Updated: Jun 12, 2020
Our culture can have a tendency to glorify and over-dramatize childbirth. Questions like: When you’ll go into labor, how it will transpire, what your options are, how to prepare for it, and what the outcome will be are all critical childbirth questions that have become mired in myth and miscommunication. Messages that pregnant women receive from TV, movies, social media, and the media in general can be detrimental (when your expectations fall short of reality) and isolating (when your experience doesn’t follow the norm).
We at EmmaWell want to dispel the disconnect between expectations and evidence and help you avoid common misconceptions, so you can come out on the other side having made informed, appropriate choices, and feeling content with a healthy baby.
Myth 1. Your due date is when you’ll go into labor.
For many expecting moms, the due date assigned to your baby signifies a momentous occasion on the calendar. “What’s your due date?” becomes a familiar refrain once your belly reaches third-trimester girth. Your baby shower, babymoon, and maternity leave all might be planned around this singular date. In reality, your due date is a (somewhat) arbitrary estimate calculated by your care provider by adding 280 days to the first day of your last menstrual period. It’s an imprecise science because not everyone has a 28-day cycle, not everyone ovulates on the 14th day, and most don't record the exact date her period starts. So, for women with irregular menstrual cycles, doctors often use the fetal measurements taken during their first-trimester ultrasound to adjust the estimated due date.
So, what percentage of babies would you guess are born on their due date...25%? 10%? The correct answer is a mere 4-5%. In fact, is considered normal to give birth any time between the 37th and 41st week of pregnancy. According to CDC data from 2017, 26% of American babies were born between weeks 37 and 38; 57% between weeks 39 and 40; 6% in week 41; and less than 1% at 42 weeks or beyond.
The moral of the story is to manage your own expectations, and stay flexible. Be prepared for baby baby to come before your much-anticipated due date, and try hard not to be too disappointed if your baby hangs out a while longer. In addition, if you find out that your cervix has started to dilate at 37 weeks, there may not be a need to rush home and wait by the door with your hospital bag. It could take another four weeks for the real action to kick off. The same expectation-setting rule can apply to late arrivals. After furnishing a comfortable home for your baby for nine months, you might feel ready to put up an eviction sign towards the end. But if your due date passes uneventfully, we hope you'll continue to ride the wave of eager anticipation instead of turning impatient and discouraged, because you’ll be equipped with the knowledge that pregnancy length can vary widely.
Myth 2. Labor is a quick process.
As our favorite OB providers like to say: it’s called “labor” for a reason. For a first birth, labor typically lasts 12 to 24 hours. There is, of course, a wide range of variability (noticing a theme?). Labor might be over in a matter of hours for one woman, while for others, it can last a few days. Understanding how it usually starts can help you prepare, and surrounding yourself with trusted friends and a supportive team of OB providers is always helpful.
Believe it or not, labor does not always begin with a dramatic gush of amniotic fluid in a public place without warning, as is so often depicted in movies and shows. In the movies, you'll often see two loud pushes producing a (completely clean and unnaturally large) newborn baby. Real-life labor is beautiful in its own way, but does have a tendency to drag out and lose its "dramatic appeal". Your water often breaks right before birth when you are already admitted at the hospital, and might even need to be proactively punctured by your doctor to speed up the labor process. And instead of the "gush", many women only experience a steady trickle of fluid.
More often, labor begins with regular contractions, which cause the cervix to open (dilation) and soften, shorten, and thin (effacement), allowing the baby to move down into the birth canal. The contractions might feel so mild and sporadic that they can be hard to distinguish from Braxton Hicks contractions and you might not even realize you’re in the first stage of labor. On average (but again, a wide variability is the rule), your cervix dilates approximately one centimeter per hour when you are in labor.
Once your contractions become stronger, last longer, and get closer together, chances are that it’s time for the real work of active labor, during which your cervix will dilate all the way to 10cm. Contrary to what Hollywood would have you believe, the birthing process is a true labor of love that, for most women, can deplete every ounce of her strength and stamina.
Myth 3. A hospital birth means medication and intervention.
There seems to be a popular assumption that laboring in a hospital means that you can’t have an unmedicated, low-intervention birth. Your OB provider and care team will try their best to avoid forms of pain relief or assisted delivery methods that you don't desire. You will not be forced to have a medicated birth if that is against your wishes, as long as your provider feels it is safe for you and your baby.
In addition to medicated pain relief options such as an epidural, spinal block, and IV analgesics, other coping methods for pain during labor, often practiced in birthing centers or at home with a midwife, are also available in the hospital. Medication-free pain management options include breathing techniques, aromatherapy, massage, acupuncture, acupressure, yoga, changing positions, lying on a birthing ball, applying ice or heat pads to your back, or moving rhythmically. With an unmedicated birth, endorphins released during the birthing process can provide natural pain relief and promote bonding with your baby afterward.
The catch is that pregnant women (especially first-timers) can’t judge in advance how painful the process will be, and most deliveries do require some sort of intervention. A medically uncomplicated birth would entail that labor starts on its own and progresses steadily. The baby would need to be positioned head-first and pass completely through the birth canal by the force of contractions and pushing. These natural processes are glorified by the media (of the social and traditional variety), commanding that a woman’s body is designed to birth a baby and inherently knows what to do. The truth is that modern medicine offers many options to relieve the intense pain of childbirth, as well as various interventions when the health and wellbeing of the mother and/or baby are at risk.
Myth 4. Your birth experience will go according to plan.
In spite of your best-laid plans, babies are full of surprises. Preparing for labor essentially means accepting that it might not go the way you expect. This is why we at EmmaWell advocate for Birth Goals, (vs. "Plans"), because the first step of becoming a parent is learning to give up control!