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The Real Scoop on Labor

The two most common questions women have about labor are, when will it start? and, how much will it hurt? The answer to both: Who knows? Fortunately, there are plenty of answers to other questions we all have but are afraid to ask because they seem silly, scary, or downright gross. "There's an awful lot about childbirth that is, shall we say, visually unfriendly," says Margaret Buxton, M.S.N, C.N.M., a certified nurse-midwife with the Vanderbilt University School of Nursing in Nashville, Tennessee, and a mother of two little girls. From placentas to mucous plugs to bodily fluids galore, here's what you always wanted to know about childbirth but were too mortified to mention.

Q What if my water breaks in public?

A. First off, only about one in four women experience their water breaking prior to the onset of labor, notes Buxton. And if you suspect that you're in labor, you probably won't be heading out to get your hair cut or browse for antiques. Even if your water does break unexpectedly, your amniotic fluid is more likely to leak out slowly than to gush down your legs like a raging river. (Often, the baby's head will act as a "cork.") Meanwhile, it's not like people are going to think you peed in your pants. What's actually happening will be obvious to even casual observers, and they'll probably fall over themselves trying to help. Take all the sympathy you can get, because in a few short hours your baby will begin to show you no mercy, and that won't abate for the next 18 years, if ever. You can also greatly ease your anxiety by keeping a change of clothes in the trunk of your car or in your office. One caveat: If your water does break in public, call your health care provider. Since the risk of infection increases once the protective amniotic sac is broken, your provider will want to discuss when you should be admitted to the hospital or birth center.

Q. I keep hearing about this mucous-plug thing and it sounds totally gross. When exactly is it likely to fall out, and will it clog up my toilet or what?

A. We cannot tell a lie: The mucous plug isn't pretty. It's basically a gelatinous glob that seals off the opening of your uterus (think of a cork in a wine bottle). You can lose the plug -- a thick vaginal discharge of mucus, sometimes tinged with blood -- all at once or in pieces. If you do lose your plug all at once, it's not going to be any worse than a menstrual clot, says Kate Abello, M.D., an obstetrician-gynecologist in private practice in Baltimore, Maryland. Wear a pad or panty liner and be alert for other signs of labor, which may begin soon after or still be weeks away. Note that the mucous plug is different from "bloody show" -- a vaginal discharge of stringy mucus streaked with blood that precedes labor by a day or two.

Q. Women in my family tend to have fast labors. I'm terrified mine will begin at work and I'll have to deliver in front of my coworkers and male boss.

A. The short answer to this worry is to take an earlier maternity leave; if you're not in the office, it can't happen. You sure as heck aren't going to feel like being there the last week or two and will probably have lost so many brain cells you won't be that useful anyway. Seriously, though, discuss your family history with your health care provider. "Fast labors can indeed be a hereditary thing, and your doctor will want to be more vigilant about checking your cervix for dilation," notes Dr. Abello. "Then we can make sure you're in a safe place for delivery if we see signs of quick progress." If you would like to work up until your due date, pay superclose attention to subtle signs of labor (backache and cramping are not just backache and cramping at this point!), and make a quick exit on days you just "don't feel right." You can also ask your boss if it would be possible for you to work from home during your final stretch. Worst case scenario, if you do go into labor at work, insist that your colleagues clear out an office and call 911, so some cute firefighter or paramedic who you never have to see again can do the honors.

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