Hoping for a natural birth? Here's your plan for success.
No two birth plans—or births—are exactly alike. Each mom-to-be must decide the where, when, and how that works best for her, based on her goals, preferences, and medical situation. Plenty of expectant moms are happy to take advantage of all that modern medicine has to offer for childbirth, while others envision a more natural birth, sans epidural or other pain medication.
And no, you're not a silly, deluded hippie if you believe in your ability to get through labor without interventions. It takes work and preparation, but it is possible. Here are eight things you can do to help you achieve your goal of birthing without pain medication.
1. Do your research
Cara Osborne, CNM, ScD, a certified nurse midwife and the founder and chief clinical officer of Baby+Co, a chain of birth centers in the United States, believes that becoming completely informed is one of the most important things you can do in preparing for a natural birth. "Giving birth is an uncontrollable process, but it's an active process. Understanding the physiology of birth, the different stages and processes, can help a lot." Comprehensive childbirth classes (especially independent ones geared towards low-intervention birth) and lots of reading will help.
2. Know why you want an unmedicated birth
What does that mean to you—giving birth without any intervention at all or just without pain meds? Do you want to limit intervention because of possible side effects, previous experiences with medical settings, or a sense of personal accomplishment? Every person will have a different why. Osborne advises that finding yours will help you address that concern, no matter what happens in your labor. Georgia Ragonetti-Zebell, MD, FACOG, an obstetrician-gynecologist who blogs at Momma Docs, says she was committed to unmedicated birth for all four of her labors: "I wanted to experience childbirth the way that nature intended—that was my goal. That meant feeling all of the sensations, even if some of them were negative."
3. Pick your setting carefully
If possible with your insurance, financial situation, and location, choose to give birth somewhere where low-intervention birth is common and supported by the overall system. Osborne says often people choose their provider and then a location, but notes that today's system of group obstetric practices make it very unlikely you'll actually have your preferred provider during birth. She says: "Ask good questions at the facility tour. Look for the availability of other labor tools. Do the policies and procedures at this location line up with your goals?" Choosing midwifery care can also lower your chances of intervention.
4. Prepare mentally
Yes, women have been giving birth since the beginning of humanity. But you really do have to do some mental preparation for this physical event. Dr. Ragonetti says, "I see some patients that say, 'I'm going to give it a try.' If you really want an unmedicated birth, that 'I'll try' mindset rarely works out. While women have been doing it for centuries, they didn't always have the option of an epidural right next door, so you need to do something to prepare if you want to avoid medication." Programs like Bradley, Hypnobabies, GentleBirth, and Blissborn can all arm you with mental and emotional coping techniques that will prove helpful. Books like Mindful Birthing or Birthing From Within (both of which have useful pain-coping exercises) can also give you some techniques to call on when contractions are rolling.
5. Make sure you're up on alternate methods for managing pain
Birthing tub? Yes. Massage? Yes. Birth ball, TENS unit, acupressure? Yes, yes, and yes. If you're really serious about avoiding pain medication, you must learn about and become comfortable with other coping methods, like the rebozo (a type of large cloth traditionally used in Mexican culture), visualization, and even lesser-known options like sterile water injections. Find out which ones are available at the place where you're giving birth and ask questions about when in labor you can use them. Bring your own, if possible. Make sure you have some go-to comfort measures you'll try first, but have plenty of backup ideas in your arsenal if your picks don't work.
6. Hire a doula
Doulas are non-medical childbirth support people who are specially trained and experienced in emotional, mental, and physical labor support. A Cochrane review from 2013 found that women who used continuous support people like doulas had a higher chance of spontaneous vaginal birth and were more satisfied with their births overall. For a more natural birth experience, doulas may be worth the price tag. Osborne says, "It's hard to overstate the value of someone who stays with you for your entire labor, knows what's going on, and can tell you that things are normal." A doula has likely seen a number of unmedicated births and can help you work towards this goal, as well as assist you if you need or want medical interventions. When you hire a doula well before birth, you can develop a trusting relationship that can help you feel safer and more supported throughout your labor.
7. Get your support people on board
It's all well and good to plan a natural birth, but if your mom is begging you to get an epidural when you're at 5 centimeters because she can't bear to see you hurting, it can be pretty difficult to continue. The people you plan on having in your birth room need to be on board with your plan. "Support people, including partners, family and friends, need to be prepared for what natural childbirth may look like," Dr. Ragonetti says. "It is very hard to see your loved one in pain, so people should be prepared for vomiting, moaning, pooping, and all of the other sights and sounds of birth." If you don't think your labor guests can handle it, consider leaving them out of the experience or reserving the right to kick them out as things progress.
8. Consider what happens if your plan goes off track
There's nothing wrong with wanting to have a low-intervention birth—but there's absolutely no shame if that doesn't happen for you, either. You should educate yourself about other options (like IV pain meds and epidurals) and make clear choices about what you would want in the event of a sudden medical complication, an induction, a Cesarean, and more. Thinking through lots of different scenarios can help. "I talk to people about making sure they know their preferences and plans, what's possible and what isn't, and what things they really want to preserve if the situation changes," says Osborne. "Keeping some elements of the initial plan can help make the bigger experience of birth positive." And a healthy baby, healthy mama and the best birth experience possible are really all you can ask for.