How to Be a Dad

How to Be a Dad

Universal Birth Reaction Assessment Tool


Universal Father Birth Reaction Assessment Tool


[ click the image to enlarge ]

Fact. Moms have a monopoly on pain when it comes to child birth. There is a medical chart called the Universal Pain Assessment Tool that doctors and nurses use to gauge it. Sure, it’s stupid and useless. But what about dads? Dads deserve something stupid and useless, too!

We consider it our duty to fill the void. We’ve created this helpful chart so that medical professionals and expectant first-time fathers alike can be better informed about what to expect in the delivery room FROM FATHERS. Charlie’s skill as an actor and my craft as a designer, coupled with both of our recent experience as observers of child birth, have come together in this potent Instructional Diagram.

Yes, Charlie and I know we can’t unsee what we have seen. And yeah, we may never look at lasagna the same again, but we know that seeing our wives do what they did and our sons come into this world is something that cannot be given value. It is priceless.



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106 Responses to “Universal Birth Reaction Assessment Tool”

  1. […] idea from the crew over at How To Be A Dad. It’s a handy chart so that medical professionals and expectant first-time fathers alike can […]

  2. Good one, I imagine most new fathers fall between 6-11. My husband opted out of the room during the actual delivery. Note: I did not mind. I was too busy screaming to care. Hee.

    Love the diagram, as always!

  3. Julie` says:

    I had a c-section, and my husband hit an 8 when they asked if he wanted to see the baby as they took him out. I imagine it’s ruined lasagna for him as well.

    The diagram is priceless.

    • andy says:

      Ha ha ha ha! That’s amazing. I know someone who blacked out during an emergency c-section and he wasn’t even in the operating room. Just too many volts for his circuits to handle.

      • Desiree says:

        The wonderful, supportive father of my babies who attended all the birthing classes? Hit an “8” and then a “10” and then an “x” (went unconscious) during my C-section. I love this chart.

    • charlie says:

      Baby crib = $400. Baby Delivery = $10,000.

      Watching a husband hit an “8” = Priceless.

  4. Lizzie says:

    I LOVE THIS!! Good thing I didn’t see your face Hubby! Also… wait… could sworn I told you not to look πŸ˜‰

    • andy says:

      My fingers were crossed when you told me not to look. C’mon! That’s like telling a kid not to peak under the Christmas tree. Just ain’t gonna happen!

      If you had looked, m’Luv, I was a 1-2 on the outside, but in all honesty there were moments that I was a well-suppressed 11 on the inside, wishing I was an X. πŸ˜‰

  5. Russ says:

    LOL. And The unconscious X is why they don’t allow fathers-to-be to be in the room anymore when the epidural is administered. I was a proud 1 (less if the chart allowed). Nothing grosses me out!! Except that first black tar poop….that was kinda gross.

    • andy says:

      I know exactly what you mean. I wasn’t grossed out really either, my bigger numbers came from concern and guilt. I can clearly remember thinking, “I will never have sex with my wife ever ever ever again! NEVER!” for what I had done to her. Ha ha! Ah, the miracle of life.

    • Benessa says:

      My husband was allowed in the room the entire time even during the epi.

    • Gale says:

      Oh yeah, that’s wise. The epidural was when my husband almost Xed. They asked him to hold my hands, and that epi hit a nerve and pain rushed in worse than anything else before or since (even including the worst of the natural birth of my third). I started squealing and suddenly it was the nurse who was holding my hands, not my husband. He told me later it was because he almost fainted, and not cause of the needle, but because of the needle + me screaming.

      Not all epis are like that, thankfully. Only reason I didn’t get one on my third was we got there too late.

  6. Liza@Blahggy says:

    Lasagna. Oh, Jesus Christ.

    • andy says:

      Sorry! Charlie threw that one out over the phone and then after I was done laughing and he realized I was going to use it, he asked if that might be too much. I figured too much is never enough when you’re talking about child birth.

  7. SuzRocks says:

    As one of those healthcare professionals that gets to giggle at the dad’s expressions/white face/etc, I think this chart is awesome.

    I may even print it out and hand it to expectant dads.

  8. Sarah_Moon says:

    My husband was calm cool and collected throughout my 36 1/2 hour first labor. He rarely left my side except when they came in to cause more pain then the act of birth actually caused.

    When he walked into my hospital room the next morning I saw a stranger he had gone completely gray every hair on his head and his beard had aged. He never lost it LOL

  9. Mich says:

    I hope we care equally when our daughters come into the world?

    • andy says:

      Gender wouldn’t matter to me. The idea that it would for some dads or in some cultures, where they would care more or less based on either gender, just creeps and grosses me out.

    • charlie says:

      I can’t wait to have a daughter, if we decide to have another child. I want a little girl I can protect who will have boyfriends that I scare the living sh*t out of….

      • Catherine says:

        Just make sure you do the Southern Dad thing. Have the boyfriend over while you are cleaning guns. And say things like.. nope.. not afraid to go back to jail.. nope… have her home by 10pm!

      • Christina says:

        My husband and I wanted boys so bad… I’m 35 weeks pregnant with our THIRD girl. Hubby is looking forward to scaring the boys, I’m dreading dealing with the girls (we are way worse, in my opinion). lol

  10. Mr Lady says:


    My son watched my daughter be born. I will never be able to fully document that reaction.

    Or afford the therapy that shall follow.

  11. I do have to say that my husband watched all three of my c-sections and he still wants to have sex. I alternate between being grossed out and grateful. πŸ˜‰

    • andy says:

      THAT is hilarious! Lizzie was super concerned I wouldn’t want to because of the “lasagna” factor. Which is just proof that pregnancy and childbirth can have strange effects on a woman’s judgement. She’s gorgeous and I love her and I lost count of the number of times I asked “So, uh, how soon did they say before we can, uh…?”

  12. Abie says:

    “we know that seeing our wives do what they did and our sons come into this world is something that cannot be given value”
    Whereas our daughters can eat s##t and die.

    • andy says:

      Wow. That was dark. The statement “our sons” comes from the fact that Charlie and I have only pulled boys in the slot machine of reproduction. Have a look at:

    • charlie says:

      Oh, Abie. I wish we were as crass and chauvinistic to say “sons” and mean “children”. Because then that way, we could get even more people to this site by being more shocking.

      My wife and I thought were going to have a girl before our son was born. I was BEYOND EXCITED at the idea.

      But keep commenting and coming back. WE LOVE HEARING FROM PEOPLE!

    • Avara says:

      Whereas Andy and Charlie are being nice, I wanted to say that your post was just plain rude, Abie. Andy has three SONS, Charlie and I have one child…also a SON. It has nothing to do with girls vs. boys. Perhaps it might be wise to think twice before writing such insulting things to strangers?

      • andy says:

        Go, Avara! Shakespeare got it wrong. Hell hath no fury like a MOTHER scorned. πŸ˜‰

        P.S. Without trying to sound too preachy, I don’t think Abie’s suggested nutritional program for daughters is very advisable.

  13. tystiles says:

    Love it! For the record I rocked the birth of my son like i’d been there a million times – held her legs up, cut the chord, all of it. Coming from a dude who can’t give blood because he will pass out at the site of a needle…

    • andy says:

      I know this is a dumb response, but what you said made me instantly think of “Dadbo: First Blood.” Hey, they can’t all be winners!

      Thanks for sharing and for being a rockstar, the world needs as many rad dads as it can muster!

  14. DadStreet says:

    I was a 1 both times with a bit of 2 for good mix. My wife had a C both times so I didn’t see much but did peak over a bit which was a little @#)()$*!@!

    We went through 4 years of scientific procedures and Frankenstien like experiments to have our little monsters so I was a bit broken in. Although, I’m not one for gross stuff and by gross I mean anything not directly related to sex.

    • andy says:

      Brilliant! I like your definition. Gross: adj. anything not directly related to sex. Ha ha ha ha!

      But, wait, my interest is peaked. What Frankenstein experimentation did two you have to endure? Sounds fertility related. I’ve got friends that have been trying for years, tried all kinds of crazy stuff, and are ready for cybernetic implants to help out (as soon as they’re covered by their health plan).

      You can share, or tell me to STFU. Or turn away and pretend I never even asked anything. After all, this is the Internet. πŸ˜‰

  15. adriana says:

    my husband looked like number 3 the whole time but was thinking like number 8.

  16. B says:

    Love it. As a mom of 3 I would have appreciated someone informing my husband how NOT to react in the delivery room. As a nurse? I find this absolutely hysterical.

  17. Becoming a dad will be my greatest accomplishment in life. I strongly recommend to all future dads the need to make time for childcare leave. I took 6 weeks. Twice. Looking back the time off being the caregiver for my family was the best investment I ever made. It strengthened the bond with my wife. I never left the hospital. The nurse only took vital signs and administered meds. I did everything else. Each time our child only left the hospital room briefly for the nurses’ shift change. It’s hard to believe this all took place years ago. Now when our family relives those moments my wife and children realize just how special they are to me. Children truly are a miracle from God.

    God Bless,
    Claude Plowman

  18. […] Universal birth assessment tool for dads. […]

  19. I really like your chart. And for the most part women do have the monopoly on pain in childbirth, save the rare time a mom in labor actually grabs her hubs crotch and gives it a twist.

    I came up with an invention years ago that would let a man who truly, earnestly wants to share the pain of childbirth do it.

    A plastic cup cradles the testicles. Then when the woman has a contraction a corresponding jolt of electricity lasting just as long and as intensely goes up the wire to the cup then to his family jewels.

    Strangely, no company has stepped forward begging to produce it. Go figure.

  20. Sara V. says:

    Love the lasagna comment. My husband described delivery as “watching your best friend being murdered with an ax”.

  21. John says:

    …12 days ago missed the birth of my son, was conned by Thai nurses that they’d wake me up when something started to happen but woke up naturally just after the happy event – no attempt on their part to involve/revive me.

    I think they’d seen your chart and know most foreigners go to 11.5 at least.

    I’m still disappointed (I think), my wife’s not (I know).

    • andy says:

      Oh man, that sucks so bad, but your comment is hilarious! Go get her pregnant again and when she goes into labor, pour super glue all over your hand and high five her playfully. πŸ˜‰ My promise to you:


  22. Laura says:

    hahahaha, I can’t stop laughing!! hahaahaha hahahahaha hahahaha.

  23. Oli says:

    Lol. I love you guys. My husband and and I had our first baby via home birth in a kiddie pool in our living room! He was so supportive during the “gross bits.” he was in front of me watching the whOle time telling me how close I was. He caught the baby and cut the cord. ( with our midwife- were not birth alone crazies) πŸ™‚ he was 1-2 that whole time. But earlier in the day he had to start pulling weeds in the yard to cope with my contractions.
    I’ve never seen him so happy to see my mother.

    • andy says:

      I love love love this comment. Ugh! You people are so crazy amazing! “I’ve never seen him so happy to see my mother.” Ha ha ha ha ha! Congrats!

      We’ll promise to keep providing material you can blame your insane laughter on as parenthood drives you insane. πŸ˜‰

  24. Annie says:

    We spent a great deal of time preparing my doctor. Explaining to them that he would in fact pass out if he had to see or deal with anything gross. We explained that despite his time fighting in two wars for some reason his brain considers child birth very different. He also cannot give blood without passing out. (that has changed since then but at the time he couldn’t)

    Well that all went out the window when due to NO fluid I had to have her almost a month early and she was not handling contractions well. Cue: emergency c-section DURING a tornado. The doctors were on the phone with their kids telling them to get into the closet during my c-section. The nurses in other parts of the hospital were rushing patients into the inner parts of the hospital. They didn’t give a sh*t about him passing out. They whipped her out of me as fast as possible and handed her to him without a thought. They plopped that placenta down right next to him. When he tells the story of that day it will bring tears to your eyes from laughter. He said it took everything he had as a Marine to NOT pass out. I am not sure who was traumatized more me or him! I didn’t get to see my daughter for close to six hours because of the weather. They had to put the babies some place secure. So in the end he had the look of 3 but he was at an 11,00000000 in his head. So that is the first and last time I will do THAT.

  25. Natalie says:

    “We may never look at lasagna the same again…” So, so hilarious. I’ll have to tell my husband this (and dad to our 16 month old) and see what he says.

    Just stumbled onto your site via Pinterest and I’m loving you guys. I’m pinning you ask we speak!

  26. […] Check out our related Instructional Diagram! An indispensable tool for the birthing process. […]

  27. An Annie & Isabel designer hospital gown might help distract the hubbies from what they are seeing and help reduce the birth reaction:-) This is our favorite assessment tool!!!!!

  28. Liz the Insane says:

    Been sharing this assessment tool with every pregnant couple I know (which is quite a few these days!) Everyone gets a huge kick out of it!

  29. Ryan says:

    Thanks for posting this. Our first born came along 1 week ago and my wife swears I hit more than a few of these marks. The best part of your article was when my wife asked about the lasagna reference. When she first mentioned it, I wasn’t sure lasagna made sense. But as I described lasagna, I busted out laughing and said next time we’d use a mirror so she too could understand. I guess it’s one of those things you just have to see to understand. Anyway, you guys are killar. Thanks for writing about this stuff. My wife and I love it.

    • Andy says:

      Ha ha ha ha! That’s so fantastic! I love the sneak attack the lasagna joke made on you, but don’t you dare hand a woman in labor a mirror. If she gets an upclose and personal look at the process, she may break the glass and then someone is going to die or be seriously injured. Ha ha!

  30. Matt says:

    I was there for wifey’s daughter #3, my daughter #1. Saw everything except the epi, helped cut the cord, carried over to the drying table. Did not witness that after, which from what I understand, was a smart choice. Daughter #4 I wasn’t there. Stupid deployment. Child #5, which is due around Aug.-Sept. timeline, I will probably be there for everything as well.

  31. britter says:

    Hilarious! What another view to look at. Fortunately I had a husband who actually fell in 1-2 range and did great. We’ll see how #2 is!

  32. Brian says:

    Not sure what my wife would rate me as, I will have to ask her when she and our 17 year old get home from hockey practice tonight. I would rate myself as a 5 on the first, but by the time we got done with number 6, a -2. I knew when she was going to deliver the last one, but could not get the nurse to get the doctor. I ended up delivering our youngest (2 years), but the doctor got in the room in time to cut the cord and clean her up.

    Now for number 4, I had to leave after the birth, they could not get the blood to stop. She ended up losing almost 2 quarts by the time they stopped it. Now that was scary.

    • Andy says:

      That sounds crazy scary! Lucas was rough, but it would have moved me way up the scale if there had been that much blood loss. Not because I’m squeamish but because IT’S F##KING HARD TO WATCH YOUR WIFE IN PAIN/DANGER!!!! Whew. Okay, I’m better now. πŸ˜‰

  33. Rach says:

    I was looking up the pain assessment chart image on the the internet and came across this site. I am terrified to give birth to my first new baby now. I was trying to be optimistic like it would be such a miracle and my husband would try to stand strong beside me. Basically I feel terrified and like I will never be attractive again. I wish I never saw this.

    • Andy says:

      Awww, so sorry it freaked you out. This post and our website are supposed to take the steam out of the freak outs of becoming a parent.

      I think that telling you not to be terrified won’t really do anything, but I’ll give it a shot anyways. Don’t be afraid. Read the comments here in the post. The vast majority of people barely experienced any drama. The drama depicted in the chart was just an extreme for laughs.

      You’re right about to embark on an amazing experience and journey. Nerves are expected. Maybe look at them as the nerves you get before meeting someone you really admire, getting married, or the excitement of going to a place you’ve always wanted to visit.

      Or go look at the other posts on our website, I’m pretty sure they’ll melt away some of the fear or worry you may have.

    • Gale says:

      Don’t worry. What’s attractive changes. My tummy turned to mush, and my husband says he likes it. I used to think “What, in a sci-fi kinda way?,” until he took a photo of my stomach…he snapped it when I was laying down and had my eyes closed…thought he was taking a picture of something else then he showed me. I just stared at that picture thinking, “Wow, that’s…actually beautiful.” and “Wow, this is how he sees me.”

      You will still totally be attractive to your husband. Even if he doesn’t like what pregnancy does to your tummy, he’ll be too happily distracted by what it does to your breasts. πŸ™‚

    • Joanna says:


      Please don’t freak out! You can do this! I had 2 drug free deliveries and while my hubby was likely a bit higher on the scale some of the time he was still strong beside me as I needed him to be. I encourage you to find some good natural birth stories (even if you are not aiming for drug-free, the stories might help you feel better). Birth is an amazing, messy, awesome thing however it happens, but finding a way through the fear is the so important!

      (I am pretty sure my hubby hit 11 on your scale after the 2nd was born when he made the mistake of looking over when they were pushing on my stomach/uterus and a gush of blood came out. It was only a little more then normal and they gave me a pitocin shot and it took care of things, but still, I think seeing that aged him by about 10 years. After the first he had been smart and was still looking at the baby).

      I also may have grossed him out when I asked the midwife both times to show me the placenta. =) I am with the Whoa Science poster on this one! haha

  34. porche says:

    this is very useful! My husband and I are expecting our first born any day now and we are doing a unassisted home birth (the risks have been assessed) so he will be the one catching the baby. Lol

  35. Outburst says:

    Am I the only male who was like No. 1 on the pictures? Maybee in Germany we are beforehand better informed about birth and know what will happen? I know no daddy here, who was more than a no. 2.
    My girlfriend wanted a natural birth so she pressed my hand (omfg! a 9 on the pain asessment tool) over the full time of the childbirth, relaxing 25 hours. I could barely use my hands for a week.

    • Outburst says:

      P.S.: Lasagna! I love Lasagna! Birth didnΒ΄t affect any of my eating preferences! πŸ˜€

    • Andy says:

      No actually you’re not alone. A lot of dads write in with really low numbers. The scale is more for humorous effect, though I’m sure there have been a few people who’ve hit the top of the chart.

      Yeah, my hand was put through the child birth vice as well. Wow!

  36. Priscilla says:

    You know.. my husband was a 1/2 most of the time until the episiotimy. Then he was a 11. LOL. And we’re EMTs.

  37. Christan says:

    I’m a birth doula (so I help support moms and dads during labor as a profession) and I absolutely love this! I’ve shown it to a couple of my clients and we have a good laugh… but in reality, it kind of HAS acted as a real-life tool, to get dad to relax and to get the converstaion flowing about what the he expects and what the reality of birth is. I seriously need a poster of this up in my office. I still LOL everytime I see it. When my 2nd son was born, it was my husband’s first experience with birth (due to deployment, he met our first son when he was a month old). I tried pretty hard to help him know what to expect, and he did great… until the placenta was born. Then he loudly said “oh my god!” and went to a good 8-9. I’m not sure what he was expecting, but he actually made me laugh out loud right then and there (not an easy task considering I had just given birth). To this day, he gets very animated with his side of the story. “I never expected it to be that BIG and gross, I thought she was birthing an alien twin!” haha, poor guy. Well at least he knows for next time. πŸ˜‰

  38. LizzieW says:

    Love it! My husband was amazingly unsqueamish, and did a very sweet welling up with tears as baby appeared! He panicked later when they handed him the baby…

  39. kevin says:

    You missed one. “Cool!”

    That was me. I was like the kid who just witnessed some awesome demonstration at the science centre, and now I want to tell my friends and parents about it, and maybe bring them all back and see if she’ll do it again.

    Now I know there are fellow geeks out there who were all “Whoa! SCIENCE!!”

  40. Mox says:

    I’m a stay at home dad and my son came much quicker than expected. I ended up catching him and saw everything. I was at a 10, but also overwhelmingly happy. An experience I’d never trade-in, but one I’d rather never have again, lol.

  41. Jared Hager says:

    I would say I was a solid 8 but I never looked below the mason dixon line. I knew if I looked below I would be a 10 or unconscious. Great table

  42. iyas says:

    What a fantastic tool! I’ve fathered 4 kids, natural water birth every time (though I valiantly refused the invitation to step into the pool – probably the wrong time to go for a personal best on the laps). I’ve been blessed with a fairly expressionless face, so I kinda look like (a balder and fatter) 3 whether I’m feeling 1 or 10. Should’ve taken up poker. Love this diagram (even if I’m late to the party).

  43. Danni says:

    So happy to have found you guys on Pinterest, y’all are too funny! I’m hoping my husband isn’t deployed when I give birth to our first..Then again he almost fainted before we got married, and there wasn’t blood or pain there! Wonder if he’ll be able to handle me giving birth haha πŸ™‚

  44. I am late to the party, too. I have the earthy-birth, hippie, wordy, female version to this chart:

    I suspect my husband likes yours better — I will ask him the next time we are out for an anniversary dinner, which judging by the ages of our boys (14, 12, 8, and 9 months) will be in about 20 years (if they haven’t come back home with their kids to live with us, that is…).

    Thanks for the ever-important dad-side of things :).

  45. Christina says:

    I’m sharing this on FaceBook for all of my friends (first time parents and veterans) that are going to be welcoming babies in the next couple of months. I also have to ask my husband what he was during my first two labors. I think he was a 4-6 during the actual delivery and a 1 the rest of the time. This chart, and the comments, make me laugh because my husband is a trained firefighter and in the Navy, but I have never seen him as frazzled as when I was in labor with our second. I was in so much pain because she’d found a great muscle that, apparently, looked like a good thing to try to tear through (rather than going the RIGHT way). We’re 5 weeks away from my due date with not only baby number three, but baby GIRL number three and I think, at this point, he’s just adding up wedding shotgun costs. πŸ™‚

  46. Karen says:

    My hubby was with me during a long and painful labor with our first child. I noticed, through the drug-induced haze, that he would disappear and reappear at intervals. Turned out I had to have a C-Section, which he was not allowed to attend. After it was all said and done he admitted he had gone off to throw up throughout the whole difficult labor, AND he admitted he wouldn’t have wanted to be in the OR for the birth, anyway.

  47. Laura says:

    My husband is an oddball, never left 1, and after two births with a front row seat (my OB believes in letting dad have a good view of the action if they want it so she offers a spot next to her) still says childbirth is one of the most amazing things he has ever witnessed. My (female) labor partner who helped us (husband is disabled so she did the things that involved moving and standing in tight spots) has a very different view of childbirth lol.

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