The Reality: "It's much more common to go into labor starting with contractions, and your water may not break until right before you give birth," says Laura Dean, M.D., an ob-gyn with the Stillwater Medical Group, in Stillwater, Minnesota.
Even if your water does break first, labor may not start right away (though you should call your doc immediately), says Judith Tinkelenberg, a nurse-midwife and clinical manager at LifeCenter Sacramento Birthing Center, in California. "Eighty-five percent of women go into labor within 24 hours of their water breaking. The remaining 15 percent could take as long as four or five days," she explains. But because there's a higher risk of infection after your water has broken, most doctors will induce labor after 24 hours have passed.
The Reality: "The cervix can start to dilate and efface weeks before labor actually starts," says Dr. Dean. What's more, some women actually go into labor before they begin to dilate at all, so don't assume that you're still ages from delivery if you're not dilated. Although your ob-gyn will likely check your cervix each week toward the end of pregnancy, it's not necessarily because it's an indicator of how soon the baby will arrive. "A baseline cervix check is helpful to have as a comparison when a patient is admitted," Dr. Dean explains.
The Reality: Patients who have already shown cervical changes, such as dilation and thinning of the cervix, typically respond better and more quickly to induction. Others will have a stepwise approach, including cervical ripening with a prostaglandin gel or a Foley bulb, followed by Pitocin, all of which takes time, explains Dr. Dean. And once you do go into labor after being induced, it may actually take longer and be more painful than spontaneous labor. The reason? Your body may not be fully prepared, and Pitocin makes contractions stronger.
The Reality: Think of your doctor's presence as a check-in, not a sit-in. She may have other patients or other births to attend to while you're in labor -- or she might not even arrive at the hospital until you're close to being fully dilated. Have a discussion ahead of time so you know what's likely to happen. No matter what, don't worry that you'll be without support. Labor and delivery nurses will be on hand throughout the entire process, and they're trained to closely monitor you and your progress, says Tinkelenberg. Your doctor will be updated regularly, in person or by phone.
The Reality: It ain't over 'til the placenta passes -- and the average time for that to happen is about 30 minutes, according to Dr. Dean. Fortunately for you, compared with birthing a child, delivering the placenta is usually less painful -- although you may have to push a little to help get it out.
Originally published in the June 2014 issue of Parents magazine.
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