While there are some lesser-known effects of pregnancy, many are commonly known. For instance, everybody knows that a chief side-effect of pregnancy is weight gain — in fact, it’s actually recommended. The Institute of Medicine actually recommends women with a healthy BMI (between 18.5 and 24.9) gain 25 to 35 pounds during the course of a pregnancy. With that and the pregnancy hormones come food cravings, swollen ankles, and nausea. None of that is new. Even some of the once-shocking aspects of pregnancy and birth have become common knowledge, like the fact that women actually have to give birth twice: once to the baby, and once to the placenta. In fact, there are even women who choose to give birth to their placenta and then eat it — Hilary Duff and Kourtney Kardashian being among them (Duff literally drank hers in the form of a smoothie.) But that doesn’t mean that every single woman goes into pregnancy and birth without a surprise or two. For instance, writer Marcey Rizzetta told Betches that she hemorrhaged so much that she had to wear an adult diaper for four weeks postpartum. Some women experience hair loss. And those feet that swell up during pregnancy? That might not be temporary — pregnancy can actually cause the feet bones to spread, meaning bigger feet.

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Every single one of us on this Earth came to be because of a pregnant person, and yet, there is still so much the everyday person doesn’t know about the nine or so months it took them to become a fully formed human. Lodz Joseph, Certified Nurse Midwife with a Masters in Public Health, hears it all the time — and from pregnant women, too! A common misconception about pregnancy is one people repeat all the time: She’s pregnant, she’s eating for two. “That’s like, the old science,” Joseph says. “I want people to eat and enjoy what they’re eating, but also think about how you’re fueling your child’s brain. You could go to Chick-Fil-A [all the time], but you could think, ‘I’m building my child’s brain — maybe I don’t want them to be a Coca-Cola baby.’” There’s science to back up those claims: According to a 2015 study, nearly half of pregnant American women gained too much weight during pregnancy.

She also mentions that there are certain foods expecting mothers should avoid that many people wouldn’t think to stay away from. For instance, cold cuts or Vienna sausages, because they carry a risk of listeria, a bacteria that can cause miscarriage and serious anomalies. Raw honey is another food pregnant women should avoid.

Adding onto the notion that many pregnant women don’t understand the proper nutrition is the fact that, Joseph says, many of her patients simply aren’t drinking enough water. “You gotta drink more water,” she asserts. “Your baby needs more water or else your uterus may falsely start contracting and you might think you’re in labor.” 

But the biggest knowledge gap, Joseph says, has to do with the actual birth process itself. “People don’t realize my job as a midwife is to make sure your pregnancy remains in the realm of normal,” adding that, “what’s normal for you may not be normal to someone else.” 

She also reveals that many people simply don’t know what to expect during the actual birthing process. “People underestimate the value of a birth ed class — they think the prenatal visit [with their doctor] is going to cover it.” She says she hears all the time from patients, “I’m really disappointed the doctor didn’t explain the childbirth process to me” and says too many people come into labor asking, “so what’s going to happen now?” Joseph says her job is to explain the different ways the birthing process can happen and the risks associated with each.

birthing class
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New mom Amelia Halstead echoes that the biggest issues she experienced during her first pregnancy were during the actual delivery, when she went in, as she put it, “completely uninformed.” 

“I put my full trust in my doctor and did whatever she said,” she recalls. That sounds like what a woman in labor is supposed to do, but for Halstead things took a dark turn. “I was bullied into scheduling an induction, but luckily my water broke ahead of time.” She also recalls, “my epidural was too strong so I was unable to push,” detailing that she tried pushing for three and a half hours before a nurse had to intervene and essentially push the baby out for her. She describes it as a “body slam.”

But the heartache didn’t stop there. Halstead says, “My baby was taken away from me to go to the nursery and I should have fought to get her back sooner.” She confesses, “I wish I knew more about my rights as a patient.”

Sadly, this sentiment is not uncommon among new mothers. A study detailed in Vox found that one in six women experience mistreatment in childbirth, with those figures being higher for women of color. The study, published in Reproductive Health, characterized mistreatment as verbal abuse, stigma, discrimination, or having requests for help ignored. The study found that the most common type of mistreatment the women experienced was being shouted at, ignored, and being forced to get treatments they did not want. 

Part of the issue could be that there is simply too much information about childbirth for expecting mothers to know ahead of time and too many complications that can happen that require a medical degree to navigate. “People don’t know the complications that can happen when you’re delivering,” Joseph says. But should it really be a pregnant woman’s job to navigate her own birth? “It is the provider’s job to ensure that you’re okay and you’ll make it through,” Joseph says of the delivery process. 

With her second child, Halstead was much more prepared. It was “a dream,” she says. “I was super informed. Hired a doula. Labored at home for 8ish hours. Got an epidural with a button so I could control it. Had a doctor who let me rest after I began pushing because my baby had to shift. And basically had the baby after 2-3 pushes once I was ready.” She also made sure she was able to hold her baby right away, which made a huge difference. 

Unfortunately, just like many issues women face, until there is systemic reform to address the mistreatment of women in labor, the onus will be on the woman to make sure she is educated about her rights. In the age of the Internet, that’s certainly easier than it was before, even though it definitely doesn’t make it right.