What No One Tells You About Labor and Delivery!

December 30

Mommy in hospital bed

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Did you know that no one tells you everything you need to know about labor and delivery because as time goes on, something ingrained in Mommies to make us all forget. Must be some sort of way to continue the procreation of man.

This post will go over all things labor and delivery. The good, the bad, and the ugly. All from the super honest perspective on an emergency room nurse turned mom of two.

Please keep in mind to ALWAYS consult your doctor for ANY questions or concerns about your pregnancy and possible labor and delivery. The safety of you and your baby are of the utmost priority!

False Labor

When you are pregnant for the first time, it can be difficult to differentiate between real and fake contractions.

Let’s talk about false contractions first.

Braxton Hicks Contractions

woman having braxton hicks contractions- false labor and delivery pains

Braxton Hicks contractions, or “practice contractions” are named after John Braxton Hicks, a physician who delineated the difference between true and false contractions.

Let’s look at it this way: Your uterus has to do A LOT of pushing for when you deliver the baby. The uterus is essentially a muscle. Muscles cannot function well if they are not strong. Nature’s way of making it strong and ready for delivery is to make it flex.

There. That is a Braxton Hicks contraction.

They are usually painless.

But nobody seems to remember to mention how strong and intense they can be. My entire belly would become so tight that you could bounce a coin off it. It was sometimes hard to breathe when I would get them.

I guess pain level was probably a 0/10 but discomfort level was definitely at least a 7/10 (especially towards the end of my pregnancy).

The main difference between these and true labor is that they are irregular. Sometimes physical exertion can trigger them. Even dehydration.

But if they don’t seem to be happening at regular intervals, then most likely, they are not true labor.

Set your timer on your phone and see how long they last and how far apart they are. If there is no consistent pattern, then try to relax.

No really, relaxing, putting your feet up, slow, deep breaths can all help to make it stop. Don’t forget to drink a glass of water too, just in case.

Here is an article from Cleveland Clinic that discusses the difference between true and false labor.

The Mucus Plug

woman surprised and grossed out reading about mucus plug on tablet

Yes, this is as gross as it sounds.

We need to get a little technical here: the bottom of your uterus (the opening) is called the cervix. In order to keep the growing baby inside of you safe and protected from bacteria (from your vagina), something needs to ‘plug’ up that opening.

That’s where the mucus plug comes in. It is usually pretty thick and dense. It is also very attached to your cervix.

When your baby starts descending, it slowly starts to stretch the bottom of your uterus (cervix) and loosens the mucus plug. Your cervix is starting to prepare itself for labor.

Some say that once you lose your mucus plug, the baby will come out within about a week. Don’t quote me on that though, there are many exceptions to the rule.

If you still have some questions about this strange but true occurrence, Health-line Parenthood has a great article that goes into depth about it.

How do you know you lost your mucus plug?

Black question marks with a red question mark in the middle

Sometimes you don’t know that you have lost it.

Sometimes you find a thick, maybe slightly bloody, jelly-like substance in your underwear or the toilet. Don’t freak out. That’s your mucus plug.

If you are experiencing other more significant signs of real labor along with losing your mucus plug, then YES, it’s time!

Real Labor (It’s Time)

calendar with post it saying baby due!

Okay, Mama. . . If you are experiencing the following symptoms, you need to grab your hospital bag and get ready to go soon.

Water Breaking

It’s not really water, it’s amniotic fluid so I have no idea why they call it ‘water’.

But start the timer!

After your water breaks, you have exactly 24 hours before that baby needs to be out of your body. You are going to have this baby!

There is a really high risk of infection after your water breaks, so your OB will want to make sure you are in the hospital and ready to give birth as soon as possible.

This article, “What to Expect When Your Water Breaks” has good, concise, and relatable information on your water breaking.

What your water breaking is really like

I was all worried, sitting on puppy pads on the couch towards the end of my pregnancy so I wouldn’t soak my couch. My bed has a waterproof mattress pad on it already so no worries there.

But I was worried for no reason. It is also nothing like the movies.

You know when you are on a heavy day of your cycle and you’ve been sitting for a really long time and then stand up? Ya, kinda like that. Only you don’t have to stand up to feel the small gush. I was laying on the couch.

Then it’s just like a slow but steady trickle with occasional tiny bursts of fluid escape with activity.

I did note a sort-of ‘popping sensation’ immediately before I felt the fluid come out. Don’t worry, this is totally normal.

Only mild contractions started for me immediately after my water breaking. So I had time to shower, shave, and go to the bathroom before I went the hospital. I like to be clean.

If your water breaks before 37 weeks gestation, you need to get to your doctor as soon as possible. This is called PROM: pre-mature rupture of membrane and your doctor needs to assess you.

Real Labor and Delivery Contractions

pregnant belly with fetal monitoring in place during labor and delivery contractions

“True labor: contractions come at regular intervals and get closer together as time goes on. (Contractions last about 30 to 70 seconds.)”

Cleveland Clinic

Contractions are slowly but surely pushing the baby down and out of your uterus which in turn is stretching and opening the cervix.

Real contractions are painful. It doesn’t get better with rest, it doesn’t get better with repositioning, it doesn’t get better after drinking some water. It just doesn’t get better. Consistently, it gets more and more intense.

Oh, and don’t forget the pelvic pressure. Really powerful pelvic pressure.

I had ‘back labor’ mostly. Then it started radiating to my abdomen and inner thighs. And then my hips and buttocks started hurting too!

Body labor, I guess we can just call it what it is, body labor.

But how do you know when to go to the hospital?

Unless your doctor gives you specific parameters,

“Many use the 411 method: Contractions 4 minutes apart, lasting at least 1 minute, for at least 1 hour are a signal that it’s time to go to the hospital.”

Very Well Family

What people say it feels like vs what I really felt:

So some crazy lucky people don’t feel painful contractions. Or feel them very mildly. These people must be androids.

When I was pregnant and frantically researching labor and delivery on the internet, I was naive enough to believe that there was a pretty good chance that this was going to be me.

Oh boy, was I WRONG!

I am sensitive, for sure, but also think of myself as being able to tolerate pain pretty well (as long as I am allowed to complain).

But this pain is in a league of its own.

“It’s natural pain, so it is not as bad” they say. Wrong!

Someone once told me that “contractions are like really, really bad diarrhea pains.” Wrong!

And yes, at first they can feel like that. But they are really just getting started, okay.

“It feels like the worst menstrual cramps you’ve ever had” true at first, but wrong!

“It’s like really bad back pain that comes and goes” Wrong again!

Who are these people?! I will never tell. . . Maybe this is what it was like for them, but for most of us, it is gonna be really, really painful.

So just get ready.

Don’t fool yourself or be in denial (like I did) that it may not be that bad for you because that does nothing for your mindset when the time actually comes and you are in the middle of some real pain.

Different types of Labor and Delivery

This is a good time to go over the 2 different delivery methods.

Have you decided on whether you want a vaginal delivery or a c-section? Do you want an epidural or do you want to go all natural? Have you weighed all the options yet?

Vaginal Delivery

woman in labor and delivery room preparing for vaginal birth

One of the main reasons why I would suggest a vaginal delivery is not the experience during labor and delivery. I would suggest it almost solely for the recovery time.

You heal so much faster with a vaginal delivery vs a c-section. I was up and about after my second (my first was a bit traumatic) by the next day. No joke. I moved WAY slower than usual, but, I could basically function as a normal human being.

Since you will have a newborn attached to you pretty much from here on out, I would recommend this method so that you can be at your best faster.

Some possible consequence:

  • Perineal Tearing
    • This happens quite often. That large baby head has to push through a relatively small opening. This opening can only stretch so far.
    • It usually only takes a few minutes for the doctor to stitch up.
    • It is less likely that the tear will be third or fourth degree (all the way into the anus and more) so don’t worry about that.
  • Episiotomy:
  • The Ring of Fire!
    • This is when the baby is stretching the skin and tissues of the vaginal to the max and it literally burns like a ring of fire in your lady parts area. Obviously doesn’t happen with a c-section.
    • You won’t feel it if you have an epidural.
  • The first poop after delivery:
    • Ask the nurse for some Colace. It is a stool softener so that your poop will be softer and easier to push out. I would suggest to keep taking it for at least the first week after delivery. It is over the counter. You can thank me later.
    • Be sure you are wiping the correct direction. Do not contaminate the perineal area (area between the vagina and the anus). The LAST thing you want is to get an infection down there.
  • The pain and bleeding:
    • Take as many of the peri-bottles (squirt bottles), the numbing spray bottles, and the tucks pads that the nurses will give you. Use them every time you go to the bathroom. It will help so much!
    • The bleeding lasts longer than 6 weeks.
    • Those ginormous clots the size of tangerines are normal. You heard me, normal. It should start to dwindle as the weeks go by and the bleeding slows down.
    • If you are soaking more than 1 pad an hour for more than 2 hours, you need to see the doctor right away.
  • Tantric Birth:
    • This is basically when you orgasm every contraction. For real though.
    • Don’t get your hopes up. This is a VERY rare occurrence. I thought it was basically a myth until one of my close friends had it happen to her. She had an epidural. And she hated every minute of it. True story.

Cesarean Section

c-section from the perspective of mother laying down looking at medical staff

Personally, I have not had a c-section. I probably should have (my hips are pretty narrow), but for some odd reason I was compelled to try for a vaginal delivery.

My mom had 2 c-sections. My mom kept telling me to just schedule one since the doctor was going to let me. But did I listen? Of course not.

Do what you want, it’s your body. But if everyone and their mama (including your doctor) is telling you you might need a c-section, maybe just consider it. It may save you a ton of agony.

Keep in mind:

It will be in a sterile environment.

A lot of people will be in there with you.

You won’t be able to see down past your chest (it will be covered in sterile sheets).

You won’t feel pain, but you will feel pressure and pulling.

There is quite a bit of suturing that the doctor has to do after delivery, and your recovery will be much more difficult (it’s surgery after all).

Possible consequences:

  • There is a high risk for infection of the wound
  • Once you have a c-section, doctors do not advise that you have a vaginal delivery. You may need to have another c-section for your next pregnancy.
  • Having a c-section is having abdominal surgery. The recovery time is lengthy and it can be really painful to move around and care for your baby for a few weeks afterward.
  • You may need narcotic pain medication to help with the pain, so if you are breastfeeding, you may need to pump and dump.

The benefits of a c-section:

  • There is less chance of losing bladder control (no peeing when you laugh hard)
  • Decreased risk of prolapse to pelvic region organs (organs pushing/slipping out of place)
  • It can decrease the risk of injury for the baby (lack of oxygen to baby, fractures, etc.)

The Stages of Labor and Delivery

CGI image of baby in the womb about to go through labor and delivery

They call it labor for a reason. It is so LABORIOUS!

Labor begins when the cervix begins to open (dilate) and thin (called effacement). The muscles of the uterus tighten (contract) at regular intervals, causing the cervix to thin and open.

Cleveland Clinic

First Stage of Labor:

If you are a first time mom, this stage can last up to around 12 hours. If not, it may last around 8 hours. But these are generalizations for what typically happens. Not everyone will fall between this spectrum.

Early Labor Stage

Most of the time you will go through this stage at home. Your cervix will open to 4 cm.

They say you are supposed to eat small light meals and stay hydrated during this stage.

But what not many people will tell you is that this is the time where you experience some serious cravings!

It’s like your body knows you aren’t going to eat for the next 24 hours, so it wants to load up.

With my first, it was Ethiopian food. My second, Indian food. What can I say, I have eclectic taste buds?

And both times I mistook the early stage of labor for really intense Braxton Hicks. So I was driving 25 miles to the nearest Ethiopian restaurant for my first and on my feet cooking an Indian feast all day long for my second.

Both times I was in early labor. I didn’t realize it until my water broke (1st) and not until my husband came home from work and asked, “Have you timed those contractions yet?” (2nd).

I thought it was really bad Braxton Hicks the whole time. I kept telling myself, “Wow, these Braxton Hicks are getting really intense lately.”

Active Labor Stage

pregnant woman in hospital bed hooked up to baby monitoring device in active stage of labor and delivery
Don’t let all the baby monitoring intimidate you. Most of the time the nurse can remove it so you can walk during labor.

When contractions start getting difficult to endure, where it becomes hard for you to talk during them, and you’ve reached the 411 method, then it is time to go to the hospital.

Welcome to the active stage of labor!

Pro tip:

Ask for a peanut ball. . . Game changer! I really wish they had one available for me when I was in labor.

At this stage you are dilated 4-7 cm.

This is where your water usually breaks (but really, it can happen at anytime). But when if it does happen, keep pin mind labor will start to progress much faster.

“Relaxing during and between contractions saves your energy and helps the cervix to open.”

Kaiser Permanente

The more tense you are, the more your muscles will contract and the more pain you will feel.

This is a great time to implement all those pain relieving and relaxation techniques that you learned when you were pregnant. It’s time to do all those stretches and use the tennis balls and get massages.

This is also the time to ask for an epidural if you want. It will be too late to ask for one in the next phase. It is too early to ask for one before.

Pro tip:

Make sure you do not get an epidural too early. It will really slow your labor and progression.

Instead, try to walk it out. Movement will help your labor progress, sitting in a bed numb as all heck will not.

But when nothing seems to be helping with the contractions anymore, you may be progressing into the next stage.

Transition Stage

pregnant woman having painful contractions while standing in labor and delivery room hunched over with elbows on bed

Cervix: 7-10 cm. Baby: slowly descending. Mommy: in excruciating pain.

The best way that I could describe this pain:

You know how when something in our body hurts, say your back, the pain seems to be localized in your back? Sometimes it can radiate to somewhere else in your body, but it basically stays in your body.

Well, labor pain feels like it is bigger than your body. MUCH bigger than your body.

During this stage, it literally feels like the pain is coming from behind and on top of you and pushing itself down onto you, crushing you, with its focus aiming toward one place, your uterus.

This already is intolerable, but what makes this stage that much more difficult is the fact that the contractions are relentless.

You can easily get overwhelmed with how little of a break you get between contractions. I lived for these breaks, but they only lasted a 10-15 seconds at a time.

And if you are on Pitocin, which I was, it felt like a never-ending torture chamber.

Here is an example of some thoughts that were running through my head at this time:

“The only way this pain will EVER stop is if I could pass out. Oh, why haven’t I just passed out yet?! Just pass out, Jen. Just pass out! NO, not AGAIN!!! WHY?!?!?”

This is the ugly stage. The part where the cursing, screaming, sweating, grabbing, nail digging, and possibly vomiting comes in. This is the real deal.

But don’t worry, over this next hump and it WILL get better.

Second Stage of Labor:

Okay mama. . . You CAN do this! Throw out any negative and self-defeating thoughts because it is too late for any of that now!

Let’s have this baby!

At this stage your baby is actually coming out of the uterus, through the vaginal canal, past the ring of fire (for you, not the baby), and out into this world.

So lets go over some things about delivering this baby. . .

Delivering Your Baby

Your cervix is at 10 cm (open) and 70% effaced (thinned out).

This is where they tell you to start pushing! Most women get a really strong sense that they NEED to push.

What no one tells you is that pushing is not just one push per contraction. It’s THREE excrutiatingly long 10 second pushes per contraction.

That’s at least 30 second of pushing. Now if you happen to be on Pitocin, this will happen at a much more unforgiving rate.

What got me through was that when I thought about it, TONS of other people have birthed children, and they are walking around like nothing happened. And I was gonna be one of these people when this is all over.

That was the very small light at the end of my very long tunnel of my second stage of labor.

The Ring of Fire:
a ring of fire to represent pain to lady parts during labor and delivery in the second stage of labor

We already mentioned the ring of fire earlier. Your vagina has to stretch to an absurd degree to get that baby’s head out of there.

The nerve endings in that area do not like this so it sends very intense burning sensations up to your brain.

Just when you think you can’t take any more pain, this happens. That is what makes this, in my opinion, one of the worse parts of labor and delivery.

I really wish someone would have told me about this before I went into labor. Not as it is happening and I have to scream, “Why is it *expletive* BURNING?!?!” with the nurse responding, “Oh, you must be feeling the ring of fire.”

One saving grace of this extra surprise pain is that you really are almost done this time.

That baby is on it’s way out to see you!

After you deliver the head:

The doctor will tell you to stop pushing after the head is out. You should really listen to the doctor at this point.

They have to clear the baby’s mouth and nose of fluid so they don’t aspirate (choke) on it when they take their first breath in. And they also have to turn the baby so the shoulders are in a safe position for the baby to be delivered.

With my second baby, I think I only partially stopped pushing when they told me to so his shoulders were not in position yet.

Well come to find out, I broke his left clavicle (collar bone) with my vagina.

Pro tip:

Be sure to tell the doctor ANY concerns at the follow-up appointments so they can examine the baby thoroughly and put your fears to rest. This is your time with the doctor, don’t let them brush you off.

They didn’t find out his clavicle was broken until weeks later at a follow-up appointment.

I told her that I noticed a very subtle clicking noise in his shoulder every time I would lift him up. After a quick x-ray, we found out it was broken.

My heart sank when I found out. My poor little tough guy only complained when he was being lifted by his armpits and when his clothes were being changed. Even now he rarely complains when he gets hurt.

Birthing the rest of the baby:

I promised you downhill, and here it is!

happy woman from behind walking down a hill with 3 yellow balloons trailing behind

The head is technically the biggest part of the baby, so the body is a piece of cake. The shoulders are supposed to come out one at a time, and after that, the rest of the body just sort-of slips out with one or two pushes.

I opted for my babies to be placed immediately on my belly right after they came out of me. Umbilical cord still attached.

If you do this be warned: it feels weird.

The baby is much warmer than expected. Just really, really warm.

Also, they will be either super slimy, super sticky, or both.

My first was slimy with practically zero vernix (a thick whitish covering that protects the baby’s skin in the womb). He was really clean looking.

My second was so sticky and white. He was COVERED in vernix. After I patted my baby on the back once or twice I looked to my husband and the first thing out of my mouth was, “Is there a towel anywhere?” He was just so sticky. I was not expecting that.

Third Stage of Labor:

You are done with the hardest part of labor! Great job, Mama! The rest is of labor is small beans. In this case, small beans is the placenta.

Labor and Delivery of the Placenta

computer graphic of a womb with placenta and umbilical cord still attached, needing to be delivered still

This is strictly for vaginal deliveries. In c-sections, the doctor easily pulls the placenta out after the baby.

When I delivered my placenta (both times) it was cake compared to the baby. I almost didn’t notice it. Even with my first one where I could feel everything, it kinda just slipped out. This is called spontaneous delivery of the placenta.

But this it not the case with some women. It can take up to 30 minutes to deliver it.

The most important thing to remember with placenta delivery is that every part of the placenta needs to be removed from the uterus. The placenta is very vascular (lots of blood vessels), and if part of it is still attached, it can cause hemorrhage (you can bleed out).

Pro tip:

The nurses will start to ‘massage your fundus’ (push down on the top of your uterus) to help shrink and contract the uterus back into shape and expel blood and clots.

What they don’t tell you is how much it can hurt if you didn’t get and epidural/when your epidural wears off.

And expect lots of blood flow gushing out as they are pushing down on you.

Fourth Stage of Labor:

This is the last stage, I pinkie promise!

Recovery:

This stage is affectionately referred to as ‘The Fourth Trimester’ now. It is still considered a part of labor and delivery because it is so closely related in all aspects to the birthing process.

Everything that is happening in the fourth trimester is a direct consequence of the previous stages of labor.

If you are going to breastfeed (which I wholeheartedly recommend you at least attempt), this is the time. Stick that baby near your breast and once they find it, they will love it!

Pro tip:

When you start breastfeeding, you will start experiencing very strong sensations of your uterus clamping down. It will mimic contractions at first, but will eventually ease up as time goes on.

This is also the time for “The Golden Hour” where you, your significant other, and your brand new baby get alone time to bond. It can be a very beautiful time full of yummy feeling hormones, relief, and love.

Check out my post on The Start of The Fourth Trimester (in the Hospital). It goes over what happens immediately after delivery and what you need to do/look out for.

Some Sage Advice on Labor and Delivery

I know you are hearing a boatload of advice right now. But for the birth of your baby, I only have 3 pieces of hindsight advice.

Have a Labor and Delivery Birth plan

This was overwhelming for me. So I gave up and didn’t have one.

I had a basic idea of what I wanted and didn’t want in my head, but that was the extent of it.

When I googled and pinterested birth plans, I started getting anxiety. There was just so many parts to it! So many decisions to make!

But what I didn’t realize is that it doesn’t have to be complicated.

Pregnancy brain is REAL, so making big decisions can be difficult.

Keep it short, simple and to the point:

  • Vaginal delivery or c-section?
  • Epidural or Natural?
  • Pain meds or totally sober?
  • Delayed cord clamping or not?
  • Etc. . .

Just make sure you have something because making decisions on the spot in such a stressful environment will lead to regrets later on.

Get moving and stretching during pregnancy

pregnant woman sitting on exercise ball to prepare for labor and delivery

Oh, how I loved that couch for my first pregnancy. My Snoogle was literally my best friend.

I thought I was SO tired during my first pregnancy! I was tired. It felt like I was constantly on Benadryl. But I didn’t know what tired really was until after my baby came out.

I say all this to say “GET MOVING!” It will really increase your tolerance for what is inevitably to come.

I was pretty active with my second pregnancy (naturally) because I had a toddler to chase around constantly. But I definitely could have done more.

What you can do:

Start out with 10 squats a day. Then move to 2 sets of 10 squats a day (morning and evening).

Take a 20 minute walk in the morning. Then add in an evening walk. Then progress to power walking for your walks.

Get a pregnancy yoga video and make yourself do it once a day. Everyday!

Even just getting an exercise ball and sitting on it instead of a chair or couch can really help.

Any exercise will help your delivery progress tenfold!

Science also suggests that giving birth is harder on a person’s body than running a marathon

mother.ly

Why did I never see this quote before labor?

You wouldn’t train for a marathon by sitting on the couch all day, right? Giving birth is very physical. You must prepare and train your body!

Looking back, I wish someone would have emphasized to me how important it is to ‘train’ for labor and delivery. I would have forced myself to get active. ANYTHING to make labor and delivery easier!

Learn to Meditate and Deep Breathe before Labor and Delivery

pregnant woman sitting on bed meditating in preparation for labor and delivery

“At 32 weeks, the placenta transports hormones from the mother’s blood into the fetal environment. The fetus relies on the mother for reassurance about the safety of this environment through the hormonal bath.”

“Meditation decreases the production of the stress hormones cortisol and adrenaline and gives the fetus a signal that it is safe and protected. This is essential as it sets the temperament of calm or anxiety in the baby.”

Headspace-10 tips for a mindful birth (I wish I would have found this article before I had my babies)

I never did Lamaze, but I did know how to deep breathe. But only because I had done a lot of yoga in the past.

Looking back now, I wish I had learned how to meditate before I had my babies.

Labor and delivery can be such a difficult thing to get through. Meditation really helps take your focus OFF of whatever is going on around you, and especially what is going on in your body, and helps you focus on being okay.

And this would have been SO helpful during my labor and delivery.

You can fool your body into relaxing by deep breathing and meditating, even if your are super anxious or uncomfortable.

This article goes over the technical aspect of hacking your vagus nerve to basically force your body to relax.

This will only help you when you are having a hard time trying to push that baby out.

*Remember: exercise before labor, relax during labor*

Final Thoughts on Labor and Delivery

Labor and delivery in itself is like a roller coaster. But it is just a tiny preview of what is to come. This mom thing is going to be a roller coaster ride of emotions and stress with a heavy sprinkle of joy.

This is a ride you can never get off of.

The only way to do this parenting thing is to literally live in the moment and make the best decisions from that place.

Toss the idea of what kind of mother you want to be out of your head. Right now, before the baby comes out. Get rid of all your preconceived notions.

Plans are all well and good, but in my experience, not living up to those plans can really affect your morale. Don’t forget, these plans were made without the knowledge of hindsight and experience. Pre-baby.

If you keep looking forward, the stress and overwhelm can cripple you. If you keep looking back at pre-baby times, you will miss all the things you can’t do anymore.

This all applies to labor and delivery as well. When you are in the throws of labor pains, just remember: Stay in the moment, no past, no future, means less anxiety and increased tolerance.

adorable baby stretching arms up with mom's hands on it's belly
They really are worth all the pain and suffering. . . Look at that little babe!

Questions? Concerns? A new perspective on labor and delivery? Leave me a comment below or email me! I’d love to hear from you!

All the love,

-Jen

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