Expecting moms often ask my opinion as pregnancy advances about who should be present with them during labor and delivery. This often feels like a trick question that can very easily veer off course into family politics and interpersonal drama, but keeping these discussion points in mind should help alleviate some of your patients’ anxiety about the big day.

The most obvious labor and delivery support person is a woman’s partner, if she has one. I usually encourage expecting couples to have an honest discussion about how each of them envisions the birth. Occasionally a partner is very uncomfortable with the idea of being present for labor and birth. It is important to deal with this before labor starts, so there is time to find an alternate primary support person. In this case, or in the rare case that a woman has no support, I often recommend a local doula. Many cities even have student doula services that offer support to laboring moms free of charge. 

Conversely, some partners prefer that no one else be in the labor room aside from the medical staff. This is also an important discussion to have before moms, sisters and best friends arrive at the hospital or birthing center expecting to be a part of the birth. 

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My hospital has a strict policy of allowing up to four labor support people. I usually advise thoughtful consideration in cases where the mom’s other children want to be present. Mature preteens and teenagers are usually fine, but it can be very stressful for a younger, sensitive or less mature child to see mom go through labor. 

Labor and birth is often a beautiful and peaceful experience. However, due the potentially intense nature of the birth process, it can also become an arena for new tensions or pre-existing arguments to erupt. I have banished more than a few fighting grandmothers-to-be from the labor room!

The most important part of planning a birth and picking labor support is to ensure that everyone is on the same page and has the same goal — a healthy and happy mom and baby.