that means the baby is coming very soon."

If only!

"Eating the placenta is good for you."

No!

Don't go there.

"Labor usually lasts a couple of hours."

Perhaps the biggest myth that we will talk about today.

Hi, I'm Dr. Laura Riley,

and I'm a high-risk obstetrician

at NewYork-Presbyterian Hospital/Weill Cornell Medicine.

My favorite thing to do is delivering babies.

And I'm Dr. Dena Goffman.

I'm also a high-risk-pregnancy physician.

I'm the chief of OB at NewYork-Presbyterian/

Columbia University Irving Medical Center.

And today, we will be debunking myths about childbirth.

Oh, this is good.

"Wide hips mean easier birth."

This is a total myth.

And what we see as your hips

aren't even reflective of

what's going on with the bones in your pelvis,

which do matter.

Riley: The bony pelvis is connected by cartilage,

which is softer, which loosens up within the course

of the latter part of pregnancy.

So that gives the baby a little bit more room.

And then, labor, all those contractions

and the coordination that forces the head into the pelvis,

a lot of that depends on the baby, right?

I think one thing that is frustrating for people

is they will say, at 38 weeks,

"Am I going to have a vaginal delivery?"

We can't tell. Because there's so many other factors

that go into whether or not your baby

is coming out vaginally.

It's not just the baby's size.

It's the baby's position.

It's how well the baby tolerates

holding its breath every three minutes.

There's more to the story.

"The best position to labor

and give birth on is your back."

That's a myth.

What you might see on television or in the movies,

of a patient flat on their back,

is actually the worst position to labor and give birth in.

We love to have patients be in bed,

certainly on their side,

but there's also a lot of opportunity

to be sitting up and even to be walking around,

depending, again, on the situation with your pregnancy,

your baby, and your labor.

There's the opportunity, potentially, to take a shower.

Some people use birthing balls as a place to sit.

Many places now have wireless fetal monitoring,

where you actually can even monitor the baby

while you're moving around.

And a lot also depends on

whether or not you have anesthesia,

because once you have an epidural,

it is fabulous for taking away the discomfort

on your abdomen and those contractions.

But it does, in many ways, weaken your leg muscles.

So most hospitals will not allow you

to walk around with your epidural in

just because you may not be as strong.

This is definitely a myth.

"You can induce labor by eating spicy food."

So, this is a myth,

and there are a number of them out there.

All of the things that people think

you can do to induce labor.

Pineapples.

Riley: Cream cheese, bumpy roads.

Sex.

Sex.

That one, there's some truth to it, right?

Nipple stimulation.

That's not a myth either.

I know it's not a myth.

Nipple stimulation actually does work.

The tough part about nipple stimulation

is that you get so many contractions at once,

your baby doesn't love it.

The sex and the nipple stimulation

have sort of valid, plausible reasons why they may help,

but I think there's not sort of a protocol

for how to do it and how to do it safely.

We know how to induce labor.

We have different medications that we can use vaginally,

medications that we can use in the IV,

and we know how to do that safely.

I think there is no evidence for spicy foods.

Sex is fine if it's comfortable

and something that you want to be doing.

Walking, being active, kind of getting out and about,

but I think this baby's going to come

when the baby's going to come.

"Your water breaks with no warning."

I know people see it in the TV and movies,

and it's a very dramatic event, and it's clear cut,

and you rush to the hospital, and the baby is born.

That's not always how it happens.

Sometimes it does break with a huge gush,

and it's very obvious.

Sometimes there's a leak, and patients are unsure.

And sometimes people don't know

whether it's urine or it's their water breaking.

If it's urine, it comes out and then it stops.

And if it's your water, it continues.

It does not stop. So put a pad on,

and if the pad is consistently wet and saturated,

you have to think, "Gee, maybe my water broke."

Sometimes we will break your water for you.

For some patients,

they will be in labor and progressing nicely in labor,

and the water will not have broken on its own.

If you're unsure whether or not your water has broken,

it's better to come in and let us tell you yes or no

rather than stay at home,

because if your water has broken

and there's a long time before your delivery,

you do increase the risk for getting an infection.

"If your water breaks,

that means the baby is coming very soon."

If only!

Yeah, we wish.

This is not always the case.

It is all over the map.

Because a lot depends on how many children you've had.

If it's your fourth baby

and you're contracting and your water breaks,

it's coming fast. If it's your first baby,

your water breaks, you're not contracting,

it could be 12, 24 hours.

So it's hard to know.

Contractions that come consistently

with the baby's head against the cervix

are what makes the cervix open.

The cervix has to get to 10 centimeters before you can push.

So that process is the process of labor.

If your water breaks in the course of that process,

great, but that doesn't tell us the timing.

For some subset of our patients,

the water will break and the patient may not be in labor.

That happens in probably 8% to 10% of patients.

So if you think your water is broken,

you should call your provider and say,

"My water's broken. I am contracting or not contracting.

And when should I come in?"

Because that answer is going to vary

depending on the circumstances around your pregnancy.

"Eating the placenta is good for you."

No!

Don't go there.

Absolutely not.

Please, please don't eat your placenta.

Many patients will ask about

the utility of eating the placenta.

There was some suggestion that eating the placenta

after birth might prevent depression, anxiety,

and while we're completely supportive

of doing anything to prevent those issues,

I think we have to recognize that there's no science

behind the placenta being helpful to that.

There was actually a recent publication

from the American Academy of Pediatrics

that outlined some of these less traditional practices

surrounding birth, and this one is specifically mentioned,

and that paper calls out the infectious risk

without added benefit.

So we are happy to have these conversations,

to talk with patients

through shared decision-making processes,

but our recommendation will almost always be

you should not eat the placenta.

Instead of eating the placenta,

it's really important to pay attention

to your nutrition; your hydration;

your rest, when you can, with a newborn;

and lots of support from family and friends.

"Labor usually lasts a couple of hours."

There are occasionally patients

who've had children in the past

who start to contract at home

and come in and quickly have a birth with us,

but it is definitely the exception, not the rule.

Depends on how many kids you've had.

Labor usually lasts, I'd say 12 to 24 hours

is average for your first baby.

Second, third, way faster, thank goodness.

Goffman: The labor process

has multiple stages and phases.

The early part of labor can take a fair amount of time.

Some people will start with cramping.

Then the cramping is, like, unbearable,

and then they'll realize it's contractions.

Those contractions, then, are maybe 20 minutes apart,

and then they're 10 minutes apart.

And you actually need a lot of contractions

that are three minutes apart, consistently,

to soften the cervix.

And most people will do some of that at home

for several hours,

and then they'll call us and say, "I think I'm in labor."

And then we'll say, "Come on in."

Once you get to sort of that 6 or so centimeters,

things start to speed up.

And then you eventually get to 10 centimeters,

and then the real work happens.

Goffman: Usually, you will begin to push

shortly after you are determined to be 10 centimeters.

And then that pushing process

is called the second stage of labor,

and it's from the time that you're fully dilated

until the time that your baby is out.

Once the cord is clamped and cut,

then we go on to the next step,

which is, we need to deliver the placenta.

We then are going to do some things

to help prevent you from bleeding,

so that's sort of the last piece,

making sure that we identify and repair

tears that were created during the birth process.

"Doctors slap the baby on the back after birth."

That's a myth.

That's old school.

And the movies.

I was just going to say, I think, actually, it's the movies.

I think that it comes from the desire

to stimulate the baby to take a big deep breath

after we clamp the cord.

But you don't really have to do that.

The babies do it on their own.

They start crying.

So sometimes you will see us rub the baby's back

or tap the bottom of the baby's feet

just to sort of make it go, "Ah!"

And then it takes a deep breath,

coughs up fluid, and then starts screaming.

"An epidural increases the chance of needing a C-section."

Myth! Epidural does not increase

the risk of needing a C-section.

I think that misinformation comes from the fact

that some patients probably get the epidural so early

that they're not even in labor,

and then it becomes intervention after intervention

after intervention,

and some people end up with a C-section.

They'll explain the risks, they'll explain the benefits,

and they'll explain the alternatives,

which is always to not have one.

But the risks that they will talk about

are a tiny risk of infection