In out of hospital births, having a reliable, competent assistant is HUGE!!! NRP (Neonatal Resuscitation Program) recommends 2 certified attendants at a birth. Training a midwife assistant is vital in today’s birth world! What if something is going on with mother and baby at the same time (happens many times when baby needs a little help transitioning the mother starts to bleed from stressing about her baby). My assistant were the most important staff I trained and hired for my home birth practice. I wanted staff that I could count on to answer their phone at 2am and have immediate babysitter options for their kids to jump at a moment’s notice.
I loved having birth assistants that were nurses, midwife students, or doulas. It added perfect opportunity for surrounding them around normal birth before completing school or seeing a hospital birth. Midwife students were great, because you got them familiar with your practice and orientated at a low cost option. Great way to interview a new midwife by having them assist you a few times!
I did a full day training for birth assistants with my practice. They needed to have BLS and NRP training prior to taking the full day program. I would do simulations of rare emergency situations, practice doing vitals on a “laboring women,” and get familiar with charting system and “tasks” that needed to be done when arrived at women’s home, prepping for birth, and postpartum recovery period. The educational day was opened to other midwives to bring their assistant and I trained birth assistants from all over the state. You are more than welcome to email for a price quote on all the educational material and details on training a birth assistant.
Your birth assistant needs to be competent in drawing up pitocin for midwife to give, keep sterile technique when helping with vaginal repair, set up for an imminent birth essential equipment (my “precip kit” included birth instruments, PPH meds, and newborn resuscitation mask), and labor support for long hours at a time on limited, scattered sleep. We would have birth assistant by on call for a 24hr period with a first call and second call rotation. We created a “resource list” of birth assistant that were comfortable with us calling at last minute to see if they were available (great to have if rare situation couple births at same time, someone gets sick, or can’t reach on call birth assistant).
There were times in a 24hr period that I did a few births, my assistant were flexible and rolled with the waves of what birth gave us. When interviewing potential birth assistants, really stress the potential negatives of this role (everything wants to be around birth and the high points, but may not be truly committed to level of care needed for home birth practice needs). I knew they were competent and qualified to be with me at a birth since I directly trained them. There was a minimum amount of call coverage each person had to commit to (hard to keep staff qualified when they only see a birth every few months).
Birth assistants were the rock of my practice. I would nap here and there with their trusting skills in the other room with the women. My really good assistant were my other half and we have a fluid motion of roles together. I could focus on charting from birth and needed paperwork while entire recovery for mother and baby was done by assistant. Birth assistant skills in breastfeeding support, labor support, basic assessment skills, and clean up were very important in out of hospital births. Clear expectations of training, competencies, tasks at birth, and commitment level were imperative when filling this job description. Your birth assistant will either safe you or break you depending on how well you train and hire them!