So you attended the labor and childbirth classes that your doctor recommended at your prenatal appointments and you're feeling pretty prepared for what's to come. I remember that feeling of having yet another box checked off of my pre-baby to-do list. I even remember sitting in each one of those childbirth classes, feeling like the doula that led them was a source of invaluable knowledge, and I could not get enough.
Yes! Show me that epidural needle and tubing! That does not make me feel like fainting at all! (It totally did.) Please pass that dilation diagram around the room, I would love to see what 10 centimeters actually looks like! Contractions feel intense? I bet, tell me more! I wanted to be as prepared as I could possibly be, and I was determined to walk into that delivery room knowing everything I could, maybe even more than the doctors.
Here's the thing though- those classes the doctors recommend? They're great, and very helpful, but they leave out some things that I think you'll want to know when you walk (waddle, let's be honest) through those doors to have your baby.
Here's what I think they should also mention during those classes:
15 Your Doctor Might Not Deliver You
If your doctor is part of a group practice, then chances are, unless your baby adheres to strict 8-5 business hours, your doctor won't be the one telling you to push when it's time. I loved my doctor and desperately wanted him to be the one to deliver both of my babies.
He reassured me that as long as my babies decided to be born on a Monday through Friday, from 8-5, that I would be guaranteed he would be there to catch them. I mean, that's 40 hours of possibility! My babies did not get this memo. They were both born on the weekend, and even though he was actually on call for my last baby's birth, my son was born too quickly for him to arrive.
He did end up arriving to repair the damage from such a quick birth (you don't want to know), but he missed both actual births.
Most doctors in group practices take turns being on call outside of normal business hours, so they can sleep, and you know, have lives of their own. Totally selfish of them, right? So we, as their patients, need to be aware that they might be living their lives (or hosting a dinner party, as mine was when I asked the nurse to beg him to come deliver me anyway- I'm a gem during labor) when we are trying to push a new one into the world.
It's an unfortunate fact. Don't lose sleep over this though, because the doctors usually show up only for the last act anyway- more on that below.
14 They Might Not Believe That You're In Labor
This one is kind of scary, but it's happened to me twice now. That's two for two in case you're wondering. I knew that I was in labor during both of my labors, because I know my body well enough to know what feels normal, and what feels like there's-a-human-on-the-way-out-of-my-body.
Both times the nurses at the hospital refused to admit me until I was dilated to 4 centimeters. All hospitals have a requirement for dilation or other symptoms in order to admit you for active labor.
I was almost sent home the first time, but I begged for the opportunity to labor a bit longer at the hospital because I knew my body was progressing quickly even though my cervix was betraying me. My nurse allowed me to be observed for another hour, and by then I had dilated to 5 centimeters and was admitted.
The relief I felt after I had met their requirement was indescribable. So, this is one of those things you need to know in the event that you know without a doubt your body is about to launch a child and the nurses are encouraging you to go home and eat lunch. Try and stall for time to get your cervix on board so that you don't have a baby while you're in the drive through.
13 Trust Your Instinct
This goes with the above item quite nicely. Even if you're a first time mom and this whole labor and birth thing is new to you, trust yourself enough to know that if it feels like labor, then you owe it to yourself to treat it as such.
During my first labor contractions I was wondering if it was the real deal, as I moaned and white knuckled our stair banister every five minutes. Thankfully, a friend of mine who had given birth a few months before encouraged me to trust myself and go into the hospital if I wasn't able to talk or walk through my contractions.
As women we second guess ourselves much more than we should, but this is not one of those times to do so. Just like you used to be able to tell when your period was on the way, or if you had just ovulated, you'll probably be able to tell when labor has arrived in all of its contracting and uncomfortable glory.
Also, this doesn't mean that you'll need to rush yourself to the hospital with the first contraction. Still keep in mind those things they did teach you in childbirth class about when to go in. You'll save yourself a lot of time sitting in a hospital gown and possibly being told to go home until you've met their admitting requirements.
12 You Might Dilate Faster Than You Think
I know that they go over the stages of labor during childbirth class and the approximate time guidelines for each stage. A good teacher will be careful to point out that every birth is different and guidelines are just that, guidelines.
My first labor and delivery took 24 hours and six minutes (don't think I didn't count every last minute to hold over my child's head in his teenage years as my own mother did) and it was longer than I anticipated by a mile. I mean, how long does it really take to move through the birth canal? It's not that far!
My second labor went so quickly that I dilated from 4 centimeters to 6 on the way from the exam room to the delivery room. Over the course of the next SIX MINUTES I dilated to ten centimeters, much to the shock of the nurses trying to get my IV line established for an epidural while I insisted there was a baby crowning.
I dilated so quickly my water never broke, and the nurse freed my son from the sac once he was partially out. He came too quickly for the doctor to be called (see the first item above), and the nurse and my husband delivered our baby without a doctor in sight.
So, all of this is to say that, every labor and delivery is different, and don't be lulled into the belief that every labor follows a set of established rules and timelines. I'm living proof that your cervix can dilate to ten faster than you can say "More ice chips please, with a side of epidural."
11 Breathing Techniques Might Not Matter
So listen, definitely pay attention during the part of your childbirth classes that goes over breathing techniques and tools to help you manage the most strenuous phases of labor. Not only are they great tools to have, it will also help you to feel a sense of control going into what can feel like a very uncontrollable time.
Here's the thing though, you might not use them. No one really knows how their body will respond during the parts of labor that literally steal your breath and hold it hostage.
During both of my labors I tried to use the breathing techniques, and was lucky enough that my nurses tried to walk me through them. I was breathing quickly, while intermittently holding my breath, and they worried I would pass out from hyperventilating. The interesting thing is that my body knew exactly how it needed to breathe to help me get through the pain of each gripping contraction.
So, while I'm sure it helped me in the moment to have nurses that centered my attention and reminded me to breathe slowly, my body still defaulted to the type of breathing that it instinctually knew would serve it best during the stress of labor. It's important to know what the recommended technique is for breathing during labor, but don't freak out if you don't have it all memorized or can't remember in the moment.
Your body will know what to do, and your nurses are trained to help you through it. Take the pressure off of your shoulders to remember it all.
10 Sleep and the Hospital Are Mutually Exclusive
Unfortunately, no one really warns you about this during labor class, and if they do, you probably aren't paying close attention because WHO KNEW TEN CENTIMETERS WAS THAT BIG? You won't care during class because this little fact that nurses will constantly be waking you for this and that really isn't a big deal at this point.
You haven't just gone through an exhausting labor, and you aren't so desperate for sleep you'd pay for your local nightclub bouncer to stand outside of your doorway and turn people away yet.
After delivery and birth, you and your baby are the star of the show, and instead of taking your picture, nurses will be taking your blood, vitals, and verbal answers to a myriad of questions every fifteen to thirty minutes. Maybe it's not this frequent, but IT FEELS LIKE IT.
Every time I would finally get a moment to drift off when my newborn baby was asleep (sleep when the baby sleeps is a great piece of advice, but it usually only happens as often as an elf riding a unicorn runs through your living room), a nurse, nurse manager, cafeteria attendant, or photographer would pop in my doorway, ready to get whatever they needed from me. I was less than enthused on each occasion, but it never dampened their excitement and optimism.
At one point, a nurse manager woke me up at FIVE in the morning the day I had given birth (let that sink in for a moment, FIVE IN THE MORNING), to ask me what I needed. He cheerfully began writing his information on the whiteboard next to my bed while asking what was the one thing I wanted during my stay. I said with no sarcasm, and a bit of blatant desperation, "SLEEP."
He wrote the word "sleep" in big letters on the whiteboard and left the room. Like I said, sleeping just does not happen in the hospital. I'm so sorry to be the one to tell you this, but you need to know this going into it. I'm still bitter about that early morning wake up, if you can't tell.
9 Hospital Coffee Is the WORST
Just when you think it can't get worse, it does. So they're waking you up in the two seconds you had to rest before your little one begins wailing again to be fed, and then the cafeteria attendant shows up and asks what you want. You want coffee. You'll worry about switching to half-caff or decaf at a later time, because right now it just feels like survival.
So you order coffee, and in your mind you have visions of a steaming and creamy cup of liquid energy that will revive your spirit and motivate you to try to get the correct nursing latch over and over and over again.
So when the cafeteria delivery guy shows up with the tray of dry toast, rubbery eggs, and a speckled brown mug with a plastic lid on the top, you can't help but get excited. This IS IT. It looks like coffee, and sort of smells like coffee. You'll anxiously add the two creamers they brought on the tray and stir in the packet of sugar, just waiting for it to cool enough to drink.
And then. Like some sort of cruel joke, the "coffee" tastes like a mix of coffee, and beef broth. It's almost like they combined them, and then just thought, what the heck, they're both brown liquids- send it out! Maybe your hospital will be different.
Maybe their coffee will taste like coffee, or at least like it has no broth mixed in. In the event that your hopes are dashed like mine were, maybe send someone out for coffee at the first chance you get. They'll never tell you this in labor class because who's thinking about coffee? Did you see how big your cervix has to get?
8 You Will Be Starving After Birth
You might have nausea during labor, and can't imagine anything more than an ice chip passing through your lips. That's okay, and to be expected. After the dust settles and your baby is in your arms, however, you'll want to eat. Everything. Regardless of the time you delivered, you'll be hoping that the cafeteria is open 24 hours because you'll be needing their services in a big way.
Both of my boys were born in the middle of the night, and I was the opposite of hungry during labor. Once they were born, and I was settled into my recovery room, however, I realized I was ravenous. I had this amazing nurse that as soon as she made sure I was tucked nicely into a bed with my baby asked "Are you hungry? What do you want?" She was an angel.
The only thing I could get at three in the morning was a turkey sandwich and this was perfectly fine with me. She came back to my room with the sandwich, a soda, a bag of chips, and a cookie, and I could have kissed this woman.
Don't be afraid to ask for food from the cafeteria regardless of the time of day or night- they're used to it, and chances are the nurses station in the recovery unit has a stash set aside for hungry new moms in recovery.
7 You Might Have A B.Y.O.Ball Situation
Depending on what your hospital provides to make your delivery experience a good one, you might need to bring the items you feel are necessary. My hospital did not have birthing balls, or birth pools. I was allowed to bring a birthing ball, but was not allowed to bring a pool. You will need to check with your hospital to see what they do and do not provide and allow.
Another item that I knew I would need was a fan, and I did not want to run the risk that one was unavailable. So along with my birthing ball, and hospital bags, my sweet husband knew that he had to throw in our oscillating fan too, before we left for the hospital. I also thought I would need ice packs (I had a tendency to get overheated during my pregnancies), but upon arrival the nurse assured me that they would provide me with ice packs and I didn't need to worry about those.
I can still remember the nurses faces when my dear husband pulled out the fan and began looking for an outlet to plug it into. We came prepared, and though they didn't mind, I think they must have thought we were quite the duo. He with a huge blue birthing ball under one arm, and an oscillating fan in the other.
Don't worry about what anyone else thinks- if the hospital rules allow you to have something that you think will make you more comfortable in your birth, then bring it. This is one time that it really is all about you.
6 Nurses Do Almost Everything (And Sometimes They Do EVERYTHING)
During your prenatal visits to your doctor you probably won't see nurses much. At the beginning of each appointment they'll take your vitals and talk to you about how you're feeling, but that's pretty much it. Your doctor is the star of each appointment, and he or she's the one telling you how your baby is doing, and easing your worries and fears related to pregnancy, labor, and birth.
So it's a complete surprise, and sometimes shock, when you get to the hospital to deliver, and realize that your doctor is only going to be called at the very end of your delivery experience. The nurses will be the ones to monitor your condition and report it to the doctor, who most likely won't be on site until you're ready to push.
It feels a little unsettling at first, because you're used to the doctor being the one to assess you, but rest assured, the nurses know what they're doing.
I know that my experience is unique to me, but I can tell you that when my second son was born unexpectedly on the table while I awaited an epidural, the nurses at my side knew exactly what to do. My husband was understandably panicked, and asked my labor nurse who would deliver our son if the doctor couldn't arrive in time.
She pointed to herself, and to him, and I'm not going to lie and say that this eased the anxiety we already felt. Our son was already crowning, and the nurse didn't blink an eye as she grabbed one of my legs and told my husband to grab the other, and instructed me to push on the next contraction.
They delivered my son, and were absolutely knowledgeable about what to do, even when I began bleeding more than they anticipated. Nurses know what to do, it is okay to trust them.
5 You Might Be More Or Less Dilated, Depending On the Nurse
This one is a bit commonsensical but it's worth mentioning. Depending on who examines your cervix, you might get different answers about your progress. If you're having nurses examine your cervix using their fingers, it really does make a difference whether they have large or small hands and fingers. Crazy, but true.
And when it comes down to a centimeter of difference whether you're considered to be in active labor or not, you begin to care much more about accuracy than you'd think.
I once had a nurse claim I was four centimeters dilated, which met the hospital's requirement to be admitted to the hospital. When the doctor came in to do the same examination not a minute later, she said I was five centimeters dilated. Not a huge difference, unless it's your cervix and you're feeling rather anxious to get the show on the road, so to speak.
Unfortunately it can work the other way around as well, though I'm uncertain if it's always a case of differing digit sizes. My doctor told me at my last prenatal appointment with my second son that I was dilated to two and a half, which filled me with joy since I had arrived to the hospital with my first son dilated only to two.
When I got to the hospital after many hours of contractions and certain I was dilated to 3o centimeters (I might be exaggerating), I was told I was barely dilated to 2 centimeters.
I don't know if my doctor had rushed the exam or only wanted to keep my spirits up, but I'm pretty sure my cervix didn't close back up. Your cervix can, however, become swollen if you push before you are completely dilated, so do make sure you have the green light from your care team before you begin pushing. Be aware that different medical staff might give you varying results from your exams, because it is not an exact science.
4 Weekend Deliveries Sometimes Get the Shaft
I kind of mentioned this before, regarding babies adhering to normal business hours. When your baby decides to be born on the weekend, sometimes this means that you are going to be in that fun limbo place of waiting for your actual doctor to return on Monday if he or she isn't the on-call physician.
The weekend nurses, in my experience, might not be overjoyed to be working the weekend, though that might just be a reflection of their dislike of dealing with several pregnant and laboring women crying about the fact that their doctors won't actually be the one delivering them. Some services might also be on hold until the weekend is over, such as access to lactation consultants or other specialists.
For the most part, a hospital runs exactly the same on the weekend as it does during the week, though during my two deliveries I felt as though things began to run smoother on Monday, when I was discharged. Make sure that if you deliver on the weekend, that you still request everything you need, such as an appointment with a lactation consultant if you are nursing.
My hospital had a team of lactation consultants that visited patients during their stay, weekend or not, to assist with those first painful days of nursing.
3 You Need An Advocate
This one is important. Even if you are the most independent woman to have ever given birth, it is a good idea to have another person that can be with you during labor, delivery, and recovery. You'll need someone to hear what the doctors and nurses are advising, while you focus on your sole job of getting the baby into the world and taking care of him or her when he arrives.
It's hard to do all the things that you need to do, and it's a huge help to have another pair of ears that can focus only on listening to the doctors and reading your discharge instructions.
Your brain might feel foggy as a result of sleep deprivation, and even though you totally feel like you're retaining every last instruction, I can guarantee you aren't. It's also nice to have someone at your side to ask the nurse for one more blanket and to go with your baby to have the various tests and vitals done so that you can rest assured someone is always with him.
Your advocate needs to be someone you trust, and someone you actually want with you during such a life changing event. Choose wisely. If your Aunt Marsha's voice gets on your very last nerve when you're not in pain, then I guarantee Aunt Marsha is not who you want as your advocate. You'll want someone unafraid to speak up and ask the right questions, and someone you can depend on to go get you the non-hospital coffee (which might be the most important job they have.)
2 Nurses Are People, Too (And They Rule the Hospital World)
I know we've all heard that nurses are invaluable people to the world, and they are. You will never believe this or understand this on a more basic level than when you are admitted to the hospital and depending on them for pretty much everything. They are up in your business from the get-go, and nothing shocks, disgusts, or alarms them.
They're kind of superheroes and their superpower is dealing with all things gross with a straight face, not even a wrinkle of the nose. So for one thing, always be nice. I know it's tempting to get snippy when you're in pain or anxious- but it's really going to get you nowhere.
Follow the same rules that (I hope) you would on the outside of the mauve walls of the hospital, and treat them as you want to be treated. They have lives and worries of their own, and while this is pretty much the biggest life event you've had up until now, be respectful that we all have days that we might feel better, move faster, or seem more present in the moment, than others.
You and your advocate should always make sure that you are receiving the best care- I'm not saying that this should be sacrificed in the name of being nice- not at all. Please ensure that you are comfortable with the care and attentiveness that you are getting while at the hospital.
What I'm saying is, extend grace and give the benefit of the doubt to others on the small things that don't matter or make much of a difference during your stay. A kind word and an understanding attitude go a long way in making sure that you have a good birthing and recovery experience.
1 Accept That Your Birth Plan Is A Plan
Birth is unpredictable. I know, that's a scary little sentence right there. What will happen? You feel the need for specifics. And so you make a plan. If A happens, then let's do B, and if B happens, then let's do C. I get it. During a first pregnancy this can feel like some sense of certainty in a very uncertain time. No one is going to tell you not to make a plan.
Do what makes you feel more secure in the birthing process. Just know, that you will most likely deviate in some way from the plan once labor actually arrives.
You might deviate in small ways or big ways, but because labor and delivery is a natural event that is dictated by your body and not your mind, it doesn't always go according to a bulleted list of steps that you printed on the cutest paper ever. It is absolutely okay to try and stick to your plan and ask that your support team help you to do the same.
Sometimes, though, for the health of you or your baby, you might need to change courses. It might look like an epidural, or a Cesarean section, or it might even mean you have a medication free birth when you had planned on an epidural (as it did for me!)
The point is, do what you need to do. Plan it out, and then acknowledge that those bullet points are what you hope and dream will happen, but aren't necessarily what will actually happen. If all goes according to your plan, that's a huge win! If it doesn't, allow yourself to mourn as you need to for the loss of the birth you expected to have, and try to move on.
These are just a few things they usually don't mention in childbirth class. Hopefully you feel even more prepared for birth now, and will take this insider information with you into the delivery room.