8 surprising things to know about giving birth for the first time

When you’re pregnant with your first baby, the idea of giving birth can be a nebulous concept, like embarking on a cross-country trip without a map. For many first-time mothers, it’s easy to worry or fear birth as it’s hard to know exactly what to expect. And when an experience is so often described as “transformational,” it’s tough to truly define. So we asked some fellow mamas to share what surprised them most about giving birth for the first time. Here’s what we found out.

What to know about giving birth for the first time: Advice from real moms

1. Postpartum bleeding

“I was surprised by the bleeding after birth. I know now that it’s normal, but it kind of freaked me out at the time.” —Rachael

Most women bleed for about six weeks after they have a baby. The lochia, as it’s known, starts out like a heavy period.

After a few days, the bleeding will become lighter in both flow and color, and then turn pinkish, then yellowish, then white and finally clear. The timeline varies for everyone. You may also have a few small blood clots, especially when you stand up after sitting or lying down for a long time.

When to call your provider: If you have several blood clots or a clot the size of a golf ball, or if you fill a pad with blood in an hour or two, call your provider right away (2 a.m. phone call totally justified).

Related: Postpartum bleeding: How much is normal and how should I handle it?

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2. Every birth is different

“I heard so many stories about birth and kept trying to picture what mine would be like based on what everyone else was saying. But I now I realize that every experience is just so different. Honestly, I wish I had focused on me a little more during my pregnancy, and worried less about what everyone else was doing.”—Renee

You may find that you’re constantly being told other people’s birth stories. And that’s awesome, as long as you’re finding it helpful and inspiring. But if you get to a place where you feel stressed as you’re listening, or are hearing things that make you worry, it’s okay to ask people to save their stories until after your baby is born. Every birth really is unique, so try to focus on what you want your story to look like.

Related: Where to give birth: Here are your labor and delivery options

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3. Your nurse = your hero

“One thing I didn’t expect was how important the nurses were vs. my doctor during the labor and birth process. I loved my OB and she was super important during my whole pregnancy, but it was really the nurses who took care of me that got me through it.”—Kate

If you’re having a hospital birth, there is a good chance your provider will be taking care of multiple birthing people at the same time. So while they should be in to check on you frequently, chances are they won’t be by your side for most of your labor. Your nurse, on the other hand, will probably be taking care of only you, so they’ll be with you for much more of your labor.

Related: I’m a NICU nurse—here’s what I tell parents about caring for their NICU baby at home

4. What crowning feels like

“I wish I had known what it feels like just before the baby came out, and maybe how to cope with the sensation.”—Aubrey

During pushing, the time when you can finally start to see the baby’s head is called crowning. It usually lasts for at least a few contractions, and many women describe as an unpleasant burning sensation.

Here are a few things to know:

• The burning sensation is actually your skin naturally stretching around the baby’s head. It is doing exactly what it is supposed to. So while it may not feel awesome, try to take comfort in knowing that it’s very normal (and will be over very soon).
• When the baby is crowning, instead of doing big long pushes, switch to short gentle pushes (and lots of breathing). This will help baby to ease out and give your perineum (the skin on the outside of your vagina) time to stretch.

5. After-birth cramping

“I didn’t know that I’d have cramping after the baby was born, and it would be a bit uncomfortable.”—Melissa

After birth, your uterus will start to shrink back to its pre-pregnancy size.

It does this by contracting, or cramping (bonus: it’s also helping to stop the bleeding).

This cramping can be especially intense during breastfeeding: When you nurse, your body releases a hormone called oxytocin, which is the hormone the causes contractions. So while it can be uncomfortable, remember that it is very much on purpose and helping you to heal!

The good news is that this only lasts for about three to five days. Talk to your provider about taking an anti-inflammatory medication for the first few days after birth to help with this discomfort.

P.S. During the first few days after you give birth, your medical team will ask to press on your lower belly periodically. They are checking to make sure your uterus feels firm and healthy. It can be a little uncomfortable, but it’s only temporary.

6. Remember to plan for you

“I didn’t really plan for taking care of myself after birth—I had everything ready for the baby, but didn’t remember that I’d need some TLC too!”—Jamie

You’re about to welcome new life into the world, so of course you want to make sure everything is perfect for them.

But remember: YOU are the one who has been growing (and will soon be birthing) that new little being. Factor in some serious healing time for yourself: rest, eat well and nurture yourself. And a big one… ask for help!

See if you can line up people to be on call to help you for the first month after you give birth. You can even send them this list of suggestions about how to help a new mother.

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Related: Postpartum plan is just as important as a birth plan. Here’s how to make one

7. You’ll still have a belly for a while

“I thought I’d magically be able to wear regular sized clothes again. It took a good two to three months, and now, almost six months in, my body is still shifting and changing a ton.”—Nina

It takes a while for your uterus to return to its pre-pregnancy size. And, your body has gone through (and will continue to go through) tremendous changes. You’ll probably be most comfortable in maternity clothes for at least the first month or so after giving birth (or way longer, who are we kidding).

Be gentle on yourself. Forget the bounce-back. Remember, YOU JUST MADE A BABY.

Related: How I learned to love my post-baby body

8. Don’t forget why you’re here

“The minute my baby was born I was like ‘Ohhhhhhhhh, okay. That was totally worth it.’ I remember my birth, of course, but honestly it was just a blip in time compared to what comes after—and I have to say, it IS totally worth it.”—Delia

No comment needed.

If I’ve learned one thing about pregnant women during my seven years as a midwife, it is that pregnant women are planners. We like to anticipate and prepare for everything! But it can be hard to really envision what the whole process is going to be like, and sometimes it’s difficult to even know what questions to ask.

Getting Ready for Baby

The Importance of Birthing Classes

Prenatal or birthing classes can provide valuable information and help you prepare for labor and delivery. These classes cover topics such as creating a birth plan, common hospital procedures, and pain management techniques. At Madison Women’s Health, we recommend our patients to attend prenatal classes offered by Unity Point Meriter, which can be taken online or in person. These classes are typically taken during the second trimester and should be completed before the 37th week of pregnancy. They offer insights into various aspects of labor and delivery that may not be commonly portrayed in popular media.

Choosing Your Support Person

Before the COVID-19 pandemic, there were no restrictions on the number of support people allowed during labor and delivery. However, it is essential to check the current guidelines and restrictions in place at your chosen hospital. At the time of writing this article, Meriter Hospital allows one support person, in addition to a doula, to be present during the birth. Your support person can be anyone you choose, such as your partner, a friend, or a relative. It is important to select someone who will provide you with support, encouragement, and comfort throughout the birthing process. Remember that your support person must remain the same individual from the beginning of labor until the birth.

Packing Your Hospital Bag

Preparing a hospital bag ahead of time is a good idea, even though the hospital provides essential items. By packing a bag around 36 weeks of pregnancy, you can ensure that you have everything you need to make your stay more comfortable. Here are some suggestions for items to include:

• Toiletries: Shampoo, conditioner, soap, toothbrush, toothpaste, hairbrush, and deodorant.
• Comfortable clothes for you, including slippers, socks, or flip-flops, and a robe or nightgown.
• Clothes to wear home, such as comfortable maternity clothes and a nursing bra if you plan to breastfeed.
• An outfit for your baby to wear when leaving the hospital.
• Snacks for your partner or support person, as the hospital may have limited food options.
• Phone charger to stay connected and capture precious moments.
• Any specific items that will enhance your comfort, such as a pillow or a favorite blanket.

The Onset of Labor

Knowing when to go to the hospital and how long to labor at home can be a source of uncertainty for many first-time moms. In general, it is safe to spend time in early labor at home. We recommend calling your healthcare provider when you experience painful contractions every 5 minutes for 1-2 hours or if your doctor has given you specific instructions due to medical conditions. If you suspect that your water has broken, it is best to call and discuss the appropriate time to come to the hospital, usually early for safety reasons.

The duration of labor for first-time moms can vary significantly. Labor is divided into three stages: latent labor, active labor, and the pushing stage. The length of each stage is unpredictable, but in general, the entire process can last hours or even days. It is important to remember that every woman’s labor is unique, and subsequent labors tend to be faster than the first.

Coping with Labor Pain

Labor pain is a natural part of the birthing process, and every woman experiences it differently. Here are some non-pharmacologic and pharmacologic options to help manage and alleviate labor pain:

Non-Pharmacologic Pain Control

• Changing positions: Experimenting with different positions such as standing, resting on hands and knees, or sitting on a birthing ball can provide relief and help with the progress of labor.
• Warm shower or bath: The warm water can relax tense muscles and provide pain relief. Water immersion during labor has been shown to lower pain scores.
• Massage: Your support person, nurse, or doula can offer back massages and provide counter pressure during contractions.
• Breathing techniques: Learning and practicing different breathing techniques during prenatal classes can help you stay relaxed and focused during labor.

Pharmacologic Pain Control

• Intravenous narcotic: In some cases, an intravenous or subcutaneous injection of a narcotic medication may provide pain relief. However, this option is not recommended if delivery is expected within an hour to allow the medication to clear from your system and your baby’s system.
• Epidural: An epidural is a common pain management technique used during labor. It involves the administration of medication into the epidural space, which numbs the lower body and provides effective pain relief. An epidural can be requested at any time during labor and does not transfer to the baby. It is important to discuss the benefits and risks with your healthcare provider.

It is important to remember that every woman’s pain threshold and preferences are different. There is no right or wrong way to manage labor pain, and it is essential to choose the options that work best for you.

To read more about labor and delivery, click here: Labor and birth | Office on Women’s Health (womenshealth.gov)

In conclusion, the journey of giving birth as a first-time mom is filled with anticipation, excitement, and some anxiety. By attending prenatal classes, choosing a supportive support person, understanding pain management options, and being informed about the different stages of labor, you can feel more prepared and confident. Remember, each birth is unique, and your healthcare provider will guide you through the process, ensuring the best possible outcome for you and your baby.

Q&A Section:

Q1: Is it normal to experience postpartum bleeding after giving birth for the first time?

A1: Yes, postpartum bleeding, known as lochia, is entirely normal after giving birth. It typically lasts for about six weeks, starting as a heavy period and gradually decreasing in flow and color. If you notice excessive bleeding, large blood clots, or fill a pad with blood in a short time, it’s essential to contact your healthcare provider.

Q2: How can I cope with the uncertainty of what to expect during my first birth when every experience is different?

A2: It’s common to feel uncertain about what to expect during your first birth. Remember that every birth is unique, and what worked for others might not be your experience. Focus on your well-being during pregnancy, seek positive stories, and communicate your boundaries regarding birth stories to avoid unnecessary stress.

Q3: Why are nurses considered essential during labor and birth for first-time moms?

A3: Nurses play a crucial role during labor and birth, particularly in hospital settings. While doctors may be overseeing multiple patients, nurses often dedicate more time to individual care. Your nurse will be with you for a significant part of your labor, providing support, monitoring, and assistance, making them instrumental in the birthing process.

Q4: What does crowning feel like during the birthing process?

A4: Crowning, the stage when the baby’s head becomes visible, is often described as a burning sensation. This sensation is the natural stretching of the skin around the baby’s head. While it may be uncomfortable, it’s a normal part of the birthing process, and adopting short, gentle pushes and controlled breathing can help manage the sensation.

Q5: Is it normal to experience cramping after giving birth for the first time?

A5: Yes, cramping after giving birth is normal and indicates the uterus shrinking back to its pre-pregnancy size. These contractions are also helpful in preventing excessive bleeding. Cramping can be more intense during breastfeeding due to the release of oxytocin, the hormone responsible for contractions. While it can be uncomfortable, rest assured that it is a natural part of the healing process.

Q6: How can I plan for self-care after giving birth for the first time?

A6: Planning for self-care after giving birth is crucial. Factor in healing time for yourself, ensuring proper rest, nutrition, and emotional support. Arrange for assistance during the first month after birth and communicate your needs to those around you. Remember, taking care of yourself is essential for a smoother postpartum recovery.

Q7: How long does it take for the belly to return to its pre-pregnancy size after giving birth for the first time?

A7: The return of the belly to its pre-pregnancy size varies for each woman. It’s common for the uterus to take some time to shrink, and your body will undergo ongoing changes. Comfortable maternity clothes may be suitable for the first month or longer. Be patient and gentle with yourself, avoiding undue pressure for a quick bounce-back.

Q8: What is the significance of the birthing classes mentioned in the article for first-time moms?

A8: Birthing classes are valuable for first-time moms as they provide essential information and preparation for labor and delivery. Topics covered include creating a birth plan, hospital procedures, and pain management techniques. Attending these classes helps moms feel more informed and confident about the birthing process, offering insights not commonly portrayed in popular media.

Q9: How can I know when to go to the hospital during early labor for my first birth?

A9: In early labor, it’s generally safe to spend time at home. Call your healthcare provider when you experience painful contractions every 5 minutes for 1-2 hours or follow specific instructions given by your doctor. If you suspect your water has broken, consult your provider to determine the appropriate time to go to the hospital, usually early for safety reasons.

Q10: What are some pain management options for first-time moms during labor?

A10: Pain management options for first-time moms include both non-pharmacologic and pharmacologic approaches. Non-pharmacologic options include changing positions, warm showers or baths, massage, and breathing techniques. Pharmacologic options may involve intravenous narcotics or epidurals. It’s essential to discuss these options with your healthcare provider and choose what aligns best with your preferences and pain threshold.

A version of this story was first published June 24, 2021. It has been updated.