At some point in the last few decades, some time after fathers were first allowed in the delivery room and the present, labor and delivery turned into a spectator sport. Pregnancy is a joyous time not only for the expecting mother or couple, but also for the extended family, friends, and acquaintances. The etiquette lines are clearly blurred, though, quite possibly more than for any other social situation we, as humans, encounter.
Most reasonable adults and many medical experts agree that a pregnant mother's wishes is really the only thing that matters when deciding who is present during labor and delivery. The woman's overall satisfaction of labor is what is important, and part of that satisfaction is dependent upon having her wishes met. Also, the actual physical aspects of labor can be adversely affected by a woman experiencing unneeded aggravation. If a woman desires to labor alone, clearly having her labor turned into a standing-room only event is going to impact her labor's progression and her health and well being. All too often, though, laboring mothers do not have their wishes met, and this is as much the result of a failure for pregnant moms to vocalize their wishes as it is a function of friends and relatives simply overstepping their boundaries either due to excessive joy or just sheer lack of manners.
If you have a vision for how you want your labor to be and who you want to be present, it is important to make those wishes known before your contractions start. You cannot depend on a sometimes understaffed maternity ward to play referee for you or to always abide by your wishes. If you are planning a hospital delivery and go into labor on a weekend, it will likely be free season for any visitor who wants to enter the maternity area.
It is a sad commentary on social manners when the labor and delivery of a cousin, niece, or even daughter-in-law, becomes a presumed automatic right of passage for the uninvited individual. Receiving a phone call from a relative of a laboring woman is not enough to qualify as an actual invitation. It is baffling at how an "invitation" from anyone other than the laboring mother can be misconstrued as an invite to show up at the hospital. In a day and age when children and babies are often excluded from family celebrations such as weddings, it seems logical that most adults should be excluded from family celebrations that involve birth. Some people prefer small adult-only weddings, some people prefer quiet, private births. Chances are if you weren't invited to the conception, there is a small probability you would be invited to the birth.
Part of the confusion about appropriate etiquette stems from the fact that, for many women, a crowded labor and delivery room is desirable. Many women, even experiencing the pain of labor and the fashion mishap of hospital gowns, relish the attention. Some women do not, however, so people can get confused because every friend, sibling, or relative that they have seen in labor has had stadium-seating. Many people automatically assume every woman wants a small army of people standing by for her baby's grand entrance.
If you are pregnant and know what type of labor experience you desire, make your wishes known. If you want someone to attend and that person is not comfortable, respect that decision. If you know someone who is pregnant and you are eagerly awaiting the baby's arrival, do not automatically assume you are or will be invited to the hospital. If the mother did not personally verbally ask you to come when she goes into labor, don't show up! It's common sense really. If a relative of the laboring mother calls you, even the woman's mother, to announce the mother's progress, do not automatically assume that counts as an invite. Unless a pregnant mother told you days, or perhaps, weeks in advance, do not assume you have reserved seating at the impending labor and delivery. Do not be intrusive. Stay home or go to see a movie. Even showing up at the hospital and not coming into the labor and delivery room presents problems. Word almost always gets back to the mother, and the last thing an expectant mother needs on what should be the happiest day of her life, is the crippling feeling that her 14-hour labor is progressing too slowly for visitors outside.
Believe it or not, labor requires intense focus and concentration, the distraction of uninvited visitors can be very detrimental to the health and well being of the expectant mother and possibly even the newborn. There are many situations in life where invitations are required for attendance, the birth of a baby should be no different.