How to Deal With Natural Labor Pain Before an Epidural

When your natural birth plan hits the wall.


Lots of women commit during pregnancy to get through labor without drugs or an epidural. They come into labor and delivery with plans and promises, skills and techniques to see them through, feeling certain they can achieve their goal of a 100 percent natural birth because they're prepared, they're tough and, c'mon, seriously, how bad can it be?

Most women do just fine during early labor using the skills they learned in their prenatal classes. When the going gets tough, they work with their nurses, doulas, partners and providers and pull out their relaxation techniques, patterned breathing, self-hypnosis, meditation, massage ... whatever they've got. When labor gets way more ferocious than they thought it would be and they've used up everything they came with, many mothers wind up begging for that epidural they swore they wouldn't get.

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It's not that women are quitters, it's that the commitment they made to have a natural labor was based on information they simply didn't have. They didn't know how long they'd be in labor or how tired they'd get, what their pain tolerance would be, if they'd be overwhelmed or frightened. They didn't know if they'd need an induction or be up for nights with pre-labor contractions before big-time labor kicked in to high gear. They didn't know if the coping skills they practiced would be adequate for the job. In short, they didn't know what they were in for until they were in it 100 percent. That's where the commitment to a natural labor breaks down and women hit the wall.

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Hitting the wall is the not-so-technical term for the moment when labor reaches a point of intensity that's totally overwhelming. It might be brief and mom rides the wave and gets past it, but it might also grab hold and not let up. It might come at 2 centimeters or at 10. But if that overwhelming, oh-my-God-I-can't-do-this-one-more-minute feeling happens to you, and the anesthetist with her cart full of epidural supplies and pain relief is one phone call away ... you, like many mothers, might make that call. That is unless you have an action plan, such as the one I wrote about in The Complete Illustrated Birthing Companion. Check out chapter four: "Unmedicated, Vaginal Birth In A Hospital."

Here's your plan for what to do before you change your mind about a natural birth. When you hit the wall, commit to going through each of these nine steps before you ask for an epidural:

1. Change positions or take a walk

2. Get in the shower or tub

3. Try an entirely different breathing or relaxation technique

4. Ask for a massage

5. Tell your labor support people the pain is more than you can handle. Ask for a progress report. That might mean a cervical exam where you'll find out you're 10 centimeters and almost done or that you're 3 centimeters and have hours to go. That information can help you plan your next steps.

6. Wait 10 more contractions before you do anything else

7. Try IV medication (narcotics) if they're safe during your stage of labor

8. Repeat steps 1-7. Sometimes all you need to get over a rough patch is a plan. You might repeat these steps many times and that's all you'll need. If they're not though, proceed to step nine

9. Ask for an epidural and be OK with that decision. Epidurals are tools —that's all. They're not the enemy. They're available to help you deal with a job that's a lot harder than you ever thought it would be.

If you get through labor without medication...and that's what you wanted to do ... that's great. If you found it was a lot harder than you expected and got an epidural ... that's great, too. Do not, I repeat, DO NOT beat yourself up about it. Millions of women deliver naturally and millions use epidurals and there's no judgment in either approach. We're mothers. We use the tools we need to get the job done.

Jeanne Faulkner, R.N., lives in Portland, Oregon with her husband and five children. Got a question for Jeanne? E-mail it to

This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.