Labor and Delivery: Separating Myth From Fact

Medical Expert: Jeffrey L. Ecker, MD

For some reason, when you’re expecting, people seem to take your growing belly as an invitation to share their own stories of labor and delivery. You’ll probably hear all kinds of tales, ranging from ease and joy to graphic horror and cryptic warnings.

Of course, because the anticipation of giving birth is scary all on its own, the stories that will inevitably stick with you are the ones that invoke even more fear than you already have (thanks so much for sharing, well-meaning friends, family members, and strangers). But it’s important to remember to take everything you hear with a grain of salt—especially if the information you’ve been fed is less real-life experience and more myth.

So, what is reliable, and what’s not? We’ve stared down some of society’s most stringent delivery room myths to learn the facts that will help ease your mind.

Myth: Your Water Will Break Before You Make It to the Delivery Room (and Likely in Public)

Remember when a very pregnant Charlotte was yelling at Big in the Sex and the City movie and her water broke right there on the sidewalk? While this scenario certainly made for good entertainment, it’s unlikely that you’d find yourself in a similar situation.

In reality, chances are high you’ll probably be well aware you’re in labor before your water breaks—so unless you plan on breathing through all of those contractions while you’re casually dining or doing a little shopping, it’s unlikely that your water will break in public. In fact, according to the University of Michigan, only around 11% of pregnant people will experience prelabor rupture of the membrane (or water breaking before the body goes into labor).

Sure, just because the likelihood of your water breaking in public is low, that doesn’t mean it doesn’t exist. However, take comfort in knowing that in the event this does happen to you, you probably won’t experience the huge flood of fluid like you see in movies and on TV. More often than not, this fluid comes in the form of a small gush or even a slow trickle—and it’s colorless and odorless, so you can quickly clean up and head to your labor and delivery unit without anyone around you even noticing.

So, will your water break in public? It’s possible but not probable. In other words, don’t cancel your dinner plans for fear that you’ll suddenly drop a water balloon from your dress.

Myth: You’ll Definitely Know When You’re Truly in Labor

While the thought of your water breaking in public may be embarrassing, the silver lining is that you’ll know for sure that it’s go-time (because even if your water breaking doesn’t automatically trigger labor, you still need to seek medical attention to avoid infection and possibly be induced). For the majority of people who don’t experience prelabor rupture of the membrane, deciphering whether or not it’s time to go to the hospital can be much harder.

If you’ve been experiencing Braxton Hicks contractions (aka false labor), it can be tricky to recognize when you’ve made the switch to true labor. Often, true contractions start out feeling the same as their false counterparts—the muscles of the uterus contract, causing the abdomen to feel firm from the outside and cramped up on the inside. However, if your contractions are coming at regular intervals and growing stronger and closer together, then you are likely in true labor.

Because it can be hard to identify where false labor stops and true labor begins, first-time parents occasionally arrive at the hospital before there’s a real need. If this happens to you, don’t be ashamed for erring on the side of caution—the care team isn’t judging you. They’ll simply send you home until you’re ready to come back and birth a baby.

Myth: You’ll Have To Make a Mad Dash to the Hospital

In the movies, it seems like a pregnant person in labor goes from 0 to 60 in a minute, from calm to red-faced and racing out the door. In reality, however, early labor is typically calm, with mild contractions gradually becoming more urgent as the cervix dilates (opens) and effaces (thins). It can take hours until active labor sets in and it’s really time to go. Also, generally speaking, expecting parents tend to labor longer with their first babies than with subsequent deliveries.

Of course, there are widely varying timetables; some people don’t realize they’re in labor until active, painful contractions kick in (see above). If you’re having painful contractions less than five minutes apart, don’t delay, head to the hospital right away. You might just be one of those people who labor briefly and deliver in a hurry.

Myth: Contractions Are More Painful With Pitocin

Oxytocin, or brand-name Pitocin, is a hormone used to induce or speed up labor. (This hormone is also present after the baby has been delivered and is often referred to as the “love hormone.”) While Pitocin doesn’t necessarily make labor more painful, it does condense the process, moving you along from relatively easy early labor to painful active labor more quickly. Jeffrey L. Ecker, MD, an OB-GYN and chair of the department of obstetrics and gynecology at Massachusetts General Hospital in Boston, explains, “Pitocin makes contractions occur sooner and more frequently than they would on their own.” Without Pitocin, labor revs up more gradually.

When considering induction, it’s important to discuss your progress with your doctor. In some cases, like if the laboring parent’s or baby’s health is in danger, induction might be the best option. Otherwise, in an uncomplicated pregnancy, it’s typically wise to let nature take its course. Induction before 39 weeks is not recommended unless there is a significant medical reason behind it. Inducing labor unnecessarily could very well lead to complications.

Myth: You’ll Be Laid Up in Bed Throughout Labor

Assuming there are no complications and you’re not numb from the waist down from an epidural, it is very unlikely that you’ll be on strict bed rest during labor. Hospitals and birthing centers are generally flexible in their birth practices and typically allow patients to choose to move around during labor, depending upon what they’re comfortable with.

That being said, the more interventions a laboring parent needs or chooses, the less mobility they will have. If you value freedom of movement, don’t request elective interventions, or at least hold off until closer to delivery.

“In healthy moms and babies, ambulation early in labor is a welcome thing. It can make everyone feel better,” says Dr. Ecker. “If someone is told she needs to be in a bed and be continuously monitored, there may be a reason,” he explains. When there are no complications or interventions, an expecting parent should be free to roam, with the exception of the occasional health care provider checks.

Myth: Meeting Your Baby Will Be Love at First Sight

While this instant bond certainly can happen, not every new parent experiences it—and that’s OK. It’s incredibly important to be patient with yourself and with this new relationship.

Even though you’ve carried your baby for nine months, the truth is that you haven’t really gotten to know the little one yet. While the physical bond may be there, the emotional connection can take some time. Additionally, for new parents who experience “baby blues” or postpartum depression, there can be a real feeling of disconnectedness—which is often exasperated by feelings of guilt about the time it takes to bond.

Baby blues—mood swings and sadness during the first two weeks postpartum—affect about 70-80% of new birthing parents, and clinical postpartum depression—longer lasting, more severe depression—affects approximately 1 in 9. For parents experiencing postpartum depression (or another postpartum mood disorder), there is absolutely no shame in asking for help, whether it’s in the form of a professional to talk to or medication therapy.

Myth: Witnessing the Birth Will Diminish Your Sex Life

As amazing as the birth of a baby is, there’s no denying that it’s also pretty graphic (especially for someone with a queasy stomach). If your partner chooses to take advantage of their front-row seat to this miracle, particularly in a vaginal birth, you may wonder if they’ll ever be able to un-see it all for the sake of intimacy.

The fact of the matter is if it were common for partners to opt-out of sex after childbirth, how would many couples end up having more than one child? Partners can be thrilled to witness the birth of their baby—complete with all of the stretching, tearing, and unsightly output that comes with it—and still be very, very attracted to their partner after the fact. It’s not a one-or-the-other situation.

“It was very special for me to be the first person on the planet to see each of my kids enter the world,” says Justin Williams, a dad in Des Moines, Iowa. “It was amazing to watch and be a part of it. I feel like it brought us very close together, and I think [my wife] is still damn sexy.”

That being said, your comfort matters, too. If you don’t want your partner getting an up-close look at everything happening below your waist during delivery, let them and your medical team know. It is your body, and you have the final say in who gets to see what during your birth.

As you inch closer to your due date, try not to let myths or the scary—albeit harrowing—tales of your friends’ or family’s births make you uneasy. Your water probably won’t break in public (and if it does, oh well!), you most likely won’t be forced to stay in bed throughout labor (and if you are, it’s for good reason), and you will feel so much joy when you meet your baby (even if you don’t bond instantly).