Tuesday, April 6, 2010

Who Should You Invite Into Your Labor Room?

I'm asked this question alot - and it is always a discussion at prenatal visits. Who should you include in your room - especially since so many family and friends these days are hoping to support you through the birth.

The easiest answer is - whomever you feel you want in the room.

If your goal is to go unmedicated on the birth, it is usually best to minimize the number of support people in the room in the active part of the labor. This is true for a couple of reasons - moms in labor "feel" everyone's eyes on them. Too many people focused on the mom can cause her to feel like a "watched pot". She starts believing it is up to her to move things along - and if it is moving slowly, she starts feeling the pressure - she can have "performance anxiety". I have seen first time moms stall out because the room is full of caring family. One first time mom was 9cm for several hours. When dad asked the family to step out for l5 minutes this was the key to helping mom finish up her labor and enter the period of excitement - pushing! Family were brought back in and everyone was thrilled to share the birth.

There is also the issue of a mom feeling the freedom to deal with contractions in any way that she feels she needs to do it. For instance, if moaning through a contraction makes her feel better - would it make other family members feel nervous or helpless assuming it is a cry for help - when actually it is a coping technique. Would their nervousness cause her to not deal with labor well?

What if she feels a need to move during contractions and yet feels too self-conscious of certain positions - will she be exposed during the movement, etc, and would this be uncomfortable with others in the room. If so - would she hold back from dealing with the labor the best way for her?

For a mom on an epidural - generally she is encouraged to get some rest before the big moment of pushing. Here again - this can be very difficult with alot of visitors in the room. Sometimes it even begins to feel like birth has been forgotten - it is just a time to eat, laugh, and visit. Of course, if the mom is wide awake - she may really enjoy the diversion. So--again, mom has the final say.

Now - having said all of that - do I feel it is bad to have family or friends in the room? Of course not - some moms have been supported by alot of people and felt their care and concern and support and they blossomed under this umbrella of love. I have fond memories of a first time mom - on her knees leaning over the back of the bed in a hands and knees position - and her husband, dad, mom and sister all had one hand on her back gently rubbing her. She told me later that was her favorite memory from the birth.

I have fond memories of sitting on a stool in the corner, while the mom's mom and husband played the support role beautifully. Having a doula does not mean your family and friends are not welcome - or needed!

So - birth is a journey and there are times the journey needs to be minimized in the room and times it can be expanded. Early labor is a great time to visit, laugh, feel everyone's support. Pushing is usually a time of loud encouragement and energy - great to have family and friends for support (if the mom and dad are comfortable with that). I feel it is a gift you give to your loved ones - a wonderful gift of sharing the birth. It is just that middle part that seems to necessitate a smaller room of support in many cases.

So having an honest conversation with family and friends in advance is the best policy - letting them know there may be times you will need them to leave. (And that of course includes the doula!) It may be you need to tell them in advance that their greatest support role will be after the baby arrives, not during the labor.

A doula's role in this is not to make rules of whom you should have in the room or to be the person sending people out of the room - she is just there to fill in the needs of the laboring family - and sometimes those needs are to give them privacy.

So who should you have in the room - give it some thought - have honest conversations and then relax - it's wonderful to have so many who want to support you in this wonderful journey! (And I'm included in that group!)