Inside Information

What you can learn from a longtime labor nurse

The job description: Registered nurse specializing in inpatient obstetrics. Provides expert care of mother and baby through labor, birth and recovery; monitors fetal heart and contractions; cleans up mess. Adjusts for quirks, temperaments and family drama. Coaches dad, pampers siblings. Translates medical-speak. Serves as cheerleader, drill sergeant and best friend du jour. Your labor nurse might spend more time with you in one shift than your obstetrician does in nine months. Here's what she wants you to know.

You can't shock or gross us out. We've seen it all. You aren't the first woman to go into labor with unshaved legs, unwashed hair and a bikini zone that hasn't seen wax in ages, if ever. We don't care. If there's time, start labor freshly showered. Bonus points for shaved legs and pedicures (who can reach?). Bikini area? Whatever. We don't care how much (or little) hair there is or what color it is. Jewelry gets in the way. (Rings can stay.) Body piercings--remove first. Tiaras--optional, though you are the queen. And don't worry about pooping, yelling, getting out of control. That said, pain's no excuse for meanness.

We aim to please--but please be flexible. Birth is unpredictable, and flexibility makes for a smoother delivery (not to mention parenting). Tell us and your doctor what you want well beforehand--we'll try to deliver. However, we can't guarantee every item on your birth plan wish list. (For more on this, see "3 Insider Secrets--Revealed!" left.) It's tough being born, and some babies need a little help getting out. It's no picnic for mom, either, and sometimes plans fly out the window once labor gets serious. So we won't hold you to every pre-labor promise you made, like "I won't, won't, won't get an epidural--just deep breathing for me!"

We really do need to perform all those cervical exams. We can tell lots by how a cervix feels, its position and how fast it's changing. But we know that no one likes these exams, so we try to only do them to determine whether you're ready for your next step, such as getting an epidural or starting to push.

We love to watch you move. Changing your position frequently lessens pain, helps guide the baby down into the birth canal and accelerates pushing. So we'll encourage you to minimize the time you spend in bed, and instead walk, squat, use the rocking chair, birthing ball and Jacuzzi. Sore back? Try labor dancing: Elevate the bed, lean on it with your elbows, stick out your butt and swing slowly; or hug your partner and sway. Stay off your back (even though that's probably what got you into this) to maximize blood circulation to the baby.

We don't have a crystal ball. Will your labor be a sprint or a marathon? We can guesstimate how long it will last by juggling the variables (spontaneous labor or induced, first-timer or old pro) and figure out when to summon your doctor. Timing is important when considering interventions and pain management, but labor's a journey, not a race. Poky or speedy, one thing is guaranteed: Your baby will arrive precisely on his or her birthday.

4 Top Labor Fears

1. Pain We live in the age of Jacuzzis, HypnoBirthing, massage, the epidural and other medications. If one method doesn't cut it, try another. You won't get brownie points for biting the bullet, and we won't think less of you if you need help.

2. Episiotomies and tears Many of both can be avoided with adequate pushing time, as well as by applying hot compresses to the perineum and massaging the area with mineral oil. Most midwives and, in some areas of the country, labor nurses will do this.

3. Needles If you're really freaked out by IVs, blood draws and epidurals, tell your nurse and she'll work with you to minimize anxiety and pain with warm blankets, a local anesthetic to numb the skin before a needle is inserted--and TLC.

4. Cesarean section Sometimes there's time to discuss the decision, but things can go wrong fast in labor, and your medical team may have to work at warp speed. A C-section is quick and almost always easier and less painful than patients think. In the end, what counts most is not how you gave birth, but the fact that both you and your new baby are safe and healthy.