“Visitors” During Childbirth
Kathleen Rice Simpson, PhD, RNC, FAAN
“V
isitors” during labor and
birth is a controversial
topic. Many clinicians
like to restrict the number of visi-
tors. Some units even have visitor
“control” policies, which is an ap-
propriate name in some cases, since
controlling the number of visitors
and sometimes the entire situation is
often the goal. Some units also limit
visiting times; some allow no substi-
tutions once support persons are
identified. Still others are locked,
requiring visitors to press a buzzer
and request entrance.
In the 1960s when women
demanded that their partners be
allowed to be with them during
labor and birth, unit policies changed
dramatically. So did unit practices.
No longer were women in restraints
It is time to reconsider our thoughts about
“visitors” during labor and birth.
lined up on carts in wards while they
labored under the influence of sco-
polamine. Women were conscious
during childbirth with their partners
by their side. As time went on, birth-
ing rooms (now known as LDRs or
LDRPs) became popular, in part
because extra space was needed for
support persons. Fathers were per-
mitted to witness even cesarean
births; some units now agree to two
support persons during cesareans if
the woman is awake. Generally, in
2013, all labor units “allow” at least
one support person during labor
and birth. It appears this change is
here to stay.
With all of the advances we have
seen in our specialty over the past
July/August 2013
Copyright © 2013 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
few decades and the much needed
focus on “what’s best for the mother
and baby based on the cumulative
body of evidence,” it is time to revisit
the issue of visitors and the desires of
contemporary childbearing women.
Family is defined by the childbearing
woman, as are support persons. Sup-
port persons during labor might not
often appear to be so supportive,
sometimes because they don’t know
what to do, they are afraid, or they
are not that engaged in the process.
However, if the woman in labor
desires their presence and feels com-
forted by their attendance, who are
we to say they should not be there?
Sure, you may have to navigate
around them to get to the bedside;
they might ask questions; they often
ask for additional chairs or sit on the
floor; they sometimes request food
and drink and so on, but in most
cases, the laboring woman wants
them there to be with her. It’s her
labor and her birth; we should
respect her wishes as long as the
mother and baby are safe. The same
can be said for policies about pho-
tography and/or videotaping. Most
visitors will have smartphones that
can record anything at any time
without detection. Controlling
recording of memorable moments is
outdated and essentially impossible
in this context. Surely our care can
bear the scrutiny of visitors, even
those with a camera/smartphone.
Consider how much time is spent
trying to regulate visitors. Efforts
to make sure the visitor rules are
followed, and working with patients
and families who are upset when the
visitor rules are not applied similarly
by all nurses or on all shifts are
examples of resources that could be
otherwise spent in patient care. Most
visitors want the best for the mother
and baby and therefore are agree-
able to requests to step outside when
appropriate. Visitors in the hallways
will move aside if an emergent trans-
fer is required for their loved one or
another patient.
The term visitor should be reeval-
uated. Is the father of the baby or
grandmother really a visitor? They
are integral family members. What
about her best friend? The designa-
tion “family/support persons” works
much better than “visitors” to
describe those that the mother wants
in attendance. Common sense and
maternal wishes should guide the
number of family/support persons in
attendance during labor, birth, and
postpartum. Space may be a limiting
factor as some patient rooms are
not as spacious as others. However,
we should all do our best to honor
the woman’s desires and abandon
the practice of visitor regulation. It
does not fit with providing the expe-
rience the woman chooses for her
labor and birth. ✜
Kathleen Rice Simpson is a Perina-
tal Clinical Nurse Specialist in St.
Louis, MO, and an Editorial Board
Member of MCN. Dr. Simpson can
be reached via e-mail at krsimpson@
prodigy.net.
The author declares no conflict of
interest.
DOI:10.1097/NMC.0b013e318290bcd7
MCN 259