You don’t die from pain in childbirth; you die from hemorrhaging. After much consideration, reading, consulting with other parents, and thought on the subject, my husband and I were determined to shoot for a natural labor. Were we crazy? Maybe. Did it work out? Yes. Would we go through it again without medical intervention or pain meds, in particular the beloved epideral? YES.
This page is based on my experience. Unexpected things happen in labor and this is no criticism of mothers who do not end up going “med-free.” Rather, it’s an encouragement for all mothers to TRY to go “med-free.”
1) Why unmedicated?
I thought you got pregnant, got bigger over 9 months, and then went to the hospital to delivery the baby. I assumed the doctors did their thing and then voila! the baby arrived. Labor and delivery are not so straightforward as this.
Here are my two reasons for aiming for an unmedicated birth: 1) better for baby and 2) better for mama.
The motivation to endure hard labor without pain medication is that simple for me. I read Erica Lyons’ “Big Book of Birth.” I talked to a close friend who had her son and daughter with midwives medicine-free. I watched a couple describe how the Bradley Method brought them even closer together throughout pregnancy, and then how it made the birth experience a mutual journey for them. I listened to accounts of infections at the site of the epidural (landing mama in ICU), moms being so out of it they didn’t know if the baby had even come out, and C-sections that seemed more convenient than necessary.
Everything pointed towards the facts that if you can prep yourself, have the right support, and get through labor without drugs, you will feel better, you will bond with your newborn better, your baby will be healthier, and your baby will receive the gift of a med-free entrance into the world.
I do not believe you can feasibly go through pre-planned unmedicated labor without preparation. Your partner has to be onboard with this. It’s kind of like breastfeeding that way. You need to both be committed. No matter how much you prepare and plan, anything can happen. Much of labor is out of your control. Your baby has a huge say in how he will emerge and your medical provider will also have a huge say in the matter. So why not be as prepared as possible to face labor without medical intervention!
a) Read the Bradley Method book. Together. Practice having your partner coach you through a contraction. You must practice what your partner will say. If you don’t practice, your partner is not going to read aloud from the book while it is actually happening.
b) Hire a doula. She will be worth her weight in gold. Your partner needs a support person. See the page on Dads for Doulas. You both need a support person. In particular if you are in a hospital setting where the nurses/midwives aren’t with you throughout all of labor.
c) Read accounts of other women’s births. How bad was it without meds? Reflect on your commitment level. At what point, if any, will you give yourself permission to ask for meds? Know where your limits are. Don’t make this be about success or failure. Labor is a series of unforeseeable and unexpected events. Have a Plan A, B, C, and Z.
d) Ask for support from your family and close friends. Have them talk it up, that you can do this without meds or intervention. Mentally train for this. It’s not just a physical marathon, it’s an emotional and mental one too.
3) Hospital versus home.
We birthed in a hospital with a neonatal intensive care unit across the hall from the Birth Center, complete with around-the-clock neonatal surgeons. I couldn’t birth anywhere other than that kind of environment. Many friends love their free-standing birth center births or home births and I get why (re: non-sterile hospital environment, comfortable, easier transportation while in labor, peace, tranquility, etc). However if anything, anything, were to happen to my baby because I wasn’t across the hall from neonatal surgeons and a neonatal ICU, I couldn’t live with myself.
4) Hospital reputation.
Important questions to find answers to:
a) Is your selected hospital supportive of unmedicated birth?
b) Will they follow your wishes in your Birth Plan? Do they provide a template Birth Plan?
c) Will your doula have to fight off the nurses’ encouragement of pain meds or laying down the whole time?
d) If you are birthing with an OB and not a midwife, will the nurses be cheering you on? (Mine was!)
e) Are the doctors in your primary doctor’s practice group in favor of natural birth or do they have to hurry you along for their golf game? (I’ve never actually heard of anyone I know having a doctor hurry them along for convenience’s sake.)
f) Do you get to meet all the midwives in their practice group?
g) Is there a separate labor/delivery room from recovery?
h) Is there a shower in either or both?
i) Is there a birthing tub if you need the reprieve of water to slow your labor a bit?
j) Do you have to have continuous fetal monitoring?
k) Does your room have a squat bar? Birth ball? Can you bring your own?
5) Progression of labor.
My water broke at home just before 7 am. My husband coached me through contractions until noonish when they had become longer, stronger, closer together to the point of needing to go to the hospital. Our doula was at the house with us providing great conversation and amazing counter pressure on my back. When I was admitted to the hospital a little after 12pm, I was 5 cms dilated and 80% effaced. By 2:30, I received the go-ahead to push: 10 cms and 100% effaced. By 3:34, SuperBoy was on my chest with AA cutting his umbilical cord. I had one tiny first degree tear, no episiotomy (which I credit to my great team including the OBGYN who did perineal massage), and was eating takeout pizza 20 minutes later. SuperBoy was 8 pounds, 10 ounces and healthy as a horse.
Yes, it was incredibly painful to endure the contractions, but relatively speaking, I had an easy labor. The pushing was the most painful experience imaginable. But I plan on going through unmedicated labor with all my babies, so clearly the pain level is not a deterrent for me.
6) Benefits to med-free birth.
A few benefits to no medications: mental clarity, ability to move freely about the room, and ease of recovery. At no point was I out of it, or disconnected from my body due to pain meds. I was keenly aware of breathing through and attempting to relax through contractions, and able to listen to what my body was directing me to do (push, change positions, etc). If you are on continuous fetal monitoring or having any injections, you need to be in bed, laying on your back, with an IV in you. In particular, an epidural is injected into your spinal column and requires you to be very much in bed with lots of cords, tubes, and wires attached to you. Without these apparati, I sat on a birth ball, leaned against the wall, pressed against the squat bar, draped over my husband, and was on my hands & knees to go through contractions. Lastly, recovery was simple in that I had no meds in me and therefore had no additional complications or need for medicine to counteract other medicine. I was tired but felt fine.
In conclusion, I’m no superwoman with a super high pain threshold. It doesn’t take extraordinary strength to plan for an unmedicated birth. Note the words “to plan for” as none of us know what complications we will encounter while in the process of bringing our baby into the world. Despite the unknown, it just makes sense to not simply hope for the best, but to plan for it.