(from someone who’s been to more than a hundred of them)
1. labor is not nonstop pain from start to finish. It comes in waves. For most of active labor, your character will have a one minute long contraction followed by a 3-5 minute break
2. people very rarely scream their way through labor. labor sounds are typically what you might think of as ‘work’ sounds: moaning, groaning, grunting.
3. birth looks absolutely nothing like it does in tv and movies. nothing.
4. labor starts with water breaking in only about 10 percent of pregnancies. contractions usually come first, and most people’s water doesn’t break until they’re pushing.
5. there are three phases of labor. 1st stage: onset of labor until 10cm dilated, 2nd stage: pushing until baby’s born, 3rd stage: from the birth of the baby to the birth of the placenta.
6. for a first timer (or a ‘primigravida’), labor is on average about 12-16 hours long
7. labor typically starts with weak contractions 10-20 minutes apart from each other, that may not be in a regular pattern. they will grow closer together and stronger until they’re coming every three minutes or so, and then will stay about that time apart right up until the very end.
8. if your character is having an unmedicated birth then they will have a strong spontaneous urge to push. they will not need a room full of doctors and support people shouting ‘push’ at them
9. typically, people most prefer warm, dim, comfortable environments for their birth
10. people feel almost instantaneous relief after birth. although after a few minutes they will start to feel some milder cramping as the placenta is born.
11. before the forties and fifties, hospital births were pretty rare, and most births were attended by midwives or ‘yarb doctors’
12. your character will call their midwife or head to the hospital when they’re having minute long contractions that are regularly five minutes apart.
13. when given the option, most people prefer to labor on all fours, walking, forward leaning, or side lying.
14. people are perfectly capable of walking during labor. once or twice ive even seen a person walking with their baby’s head already hanging out of their bodies. they do not need to be carried everywhere.
15. light bleeding during active labor is not uncommon, nor is it a cause for concern (light = a couple of drops running down the legs)
16. if you want your character to have a true birth emergency, might i recommend a placental abruption or a cord prolapse?
17. tearing is not uncommon, but in the absence of “purple pushing”* it’s not as common as you may believe. there are four degrees of tears. First degree tears are typically left unsutured or given just one of two stitches to hold them together (think: biting the inside of your cheek really hard). Second degree tears almost always require suturing. If your character had an epidural, then this will be done in the immediate postpartum. If they have not, then the midwife or doctor will use a numbing medication, likely lidocaine, to numb the area first. a third or fourth degree tear is more complicated, and involves the rectum. in these cases, a doctor may choose to take your character to an OR for a surgical repair, or they may evaluate the situation and continue with a typical minor surgery repair.
18. people are perfectly capable of eating during labor, although mostly people don’t have huge appetites, and many hospitals have policies preventing this in the case of an emergent caesarian. if someone is having a particularly long labor and their energy is flagging, you might give them tea with honey, juice, or broth to give them a bit of a boost.
19. a simplified overview of the process of labor is that during the first stage, the cervix will dilate from completely closed to a hole 10cm in diameter. during the second stage, the contractions of the uterus put pressure on the baby, moving it down through the open cervix and into the birth canal. this typically happens pretty slowly (especially for a first timer) and it is not unusual for someone to push for an hour or two with their first baby. the third stage follows the birth of the baby, and usually consists of a bit of a break and then some very mild contractions as the placenta is separated from the uterine wall and then is pushed out.
20. ‘crowning’ is not when the head becomes visible, but rather when the widest diameter of the head emerges from the birth canal (just about at the level of the eyebrows)
21. typically a baby is born head first, with its face looking back towards your character’s spine. however, babies can be born feet first or butt first (breech), or have wonky things like a hand next to their head.
22. if you want to give your character an extra painful labor, make their baby ‘sunny side up’, which is when the baby is facing towards your character’s stomach, rather than their spine. this causes lots of back pain that persists even in between contractions.
23. most (although definitely not all) people find it relieves the pain to have someone push very hard on their sacrum during contractions, or to squeeze their hips. Water is also a massive pain reliever during births
24. if your character has an epidural, they will be bed bound, and will not feel much of anything from about the ribs down. this can make things very chill for them. lots of people take naps, watch tv or read, or hang out with their families while in active labor with an epidural
25. even though they might not feel the pain, someone with an epidural will still be working very hard while pushing (think: sweating, grunting, etc.) and will usually feel a lot of pressure as the baby’s born.
26) it is not uncommon for the baby’s cord to be wrapped around its neck. the doctor or midwife will feel around the baby’s neck after the baby’s head is born to see if there’s a cord there, and will quickly pull it over the head to relieve any pressure if there is a wrap.
27) newborn babies are covered in amniotic fluid, vaginal discharge, vernix (a thick natural moisturizer with a cheesy texture), and sometimes blood.
28) newborn babies are adorable, don’t get me wrong, but they also look like little aliens
Okay, there’s a lot of stuff i didn’t include on here, but this post is already getting out of hand. Feel free to reach out to me if you have any questions about birth, or if you’re looking for someone to beta your birth scene, i would be delighted to help!
*purple pushing is the practice of a care provider telling someone to push when they have no urge to. should not be practiced except in cases of a true emergency where the baby needs to be born right this minute, although it is still frequently practiced in many hospitals.
