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!)

ANOTHER FIRST BIRTH EXPERIENCE

Recently I attended a birth with another first time family. The mom later posted her birth story to her childbirth group. With her permission, I'm posting it on my blog - one more story to say birth can be an amazing journey! Enjoy the story:


"I went into early labor around 2 am Monday the 8th, but it just felt like period cramps to me, so I went on with my day, continuing to cook, going to the grocery store (where the clerk told me that during my contractions, someone came up to him and was worried that I was going to "pass out." He replied, oh, no, she's just pregnant (I'm there every day so they know me), and all the other silly things I scrambled around doing in the weeks leading up to the delivery. By about 10 pm, things got serious and by midnight, I called my mom and doula to come over. Thanks to my husband, mom, and doula, Cyndi Whitwell, I labored at home as long as possible, so when I arrived at Sutter Davis at 3:30 am, I was 7 cm dilated. They immediately filled up a birthing tub for me - oh - that warm water felt so good! My husband got in with me and just about exactly 3 hours after I arrived at the hospital, I gave birth to our son in the birthing tub, with his bag of waters still intact, at 6:29 am. I scooped him up out of the water and held him, with his eyes locking in with my husband's behind me and his little finger grabbing on tight to my husband's finger, for about 20 minutes until the umbilical cord stopped pulsing.
We had a magical experience at Sutter Davis, and I must thank Vickie for opening my eyes to natural childbirth, the power of having a doula, Sutter Davis, and the Sutter West midwives. All the preparation I did paid off -- without it and my support structure, I would not have been able to reach my goal of natural childbirth - and would not have been able to do it without the birthing tub! For your next birth, do whatever you have to do to hire Cyndi Whitwell as your doula and deliver at Sutter Davis. I couldn't do it again any other way."

Due Dates

I read an article once on how 40 week gestation cycles were first figured out.  It seemed very "unscientific" to me when I finished reading the article.  But it confirmed what I already knew - it's like throwing a dart on a target.  If it lands anywhere within the many circles, you have hit the target.  Same is true with birth - there is a built in leeway of 2 weeks on either side of the "due date".  And we all know gestation cycles vary per woman, just as ovulation cycles and menstrual cycles are unique to the mom.

When I was having my own sons three decades ago, we weren't sent through emotional turmoil with several due dates, like moms face today.  Really, what is the first question people ask, "When are you due?"  How do you respond?  Years ago it used to be, "in the spring", now it's April l2th.  But was April l2th calculated by the first day of your last period?  Or was it the 20 week ultrasound?  Or was it the followup 30 week ultrasound? 

Why does this matter?  Because moms facing labor today have enough stresses to worry about - without having to be hung up on a certain day.  Moms who delivered at 38 weeks with their first, use their due date for #2 to say - I could go into labor anywhere from 37 weeks on. And if they reach the 40 week mark, they feel so overdue they can't stand it anymore.  Moms who are worried about induction, use that target date to start stressing over labor not starting as the date approaches.  And of course, if they are stressed, they are suppressing the ability to go into labor also.

So what is the answer?   I have always felt the baby was the only one who really knew the due date - it was their choice - they are designed to know when they are "ready" to come.  In almost 24 years and almost 700 births providing labor support, when moms have been allowed to go to 42 weeks, I have only seen about 3 or 4 inductions.  So I trust that babies just know when they should come.

When someone asks, "When are you due?", what's wrong with saying "mid-April", "early June", etc?  Or even "soon". 

Having said all of this, since I base the amount of births I take by the calender month of the due date, if I ask when are you due, I really do need a "due date" - so pick one you like and let me know, and then we'll leave it up to the baby to pick the right one.