Patricia Williams, LCSW
Westchester, NY & Vermont
PACT Level 2
As a couple therapist, it has long been a passion of mine to help couples prepare for the birth of a child, not only prenatally but post birth, as well. There is substantial evidence that marital satisfaction declines when couples have children, and early interventions to counteract that are lacking (Cowan & Hetherington, 1991). In my experience, few couples are prepared for how pregnancy and the addition of a third (or subsequent children) will challenge their relationship and what they can do to make it an optimal experience as a foundation for themselves and their family.
I love the term birth bubble. Jen Pifer, who works as a doula and is also well versed in the principles of PACT, used those words to describe what she strives for when assisting in childbirth. When asked if she would add her voice to this article, she said, “My goal is to help couples become scaffolding for each other and to identify that structure as something they can nurture and maintain.”
Most pregnancy/birth-related professionals are not trained to help pregnant couples build on their relational strengths, assess and manage their natural apprehensions, and create safety and a secure bubble. A birth bubble can strengthen the relationship and thus increase security and safety neurobiologically and emotionally in utero and beyond for the infant. Jen, for example, told an expectant father, “She knows birth, but you are the expert on her. Together, we will look for signs that her pain has become suffering.”
A growing body of multidisciplinary research supports the idea that optimal human development occurs within relationship from the beginning (even preconception). Birth and bonding are a critical developmental process for the parents and baby and form core patterns with life-long implications (Weinstein, 2016).
Lila and Sam are a high-functioning couple in their early 40s, married for 8 years. They are pregnant with their first child. They were referred to me by their midwife, who was concerned about Lila’s anxiety and her reports of tensions between herself and Sam. I can see their strengths as a couple: they maintain eye contact, express their deep love and appreciation for one another, and seem to operate as a two-person system fairly well. They collaborate when telling a story and understand the importance of having each other’s back. As they describe the tensions between them, they seem to have some difficulty soothing each other, as well as finding the baby in each other.
Given the shortness of time before their due date, I want to help them reveal their fears. I decide to use the PACT intervention Lover’s Pose. Following my instructions, Sam lies in Lila’s lap, where he gazes into her eyes and begins to share his worries of not being enough when she will need him. At first Lila is awkward and not sure what to do. With a little prompting, she strokes his head and quietly reassures him that she trusts him more than anyone in the world. She says how much she appreciates and needs him, and that it is okay for him to be afraid.
Then they switch positions. Lila with some difficulty shares her fear of how Sam will react to seeing her at her most vulnerable, both emotionally and physically. She reaches for him and weeps in his arms. He reassures her that she will be safe with him. He affirms that her vulnerability makes him feel closer to her and says how much he loves her body as it is and that he wants more than anything to be her rock in this process. He tells her that he is her king and will make sure that both she and their child will have the most support possible. They agree to make sure that when the delivery time comes, all the supporting professionals in the room understand they need to be able to lock eyes and have contact with each other.
At the end, Sam and Lila talk to their baby and tell him they can’t wait to meet him and are so grateful to be his parents. Although these two have more work ahead, it feels as if they are on their way to providing real safety for each other, and through that, for their new family.
Jen says the best birthers are couples who rely on how strong and capable they are together. Inevitably, she says, birth asks couples to embrace the unknown. It asks them to be flexible and exposed, to accept “not getting it right” and being totally vulnerable together. “Wouldn’t it be great,” she says, “if we could reach couples during this time in their lives, as they prepare for the birth of their child, when they feel most vulnerable and ripe for guidance, information, tools.” We believe the PACT principles can help not only couples but also birth professionals make this possible
Cowan, P., & Hetherington, M. (1991). Family transitions. Hillsdale, NJ: Lawrence Erlbaum.
Weinstein, A. D. (2016). Prenatal development and parents’ lived experiences. New York, NY: W.W. Norton.