In the U.S., giving birth with an epidural has become the norm. Approximately 73% of U.S. laboring patients used an epidural, spinal, or combined spinal-epidural block in 2015, up more than 10% from 2010. In Texas, that percentage is slightly higher, about 76%.
But in the past few years, more patients have inquired about giving birth "naturally" – planning to labor and deliver with limited or no pain medication. Patients have said they want to avoid the low potential risks associated with epidural, and some simply want to see what their bodies can do.
Some women consider any vaginal birth a natural childbirth, regardless of whether it includes getting an epidural or Pitocin to induce labor. Others think natural childbirth is only when there is no medical intervention. Most patients fall somewhere in the middle.
Patients who have had a healthy pregnancy and have had no complications or chronic conditions are good candidates to attempt a natural childbirth. However, it may not be the best choice for some expectant moms. We may suggest having an epidural if you are at high-risk for needing a cesarean section (C-section) so we can potentially avoid using general anesthesia. You might also be considered high risk if you have a heart condition, preeclampsia, or diabetes, or if you’re having twins or a baby in the breech position.
Our Ob/Gyns and certified nurse-midwives support patients in achieving the birth experience they want without judgment – with or without medication. We offer laboring moms plenty of options for pain relief, including aromatherapy and nitrous oxide (laughing gas).
If you choose unmedicated childbirth, it's important to prepare your mind and body for the experience. It can be difficult, but there are strategies to reshape how you think about pain, its management, and your birth experience.
Take it from my colleague, Kyler Elwell-Silver, M.D. After having epidurals during labor with her first two babies, she decided to try natural childbirth for her third. She put together five tips for moms to prepare for low- or no-medication labor and how to stay flexible if your birth plan has to change.
Dr. Elwell-Silver's 5 tips for natural childbirth
As an Ob/Gyn, I've delivered many babies through natural childbirth – I wanted firsthand experience in what my patients go through. I'd had a low-risk pregnancy, so I was unlikely to need a cesarean section (C-section) or operative delivery. And this was my third baby, so labor would likely go quickly.
If you and your doctor agree natural childbirth is safe for you and your baby, here are five tips to help you prepare for the big day.
1. Make a ‘natural’ plan with your Ob/Gyn provider
Once you’ve decided you’d like to have a natural childbirth, talk to your Ob/Gyn or midwife. Let the provider know what you mean by “natural childbirth,” and ask about the options their facility offers to support you.
For example, William P. Clements Jr. University Hospital is uniquely set up to be supportive of many childbirth options – from pain relief to emergency care. We have a certified nurse-midwife and a doctor on the floor 24 hours a day, seven days a week to help whether you are in labor for hours or you deliver 10 minutes after arriving.
2. Find a support person or doula
The key to a successful natural childbirth is having a solid support person to distract you from the pain, talk you through what’s next, and cheer you on. This could be your partner, your mom, or a friend who has been through labor before.
Along with my husband, I had a doula with me during my natural childbirth. A doula is someone trained to support a woman through labor. Their goal is to help women achieve the childbirth experience they envision.
Doulas provide a range of services before, during, and after labor and can cost anywhere from $500 to $2,500.
Related reading: What role does a doula play during and after childbirth?
3. Get educated
Labor and delivery can last several hours, and it is painful. The more you know, the better prepared you’ll be.
I recommend taking childbirth classes, which cover everything from deep breathing and pain relief to C-sections. Every labor is unique, and sometimes things don’t go exactly as planned. Being prepared for any situation is important – childbirth classes can give you realistic expectations and instill confidence.
You may want to find a class that teaches the Bradley Method, which breaks down the different stages of labor, what to expect, and how your support person can help coach you through the natural birth process.
Related reading: Class is in session: The many benefits of prenatal education
4. Prepare mentally
In the Western world, people are less accustomed to tolerating intense pain. We associate pain with something being wrong that should be fixed, often with medication.
But pain during childbirth is normal and necessary. It signals that your body is doing what it needs to do. Every wave of pain gets you closer to the goal: your beautiful baby.
My doula helped me get in the right headspace before labor started. Like a professional athlete, I visualized my baby’s birth often during my third trimester and returned to that scene during the labor process. She helped me keep my eyes on the prize throughout the pains of labor and delivery.
5. Learn natural pain management techniques
There are many alternatives to medication when it comes to pain relief. Talk with your health care provider about what is allowed and available where you’ll give birth. You’ll also want to practice your techniques before the big day, so they are second nature when you need them most.
Some natural pain management methods include:
- Breathing techniques, such as those taught in Lamaze
- Essential oils or aromatherapy
- Music therapy
- Taking a warm bath or shower
- Walking around
- Virtual reality
- Using positions such as squatting or sitting on a birthing ball
If you don’t want an epidural, but aren’t opposed to other forms of medical pain relief, you might consider trying nitrous oxide. The nonflammable, colorless gas does not actually reduce pain or take away the sensation of a contraction, like an epidural. Instead, it relieves anxiety, which helps you tolerate the pain.
One piece of advice from my doula that I really appreciated was to focus on other things. My husband and I were scheduled to look at new houses the day I went into labor. So, that's what we did – even though it make our realtor a bit nervous!
Then, we went home and I sat in my warm, soothing bathtub until my husband (who's also a doctor) finally convinced me it was time to head to Clements University Hospital. I checked in, then walked around and chatted with some of my colleagues. My baby was born just minutes after my water broke, not long after we arrived.
Why I enjoyed my natural childbirth
Don't get me wrong – natural childbirth hurts. But I felt prepared when I went into labor. And for me, there were some benefits over getting an epidural.
The most notable benefit was being able to move around during labor and after delivery. With my epidural deliveries, I was confined to the bed since I was numb from the waist down. This time, I could walk around to ease my discomfort. Right after delivery, I could stand up, pick up the baby, and use the bathroom alone (I haven't really been able to do that since, with three kids at home!).
Having had this experience, I now feel better equipped to support and advise my patients before and during delivery.
But remember, there is no wrong way to give birth. Too many women feel pressured to deliver in a certain way. Sometimes medical pain relief or a C-section are necessary. Labor and delivery can be unpredictable, and everyone experiences pain differently.