Ten ways birth isn't like it is on TV

1. Birth is generally a sloooooow process. Early (latent) labour can quite commonly last for up to two days or more, often stop-and-start. Even once labour is “established”, it commonly takes several hours (12 or more for first time mums) before a woman gets the urge to push. So the crazy car dashes to the tv hospital? Completely and utterly unnecessary and ridiculous. The best thing to do once contractions begin? Ignore them completely and just carry on with normal life – until you can’t any more. Your body will let you know when it’s time to focus on giving birth – it won’t give you a choice to do anything else. So take your time, chill out, have a nap, eat some carbo-rich food, watch a funny movie, have an orgasm or two. You’ve got all the time in the world.

2. Your waters are actually pretty unlikely to spectacularly rupture in the middle of the supermarket in a tidal wave of humiliating hilarity like they do in tv-land. In fact, statistically the most likely time for the membranes to rupture is late in the first stage of labour, as you are approaching the transition between the uterus contracting to stretch the cervix open, and the uterus contracting to push the baby out. With some babies, the waters never break, and they are born “in the caul” – which, I’m reliably told by the old wives, means they will never die at sea. And with some babies the water breaks and absolutely nothing else happens, for days (though most women will be strongly pressured to be induced within 24 hours due to fear of infection, though this number is plucked out of the air and not backed by evidence - a few years ago it was 72 hours, then 48 hours and now 24, without the evidence base supporting any change). When waters do break, it is commonly a slow leak, not a gush, sometimes with stronger little squirts during a contraction. Also, your amniotic fluid is continually renewed, even during labour, so it’s not the case that once the membranes rupture you’ll be bone dry.

3. Shit happens. Like literally. It is inevitable, because the muscles one uses to push a baby out are some of the same ones you use when having a poo. In fact, some researchers believe that having traces of mother’s poo in the general vicinity is actually helpful to a baby in “seeding” its own gut with helpful bacteria to help grow its own microbiome and immune system. You really shouldn’t be concerned or embarrassed about pooing, as midwives have seen it all, and know exactly how to get it out of the way without anyone paying any attention. Plus, having poo in your back passage can get in the way of the baby moving down, so much better out than in. Let it go!

4. Some blood is inevitable and normal. All women lose some blood during birth; it is not a sign that there is anything amiss. On tv, birth is a remarkable tidy experience, with no blood, no vernix (white creamy substance that protects baby’s skin from its watery environment), no meconium (baby’s first poo – always black and sticky and tarry and a pain to clean), no amniotic fluid except in the supermarket. In reality, it’s all about the bodily fluids, each of which serves an important function.

5. Placentas are a thing. In tv-land, they simply don’t exist. The cord that attaches baby to placenta is a thick and complex thing of wonder. Up to 30% of the baby’s blood supply is still in the cord and placenta at the time the baby emerges, and the cord continues to provide the baby with oxygen and nutrients until it is cut, or until the placenta comes away from the uterine wall, whichever comes first. This is why during a waterbirth it is honest and truly not a problem if a baby hangs out under water for quite a while once she’s out and before she takes her first breath. It is totally understandable, the urge that says “Oh my god she’s underwater and will drown! Get her up and out!” but the truth is, until she takes her first breath, she can’t drown; and until the placenta comes away from the uterus, she’s still getting everything she needs through her umbilical cord. So calm down and take your time, wait for white before you cut (that is, for the cord to stop pulsing that crucial blood out of the placenta and into the baby), and know that the miraculous placenta will take care of your baby during that transition.

6. There is no particular reason for a baby to cry upon being born, and certainly no cause for a routine smack on the bottom which is de rigeur in tv-land. There is no evidence that it is “good for the lungs” for a baby to scream and cry for lengthy periods, and cries from an infant are generally a sign of distress and a need for an adult to act to comfort. Waterbirth and hypnobirthing babies frequently don’t cry at all, or do so only as a response to the temperature change between in the water and out of it.

7. Babies are often quite grey, bluey or purple-ish in colour when they first come out, and it can take a few minutes for them to pink up properly. This can be quite frightening to new parents if they aren’t prepared for it -- after all, newborn babies in tv-land are all clean, dewy pink, and about 3 months old. It is really nothing to be worried about, and a little bit of stimulation with a towel can work wonders.

8. “The cord is wrapped around the neck” is a terrifying immediate infant death on tv, whereas in real life, cords are often looped around neck, sometimes shoulder. Midwives are really good at slipping cords back to where they need to be to enable a smooth passage, and it very, very rarely causes any kind of serious problem during birth.

9. Pushing a baby out is as instinctive a behaviour as having a poo. If you don’t need a doctor or midwife in the loo with you, coaching you how to take a shit, then you equally will not benefit from anyone telling you how to push your baby out. The exception to this is sometimes when a woman has had an epidural and is not feeling her contractions, it can be hard to judge when pushing would be most effective, so in those cases some assistance may be helpful. But for the most part, the tv-land scene of a circle of people surrounding a supine pregnant person screaming “Push, push, PUSH!!!” is completely unnecessary and counterproductive. In fact, this form of pushing (holding your breath and consciously straining with all your might) is not associated with the best outcomes for mum or baby.

10. Lying on your back in bed to push your baby out (the only way it is ever done in tv-land) is the worst possible position to have a baby in. This position is a relatively recent invention, and appears to stem from the French court of Louis XIV, who had a bit of a fetish about watching his mistresses give birth. In order to make it easier for the King to see what was going on, his doctors put the unfortunate women into a position which actually decreases the size of the pelvis by 30% or more. It also places the woman’s pelvis where she has to push against rather than with gravity. When women are entirely free to move instinctively during birth, they never adopt this position voluntarily. Upright, Forward-leaning and Open stances (UFO) are what the body normally needs to maximise the space in the pelvis. Moving, wiggling, shifting side-to-side and back to front – when free to do so, women will instinctively adopt the positions they need to work with their baby as he makes his really quite complex path through the pelvis, turning twice to manoeuvre first head then shoulders through. So trust your instincts and take the position that works for you, and don’t be afraid to move around, a LOT.

Someday I hope to see a tv programme which shows birth the way it really is (Call the Midwife probably comes closest), but until then, I’ll keep busting those tv-land birth myths, one mum at a time.