What no one tells you about the labour and delivery process

It’s no secret that pregnant women love to talk about being pregnant. Kudos to all the best friends out there (mine being one of them) who have listened to hours of TMI monologues exposing each and every dirty detail of pregnancy. Then that bundle of joy (finally) enters the world, and all topics of conversation are redirected to baby, baby, baby! But wait – what about the labour and delivery?

If you’re experiencing your first pregnancy, you’re likely asking other moms in your circle about their birth stories. And there’s a good chance that you’re hearing the same responses over and over: “It was the longest day ever,” or, “That was the most painful experience of my life.” If you’re anything like me, however, those broad recollections just don’t do the job the way hard facts and details do. So here are some of the most unexpected and not-so-discussed things you might want to get familiar with before the big day arrives, as told by other new moms. (A word of warning to those of you with weak stomachs and no interest in giving birth – you might want to stop reading now.)

Your water doesn’t break the way it does in the movies.

“I didn’t expect my water to break the way it did,” said Dolly Mistry, who recently became a first-time mom. “I was expecting a big gush and that was it but it was tamer and lasted a while. It was almost like uncontrollably peeing yourself,” she added.

Movies and television shows would have us believe that labour is kick-started by one giant flood of liquid as our water breaks, followed by the onset of immediate and intense contractions. In reality, labour often begins with inconsistent and mild contractions that slowly build in intensity during the early labour stage – and it’s an especially slow process for first-time moms. In many cases, the water doesn’t even break on its own and your doctor will break it for you (think of the amniotic membrane as a balloon, and the tool used to break it as a crochet hook. It’s not painful though, I promise).

You might throw up.

“I threw up a lot during labour,” said first-time mom Laura Mendonca. “I wish someone would have impressed on me the importance of eating early on while I felt relatively good. Not only would it have given me energy during the marathon, it would have given me something to throw up - which is better than dry heaving. Lesson learned for next time.”

According to Leigh Baetz-Craft, RN with over 30 years experience and the current Chair of the Maternal Child Nurses’ Interest Group for the Registered Nurses Association of Ontario, it’s common for women to experience nausea and even vomiting during labour.

“It’s not considered a complication, more like a variation of the whole birth experience,” said Baetz-Craft. “And it often happens right before delivery.”

Small, frequent sips of clear fluid can help if the woman is feeling nauseated, but most hospitals don’t encourage eating during active labour. Baetz-Craft also explains that vomiting only becomes a concern when the woman can’t keep fluids down and there is risk of dehydration. In that case, fluids would be given intravenously.  

You might need a catheter to pee.

Prior to going into labour, it’s likely that you’ve researched or made a decision regarding whether or not you’ll be using an epidural for pain relief. And if you’re using an epidural, you may have even determined that a urinary catheter will be used during labour in order to help empty your bladder. In my personal experience, the real shock came when a catheter was still necessary after delivery.

“The sensation of feeling a full bladder is often still blocked by the epidural, even after delivery,” said Baetz-Craft. “Or sometimes the woman can tell she has to go, but the muscular activity involved in emptying the bladder is still blocked.”

In other words, don’t expect full control to return immediately just because that baby is out. (And if you deliver vaginally, that catheter will most likely be competing with swelling and stitches, too.)

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You’ll probably feel like passing out while pushing.

“I was told and was expecting the pushing to be really painful – and it was – but the worst part for me was trying to breathe during the actual pushing,” said first-time mom Tia Pietrantuono. “The way the nurse wanted me to push meant holding my breath for more than ten seconds at a time which was really difficult to repeat over and over again.”

While fatigue and dizziness is completely normal during the pushing stage, it doesn’t make it any easier to deal with. This is especially true for first-time moms who can expect 1-2 hours of pushing, on average. Pietrantuono recommends focusing on breathing as much as possible and staying hydrated to help the process along.

You’ll have what feels like an epically long period following delivery.

So just how long is “epically long?” According to Baetz-Craft, you’ll probably experience 3-4 days of bleeding that is comparable to a heavy period, with lighter bleeding and discharge for up to six weeks. (And no tampons, either. You’re basically a cavewoman with a never-ending period.)

“It’s a totally normal part of having a baby, and the same goes whether it’s a vaginal delivery or Cesarean section,” said Baetz-Craft. She also advises to know what to look for and when to get help from your healthcare providers.

“You don’t want to see clots,” said Baetz-Craft. “And bright red bleeding that continues past 10 days post partum could mean the placenta wall isn’t healing or the woman is engaging in too much activity. It’s important to monitor the discharge.”

You’ll get contractions during breastfeeding.

As if the effort to comfortably position your new baby during those first breastfeeding attempts isn’t difficult enough, you’ll also be dealing with contractions for up to a week after delivery. (On the plus side, first-time moms might only feel it minimally while the pain increases with each additional baby.)

The contractions or “after pains” are your body’s natural way of shrinking your uterus back to its pre-pregnancy size and location (a process called involution). Your baby’s sucking during breastfeeding brings these cramps on by triggering the release of the hormone oxytocin, which in turn causes contractions, according to Baetz-Craft.  

You’ll probably get hemorrhoids.

If you haven’t already noticed, most aspects of the labour and delivery experience aren’t glamorous. Add hemorrhoids to the list. Baetz-Craft explains that hemorrhoids inside the rectum during pregnancy are extremely common, but you might not actually notice they’re there until they’re forced out during the pushing stage of labour. They will generally shrink after the baby is born, as hormones in the body reduce.

But in the meantime, hemorrhoids can be extremely uncomfortable, itchy and even painful in the weeks following delivery. Applying ice packs or cotton pads soaked in witch hazel, avoiding long periods of sitting (difficult when nursing a baby for hours and hours every day) or sitting on a pillow and Sitz baths (a warm, shallow bath) can all help relieve discomfort.

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Your emotions will be completely out of whack.

You thought your emotions were all over the map while pregnant – just wait until the moment your baby makes his/her first appearance. There’s no way to describe the amount of joy, exhaustion, relief, elation and wonder that will overcome you in those first few moments. But don’t be hard on yourself if it doesn’t feel exactly as you were expecting.

For first-time mom Shalini Dharna-Kibsey, the whole experience took her by surprise when she unexpectedly went into labour at 35 weeks pregnant. As her premature son was born and whisked off to the NICU to be tended to, reality sunk in.

“I thought it would be the happiest moment of my life, and expected to spend hours just holding my new son,” said Dharna-Kibsey. “But as soon as he was out, a wave of emotion hit me. I was expecting to be happy and laughing with my husband but instead I was cold, shivering, and wondering what the hell just happened.”

Baetz-Craft recommends being as prepared as possible in advance, but be flexible in your planning. Even the most detailed and eloquently written birth plans might end up belonging to the woman who goes into labour five weeks early, throws up on herself before delivering or barely remembers the pushing stage because she was on the verge of passing out.

“You can’t choose not to have difficulties or a complication,” said Baetz-Craft. “Be open-minded and flexible and you’ll have a much happier and more fulfilling birth experience.”