An obstetrics Chuck Norris

Fact: Movies are not a realistic reflection of real life.

Another fact: This is especially true when it comes to childbirth.

According to a recent survey by Childbirth Connection, 68% of moms say they get their information about birth from TV.

This is very troubling because TV and movies have so little accurate information about childbirth.

This is probably one of the most frequently mishandled subjects in all of TV and film. So here’s the real story behind birth cliches in the movies and TV…

Myth #1- Your labor will start off when your water breaks

Oh my goodness, I can’t believe how many times I have seen this: Nine Months, Juno, Baby Mama… In about 1 in 10 labors the bag of waters will break hours before labor starts. That’s right, hours. And sometimes even a few days. That means that if you rush to the hospital because your water broke you may be going to the hospital when labor is hours off. Now if you are more than three weeks ahead of your due date and your water breaks, you should go to the hospital to seek medical care because you have premature rupture of the membranes (a.k.a. PROM). But if you’re 37 weeks or later, it’s probably better to wait until you’re actually in labor.(Just don’t have sex, take a bath, use a tampon or put anything in your vagina.) And concurrent with this myth is the next one…

Myth #2- You should leave for the hospital right away

Ah, the episode of The Office where Pam goes into labor. Jim is convinced that they need to leave right away, after all the timing of the contractions is right? The late Dr. Bradley recommended that couples stay home and work through labor together until labor was very well-established, otherwise the mother goes to the hospital, gets poked and prodded and miserable and everyone is in for a very long ride.

Dr. Bradley recommended that in normal labor couples wait until the mother hits the emotional signpost of seriousness before leaving for the hospital. When she gets snappish about things, can’t focus or concentrate on anything else going on and can’t smile or joke, then it’s time to go. (Melissa Joan Hart described this in her interview for More Business of Being Born. She had her family around her in labor at home and they were laughing and joking and when she started crying and saying things weren’t funny, then they knew it was time to go to the hospital.)

If Pam can come out and say that she changed her clothes because her water broke, talk with her coworkers, sit in a conference room for a meeting about slowing down her labor, she’s not at the emotional signpost of seriousness yet.

Myth #3- Someone needs to tell you to push during a natural labor

Nine Months, J.J. Abrams’ Star Trek reboot, Star Trek: The Next Generation. OK, here’s the thing about pushing a human being out of your vagina without pain medication: YOU’LL FEEL IT COMING!!! For women who have epidural pain medication, the sensation of contractions may be hard to feel. This is where the doctor or nurse telling them to push comes in. However, if

worf delivers molly

Dr. Bradley, he is not.

you are not on pain medication, I promise you, you will know when it’s time to push. Though I thought Worf delivering a baby in TNG was hilarious. (“My computer simulation was not like this. That delivery was very orderly.”)

Myth #4- The woman will be hurling insults for hours on end

Labor is divided into three stages: First stage (onset of labor until dilated 10 cm), Second stage (10 cm dilation to delivery of the baby) and Third stage (delivery of the placenta). First stage labor is divided into three phases: Early labor, Active labor and transition. Early labor is when you feel energized and excited or nervous. Active labor is when you start feeling serious and focused on the birth. And then there’s transition. Transition is when you start to lose it. It’s almost time to push and this phase gets very intense. Dr. Bradley characterized this phase with the emotional signpost of self-doubt. (I have told my husband that I can’t do it every single time I have given birth when I hit transition.) “You did this to me,” “I can’t do this” are all things that a woman feels like in transition. But transition is actually a relatively small part of labor (about 2 hours to 30 minutes).

Myth #4- You’ll get a c-section (or birth by beaming) and it will be totally easy!

 Robin Hood Prince of Thieves, Star Trek: Voyager… The World Health Organization recommends that the c-section rate for a country not exceed 10-15%. So c-sections are definitely necessary and life-saving sometimes, but it’s major surgery and not some walk in the park.

In an obstetrical Chuck Norris move, Morgan Freeman’s character performs a c-section for a breech baby in Robin Hood: Prince of Thieves. C-section moms, don’t you love how he does this without a sterile operating room and with no pain medication and the mother is up and walking around just fine the next day? That’s Hollywood!

As a note, while breech births are typically performed by cesarean in the United States, a breech birth does not require a cesarean surgery like a transverse lie does. (Transverse lie is where the baby is lying sideways in the uterus. Ain’t no way that’s coming out.) In fact many breech babies have been delivered safely by the side of the road on the way to the hospital and a growing body of obstetrical and midwifery research is questioning the assumption that the breech positioning itself is always the problem and that maybe it’s the techniques associated with traditional breech delivery such as laboring in a reclining position and the use forceps that are more problematic.

As for Voyager, I think the writers just liked the novelty of beaming the baby out. They don’t really discuss the implications pf beaming a baby out of the mother’s womb, which would probably be a little different than transporting an exploration party to another planet.

Myth #5- Woman should be on her back during labor

The only movie I can recall seeing a woman in an upright position during labor was some made-for-TV movie about something in the Bible that my mom watched at Easter when I was a kid. (I think it may have been about Moses.) I was terrified of labor and baffled at the idea that a woman would be upright in labor. Since it was based on the Bible and the Bible states that women gave birth on stools during the Old Testament period, they probably went for accuracy instead of appealing to 20th century sensibilities.

Myth #6- You’ll get pain medication right away

Waitress, Junior. You scream for drugs and the nurses will come and give you an epidural immediately. Not so. You have to be far enough along in labor to get an epidural. (But Juno gets this one right.)

You’re going to die, even in a highly advanced civilization capable of interplanetary travel, and even with a genius vampire doctor father-in-law

Wow, even a long time ago in a galaxy far, far away in a civilization with light sabers and faster than light interplanetary travel, people are still freaking out about childbirth. (Or maybe that’s just George Lucas.) There are definite complications that can occur with childbirth, however, from an evolutionary standpoint the process had to evolve in such a way that even without any medical care, most (not all, but most) mothers and babies would live through the process. Otherwise, the human race would have died out a long time ago (in a galaxy far, far away- and everywhere else).

Seriously, in a civilization that advanced, I’m sure they could have safe and comfortable natural births- even for twin pregnancies. I’m imagining safe, sterile emergency c-sections at home and effective screening for blood clots and deep vein thrombosis in pregnancy. Now, I realize that Anakin grew up on Tattooine, a backwater, outlaw world that doesn’t seem to be a poster child for developments in infant and maternal health. For a slave in such an environment childbirth but seem frightening. But at no point in Revenge of the Sith does Padme point out that as a member of the Republic Senate on a developed world she would have access to the very best maternity care. What might have happened if Padme had simply opted for woman-centered care when her husband expressed his terror about the impending birth? Well, we may not have had Star Wars…but on the other hand maybe Padme would use her experience to advocate for less advantaged women in the galaxy. You know, start something like the Republic Maternal and Infant Health Coalition that would make safe maternity care available to women of all worlds. But you can’t make a sci-fi action franchise out of that. (Alternate universe fan fiction anyone?)

Breaking Dawn makes the case that pregnancy by a vampire will result in a horrifically complicated birth, though one has to ask the question that if Edward’s “father” is a doctor and so knowledgeable, why didn’t he just schedule a c-section for Bella since he should have known how high-risk her pregnancy was? Yes, a vampire human hybrid pregnancy might be little documented, but Bella would still show signs of impending labor. Seriously, he could be watching for Braxton-Hicks contractions, blood pressure readings, dilation. Labor doesn’t just come out of nowhere- even in a half vampire pregnancy.

And we’re on the subject of things that movies get wrong about human reproduction…

Conception happens right after sex

Look Who’s Talking, Look Who’s Talking Two, Nine Months. Remember your sex ed and/or health class? They didn’t tell you how conception really works. A woman is fertile during about 2-5 days during her cycle, at some point she will release an egg often during the middle to end of her fertile phase. So here’s the catch: sperm can survive for about 3-5 days during a woman’s fertile phase. That means that conception does not take place minutes later. More likely a day or two later. So no matter how romantic the night was, conception probably happens in a much more mundane moment like standing in line at the post office, cooking dinner, around the water cooler at work, running errands, vacuuming the floor… That’s why Hugh Grant’s character could be away at a psychology conference and still get his girlfriend pregnant.

You can take a pregnancy test any time of the day

 Well, you can take a pregnancy test any time of the day, but if you want to have an accurate reading, it’s best to do it first thing in the morning right after you get out of bed. That’s when the concentration of HCG is the highest for the most accurate reading.

Update: We can add World of Warcraft to the list of birth myth promoting media…

I’ve been informed that World of Warcraft shows a Tauren character dying in childbirth on her back after giving birth to human-cow hybrid babies who have horns at birth. No species with horns/antlers gives birth to young with horns/antlers. The horns/antlers show up later on. Even animals like porcupines with spines have adapted. Newborn porcupines have soft spines that harden hours after birth.


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