In the Labor Room: A Doula’s Tips for Friends and Family
In addition to doulas–and more frequently than doulas–friends and family members are often asked to accompany a woman and/or her partner in the labor room.
As a doula, I’ve attended births where I was the only additional support person, and I’ve attended births where I was one of many additional support persons. Even as a woman in labor myself, I’ve chosen a number of different support people for each one of my three births.
One thing I’ve noticed–both as a doula and as a laboring woman–is that these additional support people are sometimes unsure about how to navigate “labor room etiquette.” They might wonder what to do, what to say, what not to do, what not to say. And oftentimes, the answers to these questions vary from woman to woman, from birth to birth.
I’ve come up with a number of recommendations for those who have been asked to be present during a woman’s labor. To be clear, a physician or midwife or labor and delivery nurse would probably have slightly different–and equally valuable–suggestions. But from my perspective as someone who is trained to give continuous emotional and physical support to women during labor, this is what I think people should keep in mind when they are asked to join a woman in the labor room.
Ask about what your role should be ahead of time.
Each woman is going to have a different idea for the sorts of roles she envisions the members of her support team playing. She might want her partner and the nursing staff and care provider to be the only people who touch her. Or she might be inviting you because you are known for your spectacular arm massages. She might not want any photographs of the birth. Or she might be inviting you specifically so that you can take pictures. She might prefer silence from everyone in the room during her labor. Or she might want you in the room because she loves the verbal encouragement you’ve always given her.
All you need to do is ask what she wants from you. And when she describes what your role is–even if she changes her mind about that role mid-way through labor–all you need to do then is respect her wishes.
If a woman is coping well, let her set the tone for the room.
By “coping well,” I don’t mean that she is all-smiles and chatting throughout every contraction. Instead, I mean that she is managing the intensity of her contractions with whatever type of coping is working well for her at the time.
Coping can be quiet, or it can be loud. It can involve singing, grunting, and even swearing. It can involve movement and swaying and rocking, or it can involve a relaxed stillness as a woman goes deep within herself to meet each contraction. It is often rhythmic: not frenzied or chaotic, but not necessarily still and silent either.
Whatever the case, as long as it is clear that her pain has not become suffering–as long as she is coping and not losing her ability to manage her contractions–then it is best to follow her lead when it comes to the tone of the labor room. Is she making jokes? Don’t worry about laughing as much as she is laughing! Is she serious? Let her be serious! Is she downright blissful? Revel in the bliss with her! Is she expressing a little bit of fear about the work ahead of her? Give her a safe space to share her feelings!
Just don’t try and force the tone of the room to be anything other than what a well-coping woman wants it to be. These moments are about her comfort: not yours.
If you don’t have anything nice to say, don’t say anything at all.
This is something my mom always said to me when I was a kid. I think it’s just as appropriate for adults as it is for children, and I think it’s especially appropriate for the labor room.
For on the one hand, this will be the day that a woman is bringing her baby (or babies) into the world. It’s not the time for her to feel stressed out, scared, or hurt by what other people say to her or about her.
On the other hand, stress, fear, and doubt can all have negative impacts on pregnancy and labor themselves. So save comments or topics that might stress out the mother for another time and place: in the labor room, it’s the time and place for love, support, and encouragement.
Unless you have been given express permission to do otherwise, don’t speak for the laboring woman: let her and her partner ask questions and express their own concerns.
Even as a doula, it is not within my scope to speak for a laboring woman. I can help her to formulate questions to ask her care provider. I can encourage her and support her and remind her that she always has the right to ask questions about her care. But it’s not my role to ask these questions or speak to her concerns myself.
To this effect, it can be stressful both to a laboring woman and to her caregivers if her support people are attempting to speak in her place. It’s not that it is inappropriate to ask questions regarding an issue or recommendation about which you are curious. Some nurses, midwives, and physicians even love to educate others about the process of childbirth! Just make sure that any questions you ask or comments you make are a) voiced at an appropriate time (i.e. not when the caregivers are busy attending to immediate concerns) and b) not intended to replace a woman’s own voice.
Leave comparisons to other people’s labors for another time.
Bring up your cousin’s labor that lasted for 58 hours? The woman in labor is likely to start worrying that her labor is going to be an ultra-marathon too.
Mention something about how her sister’s labor only lasted 3 hours? The woman in labor might think that she’s “doing something wrong” by taking a longer time to bring her baby into the world.
References to how you didn’t use any pain medication might make the woman who is opting for an epidural feel as if she is letting you down, and exclamations that this is “just like last time” might make the woman planning a VBAC feel as if she is headed for another cesarean section.
Each woman, each baby, each labor, and each birth is different and unique. Comparisons to any other woman, baby, labor, or birth might very well send the laboring woman into a mental and emotional tailspin. Just leave those conversations for another time and place.
If you are asked to leave the room, don’t take it too personally.
Oftentimes, a woman in labor will discover that what actually wants is different from what she expected she would want. And so the woman who couldn’t wait for you to join her in the labor room might determine in the midst of labor that instead of a room full of people, what she really wants is just her, her partner, and her caregivers.
As sad as you might be to leave this birth–and you are certainly allowed to feel sad about it–try and respect whatever needs the laboring woman might be expressing with her request. Tell her you love her and step out quietly, in kindness and in gratitude for the moments you were able to share with on this special day. It’s likely not that she loves you any less: it’s just that at this particular time and place, she needs more peace, quiet, and calm in order to move forward in her labor.
Be kind. Be thoughtful. Be grateful for this amazing opportunity. And act and speak from a place of love.
So much of what I have written might seem like a stern list of “don’ts”: a list that is lacking many “do’s.”
For the most part, I wouldn’t expect someone not trained to provide labor support to be able to do what trained support people are able to do. I wouldn’t expect friends and family to provide medical care (that’s for the midwives, doctors, and nurses), and I wouldn’t expect them to have knowledge of all of the physical and emotional comfort measures that doulas offer (that’s what we’re trained for).
But I would expect them to love the woman and/or her partner, and I would expect that love to be far different and much deeper than the feelings that any of the hired support people or care providers have for the new parents.
This is what you bring to the labor room: that unique, amazing, deep love for the new parents and the new baby. And if you act from this love, if you speak from this love, if you choose everything you do in the labor room from a place of selfless love, then you will likely be giving the best possible support you can in the labor room.