Myths of TV shows and Movie Births

It is a rare occurrence to see a birth in person here in the United States and when we do see a birth it is most often in a TV show or a movie.  Unsurprisingly, Hollywood’s interpretation of birth is not accurate to real life.  So this leaves the question what is different between a typical Hollywood birth and a typical “real life” birth?  What are the signs of labor in a Hollywood birth?  (Note that I use the phrase “In Hollywood” to refer to TV shows and movies that are produced in Hollywood rather than famous actors and actresses themselves giving birth.)

Myth #1: Birth begins with water breaking

As Rock the Cradle’s blog post mentions, the first myth about birth that is shown in TV and movies is how individuals go into labor.  Hollywood style births almost always begin with the individual’s water breaking.  In reality the percentage of births that begin this way is extremely low.  Here in the United States only 12% of births are preterm (babies born between 20 and 37 weeks) and of those preterm premature rupture of membranes (in other words water breaking before labor has begun) “complicates approximately 3% of all pregnancies”.  Of all the term births (babies born between 37 and 42 weeks) “8-10% present with premature rupture of membranes”.  In other words, less than 15% of most births begin with the individual’s water breaking.

Myth #2: Parents need to rush to the hospital

The second myth that this blog mentions is that parents need to rush to the hospital.  In Hollywood births there are two potential reasons for rushing to the hospital.  One is just because that’s “what you’re supposed to do”.  “In Friends, Ross is so proud that he got Rachel to the hospital in 7 minutes after her water broke. And guess what? She gave birth about 47 hours later!”  In fact, it is all too common in the United States for individuals to arrive to the hospital too early.

In the United States most doctors recommend patients arrive at the hospital when they are in active labor.  In other words, their contractions are at least a minute long, occurring every 5 minutes apart, and that this has been happening for at least an hour.  Otherwise known as the 5-1-1 labor rule (some doctors even recommend you go to the hospital when contractions are occurring faster than this at every 4 minutes apart or 4-1-1). One study that shows the reason for this showed that if individuals were sent home during early labor this “has the potential to reduce the number of women receiving oxytocin for augmentation, the rate of epidural analgesia for pain relief, and the duration of the active and second stages of labor, and to improve women's evaluations of their labor and birth experiences”.

Myth #3: Individuals in labor have a lot of energy

If an individual does go to the hospital at the best time, following this 5-1-1 rule, they will be in active labor.  Once in active labor, contractions tend to be fairly intense, making it difficult to focus.  In Hollywood, upon arriving at the hospital many characters do not seem to be experiencing many (or any) signs of labor.  They still have the energy to make jokes, like Becky in Full House who comments “Jess, why don’t you just stick a sign on my back that says Wide Load” when they arrive in season 5 episode 10.  Later while still in labor at the hospital, Danny Tanner video records himself interviewing Becky.  In addition to having energy to have conversations and make jokes, Hollywood births often have scenes of people in birth being extremely aggressive and angry.  In Lethal Weapon 4 this aggression takes form of Lorna grabbing another patient’s IV pole, forcing the patient to follow wherever she goes.  In “Baby Mama” Angie’s aggression is shown after she screams “It feels like I’m shitting a knife!” and then yelling at cops and destroying hospital equipment from her wheelchair on her way to the hospital room.

All of these are very comical scenes but in reality in active labor most individuals do not have energy to be so aggressive or even hold conversations.  Aggression can still happen but from my experience it is rather rare.  If an individual is in active labor they may not even have much energy to talk at all.  This much energy tends to mean that the individual has arrived to the hospital too early and not in active labor.

Myth #4: Labor is always fast

The second reason for rushing to the hospital is that labor is always fast in Hollywood.  In Frasier season two episode four, labor happens so fast that the taxi driver gives birth in the taxi cab with no assistance but Martin, Niles and Frasier, her taxi passengers. In season one episode ten of Grace and Frankie, Mal makes it less than 10 steps from her chair when the baby is born and taken out through the bottom of her pants (without an umbilical cord, of course). 

I have yet to see a single TV show or movie where I observe contractions.  Sometimes it is mentioned that they are happening but I do not see the typical patterns of contraction followed by rest that is typical in normal birth so I’m not sure what the character does to signify that they are having contractions (if and when they do happen).  Typically contractions tend to happen for several hours prior to giving birth, starting slow and gradual and ramping up over time.  In fact, less than 3% of births are rapid labors.

Myth #5: Effective pushing means screaming

Most Hollywood births show pushing to mean screaming.  In the movie “Baby Mama” the doctor encourages Angie, “give me a big one” he says and she screams loudly with her mouth open (it is assumed this is the push when the baby comes out).   Similarly, in The Women Debra Menning’s character screams one loud sustained wail as she pushes the baby out.  In reality pushing is often compared to being extremely constipated.  Picture being constipated and trying to push while screaming.  Good luck with this unreal image.  While pushing some doctors even encourage patients not to make any noise at all as any noise made is wasted energy. There can be screaming during birth but it often is not the way the baby comes out.

Myth #6 Labor and pushing happen on your back

Also in both of these scenes (and many others) pushing always happens while the character is on their back.  There are a few scenes where this is not the case (like the scene in the Back-up Plan) but this is mostly done for comedic effect.  This wonderful Youtube episode from the PBS show Origin of Everything presents the history of why we currently give birth lying down and on our backs.  As the episode explains, there is a long history of pushing while squatting because the same muscles are used to push as to squat.  This is why giving birth while on the toilet is very common (we are from a very young age trained how to relax and push while on the toilet).  Giving birth while on your back started in the 18th and 19th century when men were brought into the labor room and women needed some way to stay modest around them.  Male doctors put patients on their backs with drapes over their legs so they could feel what they were doing while allowing the woman to keep her modesty (and not show her vagina to the man).  I would definitely encourage you to watch this rather short Youtube video on the history of this position.  Bottom line is every woman is different and therefore the position for labor and pushing is different for every woman.

Myth #8 C-Sections happen randomly

When cesarean births are much more common in real life they often don’t occur in Hollywoods and vice versa.  The TV show Friends has characters give vaginal birth to triplets, twins and breech babies.  All three of these scenarios are unlikely in real life.  In fact it is rare to find a doctor or midwife who will let you give birth vaginally in these situations.  Many hospitals ban them outright.  On San Francisco General Hospital’s website, for example, they state “Some women who have a breech baby at the end of pregnancy ("feet first") are able to choose to have a vaginal birth. This is not an option at most hospitals in San Francisco.” 

In other Hollywood scenarios, like Monty Python, the operating room is used as a comic ploy when it is not really needed.

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Myth #9 Everyone looks amazing during and after giving birth

Most of the women (all of the episodes I found were cis-women giving birth) look absolutely perfect just after or during their births.  The following are images of Lily right after giving birth in How I met Your Mother, Angie from Baby Mama and Becky from Full House while in labor.  As you will note, though their faces may be contorted, their hair and makeup are immaculate. 

Myth #10 Babies look fabulous after giving birth

Surprise!  Most babies in TV shows and movies are in fact much older (and larger) than a newborn.  This also means that babies in Hollywood are not rubbed off, their mouths are not suctioned out, nor do they need to be encouraged to cry.  In reality babies have been in the womb for a long time with amniotic fluid and other things around so they often have things on their skin (blood and vernix primarily) which nurses often rub off and suction out of their mouths just after birth.  In a TV show or movie if a baby is not crying immediately something is wrong. In reality I have seen babies who are clearly breathing and perfectly healthy but are just simply not interested in crying.  Some nurses and care providers will do everything they can to aggravate the baby and get them to cry while others see that the baby is fine and leave the baby alone.

Stanford describes all the signs one can expect in a newborn’s appearance.  These include but are not limited to skin of a dark red to purple color, a moulded (or reshaped) head, white cheese like substance and soft downy hair covering their body, tiny white hard spots on their nose, chin or forehead, pink or red patches on their eyes, blue or purple splotches on their buttocks, a rash on their chest, and swollen genitals.  Most of these things fade within the first days, weeks, months or years depending on what it is.

More realistic births to watch

The following are much more realistic than most.  Though the TV show Call the Midwife is not perfect, it is much better than most others and even has newborns in birth scenes rather than older babies trying to pass off as younger ones.

This is an even more realistic great video from Lamaze that describes the process.