How do I prepare for natural childbirth?

Once you’ve made up your mind to deliver naturally, you need to actively prepare for it – by developing a birth plan, making sure you’ll be giving birth with the right caregiver in the right environment, ensuring that you have good labor support, and educating yourself about childbirth and coping techniques.

You can have a drug-free delivery in a traditional hospital setting, but it’s likely to be easier to labor naturally at a birth center or at home. Birth centers are designed to provide a natural, family-centered experience, and you can certainly arrange things as you like at home.

If you’re planning a natural childbirth at a hospital, you’ll need to discuss your wishes and goals explicitly with your caregiver, and find out which interventions are routine and how you might get around them. Certain interventions, such as having an IV and continuous electronic monitoring, make moving around more difficult. This tends to make it harder – though not impossible – to handle with the pain without medication.

Many women choose a midwife to guide them through natural childbirth. Midwives are trained to help you cope with the demands of a drug-free labor and often stay with you throughout labor, while doctors typically do not.

If you’re giving birth in a hospital, you’ll be assigned a labor and delivery nurse to care for you. Some nurses are very skilled in natural coping techniques, but you can’t predict which nurse you’re going to get. Nurses come and go in shifts, and the nurse may have other patients to care for as well.

If your practitioner won’t be by your side for the duration of your labor, hiring a doula to stay with you and coach you may be particularly valuable.

Find a childbirth educator with a strong focus on natural childbirth to teach you a variety of coping methods and help you understand what to expect during labor. Understanding what’s happening during each stage can allow you to appreciate and work with your body’s powerful performance.

Whether or not you plan to have a natural delivery, it’s a good idea to learn as much as you can ahead of time about both natural and medicinal pain management. Tension and fear tend to heighten the perception of pain, and anything you can do to ease your anxiety will help with the challenges ahead. Being less anxious may even help the progress of your labor, because high levels of stress hormones can affect your uterus’s ability to contract.

Also, if you’re planning a natural childbirth, it’s important to remember that no matter how well prepared, healthy, or confident you are, it’s always possible that nature will throw you a curveball. You might need medical interventions that make it more difficult to manage your pain naturally, or your labor may be much longer or more painful than you had anticipated.

Even if you feel strongly now about how you’d like to deal with labor pain, a willingness to roll with the reality of your own labor and birth as it unfolds may ultimately be your greatest strength – and will also help you avoid disappointment if you don’t have the “ideal” birth you’d imagined.

Beyond the resolve to give birth without medication, there are no special rules for a natural delivery, but here are a few of the more common natural coping techniques:

Breathing exercises and visualization

Most childbirth classes cover breathing and visualization techniques. You and your partner may be given specific breathing patterns to practice, and your instructor may coach you on using visualization (imagining a place that soothes you, for example, or the safe, easy birth of your baby) to help you work through the pain.

You might also learn techniques like progressive or controlled relaxation, in which you release tension by zeroing in on a particular muscle, tightening it up, and then letting it go until it’s as loose as possible.

These techniques draw on relaxation and partnership as a way to manage your contractions, and they may work especially well if your labor progresses as it should.

If you’ve ever studied yoga, a martial art, or meditation, you might already have the practice you need to breathe through your birth. You might find, too, that bringing something special to look at (a favorite photograph, for instance) and having soothing music helps you relax.

One-to-one labor support

Having someone at your side who’s committed to giving you emotional reassurance as well as helping you be as comfortable as possible can dramatically reduce your anxiety and stress level and help you get through the rigors of labor without drugs.

Research shows that women who have continuous professional support are less likely to need systemic pain medication or an epidural during labor, tend to have slightly shorter labors, and are more likely to have a normal vaginal birth than those who don’t have such support. This may be especially true when one of the people attending you is a specialist like a doula, who has no other responsibilities but to offer support in labor and minister to your comfort.

Positioning and movement

When you’re not medicated or tethered to a monitor, you can try a variety of positions during labor, including standing or leaning on your partner, sitting, and kneeling (either upright or on all fours).

You may find movement comforting, too, and can try walking or rocking in a chair or on a birth ball. Moving around can make you feel more in control, thus lessening your anxiety and pain. Some hospitals have wireless monitoring systems, so even if you have complications that require continuous monitoring you might still be able to move about freely.

During the pushing stage, an upright position may help your baby descend, and squatting or kneeling may help to open your pelvic outlet. That said, the differences aren’t that great – so feel free to try a variety of positions and settle on the ones that make you most comfortable.

Hypnosis

Some studies suggest that hypnosis may reduce your need for pain relief medication during labor, reduce the need for oxytocin, and make a normal vaginal birth more likely. To use self-hypnosis, you’ll need training and practice ahead of time so you can learn how to focus and relax your muscles during labor.

Massage, touch, and hot and cold therapy

Massage promotes relaxation, soothes tense muscles, and may reduce your perception of labor pain. You can get a massage from your doula or other support person, or from your partner – a loved one’s touch can be very reassuring if you’re feeling anxious. You may be comforted by light stroking, or you might prefer a stronger touch.

If you’re having back labor, you’ll probably want firm massage or steady counterpressure applied to your lower back. At times during your labor, though, you may find massage to be annoying and will need to communicate that to your support team.

Many women also swear by using warm compresses or a hot water bottle on an aching lower belly or back – or anywhere else they’re feeling discomfort – to help them relax and reduce pain. Some find cold packs more soothing, while others prefer alternating hot and cold. It’s worth giving each a try. Just be sure to protect your skin from direct contact with heat or cold.

Hydrotherapy

Hydrotherapy – using water to soothe and relax the body – can help ease the discomforts of labor.

Soaking in a bath at home appeals to some women during early labor. Most birth centers (and some hospitals) provide extra-large or Jacuzzi-style tubs for laboring women. And to prepare for giving birth at home, some women rent special portable tubs that are larger, deeper, and softer than a regular bathtub.

Like other drug-free options, hydrotherapy allows you to remain alert and in control. Immersing yourself in water relieves pressure on the body, promotes muscle relaxation, and may reduce pain, anxiety, and the need for medication. As many women who have been there will attest, a warm shower can also be soothing during labor.

If you choose to settle in for a soak, make sure the tub water is at body temperature (98.6 degrees Fahrenheit) or cooler. Anything higher can raise your temperature – and your baby’s temperature and heart rate.

Not all women are good candidates for water therapy during labor, of course. It’s clearly not an option if you have complications that necessitate continuous monitoring, for instance. And most caregivers advise against immersion if your water’s already broken, to avoid the risk of infection from bacteria lurking in the tub, water jets, or hosing. (A shower is fine, though.)

Acupuncture

Acupuncture, used for centuries in traditional Chinese medicine, involves inserting and manipulating fine needles at specific points on your body.

No one really knows for sure how acupuncture works to reduce pain. Two common theories are that the technique either blocks certain pain impulses to the brain or stimulates the release of natural pain relievers called endorphins. The acupuncture points commonly used in labor include spots on the hands, feet, and ears.

Though there aren’t a lot of good studies on the use of acupuncture in labor, available evidence suggests that it reduces the need for pain medication and possibly lowers the likelihood that you’ll need oxytocin to augment contractions.

The downside of this technique is that it requires a skilled practitioner, and few doctors or midwives are trained acupuncturists. If you’re interested in trying this method and are having your baby at a birth center or at home, you may be able to arrange for a certified acupuncturist to be on hand.

What are the advantages of natural childbirth?

If you want to remain in control of your body as much as possible, be an active participant throughout labor, and have minimal routine interventions such as fetal monitoring in the birth process, then a natural, unmedicated approach to controlling labor pain will suit you best.

If you choose to go this route, you accept the potential for pain and discomfort as part and parcel of giving birth — an experience that includes working with complete awareness through each stage of labor. But with the right preparation and support, you’ll probably feel empowered and deeply satisfied by natural childbirth.

Here are the pros:

• Most natural childbirth techniques are not invasive, so there’s little potential for harm or side effects for you or your baby.

• Many women have a strong feeling of empowerment during labor and a sense of accomplishment afterward. And despite having to endure pain, many report that they’d want an unmedicated birth again the next time. For some women, being in charge helps lessen their perception of pain.

• There’s no loss of sensation or alertness. You’ll be awake and active during labor and birth — so you can move around more freely and find positions that help you stay comfortable during labor and remain able to aid the delivery process when it’s time to push your baby out.

• If you don’t need to be hooked up to an IV or a monitor, you can move around with ease

• You’re less likely than women who get epidurals to need interventions such as oxytocin (Pitocin) to make your contractions stronger, bladder catheterization, or a vacuum extraction or forceps delivery.

• Your partner will feel involved in the process as you work together to manage your pain.

• Breathing exercises, visualization, and self-hypnosis can be practiced ahead of time — and used again later. Many new mothers find themselves drawing on their relaxation techniques in the early days of breastfeeding, while coping with postpartum discomfort, or when caring for a newborn feels especially stressful.

What are the disadvantages of going without drugs?

Unlike an epidural, natural pain-reduction techniques don’t eliminate pain — so if you’re not willing to feel and work with the pain, you’ll be happier with an epidural. Also, natural approaches may not offer adequate pain management, particularly if you end up with a prolonged labor or a complicated labor that requires a lot of interventions.