the take charge routine
by Penny Simkin, PT, CD(DONA)
When to use this technique
Reserve this routine for any time during labor when the mother reacts in any of these ways:
When to use this technique
Reserve this routine for any time during labor when the mother reacts in any of these ways:
- She hits an emotional low.
- She is in despair, weeps, or cries out.
- She wants to give up or feels she cannot go on.
- She is very tense and cannot relax.
- She is in a great deal of pain. The Take-Charge Routine is exactly that. You move in close and do all you can to help the mother until she regains her inner strength. Usually her despair is brief, with your help she can pass through it and her spirits will rise. Use whatever parts of this routine seem appropriate:
- Remain calm. Your touch should be firm and confident. Your voice should remain calm and encouraging.
- Stay close. Stay right by her side, your face near hers.
- Anchor her. Hold her shoulders or her head in your hands -- gently, confidently, firmly -- or hold her lightly in your arms.
- Make eye contact. Tell her to open her eyes and look at you. Say it loudly enough for her to hear you -- but calmly and kindly.
- Change the ritual she has been using during contractions. Suggest a different position. Try changing the breathing pattern. Breathe with her or pace her with your hand or voice.
- Encourage her every breath. Say "Breathe with me... BREATHE WITH ME... That's the way... just like that... Good.... STAY WITH IT... just like that... LOOK AT ME... Stay with me, Good for you... It's going away... Good... Good... Now just rest, that was so good." You can whisper these words or say them in a calm, encouraging tone of voice. Sometimes you have to raise your voice to get her attention. But try to keep your tone calm and confident. Talk to her between contractions. Ask her if what you are doing is helping. Make suggestions: for example, "With the next one, let me help you more. I want you to look at me the moment it starts. We will breathe together so it won't get ahead of us. Okay? Good. You're doing so well. We're really moving now."
Repeat yourself. She may not be able to continue doing what you tell her for more than a few seconds, but that's fine. Say the same things again and help her continue.