The labor questions no one talks about
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I tend to be an over-preparer, but as much as I researched labor there were some questions I just couldn’t get answered. Perhaps part of the reason is that every woman has her own preferences, so there are no “right” answers to many of my questions; however, I still would have found someone’s perspective helpful. Here are the top unanswered questions that were on my mind going into labor, and my own personal answers to them. Keep in mind that my goal was to have an unmedicated hospital birth, and your own goals and experiences may be different.
What do I wear?
The labor gown
Hospitals typically provide a standard hospital gown to laboring women—shapeless, baggy, scratchy, open in the back. I wanted to be as comfortable as possible during labor and also knew that I often feel more empowered if I look better (yes, I know this is shallow, but I’m self-aware enough to acknowledge it). I ended up choosing this gown, and I loved it! Here’s why…
It’s flattering and feminine - the drawstring above the belly cinches it in a bit so you don’t feel like you’re wearing a poncho. It also comes in a lot of patterns with both fun and neutral options. Finally, it isn’t open in the back so you don’t moon everyone while you’re walking those hospital hallways.
It’s comfortable - the drawstring is super stretchy and the material is really soft, so I didn’t even notice it. I also liked that it was sleeveless because I got really hot while I labored and was glad I didn’t have to mess with sleeves.
It’s practical - the front is actually two overlapping panels, so they’re easy to sweep open for dilation checks, going to the bathroom, and pushing. It also unsnaps from the shoulders on both sides for easy breastfeeding.
The bra
It’s totally up to you whether or not you want to wear a bra when you labor. I decided to wear a lightweight nursing bra like this one, because I liked the idea of being a little more modest and wasn’t sure how long I’d keep on the gown (I did end up wearing the gown the whole time). I will say that the last thing on my mind during labor was modesty, so I don’t necessarily think I would have been uncomfortable if I hadn’t worn one.
The underwear
Like the bra, this one is totally up to you! I personally swear by these adult diapers during labor; since my water broke right at the beginning of labor, I was leaking (or gushing) fluid the whole time. I was glad I wasn’t leaving a trail throughout the hospital while I labored, and I didn’t have to worry about a pad leaking. Now if my water hadn’t broken until later on, the diaper probably wouldn’t have made much difference, but you never know at what point in labor it might happen. If you do go the diaper route, make sure you bring the whole pack. I was so surprised by the amount of fluid my body held, and I went through quite a few. Note: the diapers I used were definitely not the most natural option, but I was very happy with their absorbency. Next time, I’ll probably give these Rael ones a try instead.
The post-labor attire
Most hospitals provide women with a fresh gown to wear after labor, but I wanted something a little more feminine and flattering for any photos we took. I did take my own, however, it was the last thing on my mind after labor and the nurses convinced me to just wear a hospital one so I wouldn’t ruin my pretty robe. At the time it didn’t matter to me at all, but looking back on it, I definitely could have reminded myself that I bought that robe for that purpose, and I didn’t really care if it got ruined. It also would have been a lot easier to nurse in the robe than the hospital gown. Needless to say, I’ve carefully packed away my robe to actually use next time!
Of course, I have to mention the mesh panties too. The hospital will supply you with these, and while they’re definitely not the most flattering, I found it easiest to just use them as long as I was still in the hospital. I did, however, swap out the supplied pads for these Rael ones—no matter how smooth labor is, there’s still some trauma “down there,” and I liked using natural, organic cotton instead of synthetic material as I healed. The brand Cora is another great option.
Should I eat and drink during labor?
*Disclaimer* I have no medical background! Definitely talk to your doctor or midwife about this one and follow their professional advice. Also, your hospital may have specific rules on this.
My hospital was very open to food and drink during labor, but a lot aren’t. The reason many don’t allow eating and drinking, other than water or ice chips, is that if you have to undergo general anesthesia for an emergency c-section there is risk of aspirating anything you ate or drank previously. From talking to several different doctors about this, my understanding is that the risk of aspiration is low, but again, it is still a risk. On the flip side, labor is probably the most strenuous physical activity your body will ever undergo (unless you’re an ultra-marathon-er), and the longer you go without replenishing the calories you burn, the more likely you’ll need medical interventions, like an emergency c-section.
Given all this knowledge, my doctor and I decided that for me personally, it would be a good idea to eat plain food as long as I felt like it, but to not force anything. I WAY over-packed the snacks in my hospital bag, but I’ll do the same thing next time because you don’t really know what your body is going to need. I ended up eating very minimally because I had no appetite during early labor. My L&D nurse ordered me some whole wheat pancakes which I barely nibbled at, and my husband made me eat a popsicle (I really like these Outshine ones; if you want an all-organic option, GoodPop is a good choice). I also sipped on a Gatorade, and the sugar helped me a lot. Next time I plan on taking my own coconut water and perhaps making my own electrolyte drink (this looks like a good recipe) though, to avoid all that refined sugar and food dye.
I did make sure I sipped water pretty continuously throughout labor; it’s really easy to get dehydrated during labor, which is a risk to both the mom and baby. Most hospitals will insert an IV for hydration upon admission, but I didn’t want to be tied to an IV bag for all of my labor. I instead opted to get a hep lock and consciously drank water as much as possible.
What should I ACTUALLY do during contractions?
While pregnant, I kept searching for a Labor Bible that would tell me exact instructions of how to successfully handle contractions and make it through an unmedicated labor. The reality is, though, everyone’s body and labor is totally different, so there isn’t a perfect formula. That doesn’t mean you shouldn’t study and prepare, though. Here are my biggest tips when preparing for contractions:
There are tons of labor “cheat sheets” on the internet listing various labor positions. Pick a few and study them; you likely won’t use 90% of the techniques, but it’s good to have them in your arsenal. Choose ones that provide a variety of positions and a combination of techniques (breathing, movement, etc.). You can check out my labor cheat sheet too.
Work with your body, as it will typically tell you what you need. This sounds so ambiguous, but it will feel natural during labor. As I mention in Miss F’s birth story, I’d imagined I’d be very active during labor but ended up needing to rest a lot. This was probably my body’s way of conserving the energy I needed to continue to have effective contractions and then push out a face-up baby.
Even if you need to rest a lot, keep in mind that gravity will either work with or against you. If you’re in a more vertical position, gravity will be on your side as your baby works his or her way down. Even if this is more painful, keep in mind that more intense contractions often do more to help you progress. When you find these more difficult positions, give yourself a goal—“four contractions in this position, then I can go rest on the bed.”
Try to not tense up during contractions. This is much easier said than done, but if you’re tense, your body will have a much harder time dilating. You can google a bunch of different ways to help you do this, but a few techniques that I found most helpful were:
Focus your tension in one small area of your body—for example, grip your husband’s hand REALLY hard, but try to relax everything else.
Focus on relaxing each individual muscle in your body, one by one, starting with your jaw. Most tension usually starts in your jaw, so even if you can just focus enough to keep your jaw loose, it will make a big difference.
Create a strong visual in your head for contractions. Many women visualize contractions as a wave, and imagine surfing up and down the wave to get their focus off of the actual intensity.
Pick a handful of really happy and relaxing memories, and think through minute details of them during contractions.
Remember that labor is exhausting, and your muscles need rest to keep working. After Miss F was born, my midwife and L&D nurse told me the most common factor they see amongst women who have unmedicated births is that those women are able to completely rest and relax between contractions.
Educate yourself of the progression of labor—knowledge is literally power in this context. Most women feel like they have reached their breaking point because of the intensity of contractions during the transition phase of labor, but if you know that once you’re in transition, you’re nearly at the end of labor, it can give you the final surge of energy to push through it.
How painful is labor?
Prior to labor, I tried to imagine the most intense pain I’d ever had in my life and then multiplied it in my mind. I soon learned, though, that the “pain” of labor is very different. Pain isn’t even the right word to use for it, though, because it’s a totally different feeling and response than, say, cutting your finger or whacking your head on an open cabinet. Think about it—pain in everyday life is our body’s hardwired response to make us change or flee a circumstance that could potentially be harmful to us. Labor, on the other hand, isn’t harmful or something to be fled, but rather, something to lean into and embrace. That sounds very philosophical, but in my experience our bodies’ responses to labor are very different from our bodies’ responses to actual harm.
There is not a word in the English language that accurately conveys the sensation of labor—the best way I can describe it is to imagine the intensity associated with the word “pain,” but the sensations associated with “discomfort,” “pressure,” and “exhaustion”. I don’t mean to convey that labor is easy in any way, shape, or form, as it will likely be the most difficult thing you ever do, but you should expect a feeling different than anything you’ve experienced before.
Do I need to take a birth class?
I recommend it! While I learned the most about labor from books, the visual learning that an in-person or online class offers often sticks with you more once labor begins. I advise my friends to pick a class that has the same goals that they do. Because I knew I wanted an unmedicated birth, my husband and I chose to do the online Mama Natural course, and we both liked it. While we found it occasionally was a little anti-hospital/doctor (as many natural birth resources are), it had a ton of great information, was very encouraging, and had very practical tips throughout. My husband also liked that it had specific sections for husbands, so he had a better idea of what to expect from a guy’s perspective. We both credit this course with rounding out our labor education and allowing us to successfully make it through an unmedicated hospital birth together.
Do I need a doula?
You can’t go wrong with or without a doula as long as you make an educated decision. If you elect to not get one, you and your husband (or whoever will accompany you to the birth) just need to make extra effort to be very well-educated about the birthing process.
If you decide to have a doula, she’ll likely meet with you throughout your pregnancy to get to know you and your birth preferences, and once you’re in labor she’ll serve as your coach and advocate. She will have seen many births before, so she has the experience to help you try different laboring positions and techniques to help you progress. She also can help explain any necessary interventions. The advantage of this is that you and your husband won’t have to worry about “studying” labor techniques quite as much.
If you decide to not have a doula, you’ll want to make sure that you and your husband are very well-educated on the labor process, various things that can “go wrong,” various interventions that could be offered at different points, etc. I recommend reading or listening to multiple resources on birth, and even watching birth videos.
My husband and I elected to not have a doula. We both felt I would be less comfortable with another person in the room, which could end up slowing down labor (from talking to my friends who have had doulas, though, this probably wasn’t a valid concern). We also viewed birth as a very intimate experience that we wanted to share just between ourselves. We were confident in our ability to learn and research about the birthing process and both willing to put in the hours of “studying” to be well-educated.
After having had a doula-less unmedicated birth, I did learn a few things:
I am happy with my decision and I don’t plan to have a doula for future births, but I definitely appreciate the complexity of the birthing process more. For the next baby, my husband and I will review many birth resources again and go in very prepared. If I hadn’t had a proactive L&D nurse, Miss F’s birth could have gone very differently.
No matter how educated you are, birth is still a very new and unknown experience, and I now see a lot of value in having another person in the room who has a lot more experience and whose only job is to help you. You and your husband will be very distracted, and it is very difficult to process information and make decisions in this state.
Miss F’s birth went very according-to-plan, but much of that was due to having outstanding L&D nurses who took the time to understand my birth preferences and then advocate for me (if you haven’t read Miss F’s birth story yet, you can do so here).
I know very few people who regret having a doula.
I did love having just my husband in the room with me. It was an extremely intimate and bonding experience; when I needed support, whether that was a popsicle, to hold someone’s hand, or just verbal encouragement, he got to provide it, and that was an incredible experience for both of us.
While I don’t think the course of my birth would have been much different with a doula, there are a few ways I think a doula would have helped me:
She could have advocated for me if my nurses had been less attentive, and she could have educated me about the options presented to me.
She could have taken pictures during labor (we didn’t get any, because I didn’t want my husband stuck behind his phone the whole time).
She could have helped me labor in different positions, which potentially could have sped up my labor and lessened tearing. While my nurses and midwife did help me with this, I don’t think that much attention and support is always provided by hospital staff.
What should my husband (or birth partner) do?
This will vary a lot based on what you feel like during labor, and whether or not you have a doula. I do recommend that no matter what, your husband is educated on the progression of labor and various labor techniques. If you do not take a labor class that emphasizes this, two books I’ve heard recommended are The Birth Partner and The Dad’s Playbook to Labor and Birth (disclaimer—I have not actually read these). I personally made a “cheat sheet” for my husband to take into labor, which helped him feel more confident in being my birth coach, which you can view here. One you’re in the full swing of labor, your focus will be going toward working through each contraction, and you won’t have the mental bandwidth to think of new positions to try or what your body might need. Many women appreciate counter-pressure on their lower backs during contractions, which is a great way for husbands to provide support. Your husband might also help hold you standing up if you need to be vertical for a little while. He can suggest different positions for laboring or pushing if he can tell your labor seems to be stalling, and he can speak to your medical team to understand and decide on any necessary interventions.
I quickly learned that I did not want to be touched during labor, so the biggest support my husband could offer was verbally encouraging me through each contraction and getting me a popsicle and fluids. While I’m sure it was a bit frustrating to him to prepare so much only to be a cheerleader, this was exactly the support I needed to get through labor. My biggest advice is similar to my advice on how to cope with contractions—your husband should be aware of many different ways he potentially could support you during labor, so when the time comes he has a toolbox full of techniques to try out. He may only use one or two, but he’ll be prepared to offer whatever you need.
The most important thing is that you and your husband are on the same page about what you want from labor. Obviously, a healthy and safe mom and baby should be everyone’s primary goal, but you’ll probably have some preferences on how you get there. During the throes of labor you likely won’t have the mental capacity to advocate strongly for your preferences, but your husband will, so it’s important that you two have the same preferences.
Have other questions about labor? Feel free to contact me and I’ll answer them if I can!