How many people should be in the delivery room?

Most of the time, welcoming a life is a beautiful, amazing moment. I understand the urge to want to share that with family and friends, and we’re good about accommodating delivery room guests. But I’ve had expecting moms ask if they can have upwards of 10 people in the delivery room with them.  

I’ve seen women invite parents, in-laws, siblings, aunts, cousins and best friends. I guess their thought is the more the merrier.  

Before you gather a support squad to witness your baby’s debut, consider these tips and safety guidelines for the delivery room.  

Check your hospital’s delivery room policy  

Every hospital has its own rules about how many people are allowed in the delivery room. Many only allow two or three people to be with mom. You may want to double check if your partner and doula count in that number. Some hospitals allow a certain number of people to be in the room during labor, but fewer during the actual delivery.  

We allow up to seven people to be on the guest list, but only five people to be in the room at any time during labor and delivery. Our rooms are pretty large, so while five people can be a tight fit, it’s doable. Hopefully everyone likes each other! We do ask everyone to step out of the room during exams and the epidural.  

If you want your older child to see the birth of their new baby brother or sister, ask for your hospital’s policy about allowing children in the room. We allow children in the room as long as there is an adult other than the expecting mother present to take care of them.  

Talk to your doctor, midwife and nurses about what they expect from your visitors, and listen to what they say. They’re thinking of your comfort and safety. We want to be able to deliver the safest care possible while you are able to have your loved ones close.  

Cesarean sections, however, are a whole other story. Most hospitals, including ours, allow only one person in the operating room with you. The rest of your family can stay in your room or the waiting room. We’ll keep them updated on what’s happening. 

"We allow up to 5 guests in the delivery room for most births." via @MedStarWHC

Prepare your loved ones for labor and delivery

The day you give birth is one of the most important days of your life. Think carefully about who you want to share it with. If you’re concerned that your mother-in-law or another family member will add tension, don’t invite them. Feel free to blame it on the doctor’s policy!  

Once you’ve decided who you want in the room, lay down the ground rules. Don’t be shy about expressing what you’re comfortable with. Do you want everyone near the head of the bed, or are you fine with some people getting an up-close look at the “miracle of life”? Do you want everyone there during labor, but only your partner present during and immediately after the birth?  

It’s also a good idea to give everyone a rundown of your birth plan. This way, they’re not questioning your decisions on the big day.  

Ask your doctor or midwife about any rules your loved ones need to know about. For example, when we roll in the delivery cart, it will be covered with a blue sterile sheet. We’ll ask everyone in the room to stay back and not touch anything blue. We find most people intuitively know when to get out of the way, but it never hurts to give a warning.  

If at any point during labor and delivery you change your mind and want everyone to leave, just tell us. Don’t worry about hurting anyone’s feelings; we’re happy to take the blame and do it for you.    

Keep your loved ones safe in the delivery room

I’ve had the biggest of the biggest men pass out and hit the floor during delivery. It may sound funny, but it can be serious. I’ve seen one dad pass out during delivery and need to go to the emergency room. Another family member had a cardiac event.  

I’ve gotten into the habit of quickly scanning the delivery room to make sure everyone looks OK. I usually can tell if they’re feeling hesitant or beginning to sweat. I’ll prop a chair next to them and tell them to sit down if they need to.  

I tell delivery room guests there’s no shame in the game; I’ve had pro football players hit the ground! Hearing this usually makes people chuckle and feel more at ease about needing to sit down.  

Set rules for after birth

Think about who you want in the room after you give birth. Those first few hours of bonding are precious, and you’ll likely be exhausted. Are you going to feel up to entertaining?

I know everyone is excited to meet the new baby, but they can wait. Tell your partner and healthcare team if you don’t want visitors, or if you only want specific people to visit. Let them be the enforcers!

Childbirth is one of the most important stops along the journey of motherhood. It’s up to you whether you want it to be a private experience between you and your partner or a more public event surrounded by family and friends. Neither choice is wrong. But a little planning will allow you to focus on what matters most: welcoming your new family member. 

Celebrated Physician: Sara Iqbal, MD

Who is Dr. Iqbal?

The joyful anticipation of childbirth can also be fraught with anxiety, particularly if the pregnancy is considered high-risk, or unexpected problems develop. That’s when mothers and their families need more than just a capable physician. They also need a counselor, and a friend.

Sara Naeem Iqbal, MD, makes sure they have all that, and more. As program director for MedStar Washington Hospital Center’s Maternal-Fetal Medicine program, Dr. Iqbal believes that while each pregnancy is unique, the goal is the same—to fully support the mother with the best possible care throughout a high-risk pregnancy, and the baby’s arrival.  

A voracious student of science while growing up in Pakistan, Dr. Iqbal pursued medicine as a profession because it allowed her to apply her interests toward helping people.  

“You get to make a difference in someone’s life,” she explains. “You ease the sufferings, cure the disease and are able to feel inner satisfaction and a sense of accomplishment.”

Why Maternal-Fetal Medicine?

Maternal-fetal medicine likewise provided the opportunity to not only care for a mother and baby, but also focus on what Dr. Iqbal calls “the un-routine” cases—women who encounter problems such as early labor, bleeding or high blood pressure.  

“It was the perfect combination for me—prenatal care, ultrasound, genetic counseling, continuity of care and delivery,” she says. “I believe, by providing specialized clinical care, I can personally impact and make a difference in women’s lives.”  

After completing medical school at Dow University of Health Sciences in Karachi, Pakistan, Dr. Iqbal joined her husband in the U.S. and completed her residency training in obstetrics and gynecology at Howard University Hospital. She focused on high-risk obstetrics during her fellowship in maternal-fetal medicine at the University of Maryland Medical Center in Baltimore.  

Dr. Iqbal’s interest in gaining and sharing knowledge has proliferated through her many research interests, including intrauterine growth restriction, intrahepatic cholestasis and the effects of diabetes and obesity on pregnancy. She works with ob/gyn residents and fellows at MedStar Washington Hospital Center and MedStar Georgetown University Hospital to help shape their own research pursuits, and leads the Hospital Center’s periodic conferences on high-risk obstetrics and morbidity and mortality.  

Outside the Hospital

Given such a busy, intense schedule, it’s no surprise that Dr. Iqbal enjoys spending as much time as possible with her husband and three daughters. And if she can help her patients achieve that same degree of serenity, it makes the long hours and hard work worthwhile.

 “I feel a sense of fulfillment when I help women,” Dr. Iqbal says, “and in turn give them and their child a healthy, happy life.”  

Thank you, Dr. Iqbal, for everything you do!


Fighting Fibroids

Abnormal bleeding. Pelvic pain. Backache. Not long ago, a woman either suffered with fibroids or surrendered her uterus. But modern medicine offers many better options.

Abnormal but non-cancerous, uterine fibroids affect more than 50 percent of all American women, a figure that jumps to 80 percent among African Americans.  Fortunately, most women never even know they have the growths until their gynecologists tell them so.

But those who experience fibroid’s most troublesome symptoms crave relief from the abnormally heavy or long periods, intermittent bleeding, backaches, pelvic pain, uncomfortable sex and other problems caused by the benign masses. At their worst, fibroids can even result in infertility, premature labor and miscarriage. 

Not too long ago, a woman had two choices: Suffer through fibroid’s woes to preserve child-bearing and hormone-producing abilities, or undergo a hysterectomy to surgically remove the uterus, host to the unwanted growths.

Modern medicine offers many better, and less dramatic, options.

“Today, we have a range of approaches—medical, surgical and non-surgical— to help women with fibroids,” says James Robinson, MD, Director of Minimally Invasive Gynecologic Surgery at MedStar Washington Hospital Center. “When surgery is the answer, many procedures are minimally invasive, performed on an outpatient basis and using small incisions and precise targeting for less pain and a quicker recovery.

“Some procedures can even get rid of the tumors while preserving the uterus and ovaries. That allows for future pregnancies and hormone production, which is important for healthy aging.”

And if a woman and her doctor decide that removal of the uterus is the best approach? Fear not, Dr. Robinson says.

“This isn’t your mother’s hysterectomy. Whenever possible, we’ll leave the ovaries intact so you won’t automatically go into menopause.”

The exact cause of fibroids is still unknown, although heredity, race and obesity all play a role. While today’s procedures can successfully remove existing lesions, others may grow afterward.  At this time, the only way to rid the body of fibroids completely is a hysterectomy.

But Dr. Robinson cautions that a diagnosis of fibroids doesn’t mean you should be overly concerned.

“We can take care of your problem,” he says. “Our goal is to get you back to your life in the least disruptive, and fastest, way possible.”

We are here to help!

If you have any questions call MedStar Washington Hospital Center at 202-877-3627.

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Medical Advice: Mammogram and Pap Screening Recommendations

Mammogram and Pap Screening Recommendations

The federally sanctioned U.S. Preventive Services Task Force recently issued new findings about women’s health. The panel of experts recommended that women begin routine screening mammograms at age 50. This differs from long-established guidelines advising women at low risk for breast cancer to begin screening at 40, and continue them annually. That’s still the recommendation of the American Congress of Obstetricians and Gynecologists. And, more recently, the American Cancer Society changed its recommendation to age 45. With these differences, it is challenging to determine which mammogram and Pap screening recommendation to follow.

Mary Melancon, MD, an obstetrician/gynecologist, says patients often ask what they should do. “We are happy they are reaching out,” Dr. Melancon said. “Every woman’s situation is different, and your health provider is your best resource.” Dr. Melancon notes that the major advisory groups, including the American Cancer Society, agree that women with low risk factors for cervical cancer need a Pap screening every three years from ages 21-29, and every five years for ages 30-65, including a screening for human papillomavirus, or HPV. Women are at high risk for cervical cancer if they have a weakened immune system, are HIV positive, or have a previous history of cervical cancer or pre-cancer. These are a few conditions that can influence the frequency of mammograms and Pap screenings. Women should discuss their specific situations with their physicians to determine the plan that is best for them.

Dr. Melancon emphasizes, even if testing isn’t recommended yearly, it’s still important for women to receive regular gynecological checkups. “We urge women to maintain a relationship with their providers, even after menopause,” she says. “It’s vital to check in, remain current with health screenings and discuss any changes or concerns.” 

Have Any Questions?

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