The realities of Giving Birth 101:
Things that may Exit your Bodily Orifices
I tend to shy away from listicles, however I thought this may be helpful for those of you who are wondering about all of the wonderful and not so wonderful things that may come out of you when in labor and giving birth. If you have planned your birth as if it was your wedding day and would prefer to go into the birth experience without knowing all of the unpleasant aspects, this post is not for you.
Please do not be embarrassed or ashamed about what comes out of your body during your birth. Your care team has seen it all a thousand (or more) times before. If we were bothered by body fluids, we would have gone down a different career path.
1. Mucus plug
This is exactly what it sounds like- a thick glob of mucus in your cervix that helps create a carrier between the uterus, where the baby is living, and the outside world. It may come out in the weeks prior to labor or it may come out while you are in labor. If it comes out prior it is still ok as long as your membranes are intact the baby is separated from the bacteria in your vagina.
2. Bloody Show
This one is a little more interesting and not as scary as it seems. As your cervix starts to dilate and thin out in labor, typically as the transition is occurring to active labor, you may notice some spotting or light bleeding. This is called “bloody show” and is a normal part of labor. If you have more bleeding like a period and you are not already in the hospital, contact your provider right away and go in for evaluation.
While not everyone pees on themselves in labor, it can very likely happen. If you get an epidural often a foley catheter is placed in the bladder but this is removed close to delivery.
4. Spit and Vomit
Being in labor can cause you to become very nauseous and spitting up/ vomiting when contracting or when pushing is really common.
5. Amniotic fluid
Whether your water breaks naturally or your OB provider recommends augmenting labor by rupturing the amniotic sac, you will experience leakage of amniotic fluid. Depending on how much amniotic fluid you have and how applied the baby’s head is to the cervix when your water breaks it may be just a small trickle or a large gush. If you think your water has broken and you are not already in the hospital, call your provider.
Sometimes the baby poops before they are born and then meconium, which is what we call their first poop, is mixed in with the amniotic fluid. Sometimes they poop as they are squeezed out of the birth canal when you give birth and they leave you with a meconium present on your perineum or abdomen when placed skin to skin.
7. Gas and Stool
It is really common to pass gas and stool while you are pushing and after giving birth. The baby’s head is big and pushes directly on your rectum so with a vaginal delivery to make enough space for delivery often all the poop needs to come out. Passing gas goes along with this, and after giving birth the sphincter is relaxed and gas may come out without knowing- it’s all ok.
8. A baby
This, hopefully, was anticipated. A baby will exit your body when you deliver. And yes, they will also be covered with lots of fun things such as amniotic fluid, blood, vernix (a creamy natural lotion-like substance that covers a newborn’s skin), and possible pee or poop upon entry to the world
This is the afterbirth- a whole organ your body grew to support and feed your baby. It typically comes out within 30 minutes of birth and may be accompanied by a gush of blood. Some people want to see their placenta, some do not. The side that was attached to your uterus looks like liver (I have been told by those who have cooked liver before). I think it is a fascinating and beautiful organ, but as an obstetrician I am pretty biased.
Besides the bloody show and light bleeding/spotting that may occur with labor and pushing, after the baby and placenta it is normal to lose some blood. It is typically around 200–300ml but can be more or less. With a hemorrhage which is an obstetric emergency, you can lose a lot of blood very quickly. Stopping the bleeding often requires special medications, blood transfusions, and/or surgery.
If you have not noticed leakage from your nipples at the end of your pregnancy, you will notice the colostrum after the baby is born- the nurse may help you learn how to express it, the baby’s latch will stimulate release, and it may come out spontaneously at the site of your baby and hearing their cries.
I hope you are not grossed out after reading this. I tell my patients that in retrospect the whole process, no matter how it unfolds, will be over in the blink of an eye. The lifelong relationship with the beautiful soul you bring into this world is what lasts.