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What are the benefits of natural childbirth?
A natural, unmedicated approach to labor and birth will suit you best 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 continuous electronic monitoring.
If you choose to go this route, you accept the potential for pain and discomfort as part of giving birth. But with the right preparation and support, women often 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. Despite having to endure pain, many report that they'll choose 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 can move around more freely and find positions that help you stay comfortable during labor. And you'll remain able to participate in the delivery process when it's time to push your baby out.
- 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 can be involved in the process as you work together to manage your pain.
- You can use the breathing exercises, visualization, and self-hypnosis you learn both during labor and later on. Many new mothers find themselves drawing on their relaxation techniques in the early days of breastfeeding, while coping with postpartum discomfort, or during those times when caring for a newborn feels especially stressful.
What are the risks of natural childbirth?
Unlike an epidural, natural pain-reduction techniques don't eliminate pain. So if you're not interested in feeling and working 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.
Preparing for natural childbirth
Once you've made up your mind to try to deliver naturally, you need to actively prepare for it. You can do this by choosing a supportive caregiver and birth environment, developing a birth plan, ensuring that you have good labor support, and educating yourself about childbirth and coping techniques.
It's possible to have a drug-free delivery in a traditional hospital setting, but for many women it's easier to labor naturally in an alternative setting, such as 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 in a traditional hospital setting, you'll want to discuss your wishes and goals explicitly with your caregiver. Find out which interventions are considered routine at the hospital and how you might get around them.
Certain interventions, such as having an IV and continuous electronic monitoring, make it difficult to move around. Having to stay put like that tends to make it harder to handle labor pain without medication. (Note that the American College of Obstetricians and Gynecologists recommends that women with low-risk pregnancies have the option of intermittent monitoring and frequent labor position changes.)
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, which 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.
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 medical 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 it will also help you avoid disappointment if you don't have the birth experience 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.
One-to-one labor support
Having someone at your side who's committed to giving you emotional reassurance and helping you be as comfortable as possible can dramatically reduce your anxiety and stress level. This can help you feel more in control 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 less likely to have a forceps or vacuum-assisted delivery or a c-section 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.
Breathing exercises and visualization
Most childbirth classes cover focused 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.
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.
These techniques draw on relaxation and partnership as a way to manage your contractions. And there's some research suggesting that relaxation techniques and yoga are associated with decreased pain, fewer forceps or vacuum-assisted deliveries, and increased satisfaction with the experience of childbirth.
Positioning and movement
When you're not medicated, 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. Try walking around or rocking in a chair or on a birthing ball. Moving around can make you feel more in control, which may ease your anxiety and pain. And a meta-analysis of studies looking at positioning and movement during the first stage of labor suggests that being upright or walking around may shorten it by about an hour.
Even if you have complications that require continuous monitoring, you can still try a variety of positions in bed. You may also be able to stand, sit, or pace at your bedside.
Some hospitals have wireless monitoring systems (known as telemetry) that enable you to move about freely. If a waterproof unit is available, you'll even be able to take a shower.
During the pushing stage, an upright position may help your baby descend, and squatting or kneeling may help open your pelvic outlet. That said, the best positions are the ones that work for you. So feel free to try a variety of positions and settle on the ones that make you most comfortable.
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 – using water to soothe and relax the body – may 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. What's more, there's evidence suggesting that it may also decrease the length of the first stage of 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 as well as 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 call for 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, and many women find a warm shower to be soothing.
Acupuncture or acupressure
Acupuncture, used for centuries in traditional Chinese medicine, involves inserting and manipulating fine needles at specific points on your body. Acupressure uses no needles and entails applying pressure to these points.
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.
There aren't a lot of good studies on the use of acupuncture or acupressure in labor, and the results are conflicting. There's some evidence that the techniques may help reduce pain, but other studies show no effect. In some studies, the use of acupuncture and acupressure was linked to a reduction in forceps or vacuum-assisted delivery, and in one study these techniques were associated with a lower c-section rate.
The downside of acupuncture is that it requires a skilled practitioner, and few doctors or midwives are trained in this technique. 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.
Some women have turned to self-hypnosis during childbirth to reduce tension, fear, and the sensation of pain. To use this technique, you'll need training and practice ahead of time so you can learn how to focus and relax your muscles during labor. However, a recent review concluded that there is insufficient evidence to judge the effectiveness of self-hypnosis during labor.
Our site videos on natural childbirth
Natural Birth: Watch one mom's experience of giving birth without pain medication.
Positions to Ease Labor Pain: See positions and movements that can help ease labor pain naturally, such as swaying in the "birth dance" position, rolling your hips on a birthing ball, or leaning on a wall.
Water birth: Watch a mom of three give birth to her fourth child underwater, in a special tub made for birth.