Delivery Day Concerns
It's normal to be nervous about labor. Fear of the unknown, along with stories shared by well-meaning but slightly clueless friends, can drive even the most levelheaded mom-to-be to bite her nails. We put the most common fears into perspective.
Worry #1: A Painful Labor
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This may be your top fear. "Let's put it this way," my best friend Julie told me, "I wanted an epidural when my pregnancy test came back positive." Kara Corridan, of Springfield, New Jersey, used to have nightmares of being carted off to the delivery room screaming in agony.
Contractions do hurt, says Jennifer Krupp, M.D., maternal fetal medicine fellow at the University of Wisconsin in Madison. But there are many, many options for managing pain, "including narcotics, epidurals, other medicines -- and nonpharmacologic options, too, such as walking around, being in the tub, and changing positions," she says. That means, for the most part, how much pain you undergo is well within your control -- with a doctor's assistance.
As for Corridan, "the reality was that a few hours after I was induced, my doctor said, 'So, you ready for your epidural?' " she recalls. "I said, 'Already? I'm not really hurting yet.' And she said, 'I don't need to see how much pain you can take -- do you?' " (In fact, many mothers-to-be report that induction is slightly more painful due to increased contractions.) Corridan still regards her doctor as "my hero."
Worry #2: Having Baby in the Car
"Growing up, I had seen the occasional news story of a woman giving birth in a cab," says Marie Leach, of Newtown, Pennsylvania.
The chances of this happening are slim, says James Woods, Jr., M.D., chair of the department of obstetrics and gynecology at the University of Rochester Medical Center. This is true particularly for first-time moms. (First-time labor generally lasts 10 to 14 hours, while subsequent deliveriesare often quicker.) And in the unlikely case of a backseat delivery, he says, if you were to cut the cord, clear the baby's nostrils and mouth, and swaddle him, the baby would likely be perfectly okay. "But there aren't many people who have labors that are only 20 minutes long," Dr. Woods says, laughing. "A lot of women would love to have that."
Worry #3: The Epidural Won't Work
It's unlikely that the epidural won't work, Dr. Woods says. But if it doesn't, "It's not a big deal to put in another one," he says.
Worry #4: Fear of Needles
"Needles were my worst phobia," says Margot Kast, of Naples, Florida. Indeed, Dr. Krupp sees lots of needle squeamishness. However, "the only part of an epidural that hurts is when they numb the area first with a tiny needle," she reassures. "It feels like a little bee sting, which is not actually the needle but the numbing medicine." Once that's in, the patient won't even feel the epidural needle -- rather, she'll experience pressure. And "most anesthesiologists work behind you, so you won't see it," Dr. Krupp says. The hardest part of getting an epidural in active labor is that you have to sit still through contractions.
Worry #5: Labor Will Last 36+ Hours
"I had heard that Gwyneth Paltrow was in labor for 70 hours before Apple was born," says Mary Heller, of Kansas City, Missouri. "I imagined being in labor for days."
Early labor, when your cervix begins to dilate and thin out, varies wildly. It can last a few hours or go on for days. But for many women, this stage, which starts with mild contractions, isn't particularly uncomfortable. (I, for one, napped and leafed through magazines.) Active labor, when the cervix dilates to 10 centimeters and contractions are longer and more intense, typically lasts about eight hours. And most doctors won't let you go longer than 24 hours once your water has broken.
Worry #6: Needing a C-Section
Donna Marino, of Cranford, New Jersey, wanted to go drug-free for her first baby: "A birth that ended in a c-section was my worst fear."
More than 30 percent of women in this country now deliver via cesarean, but many mothers-to-be are as apprehensive as Marino was. "A lot of people don't want it," Dr. Krupp says. "But we do c-sections when something is going wrong in labor -- either it's not safe for the baby or the mom, or it's taking so long that they're not making any progress." Ultimately, the goal is a safe delivery for both mother and baby, and "it doesn't really matter how you get there," Dr. Krupp says.
Marino did, indeed, have a c-section when she was induced, and the baby still did not emerge. "To my surprise, my little dumpling weighed 11 pounds, 5 ounces," she says. "You can plan, but what will happen, you never really know."
Which echoes what Dr. Krupp claims is the best approach to labor. Many women "come in set on how they want their labor to go," she says. "They get so disappointed or feel like they've failed, because they set themselves up to have total control over a situation that nobody can control. You've kind of got to go with it and not worry so much." Sound advice, says Chrissy Gala, of Apex, North Carolina. "My husband was at a concert when I went into labor two weeks early," Gala recalls. "My mom had to drive me to the hospital -- not quite how I pictured it!" she laughs. "But then, again, it never is, is it?"
Information & Support
Moms-to-be fret about having some, um, gross-out moments on labor day. But when it comes to the oft-cited concerns above, docs and dads say they're unfazed. What are your labor fears?
Originally published in the March 2010 issue of American Baby magazine.