You’re expecting your first baby. Congratulations! You’ve probably heard your girlfriends lament about childbirth (excruciating pain, unpleasant bodily fluids), and while you focus on the nesting phase in a newly purchased glider, you may wonder, “Do I really know what awaits?”
“Childbirth is unpredictable and your medical team or midwife will take excellent care of you, but you may not get the birth plan or timetable you hoped for,” said Dawn Mormak, MD, an obstetrician and gynecologist with Women’s Care Florida who delivers at Baptist Medical Center Jacksonville. “During labor, things can change in an instant, either with mom or baby, or both.”
Here are 4 things Dr. Mormak wished soon-to-be-parents knew about childbirth.
1. Prepare for the unforeseen.
“I’ve taken care of some very ill patients during pregnancy or labor – women who’ve had seizures, uncontrolled blood pressure, kidney or heart failure – and those patients may have been completely healthy with no medical concerns at the beginning of their pregnancies,” Dr. Mormak said. “Cases like this are rare, but most women do not realize that these complications can happen to anyone. It is important that mom, partner and doctor or midwife are ready for anything.”
2. Keep an open mind.
“We try our best to go over every aspect of pregnancy and birth during routine prenatal care appointments. Most women want to discuss their birth plan, and the pros and cons of an epidural versus natural childbirth,” Dr. Mormak said. “However, there are certain obstetrical or medical conditions, like pregnancy-induced hypertension, that may require the baby to be delivered before its due date. If labor is induced, it can be frustrating to the patient who won’t get the birth she imagined.”
3. Know what to expect.
Dr. Mormak outlined some of the things you may experience during childbirth:
Intravenous (IV) line
An IV is placed upon admission and stays in through labor and at least the first day postpartum, Dr. Mormak said. This access needs to be available for emergencies, such as a cesarean section (C-section) or a postpartum hemorrhage that may require immediate medication.
Your cervix will be checked during labor, often, so it’s not a time to be shy. “It is important to monitor the progression, or sometimes the lack thereof,” Dr. Mormak said. “We do this through cervical checks every 2-4 hours, and if you’re not numb from an epidural, it can be uncomfortable.”
During typical labor, there are two devices strapped to the abdomen: one to monitor the baby’s heartbeat and one to monitor the mom’s contractions. Fetal monitoring remains in place through the baby’s delivery.
A urinary catheter is often placed after an epidural, when the numbing makes it difficult for the mother to feel the urge to go to the bathroom and it is no longer safe for her to get up and do so. This helps empty the bladder. Though it will likely be removed during the actual delivery, it may remain in place for the first day postpartum depending on the clinical situation. For example, if a mom has pre-eclampsia and is receiving a magnesium infusion, she will need her urine output closely monitored.
Quickened labor with an epidural
“Our natural instinct when we’re in pain is to contract or clench our muscles, which includes the pelvic floor muscles,” Dr. Mormak said. “When these muscles aren’t relaxed, labor can stall. I sometimes recommend an epidural to patients for this very reason, and once they are relaxed their cervix continues to dilate and labor progresses.”
Postpartum bleeding can last anywhere from days to six or more weeks postpartum. “It will taper down with time and become more of a yellow discharge called lochia alba. I describe this as the end-stage healing process of the uterus,” Dr. Mormak said.
4. Get the facts.
Talk to your physician or midwife and ask questions. No question is too silly. Don’t believe everything that you read on the internet, and make sure you get your information from a reliable source. Check with your delivering hospital or birthing center to see if they offer childbirth classes (many are offered virtually now!) to help you mentally prepare for labor and delivery, as well as what comes afterward.
“Pregnancy is one of the most beautiful times in a woman’s life, but it’s probably physically and mentally one of the most grueling and uncomfortable times as well,” Dr. Mormak said. “This is the time to focus on self-care: go for an evening walk or treat yourself to a prenatal massage. The happier and healthier mom is, the healthier the pregnancy and baby.”
You can create a list of questions for your doctor, read about pregnancy milestones and keep track of your baby’s development with the MyFamily app from Baptist Health and Wolfson Children’s Hospital. To learn more about MyFamily or to download, visit baptistjax.com/myfamily.