10 Things to Know About Labor
Congratulations! The long wait is almost over, and soon you’ll be in labor. I’ve given birth to 5 babies, including one by an emergency cesarean section. I’ve also delivered thousands of babies as a nurse midwife at Kaiser Permanente. The bottom line is that each labor and birth are different.
Here’s a list of things to know about labor and delivery that may be helpful.
1. False labor
It’s common to go to the hospital thinking you’re in labor and then go home. False contractions are called Braxton Hicks and can easily be confused for labor.
Actual labor has the following characteristics:
- Contractions come at regular intervals and get stronger
- Each contraction lasts 60 to90 seconds
- Contractions happen even when you change positions
- Bloody mucous discharge is usually present
2. Hospital bag
We call it a “bag” because it’s not your entire wardrobe! What should you pack? Bring:
- Personal toiletries
- Comfort items for labor
- Snacks
- Clothes for you and your baby to wear when you go home
We’ll provide other items you need during your stay at the hospital
3. Birth plans
We usually refer to Birth Plans as Birth Preferences. You can’t plan exactly what will happen at your baby’s birth, but you can think about your ideal experience. Research indicates that people have more positive labor experiences if they communicate their wishes in advance.
Remember that you can’t plan for many things, such as the length of labor, any complications, and how your baby tolerates labor. Consider filling out a birth plan and sharing it with your partner and care team.
4. Comfort with water
Being in the water has a unique calming and pain-reducing effect. All Kaiser Permanente facilities have showers for you to use, and some even have tubs.
Being in the water has so many perks, including:
- Relaxation
- Less need for pain medications
- Improved energy
- Lowered anxiety
- More effective contractions
Like being in water, getting out of bed and moving around can help labor progress and give you a better sense of control.
5. Sensations of labor
Know that your body is in charge! There are so many sensations you’lll experience in labor. Sometimes, these feelings can be new and feel overwhelming. You may even feel out of control.
My first baby came much faster than expected. I thought I was prepared, but I ended up screaming my baby into the world! It went so fast that I didn’t have time to even think about how to cope.
6. Push, push, push
There is no way around it—pushing is usually hard work! It’s common to get to a point where you feel like you can’t do it anymore, but you know what? You will!
Pushing is the home stretch to meeting your baby, but it can be long. Pushing for three or more hours can happen with a first baby, but second babies usually come much faster.
7. Birthing positions
There are many positions for pushing and birthing. Talk with your doctor or midwife about trying different positions.
When you’re upright, gravity can help bring your baby down. This position opens your pelvis. Squatting gives the bottom area of your pelvis about 20 percent more space!
Other positions to consider are hands and knees or lying on your side. Both positions can decrease tearing and open your pelvis.
One thing is certain: labor and birth are not as they appear on TV. It doesn’t fit nicely into a 30-minute TV episode. Labor and birth are:
- Often long, with average first labors lasting 12 to 24 hours
- Usually messy with blood, amniotic fluid, pee, poop, sweat, and vomit
- Noisy, as you’re often moaning, screaming, and grunting
8. Delivering the placenta
Birth isn’t over with holding your baby in your arms. You still have the placenta to deliver. It typically takes from a few minutes to an hour for the placenta to come after a vaginal delivery.
The placenta is soft, and you usually don’t have to do anything for it to come out.
9. Stitches
So now you’re done? Not so fast! Most vaginal deliveries end up with some tearing of your vagina or perineum to give baby room to be born. Those tears usually need to be sewn up. Repairs take a few minutes to over an hour, depending on the severity.
We’ll make you as comfortable as possible during the repair, and you’ll have your brand-new baby to distract you.
Ice packs to the area of your stitches are beneficial during the first 24 hours to reduce discomfort.
10. “Massage” time
Don’t get so excited! We call it massage, but unfortunately, it doesn’t feel good. Your care team will check your uterus frequently after birth to make sure it’s firm and the bleeding is normal. We massage through your abdomen. Why did someone name it “massage”? Not cool.
Every labor and birth are different. I encourage you to be flexible and know that you’re strong. With the support of your care team, you can handle whatever comes your way!
Resources for Parents
American College of Obstetricians and Gynecologists
American Academy of Pediatrics
Last Minute Activities Before Delivery
Featured Author
Ruth Mielke, CNM wrote a biography that starts: I joined Kaiser Permanente South Sacramento in 2002 after completing my midwifery training. Most of my clinical training took place at this same facility, and I valued the role nurse midwives played in providing high-quality care. I moved several times but stayed within the Kaiser Permanente system in Santa Rosa and Santa Clara.
Ruth Mielke, CNM biography reads: After almost 17 years at Kaiser Permanente, my family left California for several years, and I practiced as a nurse midwife in Massachusetts. During our time there, I returned to Frontier Nursing University and earned my Doctorate of Nursing Practice (DNP). My culminating quality improvement project focused on perinatal depression screening and treatment.
I’m delighted to be back in California as of 2024 and working again at Kaiser Permanente in Redwood City. After working at other medical care systems, I have a huge appreciation for the integrated and comprehensive care provided at Kaiser Permanente. There was nowhere else I even considered working!
Read more here: https://mydoctor.kaiserpermanente.org/ncal/providers/ruthmielke Disclaimer: If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.