7 Things You Didn't Know Could Happen During Labor

You know to expect contractions and pain. But take a look at a few lesser-known events that can happen when giving birth.

child labor illustration
Caitlin-Marie Miner Ong.

There are a few well-known things that happen during labor like contractions, pain, and maybe an epidural. Yet, there are also a few other events that can occur that may catch you off guard. Some are common and harmless while others sometimes need more urgent care.

From vaginal tearing and pooping to a super fast labor, there's quite a bit that can make your labor that much more thrilling. Read on for seven things that can happen and what to do about them.

Unintended Bowel Movements

Since the same muscles used when pooping are being used during labor, you might let one slip out during labor—and that is totally OK. Nita Landry, M.D., an ob-gyn who practices across the country and co-host of The Doctors says it's common for people to have a bowel movement during labor. "That actually means the proper muscles are being used to push the baby out," she says.

An epidural, which numbs the lower half of your body, may increase the likelihood of uncontrollable bowel movements, Dr. Landry explains. If you feel the urge, go right ahead and poop (don't be shy). "There is emerging research that suggests pooping during labor may help expose your baby to good gut bacteria, which could have long-term health benefits," adds Dr. Landry.

In a 2021 article in the journal eBioMedicine, the authors noted that it has been long understood that vaginal birth seeds the infants' gut microbiome, which was formerly thought to occur through the vaginal microbiome. But after comparing microbial strains between infants and maternal vaginal and rectal samples, researchers found that the maternal colonization source was rectal rather than vaginal.

Nausea and Vomiting

As it turns out, nausea and vomiting aren’t only due to morning sickness; they can also occur during labor. That's especially true during the transition stage of labor, when you're moving from active labor to pushing.

Also, sometimes an epidural can cause a drop in blood pressure, which can lead to vomiting, says Sherry Ross, M.D., an OB-GYN and women's health expert at Providence Saint John's Health Center in Santa Monica, California.

While people have traditionally been advised to not eat during labor due to the risk of aspiration (inhaling food or liquid into the lungs), advances in anesthesia care means this is less likely to happen today. In addition, fasting during labor can have adverse effects, like energy loss, lengthy labor, emotional stress, and fetal distress. The American Society of Anesthesiologists advises people to ask their health care provider if a light meal in labor is safe for them.

Prolonged Labor

The first stage of labor includes the latent phase (early labor), active phase, and transition phase. But sometimes these phases don’t happen as quickly as expected.

A prolonged latent phase is when labor lasts more than 20 hours for first-time parents and more than 14 hours if you've given birth before, says Dr. Landry. While prolonged latent labor can be exhausting and sometimes frustrating, Dr. Landry says it rarely leads to complications and should not be an indication for cesarean delivery.

If your cervix is slow to stretch and thin, just try and be patient and relax. Sleep, take a walk, or enjoy a warm bath.

The American College of Obstetricians and Gynecologists (ACOG) defines arrested labor as at least 6 centimeters dilation with membranes ruptured and either more than four hours of adequate contractions or more than six hours of inadequate contractions and no cervical change. If this is the case, your health care provider may recommend interventions, like oxytocin (Pitocin) to help labor along.

Rapid Labor

You can also proceed through labor really quickly. Rapid labor, also called precipitous labor, is when a baby comes in less than three hours after contractions kick in.

Most pregnant people welcome the idea of a rapid labor, but Dr. Landry says there are a number of concerns if rapid labor does occur. The main worry is making it to the hospital in time, some research indicates other risks of a fast labor include:

  • Not enough time to feel in control and find proper coping strategies
  • Increased risk of tearing the cervix or vagina
  • Hemorrhaging from the uterus or vagina
  • Retained placenta
  • Increased risk for blood transfusion
  • Prolonged hospitalization

Vaginal Tearing

It's fairly common for the perineum—the area between the vagina and anus—to tear during labor if the vaginal opening is not wide enough.

According to ACOG, between 53-79% of people experience some degree of vaginal tearing during childbirth. Most do not result in adverse outcomes. "First- or second- degree tears may only cause minor discomfort for a few weeks, but third- and fourth- degree tears may take more than a few weeks to heal," says Dr. Landry.

"In some instances, your doctor may have to perform an episiotomy, which is a surgical incision to enlarge the vaginal opening," she says. ACOG advises against routine episiotomy and recommends health care providers perform them only when absolutely necessary. Situations that may necessitate episiotomies include when it's urgent to deliver a fetus quickly or to prevent a larger tear. Stitches will help repair a torn or cut perineum.

Rectum Tearing

You may also tear into your rectum, a type of fourth-degree tear that sometimes occurs when you push your baby out. "There are times there is nothing you can do to prevent a fourth-degree tear. This is, thankfully, the least common vaginal tearing during a vaginal delivery," says Dr. Ross.

One way to reduce tearing into the rectum is by applying a warm compress to the perineum during the pushing phase of labor. You can also try massage.

"Perineal massage is commonly done to help prevent tearing during a vaginal delivery. Frequent massaging the base of the vagina with oil or a water-based lubricant is thought to soften the tissue making it more supple and improving its flexibility," says Dr. Ross.

Retained Placenta

Once your baby's out in the world, you might think it's over, but that's not quite the case. "It is normal for contractions to continue postpartum, as your body needs to expel the placenta from the uterus. The contractions are also needed to decrease the amount of postpartum bleeding," says Dr. Landry.

"Delivery of the placenta often happens on its own within the first 30 minutes after giving birth as your placenta separates from the uterine wall and is pushed out with contractions. If it doesn't happen automatically, the phenomenon is called retained placenta.”

Symptoms of retained placenta include fever, smelly discharge, heavy bleeding, or constant pain. Complications of retained placenta may include hemorrhage, endometriosis, and infection. Some risk factors for retained placenta include:

  • Prolonged oxytocin use
  • Having had more than five pregnancies
  • Preterm birth
  • History of uterine surgery
  • IVF conceptions

A health care provider will make careful choices about managing retained placenta. They may use medications to help relax the uterus and recommend breastfeeding, which could cause the uterus to contract enough to expel the placenta. As a last resort, manual removal may be necessary to rid your body of the placenta. The condition can be life threatening if not properly treated.

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