Going Natural

Why some women want un-medicated births


Megan's expecting her second baby. She had an epidural and a quick labor with her first but didn't like not having control of her body. She's hoping for an un-medicated labor this time and is practicing yoga, guided relaxation and self-hypnosis. She wants to know what I think of "natural" childbirth. Megan asks, "What improves our chances of success, what sabotages it, and what drives staff crazy about the process?" You guys ask such good questions.

What do I think of un-medicated childbirth? I think it hurts. Quite a lot actually. Sure, there are some that say it's the fear, lack of knowledge and tension that causes the pain. I say it's an eight-pound baby being squeezed at two-minute intervals for a whole lotta hours out our "butt" that causes the pain. But then, that's just me. I've done it myself both ways—with and without epidurals. I'd get an epidural again in a heartbeat. I've also attended thousands of births—both ways. Far more women choose some form of pain management (either narcotics or epidural) than go au' naturale. Why? Because most women think labor hurts and there's a good way to make the pain stop right at their disposal. They wouldn't get a root canal without the benefit of anesthesia. Why give birth without it? Now that's the real question, isn't it? Why do some women want un-medicated births?

There are so many schools of thought around this subject. Some feel it's one of our last rites of passage. Centuries of women have done it without benefit of epidurals so we can too. Some think it's healthier. That's certainly up for debate. If women or babies were getting sick, injured or otherwise dinged up by epidurals, you can bet we wouldn't do as many as we do. As I mentioned last week, people sue us if we mess up their babies (and mommies). For some, like Megan, they don't like the loss of physical control that comes with an epidural. For others, it's empowering to experience the full range of feelings that come with birth—to really test our body's endurance. Like running the marathon, there's triumph in reaching physical goals. There are those (not that many) who don't think it hurts that bad and really don't feel the need to do anything about it. Some labors go so quickly it's over with before they could get an epidural. There are quite a few women who are terrified of epidurals. They've got a story about somebody who knows somebody who knows somebody who was paralyzed for life by an epidural. I've never seen it happen and neither have any of the many, many anesthetists I've worked with.

I think women should have what they want in terms of pain management. If they want a natural birth—go for it. If not, get an epidural. There's far too much judgment being passed in both camps on those that do and those that don't. Some "natural" women feel superior to "epidural" women. Countless women, upon getting their epidurals say, "Anybody would be crazy not to get one." Knock it off, both of you. To each her own. OK?

What improves the chances of having a natural birth? All the things Megan's doing—self-hypnosis, relaxation, yoga. You need some tools. Not just a quick read through a book or magazine but a good, intensive prenatal education that includes techniques for getting through the pain. Whatever your brand of childbirth technique— study well, practice often and have an equally educated and supportive labor partner. Stay mobile and out of bed as much as possible. Use warm baths and showers. Sit on a birthing ball. All of this stuff helps a lot.

What sabotages it? Being unprepared; coming to the hospital with the first contraction; being inflexible; bringing an entourage. You're going to need a lot of focus and minimal distraction if you're going to go without pain management. I don't think asking for pain management is unsuccessful though. You might feel disappointed but if what you're doing isn't cutting it and you decide to use other tools to get the job done—so be it. As the saying goes: There's more than one way to skin a cat. And you can bet that cat would prefer anesthesia.

What drives staff crazy about the process? Oh, not that much. We're pretty versatile and our goal is to support whatever Mom wants and deliver a safe, healthy baby. Natural births are lovely when all goes well. They're uplifting and sweet. It's a joy to see parents work as a team and achieve a beautiful birth. That said, if Mom is crawling out of her skin with out of control pain and biting people, all in the name of going natural—that's hard to deal with. When Mom's had a brutal labor that leaves her so traumatized she can't really be present at her own birth, that's a toughie too. I'm all for natural births (I get assigned a lot of them because I'm "good at them.") but if Mom's freaking out, Dad's in a tearful panic and she's too wrecked to deal with the baby when it's born you've got to ask "why?"

Medicated births are beautiful too. They're relaxed and give Mom a lot of emotional control. Without the pain, she can enjoy the experience. Dad doesn't feel wigged out and everyone's calm. That happens with lots of natural births too but even with the best intentions and training, sometimes it's just too painful. It's the 21st century, ladies. You can have anything you want. Now, let's just find a way to let go of all the judgment over which is better—natural or epidural. They're both good. Let it be. And Megan, honey, here's wishing you a quick, easy labor.

Got a question for Jeanne? E-mail it to labornurse@fitpregnancy.com and it may be answered in a future blog post.

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