Some moms know as soon as they see that positive pregnancy test that they will be delivering with the aid of a pain-numbing epidural, thank you very much. But others might not be so sure they want to go the way of the needle. “I witnessed the births of my niece and nephew and knew I would make different choices if I ever had children,” says P&N Associate Editor Alyson West, a new mom of one in Atlanta. “I knew I needed to give my body a chance to labor and deliver without getting in the way. I wanted to work with my baby to get her here—our first collaboration. It was an intellectual decision to allow a biological event to take place with little to no intervention.”
In addition to the decision being a simple preference for many moms, research indicates that there could be some advantages to avoiding drugs in the delivery room. If you’re weighing your options for a natural delivery, here are a few things you should know.
Side (effect) notes
Most moms who opt for medical pain management during delivery receive either an epidural or intravenous narcotics. While both are safe options—and are, in fact, successfully used in millions of births in the U.S. each year—there is always the potential for side effects.
“Because IV narcotics can cross the placenta from the mother to the baby, the baby is sedated,” shares Alane Park, MD, OB/GYN and one of The Mommy Docs on OWN’s Deliver Me. “This sedation can be seen in the fetal heart rate tracing during labor. IV narcotics may also cause breathing difficulty in the baby at birth,” she adds, although instances of this are rare and can be reversed with medication. The mother might also experience dizziness, nausea and vomiting after receiving IV narcotics.
Epidurals also offer their fair share of unpleasant effects for mom, such as shivering, ringing of the ears, backache, nausea and soreness at the insertion site. More concerning—but less common—occurrences include a drop in blood pressure (which might require additional medication to counter) and fever. But, good to know from Park: “Contrary to what many women may believe, epidurals do not cause long-term, chronic back pain.”
Epidurals can also slow down labor and make contractions weaker, leading to the need for Pitocin (the synthetic form of the naturally occurring hormone oxytocin) to speed things along. And while use of an epidural hasn’t been proven to heighten a mother’s risk of Caesarean delivery, it may increase the need for use of delivery assistance by way of forceps or vacuum extraction.
Of course, there’s a worst-case scenario for every experience—in the instance of epidurals, it involves the exceptionally rare occurrence of permanent nerve damage or paralysis. These extreme events happen in less than 0.03 percent of births, making them highly unlikely.
Dare to compare
While you will certainly feel more pain delivering drug-free, many moms claim that following your body’s natural cues rather than suppressing them can make the experience somewhat easier. “When I delivered my daughter [with an epidural], pushing was a nightmare. The doctor had to tell me when and how to push, because my body’s signals were silenced by the epidural. By the time my baby finally arrived, I was utterly spent and slightly delirious. I also tore badly, so I needed plenty of painkillers and had to sit on a doughnut cushion for two weeks,” shares P&N Contributing Editor Ginny Butler, a mom of two in North Salt Lake City.
Butler conquered her next delivery without an epidural. “I learned what it meant to push, really push. It was bad, but I couldn’t believe how quickly it was over.” Her recovery was easier too. “Even though the baby was half a pound bigger, I didn’t tear as badly as I had the first time so recovery was much easier—fewer painkillers, more mobility, no doughnut.”
Since there are so many variables in every birthing experience, crediting a quicker and easier recovery solely to an epidural-free delivery is nearly impossible. However, most moms who have delivered both ways feel that their drug-free labor led to a better postpartum experience. And it certainly makes a difference immediately following birth: Moms who deliver naturally are able to get up and move about almost immediately, whereas those who are still partially numb are bed bound and sometimes suffer from back soreness and “spinal headaches” while in the recovery room.
I am mama, hear me roar
Another reason many moms encourage and practice natural birth is the feeling of empowerment and confidence it provides. “After I gave birth, I was amazed. I had a new respect for my body,” shares West. Butler agrees: “I rode a euphoric adrenaline high that lasted for hours. I felt great!”
Many women also find that going drug-free allows them more power over their labor experience. “Interfering with your body’s natural responses can leave you less in control,” notes Butler. If you aren’t bed bound by an IV or fetal monitoring device, you have the ability to move freely during labor and try techniques that will allow you to naturally control your pain levels. Avoiding labor enhancers, such as Pitocin, offers further control: Not rushing your labor allows for the building of a natural tolerance to your increasing pain levels, which can lessen the perspective of pain and make it more manageable. “When you’re in labor, your brain will only let down the amount of oxytocin that it feels like your body can handle,” shares birthing coach and mother of seven Sara Chana Silverstein. “You might feel like you can’t handle the pain, but your brain is programmed for survival and knows your limits. Once your brain is no longer supplying the oxytocin, your body is no longer receiving its ideal supply, which can lead to increased pain, tearing during delivery and other problems.”
When you head to the delivery room for a natural delivery, you’ll need a solid birth plan for dealing with each stage of labor, a good support team, and a strong feeling of self-belief. Trust that you can do this, no matter how hard it might be. “Your body knows how to deliver a baby. Let it do its thing!” recommends Butler. Chances are, you’ll be glad you did—moms who deliver naturally almost always plan to repeat the experience their next time around.
Know your options
If you’d like to give drug-free birth a try, it’s important to find a natural pain relief option (or two) to help you work your way through the contractions. Here are a few to consider.
Calm, centered breathing and rhythmic breathing can help pains pass more easily.
Positioning and movement.
Stand, sit, squat, kneel … there’s no rule that says you have to labor in bed! Movement such as rocking, bouncing and swaying may offer further relief.
Mentally preparing for the big day by visualizing each event (early labor, active labor, transition, etc.) can make the act of laboring appear as a familiar event rather than something new and scary.
Laboring—and even delivering—in a warm tub of water can provide sweet relief; showers can be comforting too.
Using the voice as a tool by moaning, grunting, or even softly singing or chanting has shown to be an effective implement for some laboring moms.
Both counter pressure and acupressure can provide much needed relief to overworked laboring muscles.
Reaching a state of deep relaxation is becoming a more common choice among moms looking for a way to deliver without the sharp sting of a needle.