The best way to prepare for birth isn’t more random tips — it’s a clear, step-by-step understanding of what to expect, what your options are, and how to navigate it all as a team. That’s where real confidence comes from.

Social Media

We do it, we ALL do it — I was just on social media looking at my son’s chances of getting a job he’d had a final interview for. Why? I have no idea — I’m just saying we all look to social media bout what to expect from life.

But, just like videos on social media have nothing to do with my own son’s chances of getting a job — it also can have some issues in preparing for birth.

But why?

You Don’t Get the Full Story

The videos that do the best on social media are often short (at least under 90 seconds — but often closer to 30 seconds) and include a hook that draws you in that often peaks your interest on a topic you’re interested in (but doesn’t fulfill on that promise).

Ultimately, you often get a small nibble of information which leaves you with more questions. Then, you head into the comment section to learn more only to find so many more questions and often a LOT of people with a LOT of opinions (not facts).

This can leave you feeling overwhelmed and like you can NEVER learn what’s important for your upcoming birth.

Social media can be:

• An OK way to supplement your already prepared and confident brain (I recommend this)
• A great way to share how you’re feeling and not feel so alone
• A nice way to find people you trust to help you learn MORE — you may have even found me there (find me @pregnancynurse on all the platforms).

But it really, really can’t be your main way to get prepared.

At the very least try to get videos on Youtube vs the short reels. You’ll at least get more of the full picture on a topic. You can find my channel (with a TON of videos) here. But I want more than even that for you!

Clips give you pieces. Preparation comes from seeing the whole picture.

It Can’t be Trusted.

When I first started really working as a content creator in 2014 (I’m old, I know) I learned that “if you are willing to write on a topic, that means you’re an expert”.

And I was like…. what?

Sure, that might be true on things like what diapers are best, or what hair product works best in curly hair… but when it’s something as important as your baby…? Or, possibly even your life?

Here we are in 2026 and this is honestly just a standard. There are so many people out there saying acting as experts who’ve….

• Doula’d in a few births
• Maybe just had a few kids of their own (or honestly, just one)

And these might be fine people to have a chat with at your local mom’s group, but when you’re looking for actual foundational advice for your pregnancy, labor & birth and managing postpartum — they’re not who you give that trust to.

My best tips:

• Look for experience — as a labor nurse you really don’t become competent until about 8 years into your practice — so, you should be looking for real experience in the labor room (not a physical therapist, or an RN who has not worked L&D).
• Combine that with initials — I’m an RN-BSN which means I am licensed and I have a bachelor’s degree. I have met minimum requirements a few times, which means I meet a standard.
• No Outliers — their advice should be fairly standard, and should empower you to make choices for yourself. Not pushing you into one specific way to birth.

Social media often shares opinions — not context. Learning from an expert helps you understand the “why” behind what’s happening, so you can make informed decisions that feel right for you.

Focus Just on Planned Stuff

This one catches a lot of people off-guard because the planned stuff is actually the foundation for a lot of classes. Things like:

• Stages of labor
• How baby progresses down the birth canal
• How to manage the planned pain of labor.

These are things that happen in almost all births.

We know they’ll happen — so it is smart to prepare for them. But they should only be a small section of your class!

There was a recent study that showed that out of 65 birth classes they looked at — NONE covered the unplanned events. And I’m not talking about crazy rare things — I’m talking cesareans, inductions, episiotomies. I outline that in this article.

Now, clearly a sample size of 65 isn’t big — but it’s something. AND they clearly didn’t look at the class I recommend as it has a chapter on caesareans and inductions.

The reality is that a lot of pregnancy, labor, birth and postpartum is unplanned. You need a class that is going to talk about the unplanned things that might happen. And yes — I did say postpartum. Just as important to know what to do if that’s going wrong too!

It’s not the unexpected that makes labor feel overwhelming — it’s not being prepared for it. When you understand what situations like induction or cesarean actually look like, you can approach them with less anxiety and more confidence instead of trying to process everything in the moment.

Want to know more about those unplanned events? — check out these posts:

• Episiotomy vs a Natural Tear: Which Is Better?
• What To Do If Labor Isn’t Progressing?
• What You Need to Know About Wired vs Wireless Monitors in Labor
• Your Complete Guide to Epidurals in Labor: Everything You Need to Know
• 3 Tips to Using Movement During Labor WITH an Epidural

Alone

This final one is easy to do.

Schedules are crazy, partners may not be super jazzed to learn about this — or think learning about this is up to you.

But I’m here to say that you can be as prepared as you can be — but if 5 nurses run in your room (see unplanned events above) and that partner starts to freak out, that freak out will start to pass-on to you too.

And I don’t want that for you. I want BOTH of you to feel cool, calm, collected.

Of course, this dives right into the fac that most people are “preparing” on social media and may send a few important topics to their partner, but the partner is left with those bits and pieces, and questions that overwhelm them.

That’s why a class, you can take together, and get all the important stuff is so important. I recommend this one (it’s specifically there to do with a partner — even if it’s your mom or a friend). It only takes a few hours, and if time together is at an absolute premium in the bundle there are key point videos where it’s like getting the cliff notes of labor!

One of the biggest shifts couples notice isn’t just what they learn — it’s how much more connected and prepared they feel together. When you’ve talked through what to expect, your options, and how to support each other, you’re not trying to figure things out in labor — you’re working as a team.

I just wanted to say how glad I am that you’re here. That you’re even thinking about getting prepared.

I know you’re going to pick the right path for you, and have a wonderful journey into parenthood.

What other crappy ways have you seen people prepare — tell me in the comments!

The post The 3 Worst Ways People Prepare for Birth appeared first on The Pregnancy Nurse®.

Now, before you go saying that I hate “natural birth” >> let me remind you that I also have a post on reasons to avoid the epidural as well. I want patients to have a well-rounded knowledge of what an epidural CAN and can NOT do for them at their birth…. and then make the choice on their own.

Ok, let’s jump into those benefits!

Rest

This is a HUGE thing that a lot of people don’t talk about — the fact that you’ve labored for hours, without good rest and you’re just dying for a nap but those contractions are relentless.

Many people get the epidural because they’re just tired and they need to sleep.

They also know that it’s not like they’ll be able to sleep for weeks after this baby is born, and it might be good to fill up their gas tank a bit with some rest before baby is born.

Honestly, all of that is valid.

If you’re aiming for an epidural-free birth I always encourage people to rest as much as possible in the beginning (perhaps gaslighting themselves into believing they’re not in labor). That is often easier said than done though.

BTW, a recent study showed that hardly any birth classes talk about the unplanned things of birth — unplanned cesareans, inductions and yes — epidurals. That’s why I recommend this. I think you’ll love it (in fact, it’s guaranteed).

Being Able to Pee Afterwards

Now, this isn’t true for everyone — sometimes that epidural lays claim to the muscles that help your bladder relax. BUT I will say the worst cases I’ve seen of patients being unable to pee after birth come from people who get local anesthesia on their perineum at birth (this is often given if you’re tearing or they need to do an episiotomy).

SO, you may have an easier time to pee after baby is born. It’s not guaranteed.

BUT if you’ve heard this as a “risk” it can be better than other options.

Not being able to pee after birth is actually not all that uncommon. Your nurse will have a few tricks she can try to help you (if you don’t pee, there’s a chance you’ll bleed more, so we like to minimize that).

Want to know more about birth? — check out these posts:

• Common Choices During Labor
• How to Push During Labor (What No One Explains)
• What To Do If Labor Isn’t Progressing?
• Secret Keys to Labor that No One Talks About
• What You Need to Know About Wired vs Wireless Monitors in Labor

Decreased Blood Pressure

Some of you may be experienced increased blood pressure, especially as you head towards your due date.

And, as you can imagine the pain of labor can also make that blood pressure drive upwards.

One of the big benefits of the epidural is it can help manage that blood pressure as well.

Yes, there are medications that we can give to lower your blood pressure in labor, but sometimes they work or don’t work depending on how you’re experiencing pain.

I’m just here to say that if your blood pressure is trending upwards, it may be something you want to consider. If your blood pressure gets too high it can have serious consequences including heart issues, and possibly a stroke (although super rare). SO, we want to avoid that for sure!

And be sure to check out my article about 5 things you need to know about preeclampsia that goes along with this one!

Not Having to Pee

Clearly, pee is a big deal when a person is pregnant or postpartum.

But a LOT of people really LOVE that we put a catheter in you to drain out the urine once you’re numb from the epidural (or they may put one in every couple of hours depending on your hospital and your requests).

This means uninterrupted sleep! I will admit that when I was pregnant and a nurse, I’d get jealous of my patients who had an indwelling catheter (learn more about catheters here) in — knowing I’d be up a few times in the night to pee!

Some of you might be thinking that’s a big NO THANKS to an epidural — because a catheter doesn’t sound fun. I have a whole post on if you can refuse a catheter — because you DO have options!

I’m just here to say a lot of people are big fans of it!

Everyone is so different — this is why having a birth plan can be so helpful to know what’s important to you:

Helps Your Body Relax!

This is the big one, my friends.

Imagine the last time you were in a lot of pain — maybe it was a kidney stone, or a bad bout of tummy troubles? Did you find yourself wanting to relax into that pain — or did you tense up like a ball of tinfoil around your body?

Most people don’t find relaxation easy in labor.

If you’re unable to help relax that pelvic floor you’re not going to let baby descend into the birth canal, or let that cervix dilate.

Which is super tricky. Honestly, learning to relax is important in all parts of labor, even early labor or ligament pains. That’s why I recommend a birth class that covers natural pain management (this one does).

However, sometimes all the breathing and relaxation in the world just doesn’t help that pelvic floor relax and an epidural can be a great option to help with that.

Often, in patients who aren’t progressing we will recommend an epidural to see if it can help them relax, and help baby move down into the birth canal. Often I’d check that patient an hour later and baby will have moved into the pelvis nicely — they just needed some help relaxing.

This is the part where I remind you that you can’t tell yourself that “Sally down the road was able to relax — why can’t I?”

We don’t know what Sally was doing, or how her baby was positioned, or how big it was. All you can do is make the right choice for you, and also know that both natural pain management and an epidural have proven to be effective and safe for labor pains. Anyone who says otherwise is misinformed.

That’s honestly all an epidural is – it’s a little help. It often ends up being the villian or the hero in labor stories but it is just a little help!

Want to know more about epidurals? — check out these posts:

• Epidural Myths vs. Facts: What Social Media Gets Wrong About Labor Pain Relief
• Why People Get An Epidural Even When They’re Not Planning On It
• Why Labor Pain Can Feel So Different For Each Person
• 5 Simple Tips for a “Natural” Labor & Delivery
• Is an Induction More Painful than “Regular Labor”

So, as you can see there are benefits to an epidural that we don’t talk about. I’m not saying that any of these are a reason to get the epidural — and honestly, I don’t think you have to make up your mind on your plan right now either way. I have a whole post on What to Do If You Can’t Decide if You Want an Epidural or Not? << and the spoiler alert is, that’s fine….

Get educated on what it will be like, when you might want it or not want it, and look forward to a great labor day.

Most of labor is like that. Education is key, and learning to make choices in the moment will be a huge skill both in labor and postpartum to help you thrive as a new family.

So, did you learn anything new about the epidural in this one? Tell me in the comments!

The post The Benefits of an Epidural No One Talks About appeared first on The Pregnancy Nurse®.

And yes — this is from both my own 3 births, plus watching thousands give birth in the hospital and talking to millions online. It’s something I think about a lot.

I even did a video on it:

Low Pressure

This is the first thing that came to mind. I felt FAR too much pressure to:

• Clean my house (my husband should step it up more — I’m not saying I’m cool living with it dirty)
• Still attend all the functions
• Put myself into labor
• Manage full life postpartum

Those are just the few that came off the top of my head.

But the reality is you’re going a full on human inside of you, let that be your main goal. Allow the rest of your team to come in and do the other things.

And stop thinking you control so much (like labor) it’s just putting too much on you, and you don’t need that. You control a lot less than the world makes you think you do.

Now, this doesn’t mean you lay on the couch all day. Still use movement to your advantage. I was actually really good at doing stretching and some working out, plus my job was pretty movement-filled. But I wish I’d allowed myself more naps without feeling like I needed to do more….

Want to know more pregnancy tips — check out these posts:

• The Three Biggest Mistakes Labor Patients Make—And How to Prevent Them
• Mistakes You’re Making That Makes Labor Longer
• 5 Mistakes People Make Preparing to go to the Hospital to Have Their Baby
• 5 Mistakes People Make in Their Third Trimester

Live in a State with Maternity Leave

Clearly, you can’t really control this — but gosh, living in California with paid maternity leave was a world different in Utah where I had very few maternity leave benefits.

I had enough sick days to spread out and pay for my health insurance while I was off.

Lucky me.

I’m just saying when you’re considering where to live, especially if you want a family, this should be part of the discussion. That is all.

But, once you’re pregnant it sort of is what it is…. (and I get that).

Check out my full post on maternity leave.

Taken an Out of Hospital Birth Class

My hospital birth class just sucked.

It really made me a great patient, rather than preparing me for birth or to make choices on possible intervention.

Now, not all birth classes are like that. I taught for my hospital and I really tried to prepare them for both what to expect, and how to manage the hospital chaos. But, I think those types of classes are rare. Most nurses don’t re-design the curriculum (or have mangers who let them)…

I recommend this class. Plus, it prepares your partner too, which is a big win.

Want to know more about birth class benefits? — check out these posts:

• Do You Need a Birth Class if You Plan to Get an Epidural
• Alternatives to Hospital Birth Classes
• How a Birth Class Changes Pregnancy, Labor, Birth & Life With Baby
• 6 Lies You Hear About Birth Class
• Why are Birth Classes So Expensive?
• Do Birth Classes Improve Birth Outcomes? What do the studies show?

Kick Counts

I wasn’t the best kick counter — even though Kaiser gave me a laminated book to do them in (let’s remember smart phone apps weren’t really a thing when I was having babies).

I wish I did them better. I tried.

And honestly, that’s all we can do — but the data makes me realize the outcome could’ve been worse because I didn’t pay as close attention to fetal movement as I should have.

I may have been too busy with the dumb things in #1….

Again, your main job is to grow a healthy baby and monitoring fetal movement is one of the best ways to do that in your third trimester. AND Kick counts is an evidence-based way to do them. Grab my cheat sheet on how to do them here:

As a note, I also wasn’t great about SIDS precautions either. I think we can always look back at our parenting journey and wish we’d been a little safer. I definitely tried though, but I should’ve taken the bumpers off. I knew better.

Use a Midwife

I’m talking a Certified Nurse Midwife.

I just think they’re the bomb. There are SO many benefits to them. Most of all they tend to use less interventions and still have really great outcomes with birth.

I’d love one that is tied in well to an OBGYN office as well. More and more practices are allowing midwives to handle care, and consult an OBGYN or a perinatologist when necessary. But, you can still see them, they can help with your delivery, etc.

It works well for overworked OBGYN’s, and allows us to get better care.

I wish I’d used one, but they weren’t available where we had to have our baby — so, such is life.

If you’re not in love with your doctor, and you’re not past 30 weeks yet — check out a midwife in your area.

Again, a certified nurse midwife — abbreviated CNM — they can deliver in the hospitals and provide REALLY great care!

Check out this video with more info:

Get Induced if Needed

If you know anything about my birth story, I resisted an induction even at 12 days overdue and even when I decided on one I cried and cried.

Wasted life.

I had prodromal labor for weeks, my cervix was 5 cm — I honestly just needed my water broken to have that baby but instead I insisted that nature was the way.

I tried all the things to put myself into labor… but why on earth didn’t I just consent to an induction?

I don’t know — but studies really have proven that they’re safe after 39 weeks. I was 100% miserable being pregnant and thought I was going into labor every night. Plus, my cervix was ripe and ready.

I was dumb, I wanted control over things. Like an angry toddler I thought “I do it mySELF” — but ultimately I needed them to break my water. But oh no, there are more dumb Hilary stories ahead — keep reading!

Want to know more about preparing your body? — check out these posts:

• 4 Things You Can Do to Prepare Your Cervix for Labor
• Best Sex Position to Induce Labor?
• Pumping To Induce Labor? Will it work?
• Does Evening Primrose Oil Induce Labor?

Done Perineal Massage

I tore a lot with my first, although he was a forceps delivery, so it’s hard to know if that could’ve been avoided, but perineal massage has been proven to prevent the larger tears. I think it’s worth the effort.

Although the pre-labor-nurse-me might have felt icky about it.

The labor nurse me would’ve been fine with it.

Go Through a Birth Plan with Partner

I wish I’d thought through what I wanted for birth with my partner.

Honestly, I kept him pretty out of the loop — and he maybe could’ve talked some sense into me about the whole not being induced situation as I sat crying to him that my body wasn’t going to go into labor.

That’s what a partner is for — they’re there to talk thinks over. I wish I’d used mine more, but hey — I’m The Pregnancy Nurse — I’ve got this (spoiler alert: I did not).

We all need a partner, and I have a handy birth plan series for both of you right here:

Checked my Vitamins Better

I honestly just took whatever prenatal vitamin Kaiser sold in their pharmacy — but I wish I’d checked the levels better. The more research I’m finding out about Choline and other vitamins — I just think prenatal vitamins are something I could’ve done better on.

I like this guide from my friend Mckenzie who is a Dietician. She gives you the levels you should be striving for, and some good options to take (even if you can’t keep down those giant pills).

Want to know more about prenatal care? — check out these posts:

• Charlie Horses in Pregnancy: What you can do to prevent them?
• Pregnancy, Tylenol® & Autism: What Expecting Moms Need to Know
• Allergies During Pregnancy: What’s Safe and What’s Not
• 7 Habits of Happy Pregnant Women
• Month-by-Month Pregnancy Timeline & To Do List

Prepare Partner More

I WISH (especially on my first) I’d prepared my partner more about what he could do to help me both during pregnancy and birth.

I wish I’d taken a class that talked to him at all.

They were sort of an afterthought in my birth class. Honestly, it wasn’t all that helpful:

A birth class is a GREAT way to do this (even though so many are bad at it). I recommend this one.

Let them Break my Water Earlier

So, as I said above I was resisting that induction and boy oh BOY did I resist them breaking my water.

I knew as soon as my water was broken I couldn’t just go home — I had to have that baby.

So I didn’t let them do it, even though they asked a few times — I said no.

But, as soon as I let them do it — boom. Baby.

As soon as I let go my own control I had my baby.

Honestly, a life lesson. I’m a controller and maybe they did know best.

My bad. I’d do it differently next time.

Prepare for Postpartum

I’m always horrible at this. With my second baby I moved 10 days after he was born, and a few days before birth my mom said — “You know you can’t lift anything when you guys move” — and I was like — I’d honestly never considered my own safety in that scenario…

And yes, I was a labor nurse.

I just thought I could be superhuman. I wouldn’t bleed. Not me, I’ve got stuff to do.

Buying myself pads is always an afterthought.

BTW, if supplies are on your list of things to get — grab my checklist here:

Want to know more postpartum tips — check out these posts:

• First Poop After Delivery: Make it less-hard (literally)
• Your Guide to Your Postpartum Plan with Free Template
• Self Care During Postpartum & Pregnancy
• C-Section Recovery: Tips You’ll Need
• Postpartum Essentials for a Great Recovery

I just wish I’d prepare better for postpartum because I’m really bad at….

Give Myself Grace / Be Kinder to Myself

I know I went over this a bit at the beginning but these are words I type to new moms countless times during the day.

Please be kind to yourself.

Give yourself grace, this is really hard.

They were words I never said to myself.

You’re 5 days out, you should be driving the kids to school, why are you crying so much?

That’s what I said to myself.

I also wish I’d gone on anti-anxiety meds after my last baby. I was having panic attacks almost daily, but I knew it wasn’t postpartum depression so I thought I should just power through. That was a mistake. It’s not right for everyone, but it would’ve made my transition easier.

But, I’m here to say — let other people help. It makes them feel good, and you deserve it. You’re re-populating the earth single-handedly.

And I’m also hear to say that give you a few months and you can be that village that other people so desperately need. We have to be kinder, and more willing to help each other out. Give others grace.

It makes a better world for all of us. I love helping out new moms, it’s one of my greatest joys as a human. Please let me (or someone like me) do it for you.

Be sure to take a birth class that prepares you for realistic expectations postpartum. Far too many of us believe life will be like the photos we see on Instagram. It’s likely not. I recommend this class.

So, those are what I wish I’d done differently. What did I miss? Tell me in the comments!

The post If I had a Baby Again this is What I’d Do Different appeared first on The Pregnancy Nurse®.

I also have a youtube video on the same topic:

First off, let’s go over some definitions:

Natural Tearing: This happens as the baby comes through the birth canal and most often tears the tissue between the vagina and the anus. However, it can also tear up (towards the urethra) or out to the side as the baby comes out.

Nurse Note: It’s important to know that this type of tearing happens at delivery — not during the pushing phase. A good provider helps a patient stretch (as they support) those tissues rather than push hard right at the end which can cause more tearing.

Episiotomy: This is where your provider makes a cut to help baby out — It can be either towards the rectum from the birth canal, but can also be to the sides called a mediolateral episiotomy — where the cut goes towards the thigh. They use scissors to make this cut.

Nurse Note: I am also dying as I type this. This isn’t fun to think about — but an important topic to consider, and I want to emphasize that the majority of birthing patients have some type of tear. So, I’m glad you’re here.

Let me just put a plug in for learning how to manage your care of your life and your bottom postpartum. I recommend this as I think it has a very thorough postpartum section that is missing in most.

Grades of Tears

Now, there isn’t just one type of tear — we grade them as to how close they come towards the anal sphincter and the muscles/tissues involved in it.

Sometimes patients just tear a bit, just the skin — and that is a first degree tear. If it extends further and a bit deeper, that is a second degree tear.

When the tear extends towards the anal sphincter tissues it is a 3rd or 4th degree tear depending on how close it gets to the anus. — and as you can imagine that is much more to heal from than just a first degree tear. We call these Obstetric Anal Sphincter Injuries (OASI) and that is the main thing we’re trying to prevent.

As a provider cuts an episiotomy they are most often not cutting into the anal tissues. They cut what would most often be a second degree and then often the cut extends with a tear beyond that.

If any of you are sewers reading this, I sometimes do think of it how you’ll nick a fabric with your scissors and then pull and the tear in the fabric extends easily as you’ve started it. I do see that sometimes happening. (and yes, typing this paragraph made me ).

Stats on Tears at Birth:

• About 85% of women have a tear at birth (meaning only about 15% of an intact perineum after delivery)
• First time moms are more likely to have a tear than subsequent births
• 40% of first time birth tears are 2nd degree tears
• You can also have labial tears where it it extends up towards your labia (these STING when you pee)
• Experienced midwives are less likely to have larger tears at delivery (love me a midwife)

I also want to mention that I am a survivor of a 3-4th degree tear (sort of in the middle of those) and I just want to insert some emojis of how I feel writing this. But I do want you to know I survived all of this! It is possible, even if it sounds miserable. I wish I had prepared better!

Ok, those are the basics — and I think far too many people stop there — but I think it’s important to know that an episiotomy can be necessary.

When an Episiotomy is Necessary:

These are times in which baby may need to come out quickly, or more manipulation will need to happen in the birth canal.

Shoulder Dystocia – This is where baby’s shoulder is caught behind the pubic bone. Sometimes providers have to reach up into the birth canal to help this. As there is more trauma to the tissues, most believe a cut may be necessary depending on the interventions needed. However, we can often relieve the dystocia without them having to reach up inside, in which case a cut wouldn’t help.

Fetal Heart Rate Decelerations – If baby’s heart rate is going down often they will cut an episiotomy to shorten time to delivery. It can lead to better outcomes for baby.

Forceps or Vacuum Delivery – These are assisted devices (often called an “operative vaginal delivery” to help baby to come out. I have a whole podcast episode on them if you want to learn more. I did learn in this episode that forceps do have a risk of a higher tear — and I think that’s important to know (more doctors use a vacuum lately though).

Other times I’ve seen it that seem valid:

Patient tearing towards urethra – As you can imagine a tear through the urethra is something we want to avoid — if a provider can tell that a patient is tearing up towards their urethra they may cut down to encourage the tear to go that way, rather than up. I don’t hear about this in any studies, but I’ve seen it and personally I think that’s valid!

I will say that sometimes patients get REALLY tired after a LONG pushing time (more info on pushing times here). Sometimes the doctor will ask the patient if they’d like an episiotomy to help speed-up baby’s birth. I think that’s valid. Some patients will be begging to take any more time of pushing away, while other sill prefer to continue to push. My doctor did this for me on one of my kids and I said no episiotomy, and I’m glad I did — but I didn’t mind being given the option.

You’ll notice I didn’t include things like “big baby” — while that can increase your odds for tearing, it doesn’t mean that an episiotomy will make that tear less or heal better.

Want to know more hospital tips — check out these posts:

• Epidural Myths vs. Facts: What Social Media Gets Wrong About Labor Pain Relief
• Lies I Used to Believe about Labor & Birth
• Common Choices During Labor
• How to Push During Labor (What No One Explains)
• Why People Get An Epidural Even When They’re Not Planning On It

Which brings us to:

Selective Episiotomy

So, back in the day they did a routine episiotomy — meaning they cut it on every patient. Early on in my career (remember, I started in 2001) I worked with a few older providers who cut every single patient. This isn’t considered appropriate anymore (frankly, wasn’t great in 2001, and we reported it frequently).

Now, they are encouraging selective use of episiotomy (which means “only if needed”). Obviously, that is up to expertise of your provider and would be for the reasons mentioned above. Most often due to forceps or vacuums (which happen in about 5% of births).

There is a Cochrane review where they compared selective episiotomy vs routine episiotomy. Here are the results:

• Selective Episiotomy reduced severe perineal tearing by 30% (vs routine episiotomies).
• No real difference in infection rates between the two
• Less moderate to severe reports of pain 3 days postpartum
• No changes in baby’s APGAR (shows how well baby is doing after birth) or blood loss between the two groups
• No difference in reports of pain with intercourse (reported at 6 months+ after delivery)
• No changes in reports of urinary incontinence (reported at 6 months+ after delivery)

A few other interesting things I noted in that study:

• No real difference noted between people who had their cut extend towards the anus vs to the side towards their thigh
• None of the studies in this review really dove deep into women’s pain (?) or their satisfaction with their birth {big sigh}
• Hospitals actually save money with less episiotomies (patients stay less time on postpartum when they don’t tear as much)
• The studies didn’t report on fistulas (where there is an opening between the birth canal and the rectum) or fecal incontinence (where you leak stool) — which seem important to note

(BTW, I give full citations of the studies under “sources” at the end of the article)

Benefits of an Episiotomy:

The use of an episiotomy shows less Obstetric Anal Sphincter Injuries also called OASI (meaning a tear that extends to the tissues of the rectum) during an operative vaginal delivery (forceps or vacuums). Study linked here.

Most people seem to think that if you’re doing an operative vaginal delivery you should consider an episiotomy — and that is discussed in the video linked above. You can also listen to the podcast here.

I also wanted to address something that I see a lot online:

Coached Pushing and Episiotomies

This study showed there was a higher incidence of both tearing and episiotomies when coached pushing is used.

FYI, coached pushing is when people usually hold their breath and count to ten as they push.

Nurse Opinion: I’m here to say that’s complicated. For a lot of women un-coached pushing doesn’t provide results. In order to actually get baby to descend they have to hold their breath and push a long time. I just feel like they’re two separate kinds of birth….

I agree that uncoached pushing is the best way, but often it just doesn’t work. Recently, providers have been against “laboring down” (or waiting until the patient has more of an urge to push — or baby is lower), although some studies are walking that back. It’s just complicated, and I want you to understand that with these studies.

I want you to remember that tearing happens at delivery — not the hours of pushing prior to that. To me, this means that coached pushing may be necessary to get that baby to the perineum, and then at that point we use more patient-directed pushing. Most often this happens — you’ll see providers ask for small tiny pushes as the baby’s head descends through that portion. That is very different than the types of pushing we used prior to baby coming out.

Also, that study only had 39 women in it. That may speak to the fact that most people don’t have the “fetal ejection reflex” where they just quickly bear down and baby is born.

I also have a whole post on how to PREVENT tears that dives into this all a bit more (and a few things you can do like perineal stretching and warm compresses at birth).

There are a LOT of people talking about pushing online — and many of them haven’t pushed with a variety of patients at delivery. While the studies can give us information, make sure to listen to experts about what to expect and how to make choices at your delivery.

How does this apply to you?

That’s the big question, right? How do you apply this to your own delivery. Here are a few takeaways for me.

Ask your provider how often they perform episiotomies? Honestly, it’s a good question for any provider. Gives you an idea how respectful they are of your questions. If they brush this off that it is not important, it is! A red flag in my book. If they honestly say they do it about 5% of the time but they truly try to avoid it unless entirely necessary, that’s a good answer.

Also, if a provider says “never” that’s a red flag to me too — these are sometimes necessary, and honesty is really important to me in a provider!

Ask your provider how often they use vacuums or forceps? Most of them are only trained in one or the other. Again — just allows an open conversation between your expert and you. Doesn’t need to be long, but does give an idea of what they would use if they needed to.

Be aware that sometimes a cut is necessary, and have a provider you feel confident in. I see so many people questioning their providers nonstop –but you need a provider you can trust. They could be making life or death calls for you, in addition to smaller, but substantial, calls like this.

Learn how to heal your bottom postpartum. Oh goodness, I wish I’d done better on this with my first baby. I wasn’t prepared to heal at all. I have a whole post on how to take care of your bottom after delivery, but it’s just one part of postpartum.

However that’s just one part of it. Learning to take care of yourself while taking care of someone else you love so very much is very demanding. Learning from an expert (who is honest and open about what to expect after seeing thousands of patients) is your best bet.

So yes, avoiding an episiotomy is good, but having a trained expert you trust is always the key. Plus, learning to make choices for yourself is always a good thing. I’m glad you’re here.

What did you learn or come to think after this post, tell me in the comments!

Sources:

Jiang H, Qian X, Carroli G, Garner P. Selective versus routine use of episiotomy for vaginal birth. Cochrane Database Syst Rev. 2017 Feb 8;2(2):CD000081. doi: 10.1002/14651858.CD000081.pub3. PMID: 28176333; PMCID: PMC5449575.

Is an episiotomy always necessary during an operative vaginal delivery with vacuum? A longitudinal study — The Journal of Maternal-Fetal & Neonatal Medicine Antonio Ragusa,Fernando Ficarola, Alessandro Svelato, Caterina De Luca, Sara D’Avino, Alis Carabaneanu, Amerigo Ferrari, Gianna Barbara Cundari, Roberto Angioli &Paolo Manella Article: 2244627 | Received 26 May 2022, Accepted 31 Jul 2023, Published online: 08 Aug 2023

Sampselle CM, Hines S. Spontaneous pushing during birth. Relationship to perineal outcomes. J Nurse Midwifery. 1999 Jan-Feb;44(1):36-9. doi: 10.1016/s0091-2182(98)00070-6. PMID: 10063223.

The post Episiotomy vs a Natural Tear: Which Is Better? appeared first on The Pregnancy Nurse®.

This is part of my Complete Guide to Epidurals — so if you have more questions don’t miss that!

I also have a video on this topic:

Before we jump into this I see a lot of people who have literally no business speaking about epidurals online. Most often this is chiropractors who really love to scare patients and feel like it’s their place since it is placed in your back. Please take your advice from an expert in the field — someone who places epidurals, or sees LOTS of laboring patients (that’s me!), or manages their postpartum medical care. Please don’t take it from someone who uses scare tactics to build their social media following (and often sell you something). I’m not here for that. I hope you’re not either.

Ok, let’s get going on the myths!

You Have (Get) to Decide Today

I feel like people on social media want you to decide the minute you get that positive pregnancy test if you want an epidural that day. The reality is you should:

• Learn about the epidural
• Get some natural pain management tools & techniques (don’t worry, talking about that more)
• Be open to what happens as you’re in labor

Remember labor comes in all lengths, and pain levels.

Some people have excruciating labor from the first contraction on, and some people manage it pretty easily until they’re into active labor.

That doesn’t mean that one is weak and one is “strong” — it’s just different — how baby is positioned, the nerves they have in that area and how much sleep they’re able to get.

I’m a huge fan of deciding based on the facts when labor happens.

But I am ALSO a big fan of thinking through what you’d like, and any preferences you have (like scared of needles, or not being “tied” to the bed)….

That’s why I have a birth plan mini series that’s totally free for you right here:

I actually have a whole post on what to do if you can’t decide if you want an epidural that will give you more on that topic. And remember, all of this is after seeing patients from all cultures, and walks of life for 20 years in the labor room. Plus three kids of my own. I get this.

Long-Term Back Pain With It

Ok, this is the biggest one “I had back pain” after the epidural.

Here’s the truth:

1 — You will likely have some back pain at the site of insertion for the first few weeks after birth.

This would be normal any time we puncture the skin with a needle and bug the surrounding area as we place it. You’ll also have this type of pain where your IV placement is. However, studies show…

2 — Those who get the epidural don’t have rates of long-term back pain higher than those who didn’t.

People come back and say it’s “right at the spot where they placed the epidural” but the reality is that particular area gets the worst of our expanding bellys and our bodies trying to stay upright for MONTHS of pregnancy.

Our backs take a huge burden during pregnancy, labor, birth and life with baby (looking at you giant car seat). They need some TLC after baby is born.

• Make sure that you’re using good posture and lifting techniques with breastfeeding, baby gear and baby tasks.
• Use mild stretching once you feel up to it postpartum, and work into a good core program after baby is born
• Possibly using physical therapy to help (I wish a physical therapy appointment postpartum was a standard of care and I won’t rest until it is).

I never did well at this — and I’m working my way through the Mommy Tummy Fix right now. When you’re ready — Join with the FREE 7-day trial. See what you think, the cancel and join the lifetime option and use code NURSE30 to get $30 off the lifetime access (bringing it to $119). It’s never too late to help our backs my friends! (this is a partner link)

Yes, with any procedure there is a chance of having some irritation to the areas surrounding it, but when done correctly the epidural doesn’t cause long-term back pain.

That baby did, and you just need to take care of yourself to rehab it “back”. I hate this, but it’s true. For many of us, this is a life-long persuit.

Want to know more about epidurals? — check out these posts:

• Why People Get An Epidural Even When They’re Not Planning On It
• Do You Need a Birth Class if You Plan to Get an Epidural
• 3 Tips to Using Movement During Labor WITH an Epidural
• Epidurals During Pregnancy & Labor
• How Many CM Do You Need to Be to Get An Epidural?

Slows Down Labor

People say the epidural will slow down your labor — but studies don’t bear that out.

This Cochrane review showed that it may increase it by about 15 minutes. It did show an increased instrumental delivery (but that may be for a variety of reasons including that people with a mal-positioned baby are more likely to get an epidural) but not that it prolonged labor.

Source: Anim‐Somuah M, Smyth RMD, Jones L. Epidural versus non‐epidural or no analgesia in labour. Cochrane Database of Systematic Reviews 2011, Issue 12. Art. No.: CD000331. DOI: 10.1002/14651858.CD000331.pub3. Accessed 19 January 2026.

Honestly, in some case that I have seen, it does seem to “slow” it a bit — in my mind I’ve always thought it was because of the increased amount of fluids we gave prior to giving it. You’ve got to think that “dilutes” the amount of oxytocin in your blood stream — but once that’s taken care of labor most often chugs along nicely. And in some cases, we end-up start Pitocin to make it keep going. I think that’s a risk you do take with the epidural.

AND in some cases I think it speeds it up by quite a bit. Patients are finally able to relax, which allows baby to descend (sometimes quickly) into the birth canal.

So, “overall” statements about this doesn’t help anyone. We have to take it on a case by case basis, and know that we’re not quite sure what our body will do with the epidural.

Increased Cesarean Rate

I hear this all the time and honestly — like I said before this may be true because:

• People who are being induced early tend to get an epidural due to the length of labor
• Early inductions come with a medical reason which may increase their need for a cesarean overall

However, that same Chochrane review didn’t show an increased cesarean rate. I would guess that they may have eliminated people who had risk factors for a cesarean before showing the epidural alone didn’t increase your risk.

This one did show some correlation in increased cesarean rate if you get it before active labor, or 4 cm. It showed it increases malposition — which is why movement in labor is so important. Honestly, I’m also a fan of waiting until you’re at least 4 cm to get it — which is why everyone needs some natural pain management techniques — more on that coming (but I recommend this).

These studies contradict themselves a LOT — there doesn’t really seem to be a clear-cut answer for a lot of this, which is why I prefer the Cochrane review that pulls out big themes across many studies. That, and deciding what’s right for us based on those big themes.

I hope this article is helping you realize there’s a lot more to “getting an epidural” than just being “weak” or lazy…. I hear that sometimes online and it just makes me angry. There is no room for that kind of talk in my life.

I liked this quote from that Cochrane study:

We found substantial heterogeneity for the following outcomes (meaning in patients who got the epidural –they saw): pain relief; maternal satisfaction; need for additional means of pain relief; length of second stage of labour; and oxytocin augmentation. This could not be explained by subgroup or sensitivity analyses, where data allowed analysis. No studies reported on rare but potentially serious adverse effects of epidural analgesia.

Meaning:

• Women who got an epidural had better pain relief (100% agree with this)
• Longer pushing time (looks like by about 7 minutes)
• More needed Pitocin to keep labor going
• No real serious side effects noted.

Their final conclusion:

Epidural analgesia appears to be effective in reducing pain during labour. However, women who use this form of pain relief are at increased risk of having an instrumental delivery. Epidural analgesia had no statistically significant impact on the risk of caesarean section, maternal satisfaction with pain relief and long‐term backache and did not appear to have an immediate effect on neonatal status as determined by Apgar scores. Further research may be helpful to evaluate rare but potentially severe adverse effects of epidural analgesia on women in labour and long‐term neonatal outcomes.

And, if you’re looking for more info on instrumental delivery — check out this video on forceps and vacuums.

I am a HUGE believer that much of the increased risk happens because patients aren’t adequately assisted in moving after getting an epidural. And frankly, some patients just don’t want to move. Please make sure that you’re using movement in your labor. It. is. huge. I also think partners can be a huge help for movement. I talk about that a lot in here.

Want more studies and info — I found this article very helpful as well! It links to a bunch of them — just be mindful the data is all over the place!

Inductions do increase epidural rates, mostly for how long labor ends up being — and a lot of patients aren’t expecting it. If you’re considering an induction grab my induction checklist so you’re prepared for what to expect for yours:

The Scary Needle

I hear a LOT about the scary needle, and how people are afraid of needles.

The reality is that needles can look awfully scary, but they do something that takes away a LOT of pain, and I’ll just say that good amount of people very quickly get over a fear of needles when labor pains are happening.

Which is fine. Needles are scary, if I wasn’t in pain I’d say no thanks — but when I am in pain, let’s take away the pain!

Your “Pain Tolerance” Will Get You Through

I see a lot of people in the comment section saying they have painful periods and they think they will be fine with the pain of labor.

All I am here to say is that if you hope to go without an epidural, you need some training on how to do that. I have a class I recommend that includes it.

I also think you need training on how to manage your labor. Waiting for your water to be broken, not adding Pitocin. I think all of those are important skills to have if you’re wanting to not get an epidural.

And I think that last part is overlooked, unfortunately. And yes, that class also talks about managing your labor, making the right choices for you in the moment. Because sometimes it IS right to break your water, and sometimes it will sabotage not wanting an epidural — and knowing what’s right for you can make all the difference!

If You’re Planning on an Epidural You Don’t Need a Birth Class

I don’t know where we got started on that but everyone needs some natural pain management

And everyone needs a class that helps them manage their labor and make the right choices for them.

The reality is that if you’re planning on an epidural you don’t need a bad birth class — that is correct, but you will want one that:

• Teaches natural pain management techniques (so many stop with just this)
• Helps you know what to expect as you get the epidural (because it can be scary)
• Helps you make choices in labor that are right for you.

All pregnant couples need a birth class, and yes — I said couples because you’re in this together. This is the one I recommend.

While we’re here — the epidural isn’t your only option. I go over all the options here:

Harder Recovery

I hear a lot that people had a harder recovery with the epidural.

And honestly, that varies birth to birth.

After 24 hours I don’t think, as a nurse, I’d be able to pick who got an epidural and who didn’t by just taking care of patients without a history on them.

Yes, the first couple of hours (sometimes longer, sometimes less) as the epidural is wearing off will be very different as we wait for your legs to be able to hold your weight.

But, honestly — after that. I don’t see it.

Often people get it on their first, and then not their second and then are like — gosh, that was so much easier, but the reality is that first babies tend to be harder and that is with an epidural or without.

Want to know more about epidurals? — check out these posts:

• Weird Side Effects from The Epidural That No One Talks About
• What to Do If You Can’t Decide if You Want an Epidural or Not?
• Should You Get the Labor Epidural Before They Break Your Water?
• Is a “Walking Epidural” A Real Thing?
• How Bad Does the Epidural Hurt? What to expect during placement.

Better Births Without It

Finally, I hear this one a lot. Baby does better, mom does better — they’re happier.

Honestly, again — I see this going both ways.

Some people like the “high” they feel accomplishing something they’ve worked for.

Some people get so stressed during labor they almost collapse after baby is out and have an out-of-body experience when baby is born (and don’t get to enjoy that hard work).

Better births come from preparation, and making the right choices for yourself. They don’t come from the pain management you choose. That, I can say as fact after watching birth after birth for 20 years in labor and delivery.

I’m glad you’re here learning the truth with me… it means a lot. And, I think it will make for a better birth for you.

So, what myths have you heard? I’d love to hear them in the comments. Maybe this post will need a part two!

The post Epidural Myths vs. Facts: What Social Media Gets Wrong About Labor Pain Relief appeared first on The Pregnancy Nurse®.

I gotta know in the comments — which one of these do YOU believe and did I change your mind? — tell me at the bottom!

While we’re here, no decision is right for every pregnant family, so be sure to talk with your provider about what is best for you — this is just a good, general read that hopefully informs you a bit more on your options!

I also have a Youtube video on this:

Elective Inductions are Bad

Man oh man did I believe this one. I just felt like we pushed mother nature into something she wasn’t up for. But, I changed my mind after I read the ARRIVE trial. It’s a study that compared people who were electively induced at 39 weeks vs those who were not. It showed outcomes for babies were similar, with a slightly lower cesarean rate.

Now, some providers seem to have done a 180 shift and are recommending all pregnant women get induced at 39 weeks — and I definitely haven’t gone that far.

But I do feel like, if a pregnant patient wants to be induced at 39 weeks, they should be able to.

And yes, that means even if there is no “medical” reason.

I feel like often we act like “medical” reasons are the only ones that are valid. And frankly — there’s a lot of good reasons:

• Partner can only be there on a specific day
• Mom/help can only come at a specific time frame
• They just want to plan it (the anxiety of “birth at any time” is real)
• People are uncomfortable

And those are just a few. I just don’t think it’s the medical establishment’s job to decide what’s best for people, as long as they’re choosing something that is safe.

That being said — if you’re going in for an induction, you definitely need to know what to expect. A lot of people think an induction is “the answer” and are surprised by how long and hard it is — so be sure to go through this induction checklist with your provider:

And, if you’re a person who really feels like people shouldn’t be able to choose to be induced, I’d ask you to re-think that statement. Overall, it’s been proven safe and people should be able to choose. The just shouldn’t be forced to do it. Those are two very different things.

One of the biggest lessons I learned is that the choices made during labor matter just as much as what happens before it starts. Things like elective inductions aren’t simply yes-or-no decisions—they come with timing, trade-offs, and options that can change how labor unfolds. That’s why I created The Online Prenatal Class for Couples: to help you and your partner understand common interventions, ask better questions in the moment, and make decisions together with confidence instead of fear.

Oxytocin and Pitocin are the Same

So, I had to take a lot of chemistry to be a nurse (in fact, I got to take biochem twice because I wanted to be so great at). And in terms of chemistry Oxytocin (what’s made by our body) and Pitocin are exactly the same. Yes, there’s something in the Pitocin vial that allows it to be shelf-stable, but the actual active hormone is exactly the same.

I also knew that our receptors on organs in our body can’t tell the difference between the hormone made by our body vs synthetic ones. This is why insulin works so well!

So, I always figured that they acted the same in the body.

But the big difference is that Oxytocin is made in our brain, and is allowed to bathe your brain this feel-good hormone. Oxytocin is the love hormone — and we feel it when we’re falling in love, or just feeling good around other humans. You know that feeling, and we all love it.

It is also the hormone that starts labor (kind of a mean trick, right?).

Pitocin, is given IV and is not allowed to the brain (our body has a protection mechanism called the blood-brain barrier that keeps specific things out of our spinal fluid and going to the brain to protect us). BUT since the Oxytocin is already THERE in the brain it is allowed there.

So you do miss some of those feel-good hormones. However, once labor really gets going, I’m not sure how much of that is present. That’s something I wondered with my own induction.

Beyond that, we pump Pitocin in via IV and it does get ramped up much quicker than regular Oxytocin in our bodies. But, that’s what an induction is — it’s us forcing our bodies to go into labor, and it makes sense that it will happen faster than “natural” labor. But, something important for you to know as well.

Fun fact: During an induction you can still control the Pitocin drip. If it’s going up too quickly or you’re overwhelmed by your contractions you can tell them not to increase it. That being said — if you aren’t allowing them to actually start contractions that help your body go into active labor, maybe you don’t actually want to be induced. So, it’s a balance. Learn more in my post on Pitocin inductions.

Want more information on inductions? Checkout these posts:

• Signs You’re Ready to Be Induced
• Pumping To Induce Labor? Will it work?
• 5 Things NOT to do Before Your Induction
• Inducing Labor at 39 Weeks: Pros and Cons
• 5 Reasons to NOT Get Induced

The Epidural Causes Back Pain

I’d heard this for so long as a new mom and from friends (and oddly, from a lot of men — but that’s a story for another day) so I figured it was true — that the epidural causes long-term back pain.

And is is true that there can be some bruising and pain at the epidural insertion point for a few weeks after birth. The same will be true for your IV site — just because we’ve punctured that area and irritated it running in fluids, etc.

However, studies show that those who got an epidural don’t have any more long-term back pain then those who did not.

I think the epidural gets a lot of the blame for all the back pain caused by:

• Pregnancy (SO hard on our backs to have our center of balanced changed by our protruding belly)
• Labor (and all the crazy positions we get in as we’re in pain)
• Birth
• Postpartum/Life with baby — which includes
  • Positions we sit in to nurse (not a good habit to get into — but easy to do)
  • Carrying the car seat (the worse)
  • Bending over to put baby in the crib, etc
  • Carrying baby (possibly bad front pack carriers too — I had a bad one)

Don’t believe me? I have a whole article with the studies linked about long-term back pain from the epidural.

Now, I don’t believe the epidural is for all patients, and there are definitely risks but I think there are some people out there who really push their own agenda on something like this. It’s important to be aware of it! Want more information on the epidural be sure to check out my guide to epidurals during labor.

Many epidural myths—like the idea that they cause long-term back pain—are repeated so often they start to feel true. For busy couples, trying to sort through conflicting advice can add unnecessary stress. My Online Prenatal Class for Couples focuses on clear, evidence-based explanations and real clinical experience, so you and your partner can feel prepared, calmer, and confident in your choices—without spending hours researching on your own.

Want to know more about pain management in labor? — check out these posts:

• Why People Get An Epidural Even When They’re Not Planning On It
• Why Labor Pain Can Feel So Different For Each Person
• 5 Simple Tips for a “Natural” Labor & Delivery
• 4 Things to Know About Birth Pains
• Is an Induction More Painful than “Regular Labor”

We Don’t Need National Maternity Leave

Confession that I am not proud of: I did not get maternity leave on my first pregnancy, and that really made me feel like no one else should get leave either. It was really tough heading back to work 5 weeks postpartum thinking my uterus was going to fall out on the nursing home floor I worked at ().

Not only was it really hard to leave my baby, my body was entirely NOT ready either (I had a pretty big tear). I carried a lot of pain from that — but somehow in my mind I thought it made me a better mom (coping strategy).

On my other two kids I subsequently got a 6 week leave, and then a 12 week leave (which I split up). And frankly, SO much easier. Sure, recovery from having a baby still wasn’t my favorite, but not having to count every penny was nice.

(BTW, I used California state disability on my 2nd two children — and I believe that states may have to be our answer on this one).

After being in the social media birth sphere for a bit I realized my own bias that because I didn’t have something I felt like no one else should either. That it wasn’t necesary.

But I was wrong. I checked my own biases and I am now a strong proponent of paid maternity leave, and I try to voice my opinion as often and as loudly as I can. I’m embarrassed I ever really felt the other way, but we all are just who we are, and I am grateful we can change our minds. As shown by a few different things in this article.

As mothers, we all have to stand up to make a difference for paid maternity leave. Either through states or the federal government. I hope you’ll join me in that fight and speak with your congressional leaders as often as you can too.

Of course, there is still the tricky situation on when to go on maternity leave << I have a whole post on that.

Birth Classes Don’t Make a Difference

Honestly, in my career someone taking a birth class was the exception.

Most people don’t take birth classes, and I figure their births went alright and maybe birth classes weren’t all that helpful.

Frankly, I also took my own birth class which didn’t really highlight the information I truly needed for a better birth & postpartum recovery, but that’s a post for another day (or watch this Youtube Video to learn more) — so again, my own bias told me maybe they’re not all that important.

But then I started to teach birth classes for my hospital. And then I had patients who had taken my birth class and it was a big eye-opener for me.

• How much they already knew, so they didn’t have to be overwhelmed with information the day-of.
• How much easier it was for them to make choices and not be “bullied” in the hospital
• How much easier they transitioned into life postpartum because they knew what was coming.

And then I started to read the studies on how birth classes effect birth and I was so excited to learn that birth classes:

• Reduces cesarean sections
• Reduces induction rates
• Reduces your need for forceps or vacuums
• Improves birth satisfaction

Which frankly all makes sense. Be sure to read that article if you want more of my thoughts on that.

Many couples worry it’s either too late to prepare or too hard to fit a birth class into an already full schedule—especially when hospital classes are booked out or don’t work with real life. The Online Prenatal Class for Couples is designed for exactly that season: short, practical lessons you can do together, on your time, so you feel prepared, calmer, and confident heading into birth without adding more stress to your plate.

Want to know more about birth classes? — check out these posts:

• Alternatives to Hospital Birth Classes
• How Much Do Birth Classes Cost?
• Best FREE Childbirth Classes
• Why are Birth Classes So Expensive?
• Are Childbirth Classes Covered by Health Insurance? 

Kick Counts are Useless

I believed this for so. long. And, in fact, I didn’t do kick counts until my last baby.

And honestly, the studies on “ten kicks in 2 hours” do show that’s pretty unhelpful as every baby is so different. And, after doing kick counts I am here to say that if it took 2 hours for my babies to give me 10 kicks something was SERIOUSLY wrong and I should have high-tailed it into the hospital for help.

I have a whole article on kick counts (that explains how to do them and goes more into the studies on them) but let me give you the cliff notes (and why this is now a huge soapbox of mine):

• When done correctly, kick counts have been proven to save 1 in 3 still births, that’s 33% of still borns!
• Studies show that it does not increase anxiety but overall increases bonding with your baby
• Often it shows a problem with mom and not baby (but baby shows the effects of the problem) — this can have health benefits for both of you!

Want to know more — check out this video!

And, grab my cheat sheet right here to do them right:

I’m just here to say that a lot of us believe things that aren’t true — and that doesn’t make us bad or dumb. The real measure of a person is if they’re able to change their minds — and expand their thought process to something that might be more true.

So, hopefully these lies of labor helped you realize that maybe some of what you’re thinking isn’t true either. Did any of these change your mind — tell me in the comments!

And I’d love it if you let me hang out with you for the rest of your pregnancy:

The post Lies I Used to Believe about Labor & Birth appeared first on The Pregnancy Nurse®.

And while you’re here — grab my 3rd trimester checklist — it is going to get you prepped in no time:

This post is talking about preparing YOU — but if you’re looking for preparing your BODY check out this post.

You’ve Taken a Class

This may seem reductive, but you really need to take a class to be ready.

Far too many people are feeling like they’re smart enough to not need a class, and I believe that’s a big part of why we have so much birth trauma and poor outcomes — because people aren’t taking the time to get prepared.

Yes, it’s MUCH more fun to plan your nursery, but I will promise that time spent preparing for your birth will be worthwhile. In fact, this class guarantees it.

Your PARTNER is Prepped Too

The one’s we’re REALLY leaving behind is our partners. And then we somehow expect them to get up to speed and be a full partner without and prep.

Now is the time to have conversations with your partner about your upcoming birth.

Filling out a birth plan can be a great way to start:

But, you also want to have conversations about what you want for life after baby too. This class has couples questions to get you both on the same page!

You’re Ignoring Social Media

People that aren’t ready are still ready to listen to social media. They think that somehow that person’s advice after 1-3 babies applies to them.

The reality is that I get SO many people saying “it wasn’t that way for me” for things that are pretty common in labor. They just don’t know because their experience is so limited.

Smart people start to ignore social media as they find their own “readiness” inside them (brought out by true experts).

They’re also aware that is the WORST way to prepare, probably worse than doing nothing.

Want to know more about labor? — check out these posts:

• Common Choices During Labor
• How to Push During Labor (What No One Explains)
• Why People Get An Epidural Even When They’re Not Planning On It
• How to Feel Confident Making Choices During Labor
• What To Do If Labor Isn’t Progressing?

It’s Your Due Date+

So many people fool themselves into feeling “ready” when they’re just 37 weeks. Thinking baby will come “any day” — but the reality is that the average time of pregnancy is 40 weeks — so, you’re likely to go to your due date, and possibly even beyond.

Yes, you can feel prepared (and I hope you do) before 40 weeks, but you have to remind yourself it’s not time yet.

I think that’s such a tricky balance — getting prepared and ready, but knowing you have more time to spend. I recommend some good Netflix and frozen yogurt.

Wanting to get the things baby needs? Grab my baby necessities checklist:

You’re PRACTICING Daily!

Many people feel like they are just watching the one class and then they’re done — but you need to be practicing it on your own. Practice the breathing & pushing techniques.

Breathe when you have those crazy ligament pains or braxton hicks.

You can practice pushing on the toilet when you have a poop — it’s all the same muscles, and you can find what works bets for you!

This class has a natural pain management video and then gives you tips to practice them together!

Ok, that’s my top 5 — but this one catches SO many people off-guard and it’s the questions I get most after delivery…..

Bonus: Are Your Breastfeeding?

If you’re planning or hoping to breastfeed I 100% recommend a breastfeeding class.

In our society we just don’t know enough about it in order to really make a go out of it successfully without tips ahead of time.

This birth class bundle comes with a breastfeeding class taught by an IBCLC. I think it’s smart to have some good resources for breastfeeding and I am not that. I recommend The Breastfeeding Mama for more information!

So, how prepared are YOU feeling after reading this? Did I miss anything? Tell us in the comments!

I’m so excited for you and your upcoming birth. Thanks for being here!

I’d love to hang out with you for the rest of your pregnancy:

The post How to Know If You’re Really Ready for Labor appeared first on The Pregnancy Nurse®.

BTW, if you love some labor tips — check out my insider tips for a great birth:

I should also mention that with ANY choice you should discuss your options with your healthcare team. Some of these might really not be appropriate for you and sometimes emergencies happen (that’s why you’re in a hospital after all) — I just wanted to remind you of that before we get going!

What to Wear

This is a big one. As a nurse I have a gown laid out for every patient I see — and most take that option. You have to realize it’s important we do this. Many patients come to the hospital unprepared to be there. They won’t have their own gown or are prepared for this visit.

But, this does NOT mean you need to wear it.

Pro gown tip: It opens in the back. This allows our monitor cords to come through with some privacy for you. Plus, if you’re bleeding it doesn’t get on the gown if you leave it open on a pad on the bed.

We’ll often say bra and undies off when we tell you to get in the gown. Does this mean you HAVE to take that all off? No.

Some options here:

• Commando — go fully naked. It happens. Most people don’t start this way — but many end-up this way and we don’t mind at all.
• Wear a bra — if your bra doesn’t have metal, the risk of wearing it is pretty low. You just need to know there is always a chance we will have to cut it off, so I don’t recommend wearing your favorite bra.
• Wear your own gown — many people bring their own gown. That’s AOK with me — I just want you to know that labor is a messy process. Many will choose to throw the gown away (even if it’s washable) just because of ALL the things that get on it.
• Wear something else — I love a shelf bra tank top. Keeps your top covered, and we cover your bottom half with a sheet anyway (if that’s important to you).

I actually have a few posts on what to wear during labor:

• What to Wear For a Cesarean Section
• Do You Wear a Bra During Labor?
• Your Guide on What to Wear in Labor & Delivery and Your Hospital Stay
• How to Wear a Pregnancy Belly Band

Hopefully this is getting you started realizing you’ve got options! BUT we don’t often offer all of them because most patients are grateful for the hospital gown.

Ok, let’s keep going….

Where to Be

Well, you’re in the hospital — but you have options as to where your body will be (or what position you’re in).

I will admit that often, because we want to make sure that you and baby are safe, we love to have you lay down and quickly find baby on the monitor. However, after that — I think you’re good to move about the room (just like the stewardess always says).

That’s right, you can find the position that works for you.

Now, does that mean your baby will let us monitor them in that position? Not always. However, at that point you then decide what type of monitoring you want.

I have a few posts on that:

• What You Need to Know About Wired vs Wireless Monitors in Labor (this gives a lot of tips even if your hospital does not have wireless monitoring — or it doesn’t work — which happens a lot)
• Intermittent Auscultation: Who it’s for (and why it’s better) — this is getting a lot of play in the news lately, but the reporting is poor so get the full story from that article.

A few facts you need to know:

1. If baby isn’t on the monitor there are things we can NOT do — which include running an induction or an epidural. If you decline monitoring with those, we will have to stop those things. Nurses could lose their license without them.
2. Even with wireless monitoring, there are some positions the baby just can’t be monitored in, and it varies baby to baby.
3. Your nurse may need to frequently adjust the monitor — we hate it, you hate it. You can always ask if there’s anything you can do to help. Sometimes just you resting a hand on it keeps us away a bit longer. And — sometimes your belly ends-up looking like arts and crafts with tape, and other things helping us keep baby on.

I always say that fetal monitoring (especially obtaining it– is an art, not a science) — and sometimes we have to get very creative.

There is a monitor called a fetal scalp electrode that goes into the very tip of the baby’s scalp to monitor their heart beat — and this normally allows more positions as we’re attached to baby. However, it does require your water broken, and can be a bit more invasive (and a bit more risky if you have GBS).

I also want to add that I am a HUGE fan of movement in labor — you just have to know that sometimes it requires some creativity. Which can still be done, even if you need wired monitoring. Positions can be tricky. There’s labor movement cards in here to give you ideas of positions to choose between.

Letting Them Break Your Water

I wish providers were better at giving a choice on this. Often I hear “I’m going to break your water” vs — “Would you like me to break your water”? But remember, it is ALWAYS your choice.

Honestly, if you’re in the hospital an your provider is going to check you — ask if they’re going to break your water. Some do it without asking. It’s wrong, but at least you have that conversation ahead of time.

I have a couple of posts that dive into this more:

• Should You Let Your Provider Break Your Water?
• Should You Get the Labor Epidural Before They Break Your Water?

Here’s the Cliff Notes of what you need to know:

• Breaking water is almost always a choice (there are a few times we sometimes have to do it urgently — but you’ll sense it’s different).

• Studies show that breaking it in early labor isn’t particularly helpful at making labor progress faster. However, if you’re early in labor and not progressing, they may think it might help. It’s worth a try if they do. I go more into the the studies in this post.

• Often your contractions feel more painful once your water is broken. Think of it as squeezing a full water balloon vs a mostly-empty one — you can just squeeze harder, that’s what your uterus is doing.

• Some babies don’t love having the water broken and it can (although rarely) lead to a c-section — so, you want to be sure of your choice — that the pro’s outweigh the cons.

• It is true that as you progress into active labor (so, this is past 6 cm normally) sometimes breaking water is necessary to let labor progress. Sometimes the bag of water is bulging and just can’t push on the cervix enough to open it up and let baby descend.

So often I’ll hear doulas say on social media “don’t let them break your water” — but as I hope you’ve seen, this is a nuanced discussion that requires knowing what’s going on at THAT moment. This is why you have experts in the room — doctors, nurses and YOU (you’re an expert in your own needs).

Let me just say that far too often people make these choices simple when they can have a lot of complicating factors. I really recommend learning more about all your options in labor — I recommend this.

Want to know more about hospital routines — check out these posts:

• How to Push During Labor (What No One Explains)
• How to Feel Confident Making Choices During Labor
• What To Do If Labor Isn’t Progressing?
• Secret Keys to Labor that No One Talks About
• The Three Biggest Mistakes Labor Patients Make—And How to Prevent Them

Eating

This one gets a lot of talk online — and honestly, for good reason.

For a long time we just haven’t given anything more than clear liquids (think: liquids you can see through) to people in labor. BUT the studies are showing this isn’t necessary for most people.

Clearly the choices are:

• Eat real food (either brought in from home/restaurant or what the hospital provides)
• Just drink clear liquids
• Don’t eat at all

And all of those choices are right for some people.

Decent chance of a cesarean section (think twins, or a baby that has been having issues for a while in labor) — not eating is probably your best bet so you don’t have issues with anesthesia.

Real food makes you want to die, but could use a little sugar boost — maybe ask for a popcicle?

Starving? Eating some real food might be awesome for you! More and more we’re seeing that a little food can help your body get the energy it needs to help labor progress — especially if it’s been a long time.

Hospital Pro Tip: Your nurse can actually only do what your doctor orders. SO, if they say you can’t eat she can’t provide you with food. That doesn’t mean you can’t eat — it’s just part of how the hospital works. But always understand the risks and the benefits, even before you do simple things like eating.

Why is this a big deal? Mostly anesthesia worries that if you were to have a cesarean section and need general anesthesia you can vomit and that can go into your lungs. It’s less problematic if you haven’t eaten, but clearly we don’t want food in our lungs — which is why anesthesia is adamant about this.

However, there really aren’t many patients who go to general anesthesia…. so…. there’s that.

Again, talk about your options, and make the choice that is right for YOU!

Other Choices….

Now, labor is full of choices — and I think it’s awesome to think of them ahead of time. Which is why I have a free birth plan series where I walk you through it and how to use it:

But, a birth plan is not a plan for your birth. It’s just you thinking through your options about what you’d like. It’s honestly like looking a menu over in advance — knowing, sometimes the restaurant is out of things and you’ll have to choose something else. But, you know what “mood” you’re in.

You then have to know how to apply those choices to the circumstances (and knowing some of your options). Having a foundation of knowledge for your birth is a key to this one. I recommend this.

So, what other choices are you thinking about for YOUR labor? I’m actively working on making content around choices in labor — so I’d love to know what you’d like to know more about. Tell me down in the comments!

The post Common Choices During Labor appeared first on The Pregnancy Nurse®.

Now, I think this post will be MOST helpful with a video — don’t worry it’s in the works. Stay tuned (and subscribe right here).

Really quick as a reminder labor is split into 4 stages:

1 – Early Labor: Up to about 4-6 cm

2 – Active Labor: from 4-6 cm to 10 cm

3 – Pushing: Once you’re 10 cm until baby is delivered ** That’s what we’re talking about today!

4 – Delivery of the placenta: This is the easiest phase, most people find

We’re going to go back to our elementary school report days and go over the important stuff — when to push, where to push, and HOW to push?

Want to know more about the phases or stages of labor — check out these posts:

• Stages of Labor Duration: How long does labor last?
• How Long Does it Take to Push Out A Baby?: The 3rd stage of labor
• 4 Things You Can Do to Prepare Your Cervix for Labor
• How to Prepare for Childbirth

I also have a video on this same topic:

When?

So, as you can see on my chart above — once you hit 10 cm it’s time to push. BUT, like most things in pregnancy, it’s not always that cut and dry.

For a long time it’s been thought to delay pushing for a bit — especially if baby is still high. And then you start to push with your body once baby is a bit lower. The idea here is to save mom’s strength, let her uterus do the work for a bit and then once baby is engaged, mom will push.

However, new studies are showing that delayed pushing can increase infection rates, and postpartum hemorrhage rates.

Cahill AG, Srinivas SK, Tita ATN, et al. Effect of Immediate vs Delayed Pushing on Rates of Spontaneous Vaginal Delivery Among Nulliparous Women Receiving Neuraxial Analgesia: A Randomized Clinical Trial. JAMA. 2018;320(14):1444–1454. doi:10.1001/jama.2018.13986

That doesn’t mean that delayed pushing isn’t right for some people. People who may want to consider it:

• You’re already exhausted, maybe you got a late epidural and you just need a nap
• People who have NO urge to push (maybe we turn down the epidural and give you 30 minutes to feel that pressure)
• The baby is still VERY high — maybe try some movements to help baby descend before you start pushing.

As a reminder it is always up to you when you start pushing. If they say you’re complete and it’s time to push, and you feel ready — then you make the choice to push.

If you’re complete and they say it’s time to push and you have NO energy you have a conversation about how things look like for you.

Honestly, I think some labor nurses have used “laboring down” as a way to get the next shift to deliver their patient. I’ve seen people laboring down for hours — and that’s never been good care. Yes, in certain circumstances maybe 30 minutes with good position changes, and maybe rest for mom can be a game-changer and leave her less tired.

But, sometimes it’s a lazy way to do nothing.

But, you didn’t hear that from me.

Love how I pull back the curtain a bit on labor and delivery. I think tips like this can be REALLY helpful. We’re all just human and understanding how the “system” works can be a big win. I recommend this to help out!

Where?

Well, if you’re here — it’s likely going to be in the hospital that you’re pushing — but I’m talking more about the position you push in.

And frankly — this one is up to you.

I hear a lot of people saying that it hurts your pelvic floor to be in a specific position during pushing.

The reality is that all types of pushing does put a lot of pressure on your pelvic floor — and it’s different for every patient.

Pushing needs to sort of be put into 2 different categories (or periods of time):

Pushing before baby starts to stretch the perineum — this is most often done with your nurse (or sometimes midwife) at the bedside. This tends to be the longest part of things (especially on your first baby).

Pushing once the perineum is really stretching (often called crowning) — This is most often when the doctor is called for delivery.

While both types of pushing can cause issues with your pelvic floor, I think it’s important to remember that birth in general can cause issues with the pelvic floor. I recommend patients try a few positions (even more if they don’t have an epidural). If you find a position that is working for you, I say use it.

During labor there aren’t any studies that show one position is better than another for all patients. Every study I have read notes a lot of it is based off patient preference in how they are feeling best pushing. Often called shared decision making.

Also, patients with an epidural are limited in how they push. We can sometimes get you onto all 4’s to push, but within 15-20 minutes your hips hurt enough you want to try something else. You can still use a peanut ball and change sides or sit up and use a squat bar. There are options, just not things off of the bed as your legs won’t be able to hold you up. I have a whole post on using movement during labor with an epidural.

I hear a LOT about pushing from physical therapists on social media. I think it gets a lot of views, but they really haven’t read the studies OR actually pushed with patients — so, be mindful of that one. I’ve done both.

It’s important to know that protecting your perineum from a tear is different than pushing prior to crowning. How you push prior to baby crowning isn’t going to make a big difference in how you tear (although I recommend a few things including a cold compress in my post on how to prevent tearing).

Here are a few studies with links and the main conclusions:

This study showed that not being on your back reduced tearing and episiotomies.

Familiari A, Neri C, Passananti E, Marco GD, Felici F, Ranieri E, Flacco ME, Lanzone A. Maternal position during the second stage of labor and maternal-neonatal outcomes in nulliparous women: a retrospective cohort study. AJOG Glob Rep. 2023 Jan 17;3(1):100160. doi: 10.1016/j.xagr.2023.100160. PMID: 36825260; PMCID: PMC9941360.

This one showed that at delivery all 4’s and or kneeling was the best to prevent tearing (and I’d agree). It also showed that squatting made tearing worse.

Fay Lodge Melanie, Haith-Cooper. The effect of maternal position at birth on perineal trauma: A systematic review British Journal of Midwifery. 02 March 2016

This one showed that pushing more upright or laterally (on your side) was more helpful. It strongly recommended against laying on your back with feet in stirrups.

Huang J, Zang Y, Ren LH, Li FJ, Lu H. A review and comparison of common maternal positions during the second-stage of labor. Int J Nurs Sci. 2019 Jun 20;6(4):460-467. doi: 10.1016/j.ijnss.2019.06.007. PMID: 31728401; PMCID: PMC6839002.

Now is the part that I pull back the curtain and tell you this: Most doctors are really trained best to deliver you in a supine position. It makes it easy for them, they’re used to it and they do their best work in preventing tears at delivery at this point.

Your delivering provider does do a lot in preventing tears at delivery. Both in helping the perineum stretch and talking you through how to push right there at the very end to prevent you from tearing. It’s important to know that.

Many doctors scoff at the idea of not delivering patients on their back — but this is something you can bring up at prenatal appointments. Ask your provider if they’re comfortable delivering in other positions than with you on your back with your feet up in the stirrups. See what they say.

There’s lots of things you might want to ask your provider about for your delivery — doing a birth plan can be really helpful to start these conversation. I have a free series I give you a printable and walk you through it (there is a spot for delivery position preferences on my sheet):

As a note — how a provider delivers does say something to their routines of birth, and how open they are to letting the patient make the choices. As you have these discussions you may realize this isn’t the provider for you. While you may not be able to switch, it might be worth it to at least look around and see what your options are.

As a note: After delivery almost all patients will end up on their back with feet in stirrups so the doctor can clearly see if you have torn and if a repair will be needed. It’s important they do that as if a tear goes undetected (because you’re squatting) it could be really bad — we want them to be able to visualize the space well. But it does not mean you have to deliver that way — just that we’ll move you like that after delivery.

In summary on “where”:

• Try a few different positions as you start to push, see what feels good and helps baby descend well.
• Your DELIVERY position may be different than your pushing position (but trying to be side-laying or on all 4’s has been show to reduce perineal trauma)
• Talk with your provider about how they prefer to deliver

And, if you’re thinking you’d like to know more about labor & pushing positions I have some labor movement cards in here that can get the ball rolling on using movement to your benefit during labor.

How?

There are two types of pushing. And honestly, they’re pretty similar to how you poop when you’re constipated — so you can try them out now and see which works best for you.

Here’s a couple of studies that talk about it:

Closed- or open-glottis pushing for vaginal delivery: a planned secondary analysis of the TRAnexamic Acid for Preventing postpartum hemorrhage after vaginal delivery studyFroeliger, AlizéeSentilhes, Loïc et al.American Journal of Obstetrics & Gynecology, Volume 230, Issue 3, S879 – S889.e4

Chloé Barasinski, Anne Debost-Legrand, Denis Savary, Pamela Bouchet, Sandra Curinier, Françoise Vendittelli Does the type of pushing at delivery influence pelvic floor function at 2 months postpartum? A pragmatic randomized trial—The EOLE study AOGS 09 November 2022

Again, neither one really showed a huge benefit overall in the population. Some people really hate one or the other — so, decide which is right for you when you’re having your baby.

That second one did show some benefit to open glottis pushing on subsequent babies (vs your first) which makes sense. Often you’re only giving a few pushes and it makes sense to make it a bit less forceful on those deliveries.

To boil the act of pushing down — there is:

Open-Glottal Pushing: This is where you do a deep moan as you push. You’re not holding the air in — you’re more moaning and pushing down towards your bottom with your diaphragm.

Closed-Glottis Pushing: This is more like when you take a deep breath in to jump in the pool as a kid. You’re pulling that air in, and then pushing down with the air in your lungs on your diaphragm to push on the baby.

Pro Tip: I see some people saying “forceful pushing” can cause tears — and I want to be REALLY CLEAR that this is just at delivery time. During the other hours of pushing (especially on your first) you WANT to be forceful, you NEED to be forceful to get that baby to move. At delivery your provider will coach you with small pushes when your perineum needs time to stretch.

As for the two types — I think it’s smart to try both and see which you like better. You can even switch during your pushing time if you feel like one is getting less-effective. All of that is fine. You don’t have to stick to one type or position of pushing and go with it — you can adjust as you’d like!

I see a TON of stuff about pushing online. Most of it is from physical therapists who have not seen a lot of patients push (they’re going more on theory and possibly their own birth rather than a wide swath of people). The reality is that pushing is VERY personal — it’s just kind of how you get it done. Try a few things, see what works, ask for ideas from your team if you’re stuck and remember it can take quiet a while — even if you’re a GREAT pusher (especially on your first baby).

You know, I keep saying first baby, but my second baby was quite a bit bigger than my first baby — and it still took some time with him as those tissues needed to stretch more. So, you can’t always COUNT on it being fast — that being said, my 3rd was very quick (and smaller). So, you never know!

I love that you’re here learning about pushing — but I bet you’d love a teammate for this, not just someone over there scrolling Tiktok saying — go Kylie go! I recommend this to get them engaged in this process as well. I think you’ll find it so helpful!

So, what are you plans for pushing? Tell us down in the comments. And, tell me if you’d like me to include anything else in the video (or in future videos). I am here to help you guys out!

The post How to Push During Labor (What No One Explains) appeared first on The Pregnancy Nurse®.

I also have a YouTube video on this same subject:

As a note, the epidural isn’t the only thing you can get for pain — I go over some of the most common pain management options right here:

They’re Exhausted

This is one I see a lot.

You’ve had false labor for days

You haven’t been able to sleep.

The anxiety of “when” has been killing you and you really need the rest.

So they get an epidural.

And honestly, this is smart! If you’re exhausted, and it’s available I think it’s smart to get. You’ve got pushing in front of you and then managing a newborn. It’s a LOT!

It’s REALLY hard to sleep during labor, although if you think just one small nap would do wonders, sometimes IV pain medicine can help out with this too.

Far too many people stay up timing contractions in early labor, my best tip is to ignore them until you can’t — and sleeping is one of my favorite ways to ignore them!

Want to know more labor tips? — check out these posts:

• How to Feel Confident Making Choices During Labor
• What To Do If Labor Isn’t Progressing?
• Secret Keys to Labor that No One Talks About
• The Three Biggest Mistakes Labor Patients Make—And How to Prevent Them
• Labor Anxiety? These 3 Things Help You Feel in Control

They’re Being Induced

The reality is that you start your induction from minute one in the hospital.

Which makes it hard to:

• Ignore (you’re just sitting there, like a “watched pot”)
• Sleep through (the hospital is HORRIBLE for sleep)
• Get comfy — because we have to have the monitors on the baby in order to induce you (and this is something you can’t refuse)

Often inductions are very long too. Clearly, it depends on what your cervix is when you come in (see my article on Signs You’re Ready to Be Induced for more info).

Inductions are just trickier to make it through without an epidural for a variety of reasons. That isn’t to say you can’t make it – but it is important to know it’s hard.

I think it’s important to know what you are facing (because it’s different for everyone). That’s why I made this induction checklist:

And, if you’re looking for some positivity, check out this podcast from someone who was induced without an epidural:

They Came In Too Early

Some people think the minute contractions start, it’s time to pack that bag and head into the hospital. I mean, that’s how it happens on the movies, right?

I’m here to say that for most people, the best place for you to be in early labor is at home.

Don’t forget to use your provider — it’s great to call them and check in, tell them what’s happening and get their advice on when you should head in. As an experienced nurse I could tell by your voice if it was time to head in (most often).

The thing is, this is scary. It’s especially scary for partners. They feel like you’re paying the hospital and your provider to manage the labor — so, why not use them?

Well, the hospital just isn’t relaxing, it doesn’t let oxytocin flow in early labor. It doesn’t have your people, your things, your food, your smells. It also has medical staff poking and prodding you…

So, it’s important to get some tools to help you wait at home for a bit in early labor. What to do, what to eat, and what to watch for…

I’m so glad that you’re here, but this is one partners can use some education on too. That’s why I recommend this. It has a whole chapter on early labor and managing it at home. It’s so helpful — for both of you!

They Weren’t Prepared

So many think they can muscle through labor, like they have for cramps since puberty — but I’m here to say that you really need to get prepared.

And, like all good preparation, you have to practice. It takes time and effort, and often a good teacher to get you both prepared (because you want a partner in this, not just a cheerleader).

This has a whole natural pain management bonus video included that has proven to help people manage labor pains and make good choices for themselves in the hospital. So helpful!

It’s there!

The reality is that at home, there’s no epidural.

If you deliver at a birth center, there’s no epidural.

But at the hospital it is there.

I see people all the time telling their partner not to let them get it — but honestly, my friend. You’re an adult. If you make the choice to get it, then get it. You don’t need someone holding it back from you like you’re a toddler. You can really make that choice. Epidurals have been proven to be effective, safe ways of pain management.

Lots of people are awfully scared of epidurals, which is a shame. There’s a chapter in here that explains about how they work and even walks you through it using some common household items to make it less scary. I think you’ll love it.

The reality is that you can have a lot of hopes and wishes (and preparation) about your birth, but until you’re in the actual situation it’s hard to know what is really the best choice for you. So, staying open to things is the smartest thing you can do.

Want to go over your hopes for a perfect birth – -check out my free birth plan series:

It’s important to know what you’d like if things are working out, but also know how to make choices on your own when the time comes. This teaches you both how to do just that. I think you’ll love it (in fact, it’s guaranteed).

The post Why People Get An Epidural Even When They’re Not Planning On It appeared first on The Pregnancy Nurse®.