do u have any specific tips or anything for writing pregnancy/labor? or things that people get wrong a lot of the time? 👀
wow okay this has been sitting in my inbox for weeks now SORRY but now I have the free time and the motivation so! some basic advice from someone who has seen many labours and also writes and reads fanfic and is very tired of common misconceptions. I'll go into the narrative themes and motivations, physiological and medical accuracy, and then finally some tips regarding some common mistakes that I see the most. If you want those juicy takes, scroll to the bottom to complain with me, otherwise - welcome to a long ass read.
NOTE: This is not meant to be medical advice, do not take it as such. The purpose of this is to share common knowledge with the particular insight I, as a single unique individual, think I can provide for the purposes of playing dollhouse with our blorbos like we're eight years old and stuffing balls of paper up the dresses of barbie dolls to pretend they are pregnant. Nothing here makes you qualified to do or say anything of a medical or professional nature.
Good? Good. Let's get started.
So you're writing a childbirth scene:
So! You've knocked up your blorbo. It's the big event, your favourite ship is expanding their family and we're having a nextgen baby. Or something. But first, let us look inside ourselves and consider our motivations - truly ask, what is it you want to write, and why? Some questions to get you started:
What is the purpose of this fic?: Are you writing this as a character exploration? Are you writing this to illustrate something about a character, a relationship, or their dynamics? Is it fluff? Is it whump? The adrenaline of someone having a baby in the car? Pregnancy, birth, postpartum, and parenting is a massive personal, interpersonal, and social transition within the physical, mental, and emotional realms of a person's being. Take a moment to consider how your characters would react - whether predictably or surprisingly; birth and parenting can bring out completely new sides of us! - to the physical, emotional, and sociocultural challenges they are about to face
What point of view are you writing from?: I'm not going to get into literary POV, though that will effect what information you give to your reader. But what character thoughts, emotions, and viewpoints are you writing from? Has your character read every pregnancy book at the library, or are they finding themselves in a "i didn't know I was pregnant" situation? Are they a medical professional who knows all the bells and whistles at the hospital, or are they someone who gags at the scent of antiseptic? Are they the one going through labour, supporting their labouring partner, or delivering the baby? How good are they at it? What are the emotions at play? What are your character's histories - not just with birth itself, but with other relatable experiences with things like pain, exhaustion, relinquishing control, or childrearing? All of these are going to affect what, how many, and the ways you are going to present them to the audience. That said...
It is okay if things are a little inaccurate - from the point of view of the characters: Something I can say from the provider end - the experiences of everyone in a birth room can be vastly VASTLY different from each other. When things go fast, or get scary or not to plan - if anything is unexpected from anyone at any point, that will influence their experience of the event. This differs INCREDIBLY from person to person! A healthcare provider can look at at a baby being surrounded by fifteen different people and think "ah, everything is fine, totally routine," because it might just be! But without our communicating, it can potentially be the scariest and most traumatic moment for parents. Even different providers have different takes, based on their roles and specialities. People have different experiences, and/or ways of voicing their experiences. Play in the space with it! What will make your birth scenes believable is not that you get every single detail right, but that you engage in captivating, character accurate, and narratively satisfying writing and storytelling.
"But tumblr user daisybrien," you say, "I want to be accurate, isn't that what you've be complaining about?" And I will say, yes! I'm a nitpicky bitch. So let's go over some basics.
Labour and Birth 101:
I'm going to focus a little bit more on the labour portion, because I feel like that is where there is the most diversity of experiences, and yet still the most times where I'll be reading a fic and go yeah, that's not how that works. But I'll try to be a bit chronological, and where other resources will be your best friend - make sure to vet your sources and consider their biases and evidence base!:
(Also, disclaimer: The information provided here is limited to my experience in 21st century Western sub/urban settings. The information I provide here will try to best reflect current best medical practices based on these resources and not those of like the 1900s, 1800s, 1700s - you get it. Also, resources differ greatly from urban, to suburban, to rural, to remote settings. I encourage you to do your own research about the medical and sociocultural practices of the time and place!)
(Also, also: I recognize the very vast worldbuilding communities of what I will call, ahem.... fantastical pregnancies. I respect it, but I'm not writing about or for all of that, y'all, that is not my thing omega pregnancies are outside my expertise lmaooooo)
Conception: This is where I will concede I have a very limited amount of knowledge - yes, I kNoW wHeRe BabIEs CoMe FroM, but I'm specifically referring to things like assisted reproductive technologies and the like - of which there are many! Not only can things be medically complicated - of which vetted resources will be your best friend - but emotionally weighted. Again, it's not about every narrative detail being accurate, but the narrative acknowledging the conflict of it all - unplanned pregnancy, queer parenting, difficulties with TTC, etc.
Also, birthworkers reading this!: Yes, pleasure (even sexual!), comfort, and oxytocin release are essential to easing the labour process. But please. Please, for the love of GODDD, please stop saying the phrase "what gets the baby in is what gets the baby out." We live in a world of queers, SA, and advanced reproductive technologies and surgeries. Do not alienate your clients by assuming every baby is made using heterosexual missionary sex, I'm so fucking tired. Enough!!!
Pregnancy: Way, way, way too much to go into here, but I find common pregnancy websites can be helpful to give you a foundation on common symptoms in pregnancy. Do a little bit of extra research though, on matching gestation age (ie: how many weeks/months someone is into pregnancy - I'll address common misconceptions later) with common symptoms, or even when common complications arise. No, you will not feel baby kicking at 10 weeks. No, preeclampsia will not happen at 10 weeks either, or else you're a medical marvel. That said, everyone is different, and while there are common trends and experiences. there is no one-size-fits-all timeline. Get creative!
Stages of Labour: Ooh, now we're cookin'. So! this is where things get very complicated, and also, very up to interpretation! What comes now is more of a pattern, not a rule - these are common, average physiological findings that have a lot of variety from person to person! Diverging from these patterns are not necessarily inaccurate or wrong - birth is nothing if not unpredictable! - but recognizing these phases and the tension, pink flags, shenanigans, or conflicts that can arise can make all the difference between a sensationalized depiction, a canned one, or one with depth and believability.
Stage 1: This is where the cervix goes from closed and tight to that 10cm everyone is always cheering for. It is often split into two (or three) phases. The early phase is that annoying, I'm-having-cramps-on-and-off-and-can't-sleep-but-the-L&D-nurse-in-triage-keeps-sending-me-home phase. It can last from a few minutes to a few days, and is often longer in first-time labours. Some dilation and effacement (thinning out) of the cervix takes place, some goopy bloody mucus might come out. The active phase is typically considered when a) contracts are long, strong, and close together and/or b) you're at least 4cm dilated - on paper. Again, this stage, its presentation, and clinical judgment will rely heavily on the individual person and the clinical provider. For instance, a first-timer might be very slow going once they reach this milestone, while someone who has had five babies, has a history of fast labours, and comes into a hospital at 5cm will have all hands on deck ready to GO. This stage is typically when people really start vocalizing, moving around desperately to get comfortable, or be offered some form of pain relief. Transition is part of this active phase, at the 7-10cm place where things get VERY intense VERY fast. Emotions run high, and the labouring individual will require a lot of support - the type and level of which, again, will look different from person to person. Again, though, this is what the TEXTBOOKS say - there is a lot of overlap and blending between all these phases and stages, and depending on someones labour journey, can all he different lengths, or blending together completely. No one is really paying attention to the boundaries between them, or outwardly declaring when each stage or phase is met - focus on the gradual shifts and changes of continuous progress (or if youre writing a labour dystocia, focus on the tension of why or how it isnt!)
Stage 2: We're fully dilated and it's time to have a baby! Or not - maybe we're waiting for the baby to descend in the pelvis so we don't have someone pushing their first baby out for four hours. However, it can be common for the active second stage - AKA, when we're really watching someone actively push, the body usually starts pushing, even just a little bit on its own, first! - to take a while; up to two hours or more for a first baby, especially with an epidural. Meanwhile, this stage is once again shorter for people who have had babies before. But either way, if we aren't feeling that fetus descend, some concerns abound about if the baby needs some help coming out - think vacuum, forceps, or c-section if baby is in distress or things get really stuck (note: the former can often happen in the hospital room, but the latter two often happen in the OR. Good god, I HOPE a c-section is happening in the OR.) Again, these are patterns but not rules - you can be surprised by someone sneezing out their first baby on two pushes, while someone who's had five can struggle. Also like 95%* chance they will poop at least a lil bit.
*Not the real statistic
Stage 3: Baby is out, but we're not done! We have to deliver the placenta. Everyone forgets the placenta. This can involve pushing it out, and/or the provider giving medication while providing some traction on the umbilical cord. (FYI, just yanking on it is how things go VERY BAD - again, requires a practised hand to be done safely). We get concerned about major hemorrhage the longer it stays the uterus, or if pieces get left behind.
Note: OH MY GOD STOP JUST CUTTING THE UMBILICAL CORD WITHOUT CLAMPING/TYING OFF BOTH THE PARENTAL AND INFANT SIDES!!!!! THAT IS AN ACTIVE MAJOR BLOOD VESSEL!!!ONE WAY TICKET TO HAVING A BABY LITERALLY EXSANGUINATE!!!! I would have put this in the common mistakes section but this hurts me SOOO MUCH I'm saying it here!!!
DA BABY: Ooouuhghgh squidgy widgy cutie pieeeee!!!! Weight, behaviour, and appearance will depend on gestational age (AKA: how many weeks it cooked in the womb) but also just the vast array of human diversity. Honestly babies are a whole other thing and this is already. So long. But in general, the more preterm a baby is, the more interventions they require and the more risk to life and wellbeing their condition threatens.
Recovery/Postpartum: In the immediate aftermath, vitals are taken, blood loss is monitored and managed, and breastfeeding is initiated. In the coming weeks, bleeding peters out, milk comes in (people start off with only a little bit - it is important to keep frequently feeding every 2-3 hours so the breast responds and gives you that good good lactogenesis II around day 2-3 postpartum), the vagina and abdomen are sore AF. It is important to still monitor symptoms, and be on the lookout for delayed hemmorrhage, preeclampsia, or infection. From a writing perspective - INCREDIBLE AND WHOLLY UNDERUTILIZED stage for some good good partner hurt/comfort, TLC, and romantic domestic gestures.
Pain relief in labour: Hypnobirthing is not hippie dippie nonsense okay, that shit works. Different coping mechanisms, as well as things like water therapy, sterile water injections, massage, TENS machine, are good options for non-pharmalogical methods of pain relief. But when it comes to the juicy drugs, epidural is the most common and safest option. This is where a lot of people trip up with the details, so to summarize - you CANNOT walk or bear weight on your legs with an epidural, you require an IV for fluids but NOT THE PAIN MEDICATION - the actual epidural meds require a catheter in your back (the needle does not stay in!!) to give a steady dose of numbing medication. It should stop sensations of pain and temperature, but not of touch or pressure, and if the anesthesiologist (NOT the nurse, not the OBGYN, not the midwife, the anesthesiologist) is really good at their job, people are still able to move their legs in some capacity. Other options include an injection of morphine or IV opioids, especially in communities where epidurals are inaccessible, but these do have a higher risk profile and are usually reserved for early labour pain relief if people aren't coping well.
C-sections: These occur in the OR with many people in the room. They can be scheduled and planned, or a big rush in an emergency, or even just a calm decision made after a long labour that is slowly getting more complicated where everyone agrees its the best option. It takes like, five minutes for the baby to come out once prepped for surgery and then like at least half an hour to close up, so initial bonding and infant check ups happen in the OR as well. Birth partners are not brought into the OR until the first cut is made IME, but may accompany in the pre-op and recovery rooms. Often, they use spinal analgesia - a single, big dose in the spine that lasts for about two hours - to numb people from the stomach down so they are awake for the birth, but if things are really bad people will be intubated and put to sleep for the duration; I've never seen a hospital where they let a birth partner into the room during general anesthesia.
Healthcare providers: Lots of these happening. I won't provide a comprehensive list, but know there are different people with different and important roles in different scenarios - FYI, the OBGYN knows nothing about the baby, LOL.
Note: Midwives are, in fact, regulated primary healthcare providers in most regions and not crunchy hippies, follow the same (or similar; again, region by region, context by context) evidence-based standards of physicians in their jurisdiction, and can manage spontaneous vaginal deliveries on their own. Please, the weird tradfem and hippie dippie stereotypes is just misogyny at this point and discredits the profession.
Fetal monitoring: Two major ways to do this - in most low risk deliveries, they use the handheld doppler to listen at regular intervals. However, if there is a pregnancy complication/risk factor, the heartrate doesn't sound right, or someone has an epidural or is undergoing an oxytocin drip for induction, they get the external fetal monitoring - basically, two monitors that get strapped to you on stretchy belts.
That's a whole lotta wall of text! Don't get overwhelmed, though. I'll repeat myself again - it is not about complete accuracy and detail, but story immersion, engagement and believability. I don't need a character to say "I was then hooked up to the continuous electronic fetal monitors" when it would be more in character for them to say "they strapped me to these wires and the bands itch like hell." There can also be conflict in how characters perceive what is happening vs what is actually happening, in moments of difficult decision making, etc. Healthcare providers might be wonderful and have enough time to have thorough conversations, or give incomplete or incorrect information, or get huffy. Birthing people can be informed, confident and feel safe and respected, or might not parse information, or its severity, or get overwhelmed and agitated themselves and be treated unfairly. I would always always prefer the former of these but in reality and in stories, these things unfortunately happen, and the emotional importance of these moments are what can make or break what you've written. Play! In! The! Space! Don't be scared!
However - that isn't what you were here for anon. I've gone and rambled on and infodumped enough. So I'll give you what you've been waiting for:
Oh my God, Please Don't Do This Shit: Or, Some Common Mistakes and Personal Gripes:
Here's the thing: I have an endless list, and I really can't complain about it all. I come from a very specific background where I have been exposed to pregnancy, birth, and postpartum, and I cannot expect people to know everything about it - and why I also encourage people to seek out good, evidence-based, holistic information about pregnancy and birth, because there is major social stigma and misogyny abound about it!! I will always encourage people to explore - look up the fun facts on pregnancy websites, talk to the parents in your life, look into activist spaces around birth autonomy and reproductive justice! If you can stomach it, watch some birth videos! I know people get squicked out by it, but birth is such a human thing that we have been isolated from by hyper-pathologization, gender essentialism, and misogyny - and the only way to break the stigma is to run towards the discomfort, not from it.
That said, here are a few things that will immediately make me suck my teeth and exit a fic:
"AAAAAAAAAAAAAA!!!!!": Not even a birth misconception - this is just a massive writing no-no. Please, for the love of all things good and holy, stop phonetically writing out your screams. It's annoying, its amateurish, for me personally it adds a veneer of unseriousness that feels dismissive of the birth scene. No one wants to read that shit. Instead, I challenge you to describe the sounds to enhance your writing - are someones screams high pitched and desperate? Low and moo-like (love a good open glottis moo to open up the pelvis)? Calm and measured? Paint me a picture!
Due dates are a suggestion: Did you know only 5% of people actually deliver on their "due date"? I don't mind it when characters complain about going over their due date - because yeah, being pregnant much longer at that point can suuuuuuck - but there is a wide range of "term" gestation. While a due date is determined as 40 weeks of pregnancy, a term delivery can be anywhere between 37 weeks and 42+ weeks. In fact, first pregnancies often go over 40 weeks (though, in most communities, inductions occur by 40-41ish weeks to prevent overdue pregnancies and their potential risks - and we don't need to have a debate about that right now because we will be here FOREVEEEERRR). Hell, a baby born at 36ish weeks is usually fine, albeit some minor, common complications, despite being late preterm. So when someone panics because they're in labour "two weeks" before their due date, and how everything is going to hell, I'm like... babe, you're 38 weeks, you're fine.
Birth is unpredictable, but trends do exist: Again, when it comes to the phases of labour, there is a lot of flexibility and clinical judgement that comes into play, and there is no one-size-fits-all. That said, when a writer presents a character experiencing a specific labour phenomenon, and its reacted to in a completely different and unprecedented way, I get thrown for a loop. Like, you are not getting admitted for an epidural because your contractions are 20 minutes apart unless you want an express trip down the cascade of interventions. On the other hand, contractions every two minutes is not "early"!!!! Also, only 10% of people's water breaks before labour starts - if it wasn't broken artificially, it usually breaks during transition or second stage. But again, it can happen whenever, so do whatever u want forever lol.
What is wrong with you why are you acting like this??: So this point specifically isn't a gripe, more of a discussion on realism. Because a) I don't blame most of yall for not knowing how people realistically tend to act during labour, especially when they aren't exposed to realistic depictions, and b) birth is diverse, and each person is unique in how their body and mind react to it! However, it gets a little stale when it's just people screaming at the top of their lungs like in every B-rated comedy, or I get thrown for a loop when writers just don't quite get a labouring person's demeanour right. Typically, the further people get into labour, the more they go into "labour land" - individuals almost always can (and ALWAYS should) have the ability to make decisions, but if someone is unmedicated in active labour, their demeanour will (usually - insert "no birth is the same" and "pattern not rule" phrase ad infinitum from this point on) not be the same as usual. People's social filters come down, they move around CONSTANTLY, even if it is just small repetitive movements, they can snap, they can cry, they can often draw inwards and filter out everything in the room, they can dissociate or have flashbacks to traumatic events, they can laugh, sometimes they can be completely chill and calm and collected about it. They usually are not able to hold conversations, parse new information, or speak full sentences during contractions. And there should be spaces between contractions (we have a MAJOR MEDICAL CONCERN if the uterus is constantly contracted) where, unless we're in the overwhelming stages of transition and pushing, people can typically come back to themselves and act "normal". On the flipside, when people have working epidurals, they typically do no go into this "labour land" phenomenon and are just chilling in bed snoozing or chatting or scrolling on their phones. Also, people should not be fainting, passing out, or completely unable to move from pain - that is a problem!! My best advice - if you can stomach it - is that if you are absolutely gunning for realism, watch a few IRL videos of people labouring.
That's not moodiness, that's a mood disorder: This specific life transition is physically and emotionally fraught. And yes, while hormones are all over the place and people can be irritable and weepy, it's still a symptom of a physiological and emotional event that deserves to be taken seriously, especially when antepartum and postpartum mood disorders are already incredibly stigmatized and erased. Stop giving your characters nuclear level meltdowns for a cheap laugh and get them a fucking psychiatrist. Adam Sandler ass C-tier comedy misogyny. Cut it out.
You cannot visualize cervical dilation: I don't blame y'all for this one, considering the sorry state of sex ed, but still it annoys meeeee. Cervical checks are actually incredibly invasive, and can only be felt because the cervix is (usually - again, bodies are diverse) deep in the vagina. If you can see someone's cervix, there is a fucking problem!!! They also require a lot of practice, on the healthcare provider side, to "accurately" assess - in quotes because everyone's hands feel things a little different - and a layperson will not be able to tell you jack if they've never done it before. Also, it's not just about dilation, but softness, thinness, position, etc - but honestly, unless you're writing from the perspective of a healthcare professional, don't worry about it.
Homebirth is statistically safe - just not the way y'all are doing it: There are multiple places where someone can have a baby, including the hospital (of which there are many levels that carry different resources), a birth centre, or in the comfort of their own home. My specific gripe, here, is with the depiction of homebirth - I either see people depict a homebirth like its entirely unsafe or illogical, or they depict it as safe while I'm sitting here like, where the fuck is your resuscitation station?!? Where is the second midwife?? Are you documenting ANYTHING?!?! TWINS WITH ONLY ONE HCP IN THE ROOM?!?! For the best accuracy, know when each setting might be optimal or not, what is available in each setting (ie. you are not getting an epidural at home), and if you're writing a complication, know what transfer to a higher level of care is going to look like (ie: ambulance, air evac, etc). And pick your characters' brains - their body, their choice, so tell me why they want to be where they are!!!
Please please please stop getting info from tradfem alt right MAGA doula grifters or patronizing misogynistic OBGYNs on Tiktok and Instagram: I'm not saying they're all bad, but... a lot of them are pretty bad. Vet them thoroughly, do not take what they say at face value just from a 30 second clip. That said - if you are somehow zen enough to be immune to the ragebait and the disinformation, and don't mind ruining your fyps, watching them and seeing the fallout in the comments are an incredible way to see the way different ideologies affect people and their choices when it comes to their health. I know I just mentioned statistics and safety and medical evidence, but the world is imperfect, people are imperfect, and they make decisions that don't adhere to protocols or practice statements. Consider - would your character freebirth with twins? Would they shame someone for using formula? Would they opt for an elective c-section? Would this provider recommend something not according to standards? Paint me a picture, play in the space!
Know your emergencies and complications - if not entirely well, then at least with seriousness: As much as birth usually works, when it doesn't, it really doesn't. Which is why I think its important to depict emergencies like this not only with some accuracy, but with the physical, emotional, and social weight they deserve. And while communication and efficiency and safety are so incredibly key to managing emergencies, fear, anxiety, and panic like to rear its ugly head. And if your characters are the ones experiencing it, they will have a lot to unpack about it after - about their fear in the moment, their emotions in the aftermath, the health ramifications after, the reactions of their social circle, and in their mis/understandings of the situation. Say it with me kids - it's not about complete accuracy, but immersion and believability! Just try your best - make it make some sense, factually, but give it the gravity it deserves and you're more than half way there.
So whats your point?
My point is that I'm autistic and have a special interest and I'm making it you problem. But also, I take this seriously because it is serious! Birth has meaning. Birth has meaning, and you can make it mean anything you want, but it means something. I didn't write this to pigeonhole people into rules, or restrictions - you can do whatever you want forever, as long as you don't hurt anybody - only to share my own experiences, and some information on a topic that a lot of people do not get the privilege of learning about in depth! I just hope this can be a helpful resource that can serve as a foundation for people's writing, and to inspire them to do more research and explore the space a little more, and feel more confident in what they write.
