Very few women in our culture have seen a birth before getting pregnant themselves. Many of our expectations and ideas surrounding labor and delivery come from the same place we get our ideas about how to jump out of cars (it's harder than it looks) or what to wear in Mexico (hint: most don't go for insanely large hats with tassels). That's right, we get our information from television and movies.

The problem with learning about birth from Hollywood is that directors aren't interested in turning their comedies and dramas into documentaries for the duration of the birth scenes. "Normal" during labor is often about as exciting as "normal" during real police investigations, which involve a lot less gunfire and a lot more paperwork than we see on Law & Order.

Sometimes making labor as entertaining as possible just means a movie will show a birth that is possible, but highly unusual and different from what the vast majority of women experience. Sometimes it even means getting the details about how labor works dead wrong.

What the Media Gets Wrong about Labor #1: Fast Onset of Labor

One idea particularly pervasive in our media is that women go quickly into painful, recognizable labor. So many of us have the idea that giving birth in a taxi on the way to the hospital is a real possibility that midwives and obstetricians often have to assure their clients that they won't give birth before realizing they're in labor.

Desperate Housewives Frankenbaby



In this clip, Danielle goes into labor and progresses too quickly to get to the hospital. Most labors in real life last for several hours, especially first labors, which average about 12 hours. She also feels a great deal of pain right away. Most women feel only mild pain (if any) at first, which gives mothers the benefit of working their way up to the hard part. This is especially important for women planning to birth without medication, because the gradually increasing intensity of birth gives you the ability to marshal your resources and improve your experience.

What the Media Gets Wrong about Labor #2: "Honey, it's time to go."

This misconception from the media is related to the first--it's the idea that women can immediately tell, from the moment labor begins, that "this is it." Starting in the last trimester during a woman's first pregnancy, and much earlier in subsequent pregnancies, Braxton Hicks (or "practice") contractions begin doing the earliest work of labor. Like previews of the main event, they start warming up the uterus for birth and can be as intense as the contractions of early labor.

Most movies show a woman who either goes into labor immediately after her water breaks (many first-time mothers get the idea from this that all births begin this way, when in fact the amniotic fluid often doesn't release until well into the active phase of labor for most women) or a woman who feels one contraction and immediately wakes her husband for the trip to the hospital.

Children of Men: The Birth



While labor is generally several hours long and noticeably different from Braxton Hicks contractions long before baby arrives, the idea that one contraction or even released amniotic fluid tells a woman immediately that she's in labor is almost never accurate. It can even take hours or days for labor to begin after one's water breaks.

What the Media Gets Wrong about Labor #3: Cord? Placenta?

Movies and television have a good reason to skip over details about labor that might make censors or ratings committees squeamish, like cutting the umbilical cord or birthing the placenta. I can't understand, however, why those parts of labor are almost always completely absent, without even a hint that they exist.

Nine Months Labor Scene



I've always found it strange that labor scenes in media end abruptly with the birth of the baby, usually with no mention of the cord being clamped, and never even intimating that the placenta has yet to emerge. I know that it would probably be considered too graphic to show the actual cutting or delivery, but often babies are shown with visible pristine belly buttons or visitors are invited in immediately after the baby emerges, with no reference to the placenta.

Even most videos that I have seen of actual real births end with the emergence of the baby, which seems beyond bizarre considering their educational purpose. I guess the placenta is anticlimactic, but it seems important that women know more about options for its delivery or just how the process works.

What the Media Gets Wrong about Labor #4: Cartoonish Reaction to Pain

If there is any image that is consistent throughout most media renditions of birth, it's the intentionally cartoonish wails, curses, and fury of birthing women. While labor can be loud, most of it, especially the first several hours, is peaceful and focused on the job at hand, not random and noisy with yells and screams.

Murphy Brown: Birth 101



This scene has some good elements, such as a realistic idea of the length of labor, the fact that walking around helps, and how worn out and discouraged Murphy feels during the most painful last part of labor. The exaggeration of the ridiculousness of her hollering and grouchiness--pretty typical of comedy birth scenes--is what makes it a bad thing for mothers-to-be to incorporate into their idea of what labor looks like.

Many women are afraid of losing all control and looking ridiculous during labor because of scenes like this. While it is true that a lot of things about birth seem undignified, the clownish aspects of many comedy births are nothing like the serious, calm nature of most real births. Women who opt not to use pain medication have many options for reducing pain in labor, and they often even look relaxed during active labor. That's not particularly funny, so I understand why it doesn't make good television, but the larger-than-life goofiness scares us unnecessarily.

What the Media Gets Wrong about Labor #54: Pretty Newborns

Most babies don't pop out looking rosy, clean, and cherubic any more than Cindy Crawford looks like a supermodel when she rolls out of bed for a 5 a.m. sunrise photo shoot. The babies in birth scenes aren't real newborns, just very young infants, and don't usually have the sweet but squashy look of a brand new baby.

The Nativity Story - Jesus Birth



Most babies are actually a bluish white just after they emerge, or mottled pink and white. If a nurse cleans off the messy remains of amniotic fluid and blood, chances are good the baby will still be damp and not perfectly clean. Many babies also have pointy heads because the plates in their skulls are designed to mold into an easier shape for delivery as they move along the birth canal. They may have wrinkly skin just as you would have after a long bath, or a cheesy white residue called vernix that protects the skin of babies from the amniotic fluid in utero.

All of these things are temporary and none of them will keep you from being sure you have the cutest baby in human history, but all of them could scare someone whose idea of round-headed newborns with smooth, rosy skin comes from Hollywood.

What the Media Gets Wrong about Labor #6: The Doctor is God

Most on-screen pregnancy stories completely ignore the existence of midwives and alternative birthing locations other than hospitals. Once a woman is in labor, the obstetrician tells his patient what is happening, and gives directions without any discussion of other options. If a c-section is ordered, there is no argument or request for possible alternatives from the parents. While I know that this often happens in the real world as well, I would be thrilled to see a movie in which a woman requests more time or to try laboring in a different position.

I don't have a great movie clip to illustrate this point, but here's a sarcastic sketch from Monty Python's The Meaning of Life that makes fun of the fact that women can't be in charge of birth because they are "not qualified."

The Meaning of Life: The Miracle of Birth



What the Media Gets Wrong about Labor #7: Laboring while Reclining is Good

Sitting directly on the tailbone (which pushes it into the way of the emerging baby) or while lying flat (which gives no leverage for pushing and works against gravity to boot) are probably the least effective, most painful positions in which to labor. These are still very common because they offer easy access for the doctor to catch the baby and for the nurse to attach various monitors, especially if the mother has an epidural and I.V.

Ironically, because of the entertainment value of un-medicated birth in its dramatized form, most media birth scenes show women giving birth without medication in the most uncomfortable possible labor positions.

Knocked Up: Movie Trailer (I couldn't find a clip of the birth scene, in which actress Katherine Heigl births naturally, sitting straight up)



Because the movie focuses a lot of attention on the mother's desire to give birth without medication, it would have made a lot more sense for her to have studied and known more about the many available methods and positions for easing labor. It's far easier to give birth while squatting, on all fours, or while supported in a kind of hanging hug by a labor partner. Hollywood doesn't seem to know this is even possible.

I Don't Hate All Media Births (or Even Everything about Some Media Births)

This article is intended to point out the misconceptions we pick up from watching labor on T.V. and in movies, so it has a naturally negative tone, but there are still often good things that show up here and there, increasingly so in recent years.

Murphy Brown's birth and the births featured on Scrubs, for example, are very realistic about how long labor lasts. Knocked Up shows the characters carefully choosing a supportive doctor and then demanding that the on-call doctor treat the mother's decisions with respect. In Nine Months, the babies are actually still wet when handed to their mothers. I was surprised that the character assisting at the birth in Children of Men not only mentions the umbilical cord, but knows that there need be no panicked rush to cut it right away.

In general, it seems like the media increasingly gets things right and understands that there is plenty of drama (and even muted, respectful comedy) in REAL childbirth. While there are still so many things Hollywood gets wrong, however, parents-to-be should seek out real birth videos and take childbirth classes so that they know what they can really expect from labor and delivery.

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Feel free to leave some of your own favorite unrealistic media birth offenders in my comments section, and be sure to subscribe to my blog so that you can find out next week what birth misconceptions we tend to collect even from the true stories shared by family and friends!

I loved your thorough analysis of the depiction of labor by the media. I can't help but comment aloud when I see labor scenes on TV shows and in movies...they're almost always exceedingly unrealistic.

For example, in Lost...when Claire goes into labor and it happens so fast that she can't even get back to the camp! I wish my labor would have gone that quickly...!

Oh, good one, Stephanie! I remember watching it and thinking exactly the same thing about it happening so fast, especially with it being her first baby. Thanks so much for bringing that one up! Here's a link to it on YouTube for anyone curious about it: http://www.youtube.com/watch?v=V4uJ_94ZZgA

Great examples, Cat. But what about the way they show men driving while trying to get a woman to the hospital? That's linked with the 'all women labor quickly' category, but it's scary enough to be highlighted. All expectant parents need to realize labor isn't an excuse to drive like a lunatic.

Great site, by the way!:)

KCat-- I'm so glad you're writing this book. Now that I'm a mom, I find that birth choice can be such a divisive issue for women. Who needs that? I think women need to be more supportive and understanding of each other, not defensive about their choices. Writing a book that gives the whole spectrum of birth choices, with equal time to each option, is a wonderful way to bridge the awesome experience of birth for every mom or mom-to-be.

By some accounts, I had one of those Hollywood-type births. We made it to the hospital 20 minutes before Ben arrived. However, there was no screaming, no yelling, no fumbling husband. We each did our job for the moment (him drive, me breathe) and we made it just fine. I only hope that by sharing my story women will feel empowered and not afraid of birth, no matter how they choose to go about it.