Nursing Birth

One Labor & Delivery Nurse’s View From the Inside

The Good, The Bad, and The Icky on Vomiting in Labor October 19, 2009

vomiting logo

 

Submitted on 2009/10/18 at 9:43pm

Comment left at: Top Ten Things Women Say/Do During Labor (And trust me… they are totally normal!)

 

 

Dear NursingBirth,

 

Hello, I know this is an old post, but I’ve been searching information on vomiting during labour for a few hours (lol!) and can’t quite find what I’m looking for.  So with the housework waiting I thought I should just come out with it and ask!  Your post is very informative and you seem lovely so I hope you are able to help me! (Or others who have been through it!)

 

I have emetophobia (fear of vomiting), and find I am able to calm myself about the potential of vomiting (because I have had to face that fact that I can’t just escape it!), if  I

 

#1: Know that “everything will be ok” if I do vomit. (i.e. Mainly that people won’t be disgusted, or freaked out and that someone will be able to deal with, well, the result, if I’m not able to.  Even though I’ve never vomited anywhere except in a toilet, it’s just the potential that terrifies me!  My husband is a wonder, and it’s only actually since being with him that I’ve begun to get over the phobia because he’s not scared about it, and not fazed by it).

 

And

 

#2: Remember that I can handle vomiting much better if it isn’t preceded by hours and hours of painful nausea.

 

 

SO, I find myself trying to prepare mentally for the possibility of throwing up during labour, and I have some questions stemming from this for you (I know it is an irrational fear, and these questions seem trivial but they are things that really stress me out – I actually lose sleep over them – so I appreciate your answers):

 

#1 Will the midwives be ok if I throw up all over the place? Will the staff get disgusted or freaked out?

 

#2 Will the staff clean it up or will I or my husband have to?

 

#3 What happens if it gets in my hair?

 

#4 Will I choke because I might be lying down?

 

#5 Will everything be okay if I do vomit?

 

And, finally

 

#6 Is it a different kind of vomiting – one that just kind of happens, rather than following hours of terrible nausea?

 

 

Anyway, I don’t mean to waste your time, and many thanks in anticipation of any answers – I’m just trying to mentally calm myself so I can focus more on the really important things about labour – like my baby!!

 

Sincerely,

 

NervousMumToBe

 

 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

 

Dear NervousMumToBe,

 

 

First of all I am sending you one MAJOR cyber *HUG* right now complete with back patting and me saying “You can do this!!”  :)

 

 

Second, you are NOT wasting my time so don’t mention it!!  I have written before about worrying, that is that “WORRY is the WORK of pregnancy!”  In her book Birthing From Within, certified nurse midwife Pam England tells the story about a patient of hers (Hannah) that worried a lot about having a natural birth experience after having had a highly medicalized birth with her first baby.  She writes that Hannah longed to hear her say things like “Don’t worry” and “Everything will be alright” but instead England encouraged her to face her fears.  She instructed Hannah to write down all of her worries and explore each of them with questions like “What, if anything, can you do to prepare for what you are worrying about?” and “If there is nothing you can do to prevent it, how would you like to handle the situation?” 

 

 

 England lists the “Ten Common Worries” of Labor as:

 

1)      Not being able to stand the pain

 2)      Not being able to relax

 3)      Feeling rushed, or fear of taking too long

 4)      My pelvis not big enough

 5)      My cervix won’t open

 6)      Lack of privacy

 7)      Being judged for making noise

 8.)      Being separated from the baby

 9)      Having to fight for my wishes to be respected

10)  Having intervention and not knowing if it is necessary or what else to do

I would like to add #11:

           11) Fear of pooping in labor/Fear of embarrassment regarding bodily functions

 

 As you know I am a labor and delivery nurse and have estimated that I have been present at over 300 births during my career and still, I would have to say that when it is my time to give birth, #1 through #6 are top on my list of worries!!  And I witness the amazing power of women everyday!!  So NervousMumToBe, don’t *worry* about “worrying” about vomiting!  I am so happy that you are FACING YOUR FEARS!!  If vomiting is something that you are really concerned about, no matter how trivial it might seem to others, it is important to you and that is all that matters!  So I applaud you! 

  

Okay now that the most important thing is out of the way (i.e. the hug) lets get down and dirty about the #2 thing on every pregnant woman’s mind…VOMITING IN LABOR!!  (If you are wondering what the #1 thing on every pregnant woman’s mind is it is POOP.  Don’t believe me?  Check it out here.)  I want to preface the following post with a few things in the interest of full disclosure:

 

  • I am drawing from both my experience as a labor and delivery nurse (as well as a medical/surgical nurse and nurse’s aide) and the research I have read on this subject to write this post as I do not have any personal experience with going through labor myself.  That being said…

 

  •  I have thrown up a time or two myself (I did go to college after all :) ) and know how it feels to do so.

 

  • Some readers might have personal experiences that are different than what I describe.  However it is important to remember that if I make a statement like “In general I have found most women in labor to do x, y, or z” I do not mean to say that there isn’t anyone out there that had a different experience.  There are exceptions to every rule. 

 

  • Although I have only been working as either a nurse or nurse’s aide for approximately 5 years (which I understand does not make me the most experienced nurse out there) I have certainly been working directly with patients for long enough to know a thing or two about bodily functions, including when they are likely to happen, how to make someone feel better, and how to clean them up.

  

  • I cannot speak for every labor and delivery nurse and midwife out there.  After all, I have only worked in one labor and delivery ward (not counting nursing school clinical).  But since you asked me I will answer your questions as if I was your nurse or midwife.  I will also take into consideration what the other nurses and midwives I work with on a daily basis would do and how they too would react to the situations you present.   

 

 

Now to some answers!!  I will take your questions one at a time:

 

 

#1 Will the midwives be ok if I throw up all over the place? Will the staff get disgusted or freaked out?

Yes and No!!  YES!  The midwives and the labor and delivery nurses will be okay if you throw up all over the place and actually, they probably will not even bat an eye if you throw up!  And NO!  The staff will not get disgusted or freaked out if you throw up!  If bodily functions bothered us, we wouldn’t be working in healthcare!  I have been thrown up on before…more times than the average person for sure!  I have been splashed with blood, amniotic fluid, pee, spit, and mucus.  I have also cleaned up my fair share of explosive diarrhea.  And if I do get splashed with something I just kept on doing what I was doing until I have a break where I can go change.  (Remember L&D nurses usually have to wear hospital scrubs just in case they end up in the operating room.  The other bonus to this set up is that if you get splashed with something gross then you just go in the locker room and change into a new pair of hospital scrubs!)  I am sure over the course of time there has been some burnt out nurse that has said something really nasty or insensitive to a mother if she has thrown up but in reality, it’s all part of the job and the vast majority of nurses and midwives don’t get bothered by vomit!

 

 

#2 Will the staff clean it up or will I or my husband have to?

This question is assuming two thing:  #1 That you are going to vomit (remember not all women vomit in labor) and #2 That if you do vomit that you will make a mess (remember not all women who vomit miss the bucket or don’t have a chance to throw up in a bucket).  That being said…

 

I know I can’t speak for every single nurse out there but I would NEVER EVER expect a husband (or any coach for that matter, including the mother herself) to clean up something like that.  After all it is the husband’s (or partner, coach) role to support the mother and if the mother did throw up, say, on the floor, I would ask the husband (partner, coach) to stay with the mother while I went to grab some towels to clean it up.  And then I would clean it up quickly.  And then it would be a non issue!  Done! 

 

One time I had a mother who was taken off guard by her need to vomit and accidentally threw up all over her bed.  She was very apologetic but apologies were not necessary.  I knew that she didn’t mean it!  With the help of her husband I walked her into the bathroom and had her sit down on the toilet to pee.  Her husband stayed in the bathroom with her.  Within 5 minutes I had the completely remade the bed with clean sheets.  Then I helped her into a fresh, new, warm gown and then back to bed.  It was like it never happened!  We all moved on and no one mentioned it again.  After all, who was thinking about a little vomit when there was a BABY about to be born! 

 

I learned from that experience and ever since then I always make sure that I give every mom a bath bucket when she is admitted and I put it right on her bedside table so that if she needs to throw up, it is right there for her.  Because I do this, I have rarely ever had a mother throw up in labor and not use the bucket.  Since you have a concern about vomiting, I would recommend that you ask your nurse for a bucket when you get to the hospital, just in case.  And when I say bucket I mean bath bucket (or wash basin), not those ridiculous kidney shaped “emesis basins” that wouldn’t even be helpful to catch ladybug vomit!

 

emesis basin and wash basin

 

Remember, although it is not rare for a mother to throw up in labor, it is rare that she throws up all over the place, or has no idea that it is coming.  In my experience the vast majority of moms who vomit in labor do indeed make it into the bucket and therefore, there is nothing to clean up!  Also remember that labor vomit is different that “stomach flu” vomit.  That is, there is no risk to me as the nurse of getting sick from a laboring woman’s vomit because it is not caused by illness.  I’d rather clean up your labor vomit over my own stomach flu vomit any day!

 

 

#3 What happens if it gets in my hair?

If you were my patient and you started to vomit I would hold your hair back.  And I am sure that your husband would do the same for you too.  That way you wouldn’t get any vomit in your hair at all.  Have you considered putting your hair into a pony tail or clip while you are in labor?  If your hair was up it would be very unlikely that it would get any vomit in it.  Perhaps you can pack a few extra clips or elastics into your hospital bag just in case you need them.  If you don’t usually wear your hair back you may want to consider wearing a few hair elastics around your wrist so that they are readily available if you need them to tie your hair back if you feel nauseous.  I also have been known to cut the opening off a rubber glove and use it as a make-shift hair tie for just this type of circumstance! 

 

However if a little bit of throw up did get in your hair and if I was your nurse I would probably wet a warm washcloth and clean it out.  And then I would put your hair into a pony tail or clip for you to get it out of your face.  If it was really bad (I have never seen this but I suppose that technically it could happen) and if your midwife allowed, I would help you into the shower.  After all, many women find laboring in the shower to be extremely soothing and helpful!

 

 

#4 Will I choke because I might be lying down?

NO!  You will not choke, even if you are lying down.  Only people that are unconscious, have an impaired gag reflex, or are debilitated in some other way have a risk of choking on their own vomit.  I have never seen a conscious laboring mother choke on her own vomit…NEVER.  Why?  Because every single healthy, able-bodied, conscious person sits up or leans over automatically when they start to vomit.  I have never even seen a mother who was positioned flat on her back and numb from the breasts down for a cesarean choke on her own vomit.  Why?  Because every single healthy, able-bodied, conscious mother in that situation automatically turns their head to the side to vomit. 

 

If necessary every hospital room and operating room has (or at least should have) a suction canister in it with a yankauer suction set just in case a mother does lose consciousness and her mouth needs to be suctioned.  You might not have seen it when you toured your hospital because most birthing suites keep that kind of equipment behind pictures or in cabinets so that the room doesn’t look too “hospital like.”  But they are there.  I personally have only had to use the yankauer suction set ONE TIME as a labor and delivery nurse and I used it because my patient had an eclamptic seizure (a rare complication of preeclampsia) and when she came too she was really out of it (“post-ictal”) and her mouth needed to be suctioned because it was full of secretions.  That’s it, one time only.   

 

 

#5 Will everything be okay if I do vomit?

YES!  In fact, labor and delivery nurses get excited when they see a patient vomit because vomiting is usually a sign of transition which is the last stage of active labor (usually 7-10 centimeters) right before a women begins the pushing phase.  Remember whether or not she has been eating throughout early labor, a woman may still vomit when she enters transition so it is not necessary to starve yourself on purpose because you are afraid to vomit later on.  In fact, some women vomit because they have done just that!  (I know I personally get very nauseous as well as get a headache if I haven’t eaten anything all day).  I always think of it as a way the body is “making more room” for the baby! 

 

Also since vomiting, like holding your breath or making a bowel movement, is a vagal response, it inadvertently helps your cervix dilate and hence, is a great sign to a labor & delivery nurse!  The body does awesome things to help the process along!  So really it is not just okay if you vomit, it is GREAT if you vomit because it may help you cervix dilate!  I also want you to know that you will not hurt anything if you vomit, including the baby or your cervix.

 

 

 

#6 Is it a different kind of vomiting – one that just kind of happens, rather than following hours of terrible nausea?

 

In my experience as a labor and delivery nurse most women who have a natural, unmedicated, spontaneous labor do NOT have hours and hours of nausea before they vomit.  Instead, once there labor really starts to ramp up for the last few centimeters they get a feeling of nausea that gives everyone enough warning to grab the bucket and then they throw up.  After throwing up, the vast majority of women have told me that they feel better.  It is very rare that I have taken care of a woman who continues to throw up once they are 10 centimeters dilated and begin to push or is nauseous for hours and hours before they vomit.  That being said…

 

Nausea and vomiting are very common side effects of narcotic pain medications (e.g. stadol, nubain, demerol, morphine etc.) as well as ALL forms of anesthesia (including labor epidurals as well as spinal blocks often performed for cesarean sections).  Because of this, some physicians and midwives prescribe an anti-emetic (aka anti-nausea medication) like Phenergan, Zofran, or Reglan to be administered with the narcotic, epidural, or spinal to counter act this side-effect.  Sometimes it helps, sometimes it doesn’t.  Because you have such a fear of vomiting I want you to be aware of this fact.  

 

 

So there you have it: the skinny on vomiting in labor!  I hope this has helped calm your fears and worries however if you have any more questions about this topic please feel free to leave a comment!! 

 

Thank you for writing in to me.  You are certainly not alone in your fears!!!  I know that your question will help other women out there who experience the same fears as you!  GOOD LUCK with your upcoming birth and CONGRATULATIONS to you!!!  And remember, although birth might be one of the messiest experiences of your life, no amount of fluids, cursing, farting, pooping, striping naked, howling, crying, peeing, bleeding, or vomiting will take away from how honestly empowering, mind blowing, and touching this experience can be for you and your family!!

 

 

Sincerely,

 

NursingBirth

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80 Responses to “The Good, The Bad, and The Icky on Vomiting in Labor”

  1. Terra Jones Says:

    You could also say that some women do not vomit. I’ve been in labor twice and never even had the urge to throw up…so it may not even happen! :)

  2. Nursing Birth, I just love you! I share so many of your posts with my students and clients! just wanted to say thanks!

    Sharon

  3. This is a very thoughtful response and provides information that the original commenter can use and that will make her feel better about the process and gives insight in to how others will feel around her is she should vomit.

    This is NOT like the comment from the Anesthesiologist posted on the website My OB said WHAT?!?, which was rude and unsupportive!

    http://myobsaidwhat.com/2009/10/08/we-prefer-you-be-surprised-like-the-rest-of-us/

  4. Nursing Birth,

    I just love your blog and your posts! I am so delighted to pass them on to students and clients! thank you for all the time and energy you put into this!

    Sharon

  5. Lauren Says:

    thank you so much for this!
    I spend my life in fear of vomiting, and i am more worried about vomiting in labour than I am of anything else. Sounds silly and very few people around me understand this.

  6. hillary Says:

    Great post. Just sharing my experience on the continuum in the hope it will reassure those who are fearful. I felt nausea briefly during labor. I thought I was going to throw up during a couple contractions and leaned over a bowl during them, but I didn’t. And then I felt better. It was a non-event. I should also add that I ate and drank normally (three light meals during my 24 hour labor) so I didn’t have an empty stomach.

  7. Amy Says:

    As a nurse and a doula, I really got a kick out of this post. That picture of the wash basin and the emesis basin made me laugh so hard! They really are useless…I want to know who came up with such a poorly-thought-out design. The only thing I ever use them for in my practice is to help with brushing teeth while in bed.

    I also went back to read the post on poop, and both of these definitely reinforced my feelings about my upcoming birth: I’m going to do what I need to do to get this baby out, and the people who are there supporting me through it won’t mind anything else that comes out of me in the process! =)

    • NursingBirth Says:

      Amy, sounds like you have my sense of humor!!! Hahaha! I also only use those emesis basins for brushing teeth in bed!

      You write, “I’m going to do what I need to do to get this baby out, and the people who are there supporting me through it won’t mind anything else that comes out of me in the process! =)” And I say THAT’S THE SPIRIT!!!

      • atyourcervix Says:

        I agree with you totally on the uselessness of “emesis” basins. They totally need to be “chucked” out. Pun intended :-) The big basin is the way to go if you’re going to vomit.

        And truly – we don’t care if you vomit in labor – we actually get excited! That means TRANSITION!!!!!!

  8. elizabeth Says:

    Hey Lauren,

    I just wanted to let you know that I have a fear of throwing up too, and it is one of the biggest things that scares me about labor (I’m not pregnant). Heck, it scares me so much that I question if I should even have kids!

    Nursing Birth, thanks so much for all of the helpful information! I have one more question to add to the list… Are laboring women ever allowed to throw up in the toilet (assuming they are allowed to move around)? I’m kind of scared of throwing up in a bucket…

    • NursingBirth Says:

      elizabeth, if you want to bow down the the porcelain god during labor by all means no one is going to stop you!! Haha! No but seriously, some women don’t want to bend down that far (or can’t because they are pregnant) so many nurses offer them a bucket instead! That is the only reason I talk about a bucket as opposed to a toilet! But if you feel more comfortable throwing up in the toilet and you are in the bathroom, it would totally be cool if you threw up in the toilet.

  9. briome Says:

    Very nice post!
    I really don’t like to vomit…not a strong ‘fear’ like some of you ladies but I do very understand wanting to avoid vomiting. I didn’t feel a need to vomit during birth (either of my two births) but did want as much priviacy as I could get. I did create a lot of blood with my second birth and my midwives assistant stated that she had never seen so much blood before but was glad that she knew me before hand! She was sweet and well meaning…but needs more training! You will come out the other end of birth with or without vomit!

  10. lisa b. Says:

    Thank you for addressing this! I too had a huge fear of vomiting in labor – I knew it would just break my mental strength. But I put it in my birth plan for my midwife and nurse so they knew about it and were super supportive. It didn’t end up happening, but I knew I was in good hands. Nice to know we are not alone!

    • NursingBirth Says:

      lisa b. what a great idea to put your “fear” of vomiting in your birth plan. that way, all the nurses who took care of you would be aware, without you having to remind every one!

  11. Great post! I’d like to add that I love a cool washcloth with peppermint oil during transition. For both my births, I had a few moments of nausea and found this helpful AND I didn’t vomit.

    • NursingBirth Says:

      Inexplicable Ways, what a great tip! I usually offer a cool washcloths to my moms but never thought of peppermint oil :) Thanks!

      • Alethea Says:

        A little peppermint oil in the toilet also seems to help when a mom doesn’t have the urge to pee after birth. Moms are encouraged to empty their bladder by two hours after delivery (especially if they got an IV fluid bolus with pitocin after delivery) because a full bladder gets in the way of the uterus contracting down and cutting off the blood flow that used to be going to the placenta. Try it sometime and you might avoid a mom needing a catheter if she just can’t go.

        • NursingBirth Says:

          What great ideas about peppermint oil I am learning today! Where does one get this peppermint oil? Is is just peppermint essential oil? Do you just keep a little vial in your pocket at work?

        • NursingBirth Says:

          Alethea and Inexplicable ways, I just want you to know that I went to my local “organic/earthy” store today and bought some peppermint oil. The lady a the store told me to dilute 10 drops of peppermint oil in 1 oz of grape seed oil (both are food grade/cosmetic grade and therefore safe to actually use on skin, etc.) I am so PUMPED to try it out! I bought a 4 oz bottle of grapeseed oil and put 40 drops of peppermint oil in it and I am going to keep it in my pocket for use at work! Thank you so much for this tip!

          • Alethea RN Says:

            No problem. We actually got our hospital to stock Peppermint oil in the pyxis! I actually learned the pee trick from the MedSurg nurses! If you are wanting to put the oil on your skin your need to use grape seed, almond, or some other kind of oil. But we use it un-mixed and drop a few drops in the pee “hat” that we put in the toilet to measure the first void. Sometimes I will put some drops of it in a basin of WARM water in the room to remove unpleasant smells…poop, vomit, dad’s stinky feet, whatever. If you are using it for environmental smells try mixing it with some lavender oil and using the warm water basin trick or place a few drops on a light bulb in the room. Enjoy!!!

            Also, can someone post the manufacture’s name of the vomit bags? I’m going to see if we can start to carry them at our hospital.

  12. Nursing Birth, what an incredibly sensitive and thoughful and informative response to a very good question. I’m sure you’ve just helped not only the original poster but also some other mothers out there who have had the same question but have just been too embarrassed to ask. THANK YOU for your amazing work here!

  13. I only threw up with my first birth…that’s only one out of six. I threw up in the sink as I was walking around the room….and had the urge. It was soon after that my baby was born.

  14. PurpleRN Says:

    Can I please steal and re-post your basin pictures on my blog? I promise to give credit. :)

    It’s hands down the funniest thing I’ve seen online today… Maybe it’s cuz I had a nauseated patient yesterday who only had the little emesis basin. Luckily, I swapped it out in time…..

  15. OT:

    As a side note, as a childbirth educator I found myself having to face a lot of fears since I’m “in the know” of the potential happenings during birth – even if they’re rare.

    A fellow instructor suggested that I write down all my fears.. then under each one write down the exact opposite (ie the positives) that I would WANT to happen.

    then erase the negatives and keep the positives.
    I found that this help tremendously for my emotions and mental attitude. =)

  16. Jill Says:

    This is such a kind and thoughtful post! I can’t say I have ever been afraid of throwing up in labor, but if I was, this post would have made me feel 1,000 times better. :)

    NervousMum, don’t worry! I had to throw up during my second labor, I knew it was coming, so I told the midwife, she grabbed the bucket, I threw up twice, and that was that. It was very matter-of-fact and not a big deal at all. In fact, she was excited because she told me I must be close to complete if I was throwing up! (Which I was!)

  17. Kathy Says:

    I threw up during my first labor but not my second (both home births). The first time, I had just eaten a large meal right before my water broke and contractions set in; and within a few hours, I threw it all up. Although I wanted *nothing* to eat or drink, the midwife kept “encouraging” me to drink apple juice, so I’d take a sip, and then throw it right back up within a contraction or two. [I kinda felt like it was their problem if they didn’t like the puke, because they were the ones making me drink when I didn’t want to. Served ‘em right. ;-)] During pushing, I felt like my blood sugar was a little low, so asked for apple juice, felt revived, and it stayed down.

    Second time, the ctx were widely spaced for 24 hours, I kept waiting for labor to start, and I ate and drank as I wished (although I don’t particularly remember either eating or drinking; I know I must have because of how long it was), and never had the slightest bit of nausea.

  18. Joy Says:

    Well my hospital must have just sucked with my second daughter’s birth because they gave me an emesis bowl thing to throw up in. I ended up getting some vomit on myself, of course! So to the NervousMum— make sure you get the BIG bucket if you feel nauseated!!!

    I threw up a lot with my second birth as well. I hadn’t eaten anything and was really and truly hungry. They refused me food and just gave me a popsicle (so gross). And then the epidural and pain medication made it worse. They didn’t think to give me the anti-nausea to counteract it until an hour after I delivered when I was still feeling so ill I wouldn’t hold my baby for fear of puking on her.

    So all of that to say- SPEAK UP! If you need a larger bucket to vomit in, ask for one. If you feel nauseous and want relief, ask for the anti-nausea. It made me instantaneously feel better and I stopped puking.

    • NursingBirth Says:

      Oh lordy what a story Joy! I just want to add however that the anti-nausea medication probably helped you Joy because part of your nausea might have come from the epidural and narcotics. Anti nausea medication usually does not work for a women who is nauseous from an unmedicated, spontaneous, natural labor. Usually if a woman in that situation in nauseous the only thing that will make her feel better is actually throwing up! But you are absolutely right. If you have taken medication for pain please don’t hesitate to ask for anti-nausea medication to help with the side effects of the medication.

  19. Katie C. Says:

    ha ha – i ate bananas and drank gatorade in labor at home. when i got to the hospital, the nurse had a hard time with my iv. i puked bananas all over the resident. and you know what? i didn’t care at that point at all… i was in transititon.

  20. Jessica Says:

    I almost woke my son from his nap laughing about the basin and emesis basin!!! WHY do they call it an emesis basin?!? We use it for bedbound people who need to brush their teeth! ;)

  21. nervousmumtobe Says:

    NursingBirth that is the most helpful and sensitive response I could ever have hoped for, thankyou thankyou thankyou! I feel 1000 times better knowing I can address each of my fears with a mental “nursingbirth said…….”.
    I certainly hope I am fortunate enough to go through my labour and delivery with as kind and helpful staff as you! If I wasn’t half way across the world, I might even have tried to get to your hospital! haha!
    It’s great to know I am not alone – not that I wish being fearful on anyone! – and really helpful to hear some other mums’ experiences with vomit in labour, too, so thankyou everyone and for posting comments as well. I feel well able to prepare myself mentally and deal with the situations that scare me should they arise.
    NursingBirth I just can’t say how grateful I am and how much it means, even just to have been heard, and respected despite my fears – your kindness is overwhelming (I cried all through your cyber hug:) ), and I’ll be grateful forever, truly!!
    My ultimate hope is for a *relatively* calm birth, but mostly of course a healthy and happy baby, and I feel more able to focus my energy towards that (amazing!) goal now. I will definitely let you know how I go; as I will definitely recommend your blog!!
    Many blessings and more thanks than I can say,

    *MuchLess*NervousMumToBe xxxxxxxxxxxxx

    • Danielle Says:

      Wanted to add in my personal experiences too. With my first I had an epidural and absolutely no urge to throw up. With my second I had a natural water birth and only had the urge to throw up for one contraction right at the start of pushing, and I didn’t throw up at all. The urge went away quickly too.

      Good luck on your upcoming birth and it really is all worth it when you’re holding your baby!!

    • NursingBirth Says:

      NervousMumToBe, You are SO WELCOME!!!! I am so glad you enjoyed my “cyber hug”! I wish I was there with you to be your labor and delivery nurse! We would rock it together!!! You are going to do GREAT!!

      LOVE, NursingBirth

  22. Erin Says:

    Just wanted to chime in and say that I vomited for hours and hours during early labor. (Let me just say, I was the pregnancy vomiting queen. Seriously. It was ridiculous.) I’ve read another report from another laboring mom with the same experience – both of us has rapid onset of regular and intense contractions (immediately 5-6 minutes apart, no BH before or warning that labor would commence). I was at home, and always had a bucket. But I would say this: If any laboring mom is vomiting in early labor and cannot stay hydrated, please call your doctor to ask if you should come in and get IV fluids. Dehydration + labor is not a happy combination. Don’t assume “oh this is normal thus I shouldn’t do anything about it.”
    And ditto on not being afraid to ask for anti-nausea medication!

  23. Lori Says:

    Well, while I am not afraid of throwing up, I am familiar with the fear. I think it is safe to say my mom is emetophobic. She has not thrown up (I kid you not) since June of 1968. Even when she had morning sickness during her two pregnancies, she willed herself not to throw up. I don’t know how, I guess mind over matter is very powerful!

    Anyway, I thought I would also share my labor/vomit stories. I had 3 natural births, so did not experience the nausea of pain meds. With my first labor, I had some nausea and dry heaves, but never actually threw up. With my second, my labor was kick-started by a stomach virus that had me throwing up and having contractions at the same time. I do not recommend a stomach virus as a labor inducer. ;-) And with my third, I had the urge to throw up during transition. The birth assistant handed me a trashcan (homebirth) and I threw up 2-3 times during contractions. The midwife said throwing up is actually good because it helps the baby move down further into the pelvis. (And sure enough, my baby was born about 20 minutes after the vomiting!)

    Thanks for a great post! Best of luck to Nervous Mum To Be!

  24. Renee Says:

    I had a fear of pooping. I did worry bout it, i am kind of scared of anything to do with back there. I agonized over my GBS test for weeks. But when it came down to it, I wasn’t thinking of poop, I was thinking of working to get my baby out, I had not one thought of poop. And I did vomit, but I had an epi (2 doses) and tried the stadol before that. So probably those and the pushing made it happen, but no one missed a beat. I was laying down and they helped me sit up and took care of it right away, and I felt much better afterwards. The worst part of fear is often anticipation, I’m sure you will get through it like a champ! Good luck and congrats!

  25. bridget Says:

    I just wanted to add my Emergency Room nursing 2 cents (and 4 more cents for doing a decent amount of pucking as a pregnant lady) regarding the equipment hospitals provide for vomitting patients. The BAGS work waaaaaaayyy better than those yellow or pink “buckets/basins” Some hospitals have the bags, some don’t. Those awful plastic walmart bags might come in useful here! You could stuff a bunch in the maternity bag just in case. I find that patients can vomit in a bag much more comfortably (there’s no splash back!), plus they are completely disposable.

    So I have to admit MY fear regarding my upcoming labor… how in the world to you protect your mattress from amniotic fluid?! I know that only 10% of women experience ROM as the first sign of labor. But my husband and I recently bought a new mattress and I dont’ want to mess it up :) I did some internet sleuthing and read a few threads and determined that a simple mattress pad will help protect it. Do you think it would be extreme to place towels under the mattress pad? I think this might be the only thing I’m feeling a little neurotic about. Bring on the rest of labor!

    • Kathy Says:

      I had a plastic cover on my bed — we made up the bed with a sheet, plastic cover, then another sheet on top — that way if my water broke in bed, the plastic would protect the mattress, and all we would have to do was strip the bed and *voilà* perfectly clean and made-up bed.

      As it turns out, I was one of the 10% of women whose water broke prior to labor beginning… but it broke when I was sitting on my couch. But even then, I didn’t know for sure, because it wasn’t a huge gush of fluid — I heard it and felt a tiny bit of fluid, and the gush didn’t happen until I walked down the hall to the bathroom to see if my water really had broken.

      Still, by all means — if it makes you feel more comfortable or more relaxed, put towels under the mattress pad, or get a plastic sheet — no need to get all antsy and neurotic over messing up your bed when it’s easy to protect it! :-)

      • Aimee Says:

        When we made up the bed for my home birth, we layered a plastic tablecloth with a flannel backing, then a fitted sheet, then another table cloth, then another fitted sheet. The tablecloths were nice because with the flannel backing they didn’t slip and slide around.

    • Alethea Says:

      Bridget,
      I have mean little kitties that like to pee on our beds when they are mad at us for being out of town. I was able to find a waterproof mattress pad that we now put on the beds when we are gone. I don’t think they are too expensive, and maybe more comfortable than a sheet of plastic.

      Good luck! And I’ll try your bag suggestion next time I have a nauseated mom in labor.

  26. Kate Says:

    I threw up during two periods during labor – first when I got to the hospital and was 6cm, and second during transition. I think the first was due to being nervous about actually being in labor.

    I just wanted to add a few things to this great post:

    1. My hospital had these little throw up baggies. They had a ring on the end so you could easily cup one hand around them and hold them up to your mouth. Then you could just toss the bag away. I think I went through about 5 of them.

    2. Throwing up during transition actually felt really good. It distracted me from the contractions and afterward I felt lighter.

    3. I threw up all over the yoga ball that I was leaning on during contractions. The doula and nurse cleaned it up immediately and it wasn’t a big deal at all.

    Hope this helps someone!

    • beth Says:

      I threw up in labor when the contractions got really bad, which for me was before I got to transition (and by the time I was in transition, I had an epidural). At the birth center, they had two of those square basins and the nurses kept trading me a clean one for a barfy one, and they would go empty the barfy one.

      1. Me too! When I transferred from the birth center to the hospital, I turned in my big square basin for one of those plastic bag with a ring things. That was awesome! I could hold it easily one-handed, and didn’t have to worry about spilling it. That barf bag was my favorite part of that stage of labor.

      2. Me too! They kept offering anti-nausea meds, and I kept saying no thanks. Throwing up felt really good – it gave me something I could actually *do* during the contraction (other than try to breathe and relax, which didn’t do squat). And I knew that once the pain went away the vomiting would too. (I was right. After I got the epidural I felt great.)

      3. I didn’t throw up on anything interesting though, just in the bag.

      • NursingBirth Says:

        Everyone is raving about these vomit bags with the ring! I have never seen such a thing! My hospital doesn’t have them! I WISH WE DID!! They sound great! I would probably always keep one in my pocket! Oh man I never thought I’d be jealous of a bag used to puke in!! Hahahaha!

        • bridget Says:

          NB, even better than 1 in your pocket is the dixie cup like holder that can be purchased separately and installed all over the place! There is another model that I’ve seen used on ambulances that have a zip tie like ring that you pull shut, like a zip tie, to throw away. These ones don’t have a wall holder though. The dixie cup ones are blue with a white cardboard ring and the zip tie ones I believe are white with a red biohazard symbol and red zip tie. Maybe you can suggest it to your nurse manager :)

  27. lpnmon Says:

    Does anyone know WHY transition causes vomiting? Physiologically, I mean. And does epidural use prevent it? I didn’t have any n/v with my first 2 (epidural-ized) births, but did during transition with #3. Or was that just how it worked out for me?

    Great post, NB!

    -lpnmon

    • Kathy Says:

      Not everyone vomits during transition; and not every vomit during labor is a sure sign of transition — I didn’t throw up at all during my second labor, and didn’t throw up during transition of my first labor.

      I’ll take a stab at the “why,” but I’ll just say this is an educated guess, and hope that someone with more knowledge can chime in with hard facts, if they’re available. :-)

      During labor, your digestion slows down, and a lot of times food is just too much for your body to handle at the time. I ate an especially heavy meal (delicious Chinese, with stir-fried rice and all that) right before going into labor the first time, and I think my body just couldn’t handle the oil, or perhaps the size of the meal, or something, so my stomach revolted. ;-) It’s sort of the same reason for why many women have diarrhea or loose stools a day or two before going into labor — cleaning out the body because there’s a big job ahead.

      • Danielle Says:

        I think it’s more to do with the fact that vomiting is a vagal response, not whether or not you have eaten something (eating and drinking is labor can be GOOD). Pushing, pooping and vomiting are all vagal responses so doing one (or your body getting reading to do one, ie transitioning) causes your body to do the others.

  28. AB Says:

    I threw up when I was giving birth at the start of transition. I was in the hospital and they hadn’t given me a bucket or anything. It all went on the floor. The nurse came in to clean it up, and she said that it was a good sign that things were progressing. I didn’t have any nausea beforehand; it came on very suddenly.

  29. Aimee Says:

    I threw up during both my labors. I also had pretty awful morning sickness during the first trimesters (and a little longer with my second) and threw up a lot. I got good at throwing up, even though I hate it more than almost anything. During my first labor, I was at the hospital, with an epidural, hadn’t eaten in over 12 hours, and got that overwhelming feeling, told the nurse and my mom (a former L & D nurse at the hospital), someone grabbed me a bucket, I did it and was done. During my second labor, I was at home, eating and drinking normally and my labor had stalled the day before. It was about 5:15am, when I jumped out of bed with a killer (back labor) contraction. I also got intestinal cramps, diarrhea, and nausea at the same time. I think I had two or three contractions on top of each other, while I bounced up and down on the toilet (sitting made the cramps & diarrhea feel better, but the contraction way worse and I couldn’t decide which feeling was worse) and then started throwing up in the trashcan. It was probably the grossest and most painful and uncomfortable 5 minutes of my life. One hour later, in the bathtub at my parents’ house, I gave birth to a 7lb 9oz, 21″ long baby boy. It was crazy to been woken up IN TRANSITION and give birth an hour later. So the Poop and Vomit posts are near and dear to my heart. :-D

    I love your blog!! It’s wonderful!

  30. Alethea RN Says:

    I’m not sure about why transition can cause nausea and vomiting I might just have to do a little research on that. I do not think an epidural prevents nausea and vomiting during transition however. If it is in your cards, it is in your cards, epidural or not. I have cared for women with epidurals who had nausea (not accompanied by a drop in BP with the epidural- which can also cause nausea) and that was what triggered me to check their cervical dilitation… and low and behold they were complete!

    I think every aspect of labor is different for every woman, and different for the same woman with each differnet pregnancy and birth. If we can keep in mind that we need to be open to every outcome, every possibilty in labor, I think women will be less dissapointed in what they actually get. Attachement to an ideal of what we hope birth will look like for us only sets us up to feel like a failure if what we didn’t want to happen does happen. Educating ourselves about all possibilities, working hard to accomplish what we hope our birth will be like, and facing our fears is important and empowering work. But when the birth fairy shows up and sprinkles her dust for a long pushing stage, or vomiting, or pooping, or an unexpected cesarean birth, being prepared for the potentials will hopefully go a long way in preventing birth trauma and feelings of failure.

  31. enjoybirth Says:

    I LOVE it when my doula clients vomit (which has only happened in 10% of the births I have attended. BUT I knew it meant the baby would be here soon. For both moms it didn’t bother them a bit.

  32. Tami Says:

    I think the vomiting is a reaction to the surge of hormones as you’re moving from one stage of labor to the next. I always vomit during my labors. In my last one, the labor had been much longer than all the others, and I had a couple waves of nausea that passed uneventfully. Then I finally threw up (all over my midwife’s Doppler!) and the midwives knew the birth was imminent–baby came just a few minutes after that. Once I realized that for me, vomit = progress in labor, I welcomed it! It was a sign that my body was moving into the next stage and it meant I was that much closer to holding my baby.

    As for the poop thing, I used an enema when I was sure I was in labor, because I didn’t want to have to worry about that. I was glad I did!

  33. Sarah Faith Says:

    Just thought I would share my story of vomiting my first birth was 42 hours and pain free b/c of hypnobabies and when my water broke (about 5 hours before I delivered and I must have been around 6cm-at least that what I was an hour after the water broke when I arrived at the birth center) I started getting sick. I threw up in my car (we threw out those mats!) and every few minutes at the birthing center. It seemed like if I ever took a sip of water or gatorade too big it made me throw up, but I didn’t feel nauseous until the moments before I threw up. The midwife gave DH an emesis bowl, which actually was fine for me since all the big stuff (the food I had eaten in labor) was thrown up already in the car.
    My second labor (3 weeks ago) was a homebirth and I never had any cervical checks so I don’t know where I was, but sometime during transition (I know because I was acting like a crazy person, crying and begging God to make it time to push) I threw up twice in a row, then I felt fine, I got back in the birthing pool and started pushing shortly after that. Oh and I had pain this time around, whether it was because I didn’t practice my hypnosis enough or because the labor was much shorter-9hours- I don’t know, but I will still use hypnobabies in the future.

  34. LOL…ladybug vomit? You are so right! I hate those emisis basins!

    BTW…I have had a few clients who vomit throughout first stage–even at low dialation. Without fail these women have poorly positioned babies.

  35. Alethea RN Says:

    Wow! Who would have thought there would ever be so many comments on a post about vomit in labor!!! So awesome for women who support birth and women who are preparing to give birth to have a great place for honest, open dialogue about things that aren’t usually talked about much!

  36. Jessica Says:

    ITA with those pink kidney shaped bowls being useless. I puked into one of those during my 2nd labor and it was so forceful that it splashed out the other side and onto my husband at the time. LOL I also dislocated his thumb during that labor. I was too out of though to see how it was taken care of – or to CARE! :-) I do throw up during my labors, but my completely unmedicated labor was by far much easier, I think I only puked twice and not much, compared to the numerous times during my medicated labors.

  37. kaiwhakawhanau Says:

    for a brief moment as a new L&D nurse I wondered if we should be giving laboring women ipecac to encourage vomiting as it seemed to have such amazing effects! Stalled labor? Skip the pit and go straight for the emetics!

    and it is true – we (nurses, midwives) really don’t worry about bodily fluids. vomit without fear.

  38. a newbie doula Says:

    NB, thank you so much for this post – last week, I had a client vomit through most of her labor, and when she began to flag and be disheartened by the up-chucking, I relayed to her your explanation of vomiting as a vagal reflex and how it actually helps open the cervix. She told me after the baby was born how well that helped her refocus and find peace with her body’s impulses.

    I am sending you great big cyber hugs!!!!

  39. Marissa Says:

    I vomited about five times during labor. I didn’t wait for transition, but instead the first time occured when I was about 4cm. each time I felt it coming for about 4-5 minutes (or one contraction) before it happened. I was able to get it in the wash basin each time, and since I knew it was coming I also was able to keep my hair out of the way. I also know I asked for something to vomit in when I was admitted, as it had already happed. and each time it happened the nurse took the wash basin and washed it out before giving it back to me. the one thing I would add it make sure you have a cup of water your partner can hand to you to rinse your mouth out.

  40. Sarah Says:

    I’m an emetophobic as well. This post has been interesting. My fears are more directed toward other people vomiting; I will do almost anything to avoid throwing up, but I can’t say that I’m phobic of myself throwing up.

    I’ve had 5 pregnancies; 4 drug-free deliveries and one 2nd trimester loss. I was sick for the entire 1st trimester of all 5 pregnancies, but was only sick one time with one of my 4 deliveries. I knew my water would break, and it did as I vomited. That was about 40 min before delivery, after a really long labor.

    My emetophobia is more of a problem, just the fact of having 4 kids. I don’t have an answer for this. I’d like to hear any tips that any readers may have. I try to keep my kids healthy (eat healthy, exercise & rest well) & boost their immune systems w/ vitamins. I breastfed them (and am still) until they self-weaned. The first really bad time of it was this past spring; we had almost 3 full weeks of the older 3 rotating who threw up. I nearly had a breakdown. My youngest baby was 5 mo old & exclusively nursed; I was so anxiety ridden that I couldn’t eat and lost 7 lb in that first week. I worry that it will happen again, another stomach bug making its rounds. And it probably WILL happen again at some point. After all, they’re only 7, 5, 3, and 1.

    How have other emetophobic moms dealt with this? NursingBirth, I hope you don’t mind if I hijack the comments a bit w/ this. OT, I’d love to see you get a Facebook fan page so we could more easily promote your blog & follow your posts. The Unnecesarean/Jill has done a great job of keeping up her Fan Page.

  41. stephanie Says:

    I’m not an emetophobe but I do find vomiting very painful. (thanks to repeated bouts of hyperemesis). My dry heaving & vomiting was left uncontrolled (no one even thought to give me anything to help despite being 2 cm) in my first (traumatic) induced labor and therefore is a trigger for me that I feel might impede my labor. I’ve put in my birth plan that I want meds for it if I ask. That being said, my second labor (my VBA2C with a VBAC happy OB) I thought I’d be sick when I hit transition, but nothing happened. It was just a couple waves of nausea that went away once someone got some ice on my face. Maybe just being aware of it and having a plan in place helped? I’ll never know, but it’s in my current plan for my rpt vba2c that’s going to happen any day now.

  42. […] 2. Vomiting uncontrollably. Until about a year ago, I didn’t know that it’s fairly common to vomit when you are in labor. Our friends had a baby last January, and I was horrified when I heard that she threw up with each contraction toward the end. I HATE vomiting. I know that no one likes it, but I have a certifiable fear of it and I fight it and fight it and get so worked up about it that I panic. I can only hope that it will be the least of my worries compared to having the pain and pressure of an 8 or so pound baby coming out my vagina. This Nursing Birth blog post helped as well: The Good, The Bad, and The Icky on Vomiting in Labor. […]

  43. profesora Says:

    thanks for this post…emetophobia is so seldom discussed (and i find that it’s more commonly discussed in the UK than here in the US). i am emetophobic and due in about 3 weeks and TERRIFIED of vomiting in labor, my ob is very supportive though and more than willing to give anti-nausea medication along with an epidural and even without, even for the placebo effect…

  44. Lisa Says:

    Why can’t I ever get nurses like you? I had one good nurse. I have had 7 births, 6 of which were nightmares.

  45. Neverbetter Says:

    Just wanted to say thank you for your post. As another emetophobe, and almost 8 months pregnant, I am approaching labor with plenty of reservations, most especially where vomiting is concerned. I have informed my midwives of my fear and they have put in a note to give me anti emetics when I get to the hospital (at least that’s the plan…) We’ll see how it goes.

  46. Kat Says:

    Just found this post – it’s written incredibly well! I’m an emetiphobe who has had two children and am also in nursing school to become a L&D nurse. I’ve worked long and hard to overcome my phobia and am SO looking forward to using my own healing to be of comfort to others who are as petrified as I once was of this very issue! I’m saving this post to help me when I stumble! Thank you!!!

  47. vomit phobia Says:

    As you rightly point out in your post, vomiting during labor is usually rare and quite normal. I find the emetophobia sufferer will mostly be concerned about morning sickness. As morning sickness usually occurs in the first trimester and it is in a lot of cases just nausea. The emetophobic mother to be can take heart in the knowledge that they may not actually be sick during their pregnancy.


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