Birth: The Top 10 Things They Dont Tell You

There are many ways that women prepare themselves for the delivery of their first child. Having never experienced this before, they turn to pregnancy books like What to Expect When You're Expecting, they take child birth classes, or watch one of the many television shows about childbirth.

The thing is, such books give you a very general idea about things that are possible and do not always paint the whole picture. Childbirth classes give you suggestions on comfort measures for early labor, show you different pieces of equipment that may be used in the hospital to monitor the baby, and usually give you a tour and discuss the admitting process. I often find that childbirth education doesn't address pushing and what happens after birth. Television shows give you a picture of someone's birth experience in 30-60 minutes from start to finish and edit out much of the "not for TV" content. Yes, all of these methods contribute some valuable information, just remember no two pregnancies, labors or births are exactly alike. You can not take the information from any of these sources to be gospel. Do not believe everything you see or hear!

Here are a few things that they don't tell you or that you probably will not see on TV.

1. Vomiting, diarrhea and labor often go hand in hand. Many people get an upset stomach when labor begins and have a lot of vomiting and diarrhea. Maybe this is the body's natural way to clean out your system before the baby comes and the more intense part of labor is upon you. Sounds like fun!

2. You can't get through childbirth with your modesty intact. We are trained since childhood that our "private parts" are indeed that private. Unfortunately, it is not possible to keep things covered and private during childbirth. In many hospitals it is the nurse, whom you have just met that day, who checks your cervix and reports back to your doctor. During birth there will be a number of people in your delivery depending on the setting and circumstances of delivery. After birth, during the couple of days you stay in the hospital the nurses will have to evaluate your perineum and bleeding; even more stranger looking at your "private parts". Not so private anymore... and there goes your modesty.

3. Expelling your mucus plug does not mean that you are in labor. Some women lose their mucus plug days or even weeks before they go into labor. Others continue to lose it little by little for the days preceding labor. It is also possible not to notice losing one at all. This is not anything concerning to the healthcare professionals so just wait and see if labor follows. No, you do not need to take a picture of it, or bring it to the hospital with you in a baggie! I will say that if you are premature (less than 37 weeks) and lose your mucus plug just give your doctor a call so they can inquire about any other signs that you may be going into preterm labor.

4. Early labor can go on for days. The First Phase of Labor is made up of three stages: Early Labor, Active Labor, and Transition. You are not considered to be in active labor unless you are 3-4 centimeters with regular contractions resulting in cervical change. That being said, in some hospitals if you come to the hospital during this early stage of labor you are often sent back home. With suggestions to rest, bathe, eat lightly, try different positions, and use massage for comfort. This can be a painful and exhausting process, so it is important to be mentally prepared for it.

5. Stay home. If you are preparing to have an unmedicated childbirth, and your pregnancy is uncomplicated, stay home as long as possible. It is important to be in communication with your doctor or midwife and let them know what is going on. They will help you decide when to come in to the hospital. If you are Group beta strep positive you will need to come in a little earlier than others in order to start antibiotic treatment before the baby is born. But otherwise, if you are planning for an unmedicated child birth, why come to the hospital in early labor when the healthcare workers there will have to follow their policies usually including: monitoring you baby to some extent, restricting your eating, and eventually taking measures to move towards delivery. Something for you to think about... If you can not cope anymore and need to go to the hospital and find out that you are only 2-3 centimeters, you may want to reconsider your plan for an unmedicated birth. Why torture yourself? If this is your first time, you had no idea what you were in for, if it turns out to be way worse than you anticipated there are viable pain relief options for you to consider.

6. Labor hurts. There is some information out there about orgasmic birth or painless birth but in my 9 years attending births, I have never witnessed a pain free delivery. Most women say "I can't do it" or ask for medication at some point during their labor; whether or not they actually need or get it, just depends how close to delivery they are when they are feeling this way. Also, everyone's pain tolerance is different. You sometimes consider yourself to have a high pain tolerance, but you don't really know until you have experienced labor. Typically, each baby gets easier. It isn't really that the pain is less intense, but instead that the duration of the labor is less, making it more tolerable.

7. Pushing takes time. Pushing can take anywhere from minutes, if this is not your first baby and/or you are having an unmedicated delivery, to 3 hours! During this time you will be expected to hold your breath, pull your legs back and bear down for 3-10 second intervals during each contraction until the baby is born. Sometimes despite getting to 10 centimeters and giving pushing all you have got, babies still do not come and a cesarean is needed.

8. Pushing can be traumatic! Women can poop, pass gas and develop hemorrhoids during pushing. Pushing very hard and straining your face during pushing can give you petechiae. Delivery of the baby can cause you to tear from your vagina straight through to your rectum.

· When you push if there is any stool remaining in your rectum the baby's head will push this out as they come down the birth canal. Do not stress over this. There isn't much that you can do to prevent it and your nurse and doctor will view it as a positive sign that you are pushing well.

· Pregnant women are more susceptible to hemorrhoids due to constipation, the weight of the uterus and elevated hormone levels. During pushing even more pressure is placed on that region and hemorrhoids can develop.

· Petechia is a rash caused by hemorrhage under the skin and looks like tiny polka-dots on the face and neck. These are benign and will go away. Try and follow the pushing instructions of your nurse to help prevent this from happening.

· Perineal lacerations (or tears) are classified into 4 degrees. 1st degree being the smallest, 4th degree being the most severe. It is normal to have a 1st or 2nd degree laceration following delivery. At times a 3rd or 4th degree laceration will occur if the baby is large or coming out in an unusual position. The use of a vacuum or forceps can also contribute to lacerations. Even delivering rapidly and in an out of control manner can cause more tearing. In general things that can be done to help keep tearing to a minimum, or prevent it altogether include: daily application of lotions high in Vitamin E to the perineum during pregnancy, doing your kegal exercises, perineal massage by your healthcare provider or nurse during pushing, and the application of mineral oil or some sort of lubricant to your perineum during pushing. Also, follow the prompts of your nurse, midwife or doctor during pushing. At times they may ask you to back off of pushing and give a half of a push to allow the baby's head to ease its way out in a controlled manner allowing your skin time to stretch properly.

9. Babies usually aren't pretty when they are first born. At first glance babies are a pale, blue grey color and have misshapen elongated heads. Sometimes their faces are swollen or bruised. They are often covered in blood, amniotic fluid, vernix and sometimes their own feces. Some babies, particular if they are premature, are covered in fine hair called lanugo. Maternal instincts kick in and all women usually see is their beautiful baby. Dad's sometimes take a little longer to come around. All of the things listed are temporary so no worries. Nurses will immediately begin to wipe away the blood, fluid and vernix from the baby in order to stimulate crying and help the baby keep warm. Within minutes of crying your baby will pink up; although it is normal for both the hands and feet to remain pale for some time after delivery. Swelling or bruising of the baby's face and head will go down in a couple of days. In time the lanugo will fall off as well.

10. The poking, prodding and pain does not end with delivery. Once the baby is born, there is still the matter of the placenta. The placenta is the disposable organ that has enabled you to sustain your baby. Pitocin is often administered after birth to encourage the placenta to separate from you uterus. Your nurse, midwife or doctor may also do a "fundal massage" to help this separation to occur. Once the placenta comes out, any tears that you may have will need to be repaired. Evan after the delivery of the placenta, the nurse will need to evaluate your bleeding closely over the next hour. Every 15 minutes a "fundal massage" will be performed to push out any blood clots that remain in your uterus and prevent excessive bleeding. I put this term in quotations because the word massage implies that this is a comfortable thing. In fact, a fundal massage is when the nurse, midwife or doctor firmly press down on the top of your uterus. After everything that your body had just been through, this is a very uncomfortable thing albeit necessary.