If you don't yell during labor, you're a fool. I screamed. Oh, how I screamed. And that was just during the conception.

In this one-liner, Rivers uses a classic bait-and-switch: she begins with a seemingly earnest comment about childbirth pain (“labor”), then flips the meaning by revealing she means “labor” at conception. The joke hinges on sexual frankness and exaggeration, a hallmark of Rivers’s stand-up persona, which often mined taboo subjects—sex, marriage, and women’s bodies—to puncture sentimentality and expose social hypocrisy. Beneath the punchline is a satirical inversion of cultural expectations that women should be stoic or discreet about reproductive experiences; Rivers instead foregrounds discomfort and complaint as a form of comic honesty and self-assertion.