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First-timer’s primer on childbirth Labor & Delivery

First-timer’s primer on childbirth

If you’re new to the baby-making show, there’s a lot to learn. Fortunately, you’ll find the answers to many of your questions (along with a few you didn’t even know to ask) right here.

This is really embarrassing to admit, but before I actually had my first baby, I didn’t fully understand what went on down there during delivery. I mean, I felt like I grasped the gist of it, but I didn’t know the nitty-gritty details. And frankly, I was OK with that ignorance-is-bliss mentality.

Then, during my third trimester, a well-meaning friend gave me a very detailed book on childbirth. I still remember the horror I felt as I read those pages on the plane ride back from my blissful babymoon in Portland.

“Wait! That isn’t what dilates?” I screeched to my husband.

“No, how did you not know that? You’re a woman!”

“But then how does the head fit through?” I asked, beginning to hyperventilate.

“It just comes through, I guess. That’s why so many women tear,”
he said nonchalantly.

“Tear? Oh my God. I thought the opening was what dilated! I thought it got bigger! You mean it’s not going to get bigger?” I said between breaths. (The hyperventilation was fully kicking in at this point.)

“It stretches or something. It’ll be fine.”

At that point, given the chance, I would have completely undone the entire pregnancy.

Two easyish births later, however, I’m happy to report that I now know exactly what goes on down there—and I’m ready to spill all the secrets, so you’ll be as prepared as possible when the time comes. Here are some of the things I wish I had known before the big day.

The contractions might be easier to deal with than you think. 

If you’ve ever watched a TV show or movie in which a woman is giving birth, you are probably rightfully scared about what you’re about to go through. But here’s the thing: Although contractions aren’t exactly fun, they are rarely the type of soul-splitting, scream-causing sensations you see on the big screen. They’re nothing you can’t handle.

I’m a pretty big sissy, and yet I made it through 17 hours of consistent contractions with my daughter before getting an epidural. With my son, I survived a single hour in which I went from 2 centimeters dilated to 7 centimeters. Of course, what pain management techniques or tools you choose to use are completely personal, but you may just surprise yourself.

“Don’t get me wrong: It’s not easy. But the contractions weren’t quite as bad as what I had built up in my mind,” says Sydney Kroll Register, mom of one in Nacogdoches, Texas. “They’re only bad when you let them be; when I was focused, they were painful but doable.” The thing is, when your body is getting ready to birth the baby, you have help on your side in the form of hormones. Besides the adrenaline that will help propel you through, endorphins—your body’s natural pain killers—kick in.

Heck, even oxytocin, the “love hormone,” spikes during labor. And while childbirth might not feel as good as, say, falling in love, oxytocin can definitely help you refrain from murdering the one who got you into this situation in the first place.

Even if you get an epidural, it’s not smooth sailing.
For whatever reason, I was convinced that once I got my epidural, my job was done. Ha! I felt every second of that pushing phase, and because my expectations were so far off, I was mentally unprepared.

“An epidural does not always make the experience pain-free,” says Shannon Clark, MD, FACOG, OB/GYN at the University of Texas Medical Branch. “Some women expect to feel absolutely nothing. However, if you have an epidural, it’s particularly important that you still be able to feel pressure when it comes time to push, so you will know where to push.”

Going into labor, most women have never experienced an epidural and only know it as a quasi-mythical shot in the back that helps make birthing a baby bearable. Considering that more than half of women who deliver at hospitals use epidural anesthesia, it’s probably helpful to know a little about how they work.

An epidural is a regional anesthesia, which means it blocks pain from a specific region of your body (in this case, from the waist down). It provides pain relief, not a total lack of feeling. This is the part that I didn’t know. While the epidural made my contractions mere hiccups, I still felt intense pressure during the pushing phase that took me by surprise. Know that if you elect to use this form of pain relief you’ll likely still feel some unpleasant sensations.

There’s a chance that your doctor won’t be the one who delivers your baby.
Your odds of delivering with your doctor are dependent upon the type of practice, explains Clark. Older and more established practices are more accustomed to delivering their own patients.

“Some even deliver up to 90 percent of their own patients,” says Clark. “They accomplish this by working very long hours and scheduling inductions when the patient is agreeable.”

Some newer practices have a shared call schedule, which means that the doctors rotate who’s on-call for those after-hours babies. “They likely end up delivering about 60-80 percent of their own patients,” Clark estimates. “It’s important to have this discussion with your provider, but most practices will explain this up front.”

The latter was the case for me with my first baby. Being due on Thanksgiving, I’d long harbored a fear that I’d be stuck delivering with whoever got the short straw on Turkey Day. I told myself that so long as “Scary Doctor” (the one who looked grumpy whenever I saw her at my happy-go-lucky doctor’s shared practice) wasn’t on call, I’d be OK.

Sure enough, I woke up at 3 a.m. on Thanksgiving morning with contractions, and guess who was on call? Scary Doctor, who turned out to be incredibly nice, funny and—most importantly—willing to listen to me and follow my lead for labor. I don’t think I would have had as good of a first experience with my own doctor, which goes to show that being open-minded is one of the best things you can be going into childbirth.

There is no such thing as the “perfect delivery,” and that’s OK.
It’s important to go into birth with a game plan, but one of the top complaints of obstetricians and labor and delivery nurses is when a woman clings a little too tightly to a birth plan.

“You should be willing to compromise on whatever idea you have in mind about what the perfect labor and delivery experience should be,” advises Clark. “Things can change very rapidly and don’t always go as planned—not only for the patient, but for the obstetrical provider as well.”

When your birth takes an unexpected turn, remember that you have a team of dependable professionals who do this day after day. Yes, you should always trust yourself and what your body is telling you, but you also need to trust the nurses, midwives and doctors around you to do their jobs and get your baby out safely.

A year from now, you’re not going to care that you needed Pitocin to get labor moving, or that you ended up using drugs when you had sworn you wouldn’t. You’ll have your baby, and how she got here won’t much matter.

Don’t forget the placenta!
After all the work and excitement of delivering the baby, many women overlook the fact that they have to get the placenta out, too.

“There is never enough warning about delivering the placenta,” says Rebecca Cassel Roese, a mother of three girls in Littleton, Colorado. “I couldn’t believe it when I started having more contractions after delivering Izzy. I think I made more of a fuss over the placenta than the six hours of pushing!”

Although it can be tough for some women, delivering the soft, pancake-shaped placenta is usually a cakewalk compared to the much bigger, harder skull that just squeezed through. “

The birth of the placenta often goes unnoticed by a woman,” says Pam England, CNM, Albuquerque-based midwife and author of Birthing From Within.

According to Joseph Apuzzio, MD, OB/GYN in Newark, New Jersey, the average time for the placenta to be delivered is about eight to nine minutes. However, it could take up to 30 for some patients—that’s still within the normal range.

They say knowledge is power, but then again “they” probably weren’t in the process of pushing a watermelon-sized baby through a lemon-sized opening. Go ahead and read those in-depth, hyperventilation-inducing childbirth books (but maybe not on your babymoon) to learn what you can and become educated on the process. Just remember that when the day comes, whatever experience you have will be uniquely your own.