Choosing an OB/GYN or midwife when you’re pregnant is one of the most important decisions you’ll ever make and one most moms give a lot of thought to. In fact, 89 percent of women said the reason for selecting their provider was because the person’s values were in line with their own, according to a study in the Journal of Perinatal Education.
Although your provider’s priority is for you to have a healthy and safe delivery, she may not have told you everything about what giving birth is really like. Here are 10 things you should know.
1. Your baby may not be that big.
If your provider tells you that your baby is “big,” realize that size and weight are only estimates.
“Ultrasounds can be off by as much as a pound or two, especially in the last weeks,” said Jeanne Faulkner, a registered nurse in Portland, Oregon, author of “Common Sense Pregnancy: Navigating a Healthy Pregnancy and Birth for Mother and Baby” and host of the Common Sense Pregnancy & Parenting podcast.
Many doctors will suggest women who are measuring large be induced or have a C-section, but most of the time these babies weigh in at a normal weight. Besides, if your pregnancy has been healthy, there’s no reason to make these decisions without allowing your body to do what it was designed to.
“How are we to know that mother can’t deliver a really big baby?” Faulkner said.
2. You don't have to push.
If you’re worried about how to push and how long you’ll have to push, take heed.
Much like your gag reflux, the fetal ejection reflex helps your body birth your baby.
“The top of the uterus starts to get thicker and thicker and it almost rolls up behind your baby like a tube of toothpaste,” said Tracy Donegan, a midwife in San Francisco and founder of GentleBirth. “Once the baby’s head triggers that reflex, it starts to push your baby out. It literally ejects your baby.”
Although you’ll still have the reflex if you’ve had an epidural, without one, the reflex is “so irresistible you can’t not go with it,” she said.
Also, studies suggest that being directed to push or pushing down can cause fetal distress, perineal tears and damage to the pelvic floor and the pelvic organs.
“It’s not that we’re telling moms they don’t have to push, what we’re telling them is ‘Do what feels really good right now,’” she said.
3. Get waxed for you.
You might want to book a manicure, pedicure and a bikini wax before you head into the hospital, but the truth is doctors don’t even care if you showered, said Dr. Kelly Kasper, a board-certified OB/GYN at Indiana University Health in Indianapolis. If it makes you feel better about yourself, by all means go for it— but no one is looking.
4. You can eat during labor.
You might not feel much like eating in between contractions, but if you’re hungry, you should.
“The body works better if it’s well hydrated [and] well nourished,” Faulkner said.
Once you get to the hospital however, you probably won’t be allowed to eat. Hospitals have this policy in place to prevent the risk that you will aspirate food should you have a C-section.
5. You might poop and vomit.
Although it might be one of your fears, the reality is that many women vomit while they’re in labor and poop when they push. It’s not pleasant, but the reality is that your doctor, nurses and doula could care less.
“Nobody comments on it [and] nobody makes a big deal about it,” Kasper said.
6. You have more time than you think.
If your membranes rupture and labor doesn’t start right away, many conventional providers will want to induce right away or say you have 24 hours to go into labor until you’re induced in order to prevent infection, Faulkner said.
Although it’s true that some women are at an increased risk for infection, going 72 hours before being induced is safe and gives you the time to go into labor. In fact, 50 percent of women with premature rupture of membranes give birth within 5 hours and 95 percent with 28 hours, a study in the New England Journal of Medicine found. Of course vaginal exams can introduce bacteria into the vagina, so if you’re not contracting you should avoid them.
7. You don’t have to push on your back.
You might think you have to push in the hospital bed, but gravity works better if you push in a more upright position or squat. If you feel that pushing on your side, on your hands and knees or on your back feels right, then go for it.
“She’s listening to her body, and that may be exactly the position she needs to be in order for her baby to fit through,” Faulkner said.
8. An episiotomy is outdated.
In 2006, The American Congress of Obstetricians and Gynecologists (ACOG) issued recommendations against routine episiotomies. More recently in June, they released a practice bulletin that called for specific ways OB/GYN’s can reduce the risk of both the procedure and vaginal tears. The good news is that between 2006 and 2012, rates have been on the decline, a study in the Journal of the American Medical Association found.
Before giving birth, ask your provider how often he finds it medically necessary to do the procedure. Ten percent is ideal and less if you have a midwife, Donegan said.
9. You don’t need a spotlight.
When you’re fully dilated and it’s show time, your doctor will probably flip a switch to reveal large, bright, overhead lights. Although it may help her see better, this is the exact opposite of what your body needs when you’re ready to give birth.
There are melatonin receptors in the uterus that help oxytocin, the hormone that produces contractions while you’re in labor. Since low light increases melatonin, the lights should be kept dim.
10. Don’t invite too many people.
You might want family members and friends to join you, but think about how you want your birth experience to be. Giving birth is an intimate and private experience so the less people, the more calm, quiet and beautiful it’s likely to turn out, Faulkner said.