Who Should Be There?: Making Decisions about Who Will Attend Your Birth
by Farrah Sheehan
Many parents-to-be spend at least some time worrying about who should be present for the births of their babies. Childbirth educators, doulas, and other birth professionals often field questions about the matter. “Who should I bring to the hospital with me?” “So-and-so wants to be at the birth, but I’m not sure I want that…what do I do?” “My family thinks that since I’m having a home birth, they’re all invited to be there!” “Everyone wants to come see the baby right away after birth, but is that the best thing for me or the baby?”A while back, I read an article entitled “Unpopular Opinion – Childbirth is Not a Spectator Sport.” (We can’t locate the original piece by Melissa Charles; the link is to a page that contains a copy-and-paste version. - eds.) The article received many comments, and it was interesting to see how those comments revealed a huge variation in opinions about how and why to keep childbirth “private.” It can be confusing: our culture sends mixed messages about who should be present in childbirth, and our biological predisposition may encourage us to welcome others in for support and reassurance. In addition, as we prepare for parenting our relationships are changing. This can make decision making and conversations about what we want and need in labor and birth difficult.
While many adults in our culture will say that they know nothing about birth, the truth is that we are exposed to countless ideas and “facts” about birth through TV, movies, social media, and friends and family.
There are many, many images of labor and birth imprinted upon our psyches by the time we are getting ready to have a child, and along with the images come unconscious beliefs about the experience, including who should or should not be present. Parents-to-be often have conflicting images of intimacy and privacy on the one hand, and plenty of community support on the other. To complicate matters further, parents-to-be have had a lifetime of being the child — even as adults, they are still their parents’ children — and may feel reluctant to disappoint or upset their own parents (or other relatives and friends) by refusing their presence during or immediately after the birth. Their instinct is often to keep peace rather than risking relationship breakdowns at a time in their lives when they intuitively know they will need these relationships the most. When we consider our biological needs and programming, we can have even greater awareness of the complexities involved in the presence of others in labor and birth. As far back as we know, birthing people in most cultures have been attended in labor, birth and postpartum by community members. Not only do birthing people often yearn to feel loved and supported, but also the presence of trustworthy, wise, and loving support affects their biology, allowing their minds and bodies to work optimally towards birth.Yet over the past few generations, our culture has removed birth from the family and community and turned it over to the health care industry and hospital system. This often leaves birthing people without a natural circle of support people who are both trained and experienced in birth and close enough to the parents to be able to help them navigate their emotional, spiritual, and physical needs during labor and birth. Medical professionals may not be able to meet parents’ personal needs; but on the other hand, those in parents’ family and community circles may not have the experience and skill necessary for understanding and providing what is needed in the moment. This is why supposed support people sometimes end up becoming mere spectators, or worse, destabilizing nuisances.
Given all of this complexity, exploring the question of who could or should be present at a birth can be a very rich part of childbirth preparation.
In “Worry is the Work of Pregnancy” on this blog, BFW founder Pam England points out that worry is an integral part of preparing for parenthood — our worries tell us what sorts of preparation we need to do. So if you find yourself, as an expectant parent, worrying or wondering about how to decide who will accompany you in labor and how to communicate that decision (often the most difficult part), you may find more value in exploring the question rather than suppressing it out of fear of negative feelings.
The first step in working on this issue is simple but important: acknowledge that these decisions are complex and sometimes difficult, and that they involve layers upon layers of feelings and beliefs that have been laid down over a lifetime of relationships and cultural influences.
After acknowledging this to yourself and perhaps your partner(s), you might then use questions like the ones below to help you consider what is most important to you in labor and birth — and how you know those things to be important. You might journal about these issues and/or discuss with your partners, friends, families, or birth professionals. Some questions that maybe useful are:
Who do I want and not want to be at the birth?
How do I know that I do or don’t want ____ to be there?
How do I know to have or not have that discussion with _____?
What is it about _____ being there that is appealing to me or a problem for me?
How do I think having or not having _____ present might impact my partner(s)?
If there are people who I want to be involved but not present at the birth, what are other meaningful ways for them to be involved?
If there are people who seem to really want to be present, what do I think they are wanting to know or experience that they believe they will receive from being present? What are some other ways they may be able to receive this?
What do I think a support person needs to know/do/be in order support me best?
Finally, it’s important to remember that the path of labor and birth is profoundly unpredictable. Perhaps one or more of the people who you had planned on having at your birth (doctor, sister, partner, doula) end up unable to make it there, or turn out to not be the best fit for your needs in labor. Or perhaps you end up receiving invaluable support from an unexpected source (backup midwife, mother-in-law, shift nurse). So ask yourself:
How might I feel if my preferences about who is and is not present at the birth do not come to pass? What might it take to make that okay? What might I need to cope with that situation?
How might I feel if my support works out differently from how I am hoping/imagining? What might it take to make that okay? What might I need to cope with that situation?
Expecting parents do a variety of things to prepare for birth — they may take classes, read books, write in their journals, practice relaxation or mindfulness techniques, create art, and/or do physical exercises.