Creating a winning birth team…

So you are going to have a baby!! The time is approaching and you are beginning to think about WHO is going to be present for the big event.  Will your mother be there?  Your best friend?  Your partner/husband? Did you hire a doula?  What will your nurse be like?  What midwife/doctor will be on call?

While to some these may seem like simple questions for others they cause extreme stress and anxiety.  The wrong people can create uneasy conflict in your birth room while the right team can create harmony and peace.   There are two primary categories of people who make up your birth team; your health care providers, and your family and friends.   The ultimate goal is a winning team where Together Everyone Achieves More, and where they work together to create a conflict free birth room filled with peace, happiness and love.

Let’s quickly talk about the people on your team:

Your midwife/doctor: IF it is very important for you to KNOW the provider who will catch your baby, you want to be sure you pick someone in solo practice or choose a group with only a few providers.  Make sure you are able to meet everyone of them more than once during the prenatal period.  Keep in mind, everyone needs a day off sometimes, so even with a solo practitioner there is the off chance that your provider may be unavailable.  However, if this is VERY important to you, you can minimize the chances of having a “stranger” in your delivery room if you choose the right provider prenatally.

If it is important to have your provider present throughout your labor, providing support and encouragement, be sure to talk to them EARLY in your pregnancy about your wishes to determine if she/he is the right provider for you. Generally speaking, if you really want your provider to give you labor support you should choose a midwife.  While not every midwife provides labor support, in general a midwife is more likely to be with you in labor compared to a physician.  The bottom line about your birth attendant is knowing that you cannot wait until labor starts to choose the right provider for your labor and delivery team.  This is a process that MUST begin the moment you find out you are pregnant.  Your provider is an integral part of your birth team and you want to be sure you are happy about your choice.

Your nurse: If you will be birthing your baby in a hospital, your nurse will be a critical part of your birth team. She will likely spend more time with you than anyone else.  Not every nurse is the perfect fit for every patient but with a little patience and open communication, you can make the relationship work.  Know what you want, and be prepared to discuss it with the nurse upon admission.  Having a written birth plan is not a bad idea but it is not required.  The most important thing is to know what you want and to have a CONVERSATION.  With open communication, your nurse can become your biggest advocate and friend. There are times when regardless of communication, you and your nurse are not a good fit. When this happens, you can ask for the charge nurse on duty and request another nurse. While this is not always possible due to various staffing and time constraints, it is worth trying if all else fails and there is a definite conflict.

Your doula: Doulas are not just for women who want to “go natural.” While this is where they are primarily used, they can be a valuable asset in any birth room.  Like your prenatal provider/birth attendant, it is important that you meet your doula BEFORE labor starts. It’s important to choose someone who you feel comfortable with.  You want a doula that is going to respect what YOU want, without trying to push her values and beliefs about birth onto you.  You want a doula that has the skill to speak up for you without alienating the staff at the hospital.  Nurse/doula relationships can create some of the biggest conflicts. Be sure to communicate with both the nurse and the doula to make sure they are a part of YOUR team, not in a competition.

Your family and friends: Some women feel obligated to let anyone into their birth room who says they want to be there.  I have seen women become visibly stressed out about trying to decide who should be there and feeling some obligation to allow this one or that one in the birth room although she really doesn’t want that person present.  Some of the relationships that I have seen create the biggest conflicts for women include in-laws and friends especially friends where she was present for their labor and birth.  Birth is a special time for the mother her partner and their infant.  Just because you were invited to her birth room does not mean she has to be invited to yours. Those wedding/party “rules of etiquette” don’t have any place in labor and delivery.  This is a very different experience and should be treated as such.  It is a private event and should include only the people you REALLY want to be present. Remember that during labor and birth, much of you may literally be exposed and if you are a having a natural/unmediated birth you will be in a vulnerable state.  EVERYBODY does NOT need to be there.  Labor and birth is not a spectator sport yet when you have LOTS of visitors during the process just “waiting for the baby,” this is what your precious birth experience has the potential to turn into. When you are trying to work with your contractions or rest after an epidural, the last thing you need is your family/friends standing around “speculating, and watching.”

To avoid in labor decisions/conflicts be sure to have these discussions with your partner, mother, in-laws, friends and doula BEFORE labor ensues.   An easy way to avoid some of the conflict is to keep your “I’m in labor” phone calls to a minimum. After you have the baby and you have had time to rest, THEN you can make all the calls you want. If they don’t know you are in labor there will be no stress about uninviting them from the birth room.

If you do end up having lots of people coming to visit, I encourage my patients to send non-essential visitors HOME.  Let your nurse or your doula be the “bad guy” to send them on their way.  It’s like you are the quarter back and we are the offensive line. We protect you. Ask us and your wish is our command.

After delivery, you will want to rest and spend some private time bonding with your newborn.  Encourage your friends to come over to your house AFTER you are home. You will feel more like normal and be more open to visiting. As a side note, I also make the suggestion that you ask friends to come bearing edible gifts!! Who has time to cook with a newborn baby!  While they love us the most, family and friends are often the ones who create the most conflict.  Be careful about who you choose to invite/allow into your birth space.

When it’s all said and done, you are the captain and your partner is the co-captain of your birth team. Together you have to decide what other team members will help you win.  Be sure to Choose Wisely because your birth team can have a profound effect on your birth experience.

In Birth and Love
Nicole ~ Follow me on twitter @SistaMidwife


11 responses to “Creating a winning birth team…

  1. This blog post is what I’ve been looking for! We’re planning a homebirth and at 39 weeks I’ve been wondering recently how to handle the spectator situation. My 13 year old daughter would like to be present, and I agreed, but I can’t even leave the room most days without her arguing with my husband, and I definitely don’t want any of that going on during my birth. I want so much for her to be able to witness for herself an unmedicated birth, but I’ve been thinking that this desire shouldn’t trump my need for calm. The team approach is definitely not looking like it’s in the cards. I didn’t realize I was making myself into a teaching object until today when I found a link to your blog and started reading. Thanks.

    • Hi Janice, at 39 weeks when you made your comment, I hope I havent missed the big day :-)… I wanted to just quickly reply and remind you that a TEAM does not have to mean having lots of people physically in your birth space. There are many people on the TEAM. The question is what role do they play. Your daughter is still a part of your family and is therefore a part of the TEAM. Perhaps you can involve her in other ways by making her in charge of the phone tree or in charge of preparing the first after birth family meal. Also remember that there are TEAMs of 2 and 3 so if you decide to have only your husband and birth attendant with you during labor and birth THAT my friend, is your TEAM. You wrote “The team approach is definitely not looking likes its inthe cards.” Remember its not the size of the TEAM that matters its who is on it and what role they play. Small TEAMS are just as effective as large ones. So make the TEAM you feel you have to, based on the situation at hand… and go forth and win!!

  2. First birth- just the husband.

    Second birth- hubby was definitely there. I felt closer to my MIL and invited her to be a birth coach and attend the birth, too. She helped take pictures and was a blessing in helping me with pain management.

    And I’m pregnant with our 3rd. I haven’t really thought about what we’ll do this time around and it’s far enough away that I have time to think about it. But I enjoyed having my MIL and husband working together to help me. It’ll be interesting to see how things pan out!

    • Great to get your comment Joy. I definitely think its interesting how with each birth choices and decisions about who is in the birth room can change. I see that with a lot of women. Good luck with the decision for baby number 3!!

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  5. I would only add that even if you think someone won’t be able to attend the birth, you need to make sure that if they’re a close enough friend or relative that you let them know that they’re not invited to the birth. A friend of mine assumed that her MIL would not even know she was in labor because she lived 2 hours away and she wasn’t planning on calling her until after the baby was born. Well, she happened to go into labor or her water broke while the MIL was visiting, and then the MIL refused to leave. (Although, if dealing with the in-laws, I would say that it’s best to have the spouse have “the talk” to dis-invite them.)

    • OUCH….that was probably interesting. I have seen people show up who no one thought would so you make a really good point. If you can let them know ahead of time that they are not invited (in a nice and loving way of course) let them know. Then there are fewer surprises. Thanks for the comment!!

      • Oh, yeah, it was **really** fun — the birthing mom wanted her sister to be there when the baby was born, but the hospital had a limit on the number of people who could be in the room, so somebody had to go. The MIL refused; the husband didn’t make his mom go; the laboring woman was not in a position to argue. Fortunately the staff finally allowed the sister to stay in as videographer, as long as she stayed over by the door, well out of the way.

    • Birth_Lactation

      This is a great collection of info! In my situation as the dreaded MIL (ha ha)…I was told in advance that they wanted to be alone for the birth. No other family at all. I was in the waiting room with everyone else though having driven 2 hrs. I was not at all upset..It was their birth—their way!
      I have seen so many people expect to stay at a birth because they want too…invited or not. We as the staff try to act as advocate for mom in those cases. Thanks Nicole for another fabulous post!

      • Thanks for the comment. Its so great that you knew how to stay on the sidelines. It would be so nice if everyone did!!

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