Who will be at your birth?
That's a question on many parents' minds, especially those preparing for their first birth experience. It's such a common question, in fact, that there are even infographics for doulas to give their clients to help them figure it out.
Sometimes this question springs from a place of wanting loved ones around you to support you through labor. In other situations, family members or close friends raise the question, hoping they'll be able to witness the birth of this new baby they already love so much.
Of course, for some people this is a no-brainer. They either know for sure, 100% that they don't want anyone else with them during birth, or they know with absolute certainty that they don't want to go through this experience without someone else special in their life.
But if you don't fall into the "100% already know for sure" category, let us offer you some words of wisdom.
If you have a partner and there is any question around who will be at your birth, this is definitely something to talk about together. The main hormone responsible for labor is oxytocin, the same hormone involved in cuddling, intimacy, and sex. Adrenaline interrupts the flow of oxytocin, so having someone in the room who activates that "fight, flight, or freeze" feeling is not conducive to the birth process. Deciding together which people in your lives will be involved in your labor can help you both feel more comfortable as you approach your birth.
Our birth doula clients sometimes ask our opinion about whether their mother, best friend, sister, mother-in-law, aunt, grandmother, etc. should attend their birth. Our answer is always... we don't know! Only YOU can sense what might feel most helpful, comfortable, encouraging, supportive, and safe for you in birth. Spend some time feeling this out alone and with your partner (if you have one).
As doulas, we've been present at births with anything from one extra family member to something nearing a party of close family and friends (up to 15 people in the labor room... seriously!) and there are some things we want to share.
If you decide you would like to invite any additional loved ones into your birth space, there are a few things you should know:
1. Typically the feeling of being watched during labor is not helpful.
The hormones of labor don't work in conjunction with the hormones in our bodies when we feel like someone is watching us. There is much you can read on the subject, but suffice it to say that the "being watched" feeling can slow labor progress. If you are inviting others into your labor, you may want to consider whether they are people who can simply be there, be with you, rather than lead to you feeling observed or scrutinized.
2. If you want someone to spend some time with you during labor, it doesn't have to be all or nothing.
We love the idea of "labor visits." It can be special to share a few minutes during labor with your loved ones, even if you don't want them to be present the whole time. If you're interested in doing this, we recommend considering these visits in early labor so you can limit who is present during active labor and pushing (when you may be much more preoccupied with the business at hand).
3. "Be our guest" should not be your motto.
Consider whether you (or your visitors) will feel that you need to take care of them, make sure they're ok, etc. while they're with you. YOU should be the only one you're worrying about during labor! If you have loved ones who you feel might expect to be cared for by you, consider carefully before inviting them into your birth space. (This might be especially applicable for a home birth - it’s very easy to feel like you need to be a host while you’re in your own home.)
Depending on the needs and personalities involved, it's not always easy to have a visitor in the room who is physically uncomfortable, even though birth is not always comfortable for others present. When the person in labor experiences temperature fluctuations (totally normal during birth) and needs the thermostat adjusted up or down, sometimes it's not super comfy for others in the room. Or sometimes when laboring overnight, visitors have trouble getting comfortable to try and nap. Once we witnessed a laboring person's mom interrupting the care providers to ask if they could get her a couple pillows because the chair she was sitting on was uncomfortable. Let's just say that moment wasn't pleasant for anyone involved.
Side note about language barriers: Some of our clients have had loved ones in the labor room who don't speak English. If you don't have a partner or if your partner doesn't speak the same language as your loved ones, this puts you in the position of interpreter. We've seen situations where the person in labor has not been able to continue interpreting, causing a lot of anxiety on the part of their relatives who no longer have anyone to help them understand what's going on and if everything is ok.
4. If you're birthing in a hospital setting, it's easy to feel that having visitors hang out in the waiting room is a happy medium. In our experience, that isn't the case.
In some hospitals, the waiting room is only a few steps away from the labor and delivery rooms. This means that the people who you've decided you don't want in the room with you might be hanging out only 30 feet away from your room. That short distance just isn't the same as having the person you didn't want in the room situated several miles away from the hospital in their homes or going about their business.
Remember the "being watched" thing we just mentioned? That REALLY applies here. Sometimes it's even worse to have loved ones in a waiting room because you might feel guilty that they are inconvenienced or uncomfortable, spending their time waiting around in a hospital. This is especially true if you're laboring during the middle of the night.
Another moment that can be awkward in this case is when to say goodbye. If loved ones are in the waiting room and end up leaving (for whatever reason), they and/or you might feel awkward if they leave without stopping in to say goodbye. Which means a visit into your laboring room at a time that might not be good for you to have visitors.
It's also important to remember that it's possible your loved ones might overhear information about your labor from the waiting room. Depending on the layout of the floor, sometimes nurses are talking to each other, making phone calls, etc. near enough to the waiting rooms that your loved ones would be able to hear their conversations. If you don't want the details of your labor shared unwittingly with your loved ones, this might be another reason to ask your loved ones to wait at home rather than in the hospital waiting room.
5. Although it sounds sweet, visitors right after the baby is born are usually not a great idea.
There is often a lot going on right after the baby is born. As excited as your loved ones may be to meet your little one, and as excited as you may be for them to meet, consider waiting a couple hours before inviting visitors in. Let yourself get settled and meet your baby first.
A baby's first hour or two are extremely important for their ability to bond, initiate breastfeeding, and begin learning how to regulate their body systems. Since there is usually already activity happening during that time, it's usually best to limit visitors. Newborns are still just as precious several hours (or even days) after birth!
6. It's absolutely ok (and probably a really good idea) to set ground rules.
Ideally, loved ones will have the utmost respect for decisions made by someone who is expecting or in labor. But if you've decided to invite a loved one or several to spend time with you during labor, it's ok (and probably a good idea) to set some ground rules, just in case. Here are some things you might consider:
If your visitors have witnessed or given birth themselves, they will probably have memories of those past experiences while they're with you. It's ok to ask them not to share those birth stories during your birth. The last thing someone in labor needs is to hear, "With my third, I only felt two contractions and then the baby was out!"
Ask them to turn off their phone sounds (calls, texts, alerts, etc.)
Ask them not to take phone calls in the room. If they need to talk on the phone, you can ask them to walk outside and close the door behind them beforehand.
Consider whether you want your loved ones asking questions directly to your care provider. Some people are fine with this; others feel they would like to be the only ones communicating directly with their nurse, doctor, or midwife.
Ask them not to wear perfume or cologne, or bring strong smelling food. The sense of smell can intensify during labor, so it's best to avoid having heavy scents in the room that you didn’t choose yourself.
Set the expectation that there may be times you might ask your visitors to step out of the room. These might be times when personal questions are being asked (during the hospital admission process for example), when you aren't fully clothed, when a cervical exam is being performed, when you need to have an important conversation with your care providers, or if you need some time to yourself for any reason. If you are limiting visitors during your baby's first couple of hours (which we highly recommend), you should also let your visitors know this ahead of time too.
If you're working with a doula, consider explaining the doula's role to your visitors ahead of time. This can help limit confusion and hurt feelings, especially if there are times they are asked to step out of your room but your doula is staying with you.
Let your visitors know ahead of time that depending on how your labor goes, you may ask them to leave at any time for the remainder of the birth. Situations like that can be hard and emotional because often, your loved ones feel the best place for them to be if things are difficult or scary is with you. But the truth of the matter is that you may feel more able to get through a difficult moment in birth if there are fewer “extra” people in the room, so you can more easily focus on whatever happens to be going on.
If you're birthing in a hospital setting, there may be restrictions on how many people can be in a labor and delivery room at one time. This may necessitate some rotating in and out if you plan to have several visitors. We recommend finding out your hospital’s guidelines ahead of time and making your visitors aware well before labor begins.
7. You have the right to change your mind.
If you invite loved ones to be with you in labor and then change your mind before (or during) birth, that's ok. It is perfectly fine for you to change your mind about something during such an important, intimate event in your life. If your social brain tells you that you shouldn't go back on your word and uninvite someone, please remember that your birth experience is MUCH more important than your loved one's experience attending your birth.
8. Whatever you decide, communicate with your care team.
Let your care providers know what your wishes are regarding visitors at your birth. Whether you want anyone and everyone who drops by to be let into your room, or you'd rather have the chance to say yes or no before anyone comes in, it's important for your team to know. Your partner, doula, and care providers may all help act as gatekeepers if needed.
You may even want to work out a code word or signal of some kind between yourself and anyone else who will definitely be with you (partner, doula) in case you want to ask any visitors to step out for a few minutes. Just in case. And it’s totally ok for you as the person in labor to NOT be the one who has to ask them to leave! If you have a partner and/or doula who can help, that’s great. If not, or if extra help is needed, nurses are usually quite happy to take on the role of unwished-for-visitor-kicker-outer.
If there is anyone you definitely don’t want at your birth (or if you want a zero visitors rule), hospitals usually have a system set up to make you "anonymous.” Usually the hospital security team will ask you for a password so that any of your loved ones who have it will be let in, and anyone who doesn’t will be turned away. If you feel strongly about preventing anyone from showing up (announced or not) to visit you during labor, this is a very useful thing to keep in mind.