Ah, the miracle of birth. Here’s what to expect on the big day(s) from people who deliver for a living and those who have survived labor.
As you read this, I am currently caring for my 1-month-old son. (And hopefully kicking butt at this whole new parent thing.) But before his grand arrival, the journalist in me needed to know: What’s it really like giving birth? As a first-time-mom, I turned to the experts — obstetricians and doulas — and, of course, fellow parents who had been there, done that. Here’s what they had to say.
The Truth About Your Due Date
Just like best-by dates on foods, your due date is just that, an approximate timeframe; there’s nothing inherently bad if you go a bit beyond the day, just like it’s OK to keep using that ketchup or mustard. Due dates — calculated based on the first day of your last period — are a guesstimate. And for many first-time parents, they roll right on past it with baby making no plans to vacate. In fact, according to the Perinatal Institute, only 4% of first-time mothers deliver on their due date. Pro tip: Pass this information on to friends and family who will likely be constantly checking in for a birth update.
The Truth About Your Water Breaking
Virtually every movie or television show featuring a pregnant person about to go into labor has a dramatic water-breaking scene to indicate — It’s happening! The baby is coming any minute! But research has shown that only around 10% of women experience their water breaking before labor. (The other approximately 90 percent experience their water breaking during labor, during delivery, or even preterm.) Even when your water does break, it can still be hours until you reach active labor.
The Truth About Your Dignity
Just like your baby will make their big debut naked, wearing virtually nothing in the hours, or day(s) leading up to their arrival is standard for many pregnant people. And I’m told that frankly, I just won’t care.
“I am not one of those Oregonians who does naked yoga at the river,” says one of my PDX Parent colleagues, and mom of two. “But with (my first child) I was sitting in a labor tub pretty much naked and did not care at all. In fact, when I was getting out of the tub to go get my epidural, I think I almost walked into the hallway naked.”
You may also vomit, poop, or both. But labor and delivery nurses are pros; they’ll clean everything up like nothing happened. For everyone else in the room, including you, expectant mom, it’s a don’t ask, don’t tell situation.
The Truth About Your Birth Plan
I quickly learned that it’s a rookie mistake to rigidly adhere to my birth plan as if it was the user manual for NASA’s lunar rover.
“Birth is not a work plan where x+y=z,” says Rebecca Durlin Smith, certified birth doula and co-founder of Birth First Doulas and the Birth First Education Center. “We refer to it as birth preferences or ideals. This concept allows for the openhanded flexibility that will help you lean into the reality that in birth — and life — there are things that can and cannot be controlled.”
Smith says while it’s absolutely a good idea for you (and, if applicable, your birthing partner) to educate yourself about the birthing process, and postpartum care, being adaptable is key. This applies to pain management and any medical interventions.
Another critical component: Have a support system in place. These people can help advocate for, and with, you.
Wendy J. Smith, the chair of the Department of Obstetrics and Gynecology at Randall Children’s Hospital at Legacy Emanuel Medical Center, echoes the importance of flexibility. “Understand and believe that there is no one ‘right way’ to deliver,” she says. “Trust your body and also trust the experienced providers who are there to help you with the experience. Our job is to honor your process and make sure that you and your baby stay safe.”
The Truth About Time
When I asked about the amount of time spent in labor, the mere concept varied from parent to parent. It will feel like an eternity, said some, or it went by way faster than I ever imagined, said others. “Time is weird when you are in labor,” recalls a PDX Parent staffer. “Hours can seem like minutes, and minutes can feel like hours. You might even sleep while you are in labor, which I did not expect at all.”
The Truth About Contractions
I was routinely asked during my pregnancy if I was experiencing any contractions. I always said no, but toward the end, I became less confident in my answer as I started to experience those sneaky Braxton Hicks contractions.
“Labor contractions result from the muscle fibers of the uterus squeezing at regular intervals to progressively dilate, or open, and thin, or efface, the cervix,” says Smith. This progresses from period-like cramping, to ‘takes my breath away’ sensations.
Essentially, I’ll know my labor has progressed as they become more painful, more frequent, and last for longer stretches.
The Truth About Getting an Epidural
To be (numb), or not to be (numb). That is the question. Most pregnant people know well ahead of time whether or not they will get an epidural while in labor — but again, channel that flexibility and know that it’s perfectly acceptable to change your mind.
Epidurals are used by 60% of patients during their labor, says Irina Cassimatis, M.D., and assistant professor in the Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, OHSU School of Medicine. “Because the labor process can sometimes take several hours (and even a few days), I always recommend that an epidural be placed whenever the pain becomes intolerable.”
Cassimatis says there is no “ideal time frame” to get an epidural. “Some patients have expressed concern that if they wait too long, they won’t be able to receive an epidural, but there is no specific rule. Most patients will opt for an epidural sometime between 3 and 10 centimeters dilated.”
And what does it feel like, I asked. “Oftentimes, this discomfort is less severe than the pain of contractions, and it lasts just a few minutes. Following placement, patients report initially feeling numbness or heaviness in the lower abdomen and legs, along with a gradual decreased intensity of their contractions that eventually results in complete pain relief within 30 minutes that allows them to rest, and even nap.”
The Truth About Being Induced
Not everyone goes into labor spontaneously; there are a variety of reasons why, mostly due to a medical recommendation. “It is important to acknowledge that approximately 25% of all labors in the United States are induced and it may be even more common with first labors,” says Smith.
While she says that induced labor generally lasts longer than spontaneous labor, “sometimes the onset of painful contractions feel less gradual, which can be perceived as more painful.”
The Truth About Getting a C-section
As with epidurals, people have feelings about cesarean sections. Smith stresses again, that there is no one correct or right way to give birth, “and that in no way does having a cesarean section represent failure. In fact, proceeding with a timely cesarean section can lead to the best outcomes for both the birthing person and their baby.”
Cassimatis explains that the procedure itself — particularly for first-timers — will take 45 to 60 minutes, and the pregnant person will be awake. “Oftentimes, if both the laboring parent and baby are stable at the time of delivery, skin-to-skin bonding with the baby can occur after the cesarean, and partners are usually present for the duration of the surgery.”
PDX Parent staff themselves are no strangers to the phenomenon. “Some parents feel so terrible when the decision is made to do a C-section, but I actually had an easier recovery from my section with my second than my forceps delivery with my first. A C-section isn’t ideal, but sometimes it’s ideal for your birth,” says one staffer.
Another colleague and mom of two, says she also had an uncomplicated recovery with both of her C-section deliveries. “Sometimes I wonder if C-sections get a bad rap because so many of them are unplanned — performed in emergency-type situations where there are frightening complications, or when the labor is taking too long and everyone is grumpy and exhausted.”
The Truth About Recovering
Everyone’s labor is different, so too is everyone’s recovery. But generally, says Cassimatis, recovery from a vaginal delivery can last two to four weeks and the recovery for a cesarean is often around four to six weeks. “In general, we recommend taking it easy for the first six weeks after any birth, but after that, patients can resume physical activity and sex as they’re comfortably able to.”
There are some definite adjustments to normal, everyday activities, like using the bathroom. Your pelvic floor just experienced the workout of its life, and if you’re recovering from a C-section, well, that was major abdominal surgery — so your first postpartum poop might feel just as painful as delivering the baby. Pro tip: Don’t skip on the stool softeners and the upside-down perineal bottle (the hospital will give you both).
Another surprise during recovery? Postpartum bleeding, also called lochia. “Some birthing people are surprised to learn that while an average menstrual cycle lasts about one week, lochia lasts on average six weeks,” says Smith. This post-delivery bleeding is triggered by the release and delivery of the placenta. Because it’s much heavier than a regular period, the hospital will dispense large, thick pads, and/or adult diaper-like underwear.
“Lochia may also be inconsistent,” says Smith. “Just when you think it’s done, you may have another day of dark red bleeding. … Rest, rest, rest postpartum — you and your baby deserve it!”
It Takes a Village
Don’t be afraid to ask for help as a new parent. Here are local resources ready to help you and your growing family. Even better, many of these resources are PDX Parent Reader Favorites winners — beloved by your fellow, local parents!
- Mendwell Pelvic Health offers certified pelvic health therapy.
- Birth First Doulas not only has certified birth and postpartum doula services, but also classes on pregnancy, childbirth and parenting.
- Bridgetown Baby offers postpartum doula services, lactation and feeding support, and classes and support groups.
- Mother and Baby Clinic at Providence St. Vincent Medical Center is a safe space for new parents to meet with lactation consultants, who are also nurses, nurse practitioners and midwives.
- Baby Blues Connection serves parents in the Portland metro area, and Vancouver, via support groups, referrals and resources for postpartum depression.
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