the concept of his future baby becomes more real.

There is now “…evidence that massage reduces levels of noradrenalin and cortisol, two hormones associated with stress (Field, et al., 1999),” which provides the scientific proof that massage can have a very relaxing effect on the body.[16]

As a massage therapist, I know that the process of giving a massage can have a very relaxing effect on the body and I have also seen just how anxiety and stress can be elevated during the antenatal period for both mothers and fathers-to-be. By introducing massage at this time, the relaxation benefits will be experienced by all involved.

Reading, attending classes and participating with your partner will provide her with valuable support. She will likely need and appreciate it in the early months. Connecting with your child, while he is in the womb, and actively bonding also sends signals to your partner that you are devoted to your new family. This is very important for a mother-to-be.[17]

In the Appendices, I have outlined a couple of massage exercises which can be used to encourage a father and mother-to-be to spend some time together, and provide an opportunity for the father-to-be to connect with his child. Called ‘Simple Touch’, ‘Breathing Together’ (taken from Beautiful Birth by S Yates), ‘Snuggle’ and ‘Supporting the pelvic girdle’ (taken from Beautiful Birth by S Yates), they have been selected and included since they are wonderfully gentle, safe and easy to use at any stage during the pregnancy. By enabling the father-to-be to actively participate in the physicality of the pregnancy, it will really enable the family unit to bond together. Many massage therapists who have undertaken the Well Mother Massage & Pregnancy Diploma Course will happily work with couples to enable them to develop confidence and reassurance to massage each other during pregnancy in a safe and supported manner.

© Jules Selmes Beautiful Birth

During Labour

Birth can be a very sensual and intimate experience between a man and a woman, if allowed to be. It is an extension of the sexual experience that began this phase of a couple’s life together.[18]

There are many ways in which a father-to-be can assist his partner in preparing for labour, and actually experiencing labour. The one thing he can’t do is undertake it on her behalf, but this doesn’t mean that his role at this stage should be considered passive. Indeed there is much evidence to support how important his presence and role is in his partner’s experience of labour.

It is important that fathers understand how their partners’ hormones can assist the process of labour and birth and equally important that they understand how their own stress hormones can hinder the process. This is useful in highlighting the relevance of relaxation for labour and birth, to men.[19]

In the appendicies, there is a quote by Patrick M Houser regarding the reversal of roles experienced by men and women during labour which beautifully illustrates the importance of a father-to-be understanding the impact that he can have on his partner’s birthing process. The role of massage during labour will very much depend upon the nature of the labour the mother-to-be experiences, and this is in part why his preparation and practice of working with his partner is important. It enables him to focus on what the mother is needing, rather than fretting about whether he is ‘doing it right’.

Having some form of massage during labour can bring you many benefits. It is a way to involve your partner, so that he can give you real support and connect with both you and your baby. It may provide effective pain relief and comfort, and give another focus to your breathing so that you are able to relax and work with your contractions. You can also include your baby in the massage, which can help both of you to enjoy the beautiful experience of birth.[20]

Fundamentally, there are three stages of labour, each holding a different focus of attention for the mother- and father-to-be. The first stage of labour has a focus on opening up, enabling the pelvis, uterus and most noticeably (to the medics) the cervix of the mother-to-be to dilate sufficiently so that labour can progress. This means that the first stage is typically the longest so it is important that she is able to stay as relaxed and conserve as much energy as possible. As such, the exercises outlined in the appendicies, particularly the ‘Simple Touch’, ‘Breathing Together’ and ‘Snuggle’, can be used to help encourage both of these aims. Whether or not a couple have been able to have a massage lesson from a suitably qualified massage therapist, it is important a father-to-be is able to listen to his partner and feel comfortable and confident holding, rubbing, stroking wherever she says she would like attention. This is why the Simple Touch exercise is a great starting point; helping draw the couple together as they work with quiet relaxation or with a more dynamic focus, working through a contraction. Unless the mother-to-be finds it uncomfortable or disconcerting, there is no reason why touch can’t include holds or suitable pressure work on the abdomen with an awareness of the baby, but always making sure that the father-to-be is paying attention to his partner, her comfort and her feedback.

“Breathing is a key tool in supporting relaxation”[21], and so the Breathing Together exercise developed by S Yates will enable a labouring couple to use the time in between contractions to come together as a family, whilst encouraging the relaxation brought about by deep breathing, releasing endorphins and oxytocin which are the body’s natural ‘home made’ painkillers. The important thing about these two exercises is that the mother-to-be should be encouraged to position and reposition herself as she feels necessary, so that she can be as comfortable as possible. Because the first stage of labour can last a long time, the Snuggle is the ideal position in which a labouring couple can rest and attempt to sleep, whilst also allowing for the father to focus on his soon-to-be-born child.

As labour progresses into the second stage, the father-to-be will find that his role becomes less of a comforter and more of a supporter. His partner will need to be free to focus on the needs of her body and what she is doing, so the father-to-be can encourage her to listen to her body, to be supportive of her physically as she might be wanting to move around or take a more upright position, and to be still and present with her, through to the third stage of labour. Following the birth of the baby, the woman’s body isn’t finished as it needs to deliver the placenta, but at this stage the couple can relax and bond with their new child.

Post natal

It is well known that the ideal birth would see a baby swiftly laid on the mother or father’s bare skin, an action that is very comforting for the new infant, and enables the parent to strengthen the bond with their newborn, and can help to facilitate sleep and calm a baby faster according to research when compared to infants who received no touch.

“In no published paper is a single adverse outcome reported for KMC [Kangaroo Mother Care]. Positive effects on the mother are better bonding, healing of emotional problems associated with premature birth, among others.”[22]

The hours, days, weeks and months following the birth of a baby are a beautiful, dramatic, potentially shocking and traumatic time for a couple as they adjust to the reality of their loving creation. It can be very easy for a father to get swept up into the ‘doing’ of fathering, caring for his partner, rushing around to make sure everything is in order, but it is just as important for him to focus on ‘being’ a new father. With the modern ‘invention’ of paternity leave, a family unit can hopefully have some quiet time together in the days and weeks immediately following the birth, giving the couple the opportunity to adjust to parenthood and to bond together as an expanded family unit.

The exercises outlined in the appendix can be very useful to a new father in bonding with his baby in the post natal period. If the mother is lying down whilst breast feeding her child, or whilst their baby is sleeping, he can take the opportunity to Snuggle up to his partner and embrace them both gently and softly, without disturbing any feeding or nuzzling that the infant might be undertaking. Likewise, the Simple Touch exercise can be gently adapted to working with his new child, by which I mean embracing his baby with awareness rather than merely holding his child; perhaps a gentle hold on the infant’s tummy, or lightly stroking the skin on the arms and legs in a soothing and rhythmical manner.

“Studies conducted to determine if infant massage helps decrease fathers’ stress … for example, ‘The Fatherhood Study, Phase II,’ conducted by the Boston College Center for Work & Family, found infant-massage classes significantly decreased fathers’ stress levels.[23]

Many classes are now available for infant massage, and it would be highly beneficial for both parents to attend these classes, but in my opinion the impact for the new father is huge. Whether his partner is able / choosing to breast feed or not, being invited to give his child a massage can provide him with a natural way to spend time with his baby in a relaxing, bonding manner. I was thrilled to discover a handout with the title The Importance of Touch & Massage when researching this subject, and have included it in the appendices to highlight the physical benefits of infant massage.

The ‘love hormone’ oxytocin is a wonderful thing and its release is elevated in fathers just as much as it is in mothers. Indeed, “in research published in Biological Psychiatry, investigators found at both six weeks and six months after the birth of their first child, males presented with higher-than-usual oxytocin levels, just as their female partners did.”[24] Nature really is very clever!

What about dad?

Since Swedish men started to take more responsibility for child rearing, women have seen both their incomes and levels of self-reported happiness increase. Paying dads to change nappies and hang out at playgrounds, in other words, seems to benefit the whole family.[25]

Pregnancy affects everyone in the relationship and so a father should not overlook the benefits of receiving massage during pregnancy. One of the aspects of my client work during my course that most surprised me was the change in habits of the fathers-to-be. As three of my clients moved through the pregnancy, they continued their routine of regular massage, typically once per month or 6 weeks, but since the arrival of two of their babies, only one of the new father’s has been back to see me for his appointment. It isn’t just the mother’s life that is turned upside down with the arrival of a baby.

As a massage therapist it is my belief that massage therapy will help everyone be the best they can be, and this includes being a new parent – helping them to take some time to gain perspective and re-centre themselves, providing a safe place to reassess their priorities and what is most important to them in their new role and reality.

For many men, it can be easy to put up walls that prevent them from connecting emotionally and nurturing their babies.[26]

I believe that massage can have an enormous impact on helping to break down these potential walls and encourage the development of a meaningful relationship between fathers and their children at an early stage.

Moving forward

It has been an honour to undertake my case studies, working with expectant ladies as they move through their pregnancy, and I am very excited to bring this work into my practice. However, I have also realised that I want to reinforce the importance of massage for fathers-to-be, as receivers, as givers and its role in enabling them to bond with their new child both pre and post natally. In time, I would like to undertake training in infant massage, and if possible in future, to include working with babies and parents of babies with special needs. My brother was one such baby, and the love, hard work and devotion of my parents, particularly my mother, has resulted in a wonderful man whose potentially devastating start to life you would never guess at.

If children are our future, the physical health and mental well-being of the parents of these children is more vital than we realised for a very long time. Thank goodness that times are changing and the role of the father is being recognised and supported.

For the vast majority of mothers, an important ingredient for her successful pregnancy, birth and breastfeeding is the quality of care she receives from the father. Fathers DO make a world of difference and isn’t it time for society to better support our children, mothers and fathers?[27]

 

 

Appendices

I know that I am a professional massage therapist, and for me to talk about ‘massaging’ your pregnant partner might seem easy because I’ve quite literally done the course, ticked the box and got the t-shirt. However, before I even did my first introductory course I had been massaging my parents’ backs for years – complete with slipped discs, operations and crushed vertebrae … so take it from me, you’ll be ok with what follows.

I’d like to introduce you to a couple of exercises that I have outlined with the view to enabling you to spend time with your partner and your baby and to encourage a relationship and bond to form between you and your unborn child.

Appendix – Simple Touch

This exercise helps you ‘tune in’ to your fingers and hands so that you are more aware of what you are touching, and more able to ‘hear’ what the feedback is. OK so that sounds a bit hippy, but in the days of radio dials a small adjustment to the dial could make a huge difference to the enjoyment of a song or radio programme.

Firstly, make sure that wherever you are sitting, you are both comfortable and likely to remain so for a short while. Take your partner’s hand or foot (I suggest not starting with the foot if they are ticklish!), hold it in the palm of one hand, taking the whole weight, and use your other hand to cover the surface. Gently hold the hand or foot in your hands for a couple of moments, and feel the difference in temperature from your hands. Watching what you are doing stroke over the surface of the hand or foot that is uppermost, feel how the texture of the skin or hair might change over the surface, can you feel the bony points, stringy connective tissue, nails? Now hold with your top hand and gently stroke with your lower hand over the other surface – notice a difference? Now repeat this with your eyes closed, paying attention to the differences you may be aware of.

Now you’ve tuned in to your hands, go further up the limb (so forearm if you’ve been working on the hand, calf if the foot) and start to gently touch, hold, mold, using a very soft grip, press and wring the belly of the muscles on this lower limb, always paying attention to your partner and any feedback they might give (verbal or otherwise). Try to keep holding the weight of the limb so that your partner can relax, let go of being responsible for holding it for a while and just give in to allowing someone else look after her arm / leg. To finish this section of work, lightly run your hands down over the area you’ve been working on and hold the hand or foot again for a few moments.

Ask for feedback, what was nice, what wasn’t so comfortable, try it on the other side … and of course the other way around so she can work on your hand or foot. Don’t forget to make sure that you are both very comfortable where you are before you start, otherwise you’ll end up wriggling and not being able to concentrate on listening to your hands. Once you feel comfortable and confident, move on to other areas of the body, perhaps the shoulders and back as a great place to start?

Appendix – Breathing Together, from Beautiful Birth by Suzanne Yates p18

This exercise helps both you and your partner to make an antenatal connection with your baby. This connection can also be useful during labour.

Find a comfortable position in which your partner can settle next to you with one hand on your lower back – wherever it feels most comfortable – and one hand on your abdomen. You could sit with your partner next to you, rest on all fours over a ball, or lie on your side with some cushions placed under your knees, belly or chest.

Connect with your baby

Breathe out slowly and deeply together, using the basic deep breathing technique. As you breathe out and relax, your partner will gradually become more aware of the rhythm of your breathing, and can adjust his to match it. After a while, your partner also can begin to be more aware of the baby beneath his hands. Maybe the baby will make his presence felt as soon as your partner touches you, by kicking or moving around. With each out breath, your partner can focus more on the baby and will feel more connected with both him and you.

You can respond to your baby in whatever way feels appropriate. You could try some gentle stroking over his body, or talk to him, maybe using the name you call him while in the womb or the name you are going to call him when he is born.

When you feel you have a good connection with each other and with your baby, try this exercise in different positions. For example on all fours, sitting, standing, or lying next to each other. In each position notice the pattern of your breathing, how comfortable you are and how comfortable your baby is, and spend as long as you want to in each position.

Appendix – The Snuggle

Practicing positions which will be helpful during the pregnancy and through labour not only give a couple a chance to prepare themselves physically, but also invites the couple to spend time together. This position I refer to as ‘The Snuggle’ but is actually simply a side lying position which is restful and great for relaxation, and it can be a position in which to give birth.

The mother-to-be should lie down on one side, whichever feels more comfy and natural, and arrange pillows, cushions and bolsters in such a way as your legs, head, abdomen and arms are all feeling supported. Now you can lie down behind and snuggle up to her, making sure that you are supported with pillows and cushions as you require. Take some time to allow yourselves to mold together in a position that is soothing and relaxing for you both, some women find the pressure of their partner’s abdomen on their sacrum quite relieving. Now the work can begin.

Place one of your hands on your partner’s abdomen, and just lightly rest it there. If you feel a desire to move your hand and gently stroke or massage her abdomen – then that’s ok. You can do this through clothes or directly on skin, but if you are going to massage her, do keep checking in about the level of pressure you are using. Spend some time being aware of your partner’s breathing, how this rhythm changes the shape and feel of her abdomen. Once you have spent some time just being and holding (or gently massaging) her abdomen, either in your mind’s eye or in conversation with your partner, start to think about the baby you are holding in your hand. Spend some time being aware of any movements your baby might be making. You can move your hand to different areas on your partner’s abdomen and keep still in these places until you feel you want to move on somewhere else.

Be kind to yourselves, this might take some getting used to – spending time being still, peacefully relaxing in each other’s company and welcoming your baby into your family. Remember, just because your baby hasn’t been born yet doesn’t mean that fatherhood hasn’t started! You are both pregnant together and are parents together. This is also a wonderful position in which to reminisce about falling in love with your partner, to tell your baby about those early days, trips, weekends away, conversations spent planning your future family; and talk about what you are going to do together, the skills you want to impart, the journeys you will take. Try to leave cares and concerns for another time, just focus on the three of you.

This wonderful thing about this position is that you can do it at any stage of the pregnancy, during labour when your partner might want to have a rest and feel close to you, and post birth, perhaps when she is breastfeeding. The Snuggle is not rocket science, but is a beautiful way to bond with your baby, and connect to your partner as your relationship deepens and changes.

Appendix – Supporting the pelvic girdle, from Beautiful Birth by Suzanne Yates p68-9

You can try this technique in many different positions, but a good one is with the mother on all fours, perhaps leaning over a ball or a beanbag. You can do this with her fully clothed or use oil and work directly on her bare skin.

© Jules Selmes Beautiful Birth

The Practice

Stand or kneel, depending on your height, with your body behind the mother and your abdomen, which is going to give support, close against her back. Place your hands over the whole of her abdomen, either above or below her navel, depending on which is the more comfortable for her. Being supported quite low down – just above her pubic hone, where her abdomen starts to round out and the muscles and ligaments are quite stretched – will often feel good to her.

As the mother breathes out, gently draw your hands towards her back. Then, with a firm stroking movement but without pulling on the muscles, move your hands from her front to her back. Pass them around her hips, ending up at about the level of her second or third lumbar vertebrae and drawing the energy from her pubis to her back. Focus your mind on the inside of her body as well as the outside, so that a deep connection is made, then focus on the baby. Rest your hands on her sacrum to finish the first part of the massage. Next starting from the sacrum, repeat all those actions in the reverse order, sliding your hands from back to front. Some mothers are clear that they prefer the movement in one way only, while others enjoy both directions. For mothers with symphysis pubis disorder, however, it is usually best to draw the energy from the back to the pubis, as there is often a lack of energy here. As this is not a strong opening technique … it also can be used the other way, if there is too much energy in the front.

In Labour

The mother may find this a very calming and reassuring hold, one that can help her focus on her breathing and on her connection with her baby. If she feels more discomfort in her abdomen than in her sacrum, you can focus on drawing the pain from the abdomen round to the back. If the pain is more severe in her back, draw it round to her abdomen.

Some mothers may like this hold all through labour, but others may find that as labour progresses, they don’t want to be held around the abdomen so much. Some appreciate this hold more during a contraction, while others prefer to be held in between contractions.

Appendix – Massage Strokes for Labour, from Well Adjusted Babies by Dr Jennifer Barham-Floreani p207

  1. Position yourself comfortably behind your partner
  2. Using the heel of your hand, place both hands over the sacrum (base of spine) and stroke up and then outwards, in slow circular movements. Move over the buttocks and around the lower back, repeating rhythmically.
  3. Use a very light touch to begin with and increase the pressure if the mother finds this offers her relief from pain.
  4. You can also use long downward strokes from the top of the spine towards the sacrum.

Appendix – The role of the father during labour as explained in “Go Ahead…Use the F Word” from Fathers Make A World of Difference by Patrick M Houser

There is a monumental paradox surrounding birth which goes largely unrevealed. During birth a woman is doing the most female, womanly thing any woman can, and yet she is ‘using’ what is typically considered to be ‘masculine energy’. Birth is often very energetic and physically demanding. Fortunately, if she is not interfered with, she has significant hormonal resources to assist her in carrying out this ‘work’.

The father at birth, on the other hand, is at his best when he enters into a stillness, a quiet and reflective presence. He is best at birth when supporting the birthing mother with listening and calm; more archetypically female. Yet how is a man to achieve this, and be truly helpful to his loving partner, without proper preparation? How can he feel safe in this female world? Most fathers are not aware that they are going to have an emotional experience surrounding birth. The intensity of labour can encumber them significantly if they are unprepared, under informed or not feeling safe and welcome. The moment of the birth itself, or upon first holding their newborn, can open a floodgate for many fathers. Everyone does better if he has the opportunity to prepare.

[1] Joshua Florence, a father quoted in ‘Father-Baby Bonding: Infant Massage Builds Bridges that Last a Lifetime’ by Tina Allen, LMT, CPMMT, CPMT, CIMT in Issue 213 of Massage Magazine (Feb 2014)

[2] Fathers do make a difference … birth? by Patrick M. Houser – http://www.dad.info/expecting/birth/fathers-do-make-a-difference-birth

[3] Well Adjusted Babies by Dr Jennifer Barham-Floreani p198

[4] Should dads be in the delivery room – http://news.bbc.co.uk/1/hi/8377099.stm

[5] ‘Crisis in NHS Maternity Care Comes to an End’ in Fathers Make A World of Difference by Patrick M Houser p15

[6] Fathers-To-Be Handbook by Patrick M. Houser, p69

[7] Dads2b Resource: A resource for professionals providing antenatal education and support to fathers, 2011

[8] ‘Father-Baby Bonding: Infant Massage Builds Bridges that Last a Lifetime’ by Tina Allen, LMT, CPMMT, CPMT, CIMT in Issue 213 of Massage Magazine (Feb 2014)

[9] A Gift for Healing: How you can use Theraputic Touch by Deborah Cowens, MSN, RN, ANP, with Tom Monte, p18

[10] Fathers-To-Be Handbook by Patrick M. Houser, p18

[11] Dads2b Resource: A resource for professionals providing antenatal education and support to fathers, 2011

[12] Dads2b Resource: A resource for professionals providing antenatal education and support to fathers, 2011

[13] Getting Fathers Involved article on NCT website – http://www.nct.org.uk/professional/diversity-and-access/supporting-dads/general-resources-supporting-dads/involving-father

[14] ‘Father-Baby Bonding: Infant Massage Builds Bridges that Last a Lifetime’ by Tina Allen, LMT, CPMMT, CPMT, CIMT in Issue 213 of Massage Magazine (Feb 2014)

[15] Fathers-To-Be Handbook by Patrick M. Houser, p75

[16] Anatomy, Physiology and Pathology for the Massage Therapist by Su Fox & Darien Pritchard p236

[17] Fathers-To-Be Handbook by Patrick M. Houser, p31

[18] Fathers do make a difference … birth? by Patrick M. Houser – http://www.dad.info/expecting/birth/fathers-do-make-a-difference-birth

[19] Dads2b Resource: A resource for professionals providing antenatal education and support to fathers, 2011

[20] Beautiful Birth by S Yates p48

[21] Pregnancy and Childbirth: A holistic approach to massage and bodywork by S Yates p294

[22] Background to Research on Skin-to-skin Contact website http://www.skintoskincontact.com/background.aspx

[23] ‘Father-Baby Bonding: Infant Massage Builds Bridges that Last a Lifetime’ by Tina Allen, LMT, CPMMT, CPMT, CIMT in Issue 213 of Massage Magazine (Feb 2014)

[24] ‘Father-Baby Bonding: Infant Massage Builds Bridges that Last a Lifetime’ by Tina Allen, LMT, CPMMT, CPMT, CIMT in Issue 213 of Massage Magazine (Feb 2014)

[25] ‘Why Swedish men take so much paternity leave’ article in The Economist – http://www.economist.com/blogs/economist-explains/2014/07/economist-explains-15

[26] ‘Father-Baby Bonding: Infant Massage Builds Bridges that Last a Lifetime’ by Tina Allen, LMT, CPMMT, CPMT, CIMT in Issue 213 of Massage Magazine (Feb 2014)

[27] Fathers do make a difference … birth? by Patrick M. Houser – http://www.dad.info/expecting/birth/fathers-do-make-a-difference-birth

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