Tuesday, December 8, 2009

A Word About People in the Birthing Room

I hope you all had a wonderful weekend. I'm wondering if any of you doulas or midwives have experience this phenomenon...the-labour-lasting-forever-even-sometimes-ending-in-section-because-woman-has-no-privacy phenomenon.

Ina May hits the nail on the head when she talks about sphincter laws...how can one progress when one is feeling imposed upon by others, even just energetically? If you're trying to go to the bathroom or make love, and there are people outside...not even in the room watching you, but outside knowing what you're up to, you kinda lose your mojo, know what I mean? Our sphincters are sensitive to scrutiny (say that 5 times fast), and the cervical "sphincter" is no different.

I meet all kinds of wonderful and fascinating people who come to births to help out their daughters/sisters/friends who are labouring. When these people are beloved by the mother to be, AND are truly wanted in the room for their support, AND are sensitive to the needs of the woman and her partner by being quiet when necessary and hands on when requested, things most often go GREAT! We all have a nice time, the birth goes well, the baby is born into a web of even more love.

Now sometimes I meet wonderful and fascinating people who are not actually wanted in the room for most of the labour. They are usually lovely, well meaning people who want to support the woman from afar by waiting in the waiting room, to pop in now and again to say "hi", and to come in after the baby is born. This rarely goes well. It may be the expecting parents don't realize that good labour is not really about chatting and hanging out excitedly and so have the idea it's a social event. And the people, as truly lovely as most of them are, probably don't understand that by lending their occasional popping in support, they distract the mother from her important work when they ask, "how are you? what can I do?" Mothers- to- be are sensitive individuals. They worry about their perhaps bored siblings out in the waiting room, or maybe about their elderly father, who, like a trooper, is camped out all night in an uncomfortable hospital chair, eating yucky hospital food. I can give proof from my little books of labour notes, that this situation makes labour llloooonnnngggg. Or, at least. longer than necessary. When I look at my ladies who take epidurals, many of them do so when there are people in the waiting room. I usually suggest people tell their families to come several hours after the birth, but there is the sense that it is something that is so exciting, that it should be shared from moment one. I understand this, I truly do. A baby is a blessing, and to hear the first cry a gift. But not if it is at the expense of the process of getting the baby out.

Now how about a waiting room with not so nice people, or mostly really nice people but one or two not so nice people thrown in the mix? Or, perhaps they are really nice people, but they are not actually people the mother or father want at the hospital. I see this from time to time, unfortunately. I have seen every politically charged family situation you can imagine. There are the lovely people who the mother-to-be is humouring by inviting, because she doesn't feel like it would be right to have Auntie Pam be in the waiting room over Auntie Meg, so Auntie Pam is just kind of there as a courtesy. Then there is the mother-in-law situation, which is when the paternal grandmother is kind of invited because she's the grandmother too, but whom the expecting mom isn't really thrilled to have around.

Then we switch from the lovely people to the overbearing ones, whom the mother invites because to not do so, would be to invoke World War Three. I have even had a few situations where the people are explicitly told not to come, that they will be called when the baby is born, and to stay at home, and then just show up anyway because they don't know what else to do with themselves and are too excited. The worst, is when the person who sweeps in has some serious ego issues, and pulls dramas and sulks that they weren't invited, and comes into the room anyway even when they are told to stay out. Sometimes, some people just expect to be involved, whether the expecting parents want that or not. This is not help and support, obviously, it is ego serving and an expectation to be included in a private event as if it is their right.

I try to keep the peace as much as possible. If the mom is relaxed and really happy to see the unexpected person and labour doesn't get hung up, fine. If contractions stop, which they usually do, or at least slow down, I try to negotiate space for her. I have to be the bad guy sometimes, going out into a hallway full of wellwishers to say, " the couple is SO happy you love them so much and are so supportive, but they'd really be happier if they knew you were comfortable in your own beds." Most of the time, the people go, leaving some nice food for the parents or with lots of encouraging words, and that's the end of it. But there have been times I have witnessed the grossest acts of disrespect you can imagine, like my asking them to please leave, and being met with absolute hostility towards myself and the labouring parents for having the audacity to not relish their presence. I remember one beautiful labouring mom, having a hard, long, painful labour with a hallway full of very demanding in laws. The sweet father was busy supporting the mum, and was having a hard time standing up to them all. The mom finally said, "I FEEL them out there, and I know it's hurting my progress." A doctor finally had to shoo them away with threats of security, and I kid you not, that lady dilated to fully not 15 minutes after the last straggler left.

But some don't leave. I am sad to say this, but in situations where there is not ease with the relations who are waiting "out there" somewhere, and especially with the ones who flounce into the room uninvited because they think they're so important it is their right to participate, the C-section rate is high. I have even heard a couple of doctors mirror this observation. The epidural rate is over 50% in this situation, and C-section potential doubles for first time moms. Just from having extra vibes around, the labour can change...when the vibes are well meaning it is still usually a harder labour with request for pain relief, but when they're not nice, it is positively detrimental. When I get to the hospital and know this birth is going to "waited for", I call my husband and tell him I won't see him 'til tomorrow at the earliest.

It's challenging for doulas too, because we bust our asses doing our job. So to emerge from the birthing room to have a pee or a quiet moment in which to think about our next move, and to be met with faces ranging from the sweet to the hostile, asking for/demanding information and updates, there is no breathing space. Sometimes I want to whine and complain and vent to a fellow doula on the phone about frustrations or get some fresh ideas, but I can't because there's someone wanting to chat. It's not that I don't like chatting, truly I do. But maybe not at 3 am when I've been there since 3am yesterday, and I'm suspecting the reason the labour is taking so long is because of the one engaging me in the chat.

I try to educate my clients on the importance of not having stragglers about, only true chosen support people. But if they don't agree or get a look of horror on their faces when I suggest this, there's nothing I can do but my job. I stay centred and try not to put my projections into it, because, after all, what do I truly know? But I'm hoping there are some moms- to- be reading this and are re-thinking their support strategies, or perhaps some people who are really attached to being in a waiting room who are changing their minds, or maybe a doula or two who are also making connections between long, medicated births and Peanut Galleries.

After all, those people weren't around when the baby was being made, right? Neither was I, but I know how to skillfully flow with that sexual energy of labour, and am an honoured guest into that inner sanctum. My presence, for the most part, will not hinder labour, and if it did, I'd get out of Dodge fast. If I see Mom's labour stalling, I usually go for a coffee and come back to see a little intimacy with her partner has made the labour escalate, and she gives birth not long after.

I would love to hear if anyone has similar experiences!