13 Tips for Having a Successful Non-Medicated, Low-Intervention 'Natural' Birth
While "natural birth" is an outdated term, it often refers to an unmedicated vaginal delivery with minimal interventions. This type of childbirth isn't for everyone, but ditching the drugs might have some advantages for pregnant people. For example, those who get an epidural have a greater incidence of risky interventions to get Baby out, such as vacuum extraction, delivery by forceps, and emergency C-section, according to a study in National Vital Statistics Reports. An epidural can also mean short-lived but unsavory side effects for Mom, including low blood pressure, headache, and fever.
Recovery can also be smoother for those who deliver without drugs or anesthesia. "These moms are up faster, feel better, and often experience less tearing and swelling," says Ryan Dickerson, M.D., an obstetrician in Baton Rouge. Women who skip the meds instinctively push, rather than exerting when they are told, which means less pushing and less tearing, Dr. Dickerson explains. Other reasons moms with unmedicated births stay more intact: They generally don't need equipment to get Baby out and they get vaginal exams to see how far labor has progressed.
An unmedicated childbirth is an entirely achievable and reasonable goal for about 85 percent of pregnant women. The other 15 percent have health complications that put them in a high-risk category, and they need certain interventions (such as a Cesarean section) to make birth safer for Mom or Baby.
If you want to have a drug-free delivery, tap into these "natural birth" tips from experts. Most of the tips work for "natural" home births and "natural" hospital births. Even if you do opt for the epidural (remember, it's your choice!), these strategies can help you stay calmer and more comfortable until the anesthesiologist arrives.
(Note: The term "natural childbirth" is problematic. Labor and delivery are natural processes for all pregnant people, whether they have a C-section, a medicated vaginal delivery, or an unmedicated one. No method of delivery is superior to others. When referring to a low-intervention birth, a better term would be "drug-free birth" or "unmedicated birth.")
1. Know why you want an unmedicated birth.
What does "natural birth" mean to you—giving birth without any intervention at all or just without pain medication? 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 reason why, and finding yours will help you address that concern, no matter what happens in your labor.
2. Enroll in childbirth classes.
Wondering how to prepare for "natural birth?" Start by getting a solid prenatal education with classes that include how labor and birth work, as well as natural labor pain management techniques like breathing, self-hypnosis, and relaxation. Some popular options include Lamaze, the Bradley method, Hypnobirthing, and Hypnobabies.
- RELATED: What to Expect in Lamaze Class
3. Create a "natural birth" plan.
Once you have an idea of your ideal birthing experience, the next smart step is creating a birth plan that details what you'd like to happen before, during, and after labor. Along with general preferences such as who you'd like to be in the hospital room during delivery, what the physical environment should be like, and if you wish to breastfeed, your "natural birth" plan may include extra preferences like the following:
4. Pick a health care provider who's into "natural birth."
"Look for a midwife or doctor who is just as invested as you are in 'natural' childbirth," advises Maria Lorillo, Licensed Midwife (LM), Certified Professional Midwife (CPM) at wisewomanchildbirth.com, in San Francisco. "She or he will manage the entire birth in a way that's most conducive to success." You can also consider hiring a doula, who acts as your own personal cheerleader and supports you before, during, and after labor.
5. Learn to face contractions.
One of the secrets to an unmedicated birth is being able to relax in response to pain—a tall order, we know. When you're afraid in the throes of agonizing contractions, your body's reaction is to stiffen, which tends to exacerbate discomfort, explains Heidi Rinehart, M.D., an obstetrician in Keene, New Hampshire. Fear increases tension, which ups the agony. "When you're tense, some muscles are tightening and trying to hold the baby in, while the muscles in your uterus are tightening to try to push the baby out," says Dr. Rinehart. "The muscles are fighting with each other, which makes it hurt more."
If you can stay (somewhat!) relaxed in the face of strong contractions, you'll have less resistance to opening up for the baby to come out. One trick? Try an exercise called The Grip throughout pregnancy. "It simulates contractions and allows you to up your pain threshold," says Julietta Appleton, certified childbirth educator, hypnotherapist, and labor doula in Bedford Corners, New York. Lie down on your side with a pillow between your knees, and if you're in your third trimester, with one supporting your belly too. Have your partner apply steady pressure to the muscle between your neck and shoulder for one minute. Focus on relaxing that muscle beneath your partner's gasp. Wait for the pressure to grow very strong before tapering off. The idea is to get used to relaxing your muscles rather than tensing them in response to pain. You can also try the space between your thumb and index finger, or an even more sensitive area, such as the Achilles tendon at the back of your ankle.
6. Know how to squat.
Contrary to what you see in most movie birthing scenes, you don't have to be lying in a hospital bed to have a baby. In fact, many women are more inclined to squat during labor. Squatting opens the pelvis and helps the baby get into the ideal birthing position (head down, face toward back, chin tucked in), explains Henry Dorn, M.D., an obstetrician in High Point, North Carolina. It's most effective if you've been practicing your squats throughout your pregnancy and building those muscles in your legs.
It's safe to practice squatting throughout pregnancy as there's no evidence it can induce labor. "If your doctor tells you the baby is not in an optimal place in the last trimester," says Dr. Dorn, "try kneeling, sitting cross-legged, or perching on an exercise ball for as much of the day as possible." Or, open a door, hold onto the doorknobs on either side, and drop into a squat for one or two minutes with your knees wide apart. Pull yourself back up using the doorknobs.
- RELATED: The Best Positions for Labor
7. Start an exercise routine.
Like long distance running, childbirth calls for energy and stamina. "You increase your chances for success (of drug-free birth) by being very physically fit," Dr. Dickerson says. You'll want to consider the nine months of pregnancy your training period, and start preparing for labor early on by working out regularly, he says. Dr. Dickerson's prescription: 30 minutes of movement, seven days a week. Hit the elliptical machine or stationary bike and aim to get your heart rate up, or lace up your sneaks and walk whenever you can. (However, if you were not physically fit before becoming pregnant, check with your doctor to come up with a safe cardio plan for you.)
Flexibility, especially in your hips, will help you when it comes time to push, so stretching sessions are important, too. Shoot for 30 minutes of prenatal yoga one or two days a week. Cautionary word to the wise: Your body produces relaxin in pregnancy, which makes you naturally flexible, so be careful not to overstretch or work yourself too hard.
Exercise will also prevent you from gaining too much weight, which correlates with delivering a bigger baby. The larger the baby, the harder they'll be to get out, emphasizes Dr. Dickerson. Of course, following a healthy diet is also key. Pass the veggies, please!
8. Spend early labor at home.
If you want an unmedicated "natural birth," you might want to stay home from the hospital as long as possible, especially if this is your first baby. That's because the best strategies for achieving a drug-free labor are often easier to put into action at home than in the hospital.
Most low-risk women are perfectly safe spending early labor at home. During early labor, which can take an average of eight hours or more for a first time mom, the cervix softens, thins, and eventually dilates. Doctors used to say that women should head to the hospital when they were in active labor, which was defined as starting at four centimeters. But studies indicate that this leads to too many unnecessary cesarean sections. Revised definitions take into account the fact that early labor often takes a whole lot longer than many providers have previously been willing to wait. In fact, the American College of Obstetricians and Gynecologists now says that for first-time moms, active labor begins when the cervix is dilated to about six centimeters.
When women head to the hospital during early labor, they may spend too many hours in bed with doctors, midwives, and nurses clocking their progress. They can expect long hours of fetal heart and contraction monitoring, lots of staff interruptions, and limited access to a tub or ability to move around.
If you're spending early labor at home, give your midwife, doctor, or hospital a call when your contractions are at least five minutes apart for an hour or more. Also call your doctor if contractions are getting progressively stronger and closer together no matter how you move. If they're five minutes apart while you're lying in bed but spaced further apart when you move to the tub or go for a walk, it's probably not time to go to the hospital yet.
9. Move around during labor.
When you begin labor, keep moving to stay comfortable. Walking, rocking, squatting, sitting, swaying, and switching sides while resting can help your body work with your contractions as gravity and mobility help Baby move into the birth canal. Plus, movement eases tension and gives your mind something to focus on other than pain.
"Walk and stretch, sit on a birthing ball, and hop in and out of the birthing tub if it's available," says Dana Gossett, M.D., an OB-GYN at Northwestern Memorial Hospital in Chicago. And use a combo of gravity and hip movement to help the baby come down, advises Dr. Rinehart, who delivered two of her own three children without medication. "When you take the cork out of a wine bottle, you don't take it straight out, you jiggle it back and forth to get it to ease through," says Dr. Rinehart. "Movement of the hips, belly dancing, hula dancing, squatting, rocking, pelvic tilts, and such help maneuver the baby down and through to find the easiest path out of the mother," she says.
10. Use water to manage "natural birth" pain.
Even if you're not having a "natural water birth," you can use a shower, bathtub, birthing pool, or hot compresses for easing pain and helping you relax. Some women love spending as much time as possible in water during labor.
11. Remember to relax.
Rhythmic breathing, meditation, self-hypnosis, and other relaxation techniques are excellent tools for all stages of labor, but they're easier to manage when you're not being interrupted. Once you're in the hospital, your nurse will frequently check your vital signs, hook up monitors, draw blood, start IVs, and do other interventions that may clash with your Zen. At home, you can light candles, close your eyes, follow your breath, meditate, and create an ambiance that promotes relaxation.
12. Practice patience when following "natural birth" tips.
Some labors start with days of on-and-off contractions that wear moms out long before "real labor" begins. Even after contractions get organized into a regular pattern, early labor takes an average of eight hours for a first-time mother and five or more for experienced moms. As much as you'd like labor to be over, there's usually no need to rush things. Keep yourself entertained, relaxed, hydrated, and nourished and plan on labor being a marathon, not a sprint. Be sure to let your midwife or doctor know if you're becoming exhausted. They'll help you decide on next steps, whether that's at home or in the hospital.
If you're bleeding heavily, your baby's not moving, you feel ill or have any other concerns that your labor isn't progressing normally, then forget about staying home and go to the hospital, where your provider can evaluate you and your baby. And, if you arrive at the hospital only to discover that everything's normal but you're still in early labor, think about heading back home. There's no shame in that and you may increase your chances for having the "natural birth" you hoped for.
13. Decide when to get an epidural.
If you can't focus during contractions or relax between them, doctors agree it's probably a good idea to ask for pain meds, which at this point may help move things along. Your pelvic muscles can go into spasm mode if you aren't able to catch a breath between contractions, and then it's difficult for the baby to descend. An epidural, by relieving your pain, can let the pelvis do its job. Have an open mind: "If you reach the point where a [drug-free] labor is just not happening, you have to accept what's good for your child," Dr. Gossett. "The goal is a healthy baby."