When I was pregnant, I was petrified that in the throes of labor, I'd lose control -- scream, curse, yank at my hair. Though everything turned out fine (and I didn't yell once), my fear was neither irrational nor uncommon. Here, obstetricians reveal what frightens women most about childbirth -- and explain why they shouldn't worry so much.
Relax -- the average first-time labor lasts about 18 hours, says Marjorie Meyer, M.D., a maternal fetal medicine specialist at the University of Vermont College of Medicine, in Burlington. In fact, after your water breaks, you won't be allowed to labor for more than 20 hours because of the risk of infection. Active labor begins when your cervix is dilated four centimeters. From that point, most first-time moms will dilate one centimeter every hour to hour-and-a-half, meaning you'll reach the pushing stage of labor in an average of six to ten hours. "If not, your doctor may give you a drug, such as Pitocin, to speed up contractions," says Kellie Flood-Shaffer, M.D., a professor in the department of obstetrics and gynecology at Texas Tech University Health Sciences Center, in Lubbock.
During an episiotomy, the doctor makes a cut in your perineum -- the area between your vagina and anus -- to make room for the baby's head.Although the procedure was once fairly standard practice, the good news is that doctors today perform episiotomies less than 30 percent of the time. And recent studies have shown that the number of routine episiotomies is dropping dramatically. Talk to your doctor ahead of time about her philosophy concerning episiotomies, making it clear that you'd like to avoid one. Keep in mind, however, that there are times -- such as if your baby is very large and your pelvis very small -- when an episiotomy may be medically necessary.
When you get an epidural, pain medication is administered into the area just outside your spinal sac via a catheter that's threaded through a hollow needle in your lower back. While epidurals can help preserve your strength by limiting the pain of contractions, the procedure does make some women's fear of needles kick into high gear. Rest assured: "The complication rate associated with epidurals is very small, and there is absolutely no risk of spinal-cord injury," says Dr. Meyer. And aside from the initial prick of the needle, getting an epidural doesn't hurt.
The odds of having a vaginal birth are in your favor. The overall rate of cesarean delivery in the U.S. is 20 to 25 percent -- and first-timers have a 12 to 13 percent chance. Failure to progress is the most common reason for performing C-sections. "If your doctor has seen no change in the dilation of your cervix for at least two hours, despite the fact that you are having regular contractions, he may conclude that labor is not progressing," says Carl V. Smith, M.D., chairman of the department of obstetrics and gynecology at the University of Nebraska Medical Center, in Omaha. A C-section may also be performed if the baby is in distress or in breech (feet-first) position, or if you have a condition called placenta previa, in which your placenta is low-lying.
Except in the situations mentioned above, you can reduce your chances of getting a C-section by taking childbirth classes and talking to your doctor about what to expect during delivery. Doing so will better prepare you for the experience, and you'll be less likely to panic and agree to a C-section prematurely.
Your ability to handle pain is greater than you think. Make sure to practice the breathing and relaxation exercises covered in childbirth classes. Remember, too, that pain-relief medications really do help. Even if you have your heart set on a natural birth, talk to your doctor about these drugs -- just in case. Finally, while some women do go a little crazy during labor, it's nothing doctors and nurses haven't seen before. "We really don't care if you scream or curse," Dr. Meyer says, "as long as it helps you cope with the pain."
In reality, most men hold up just fine. If your husband is particularly nervous, make sure he attends childbirth classes. "Men who watch childbirth films beforehand are less shocked when they see their wives deliver," Dr. Carl V. Smith says.
It's their big moment -- but some men worry that they'll somehow do it wrong. Remind your spouse that there are no nerves in the cord, so cutting it doesn't hurt mom or child.
Copyright © 2003 Denise Schipani. Reprinted with permission from the September 2003 issue of Parents magazine.
All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.