What No One Tells You About Labor

Here's the truth about labor -- what's normal, what's not, and what to expect.

Expecting the Unexpected

Now that you're pregnant, you're dutifully attending childbirth classes and reading everything you can get your hands on about labor and birth. But classes and books tend to give you the big picture, not the surprising -- and sometimes embarrassing -- details. Because knowing what to expect makes for a less stressful delivery, we've asked the experts to spill the beans on the following common (yet seldom-talked-about) scenarios.

You May Throw Up

Who knew that vomiting during labor is normal? I certainly didn't -- until the birth of my daughter nearly three years ago. One reason it happens: Epidurals can cause hypotension, a sudden drop in blood pressure. "An early sign of this is nausea and vomiting," says David J. Birnbach, M.D., spokesman for the American Society of Anesthesiologists and vice chair of the department of anesthesiology at the University of Miami. But throwing up can occur even if you haven't been given an epidural, either because of the pain you're experiencing or as a result of food sitting in your stomach (digestion usually stops during labor). To keep vomiting to a minimum, eat only light foods during the earliest stages of labor, and stop eating completely -- and drink only clear liquids -- once you're in active labor.

Your Teeth Chatter

"Nearly 50 percent of women complain of shivering and chattering teeth," Dr. Birnbach says. It has nothing to do with being cold. (In fact, your body temperature may rise a degree or two during labor, making you feel hot.) The jury's still out on what exactly causes this, but the latest evidence points to blood incompatibility. "During labor, a small amount of fetal blood crosses into the mother's bloodstream," says Henry Klapholz, M.D., an associate professor of obstetrics and gynecology at Harvard Medical School, in Boston. "Studies show that if there's an incompatibility in blood type between mother and baby -- for example, your blood is type A and your baby's is type B -- the mother shakes, shivers, and gets chills."

You Make Nasty Noises

As a baby descends through the birth canal, air gets forced out the anus, so be prepared to pass gas. This is especially likely if you've had an epidural, which paralyzes the anal sphincter. Another unpleasant side effect of childbirth: You may have a bowel movement right on the delivery table. "It's purely a space issue," says Arianna Sholes-Douglas, M.D., director of the High-Risk Pregnancy Center at Mercy Medical Center, in Baltimore. "As your baby's head makes its way through the birth canal, the rectum gets flattened and its contents are pushed out." In any event, don't worry. "These bodily functions happen all the time -- there's very little we haven't seen or heard before," says Deborah Robbins, R.N., program manager of parent and childbirth education at Brigham and Women's Hospital, in Boston.

You Might Act Like a Lunatic

During labor -- especially if you haven't been given pain medication -- you may find yourself screaming, crying, even swearing at your husband or doctor. Or you may strip. "I've had patients who were so uncomfortable that they pulled off their gowns and delivered naked," says Lisa Fraine, a certified nurse-midwife in Allentown, Pennsylvania. All of these reactions are common; they're simply a response to pain and exhaustion. You can also blame your hormones: "Labor causes a shift in your estrogen and progesterone levels, which is akin to a major case of PMS," Dr. Klapholz says. If you do lose it, don't feel bad. Doctors and nurses are used to these reactions. (Still, it doesn't hurt to apologize afterward.) But if you're uncomfortable with the idea of such a display, be prepared for your delivery. "Women who take childbirth classes tend to stay calmer during labor than those who don't," Dr. Klapholz says.

Your Mind Goes Blank

In the heat of the moment, it can be easy to forget what they taught you in childbirth class. "I couldn't remember the various positions I was supposed to get into to ease pain," says Elizabeth Estes Niven, of St. Louis. "Instead, I stayed flat on my back, gripping the bed railing." You're also likely to forget many of the details of the birth. So be sure your partner takes plenty of photos or captures it all on videotape.

It May Not Be Love at First Sight

Don't feel bad if your first reaction to holding your new born isn't overwhelming joy. You've just been through an exhausting experience and need time to recover. If you can, try breast-feeding -- then let a nurse take your child so you can get some rest. That's what I did after 17 hours of labor and a C-section. But after an hour, I had them bring back my baby girl and was immediately smitten.

Labor's Tough for Dads, Too

The nerve-racking beep-beep-beep of the fetal monitor. All those bodily fluids. Your roller-coaster emotions. Childbirth can be just as difficult for Dad. "We've had to ask men to leave the room," says Elsie Santana, M.D., an obstetrician at Nassau University Medical Center, in East Meadow, New York. "Seeing a spouse in that much pain can upset a man, which in turn only makes his wife more nervous." If your husband is asked to leave the room, let him know it could be worse: "One father fainted when his wife delivered," Henry Klapholz, M.D., recalls. "The poor guy broke his leg and had to be admitted to the hospital." If you suspect your partner might not have the stomach for labor, consider bringing a second person along. Your best bet: a female friend or family member who has given birth herself and knows just what to expect.

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