On February 8th, 2009 I wrote a post entitled Top Ten Things Women Say/Do During Labor (And trust me… they are totally normal!). This piece has been the most popular post on my blog yet, which is pretty exciting! When I originally thought of the piece, I figured that most women would stumble upon it by searching for something like “Things to do in labor” or “Things women say in labor”. However, upon reviewing the top searches of February/March for this blog, I was surprised to find that they didn’t include those phrases at all! Instead they all had one simple thing in common: POOP. That is right… poop!
Here are the top 7 searches for NursingBirth in the last two months: (Note: The wording is not altered at all…these phrases were actually typed into a search box and searched for!):
#1 Pooping in labor
#2 Will I poop while I push?
#3 How many women poop during delivery?
#4 Labor and delivery nurse poop
#5 L&D nurses and bowel movement during delivery
#6 Woman in labor thinks she has to poop
#7 What will happen if I poop during delivery?
Since I am a labor & delivery nurse, I am naturally inclined to jump on any opportunity to talk about bodily functions (especially during awkward times like dinner or outings with the in-laws J) and consequently, I have been inspired to write a post about, what seems to be, the number one thing on every pregnant woman’s mind…POOP!
So here they are: The Top 10 DOs & DON’Ts of Pooping During Labor & Birth
#1 DON’T forget that life does go on after an embarrassing moment. How many of you have accidentally passed gas during sex? You’re all “hot and heavy” with you man (or woman) and you’re both getting into it and then…whoops! If he/she happened to make a big deal out of it, hopefully you kicked him/her to the curb! Let’s face it, the people that are closest to us often see us in embarrassing situations at one point or another in our lives: bowing down to the porcelain god after a night of partying, passing gas during lovemaking, runny nosed and hacking up a lung during a bout with the flu, squatting to pee in the woods during an outdoor sporting event etc. etc. etc. And if those things happened in the company of someone who really loves you, they probably still loved you just as much, or even more, afterwards. Cuz hey, you’re human! (By the way, I have personally experienced all of those things so if you are laughing and thinking the same thing…you are not alone! And for the record, the guy that I passed gas on during sex ended up marrying me this summer so it couldn’t have scared him that much!)
#2 DO understand that the vast majority of women poop during the birth of their babies and that this phenomenon is NORMAL. If you think about it, when your birth attendant tells you to “bear down and push” they are really telling you to “push like you have to poop!” It is the exact same motion. And if you do poop, your nurse, midwife, or doctor is usually reassured that you are pushing correctly!! In fact, the WORST thing you can do is not push right because you are afraid to poop! I have seen it happen before and it is such a shame because these women just end up pushing for way longer than they should have all because they let their fear of embarrassment overcome them. As a labor & delivery nurse, I do not keep records of exactly how many women poop during birth (can you imagine pooping statistics! haha! J) but you can rest assured that it is the VAST MAJORITY of women. If someone you know tells you they didn’t poop during childbirth they either are: #1) part of the very small minority of women who actually don’t, or #2) just didn’t realize they did. And to be honest, #2 is way more likely!
#3 DON’T invite anyone to be present at your birth that you are not totally and completely comfortable with them seeing you in your most vulnerable and trying moments. Let’s be honest, even in the closest of relationships not many women are comfortable going to the bathroom and pooping in front of their significant other or family members but it is important to understand that the circumstances of childbirth are way different than just your daily morning bowel movement. My mother doesn’t prefer to be there when my grandmother is bathing, dressing, and going to the bathroom but when my grandmother broke her arm this past winter and needed surgery, that is exactly what my mother did because she needed her. And I would do the same thing for my mother as I know she would (and has) done for me! Passing a bowel movement or gas during labor & birth are normal bodily functions that happen during normal labor (as is burping, throwing up, grunting, groaning, crying, etc). Labor and birth are NOT spectator sports and you are NOT a “hostess” and therefore if you are going to be too preoccupied with the thought of how embarrassing it will be to poop in front of your mother or sister or best friend, then perhaps you should think more carefully about who you invite to your birth. Just because a family member loves you and “really wants to be there” at your birth, it doesn’t automatically make them a fitting labor companion. Remember, excessive worry and fear during labor releases hormones that can physically slow or stop your progress!
#4 DO go to the bathroom and empty your bowels (only if you feel the urge) in early labor. Feeling like you have to “poop” during active labor or transition is almost always the baby putting pressure on your rectum. Even if you end up passing some stool during the pushing stage, the rectal pressure you were feeling right before was NOT poop, it was the BABY and therefore you would have STILL felt intense rectal pressure even if you had emptied your bowels earlier! However, if you are in early labor and you feel like you have to poop and you can easily pass stool without straining, then go ahead. In early labor, it won’t hurt the baby or your cervix. That being said…
#5 DON’T try to go into the bathroom during active labor or transition and “try” to have a bowel movement right before the pushing stage just because you are afraid of pooping during birth. If you are in active labor/transition and you feel rectal pressure, please know that it is the BABY pressing on your rectum that is giving you that sensation. Therefore straining to have a bowel movement during this time could at best, worsen your hemorrhoids and at worst, injure your cervix by causing it to swell or tear. There is an appropriate time to start pushing, and many women tell me it is the best part (because they can actually do something about all that pressure!) but it is only time to push when your birth attendant gives you the okay.
#6 DO make a pact with your labor companions (husband, partner, mother, sister, etc.) to NOT tell you that you are or did poop during your baby’s birth if you happen to be really self conscious about it. The vast majority of the time the mother doesn’t even know that they did poop because the nurse, midwife, or doctor quickly wiped it away. Trust me, as a nurse, you see it all the time and if vomit, pee, spit, poop, or blood bothered us, we wouldn’t be nurses, midwives, or doctors!
#7 DON’T ask for an enema/accept an enema before or during labor. Please! Given enemas to women in labor is an outdated and unnecessary practice. Birthingnaturally.com writes:
“A substantial portion of women in labor will have bowel movements, whether or not enemas are given,” especially during both early labor and pushing (Mahan and McKay 1983:247). Available evidence indicates that enemas do not in fact decrease the chances of elimination during birth nor the incidence of fecal contamination during labor, whereas they do often cause considerable pain and distress to the laboring mother (Romney and Gordon 1981; Whitley and Mack 1980). Moreover, the expulsion of feces during labor does not seem to increase infection rates: in a study of 274 birthing women randomly assigned to enema or no enema groups, no difference in infection rates was found (Romney 1981), and the risk of neonatal infection was very remote (seven babies from each group showed signs of infection which may or may not have had to do with bowel organisms). Another finding of this study was that the two groups had similar durations of labor, contradicting the notion that enemas shorten labor.”
Also as a side note, please don’t take Immodium AD before labor to “prevent” pooping! It will at best, not work and at worst, make you constipated.
#8 DO remember that your body will probably “cleanse” itself out during “pre-labor”. After all, mild diarrhea or loose stools can be a sign of “pre” or “early” labor. And even if you do experience “pre labor diarrhea” you might still poop during delivery and that is okay!
#9 DON’T limit your food intake during labor if you are hungry because you are afraid that you will poop (or throw up for that matter). A runner does not prepare for a marathon by starving themselves and you shouldn’t prepare for birth by starving yourself either. Both you and your baby need energy to have the endurance for a successful vaginal birth. If you aren’t hungry, well then that is different, and you should still be encouraged to drink at least 4 oz of water, juice, or Gatorade every hour. If you are preparing for a normal vaginal delivery, even if you are being induced, you should not have to follow a “clears only” or “nothing by mouth” diet. Good prenatal nutrition recommends women eat 6 small meals per day with frequent healthy snacks so why should we starve women during labor? The answer is: we shouldn’t!!
If after reading all of the above you are still worried about pooping during delivery, then:
#10 DO realize 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 Pregnancy 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
In summary, if you are a pregnant mom reading this post, please know you are not alone in your worries! Please use these next few months, weeks, or days, preparing not only physically, but mentally and emotionally for the amazing journey you are about to embark upon. Please understand that getting ready for labor doesn’t just mean a tour of the hospital or learning about birth technology/interventions, but also means acknowledging and talking about your worries and fears with people you trust, especially your birth attendant! No mother can give birth if she feels unsafe, senses danger, or has never explored her fears, even if they seem “trivial.” Please know that although the thought of it might be “mortifyingly embarrassing,” when you actually are working hard to push out your baby, anyone that really cares about you and loves you will not be bothered by a little poop and most likely, you will not even notice it! Please know that although birth might be one of the messiest experiences of your life, no amount of fluids, cursing, farting, vomiting, striping naked, howling, crying, peeing, bleeding, or pooping will take away from how honestly empowering, mind blowing, and touching this experience can be for you and your family J.
The Good, The Bad, and The Icky on Vomiting in Labor October 19, 2009
Tags: bowel movement, gag, labor, labor and delivery, labour, poop, pooping during labor, pooping during labour, throwing up, throwing up during labor, throwing up during labour, vomit, vomiting, vomiting during labor, vomiting during labour
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:
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!
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