Preparing for an Unmedicated Birth
Guiding Principles for the Unmedicated Birth Conversation:
- I use the word “unmedicated” to describe a vaginal birth without the use of pain medication, instead of “natural.” All types of birth are natural; “unmedicated” is a more accurate, objective description.
- No one can tell you how you will experience the sensations of birth. There is a full spectrum from tales of pleasurable, even orgasmic, birth to intense and acute pain or even suffering. It is presumptuous to think that we could impart our own experience onto another person’s and tell them what birth will feel like for them.
- MANY factors contribute to our perception of pain during childbirth — some are things we have control over, others are not. Birth environment, baby’s position, our personal pain tolerance, and our mental preparation all have influence.
- Finally, a note about the word pain: I choose to use this word because it is reflective of my own experiences and used by many to describe what they experience during birth, especially in the later stages. I recognize that the pain of childbirth is different than the pain of breaking a bone or experiencing a cut or burn. To me, it is not a negative word within this context, but some choose to avoid using this word when discussing birth and opt for something like pressure, discomfort, or sensations. The language we use surrounding birth does indeed matter and you will find the language you feel comfortable with.
For most, achieving an unmedicated birth requires some level of preparation throughout pregnancy. I’ve divided these areas of focus into education, spiritual and mental work, and a supportive environment.
1. Education
Find the most enjoyable method of education for you and your partner’s personalities. This may come in the form of a childbirth education class (through your hospital/provider or online), reading, or listening to podcasts. Having a basic understanding of how long a typical labor lasts, the hallmarks of each stage of labor, and variations in types of labors is a good start for preparing for an unmedicated birth. This knowledge allows you to avoid confusion during the labor process and adjust your expectations for what you may experience. Learning about the cervix and how it prepares and changes over the course of labor can strengthen your confidence in your body’s ability to birth your baby, even when it feels like an impossible challenge. Choosing a few comfort measures (such as position changes, counterpressure and massage, a TENS unit, etc.) to use over the course of your labor and educating yourself on using them effectively can help you cope without medication.
I believe that one of the best ways to prepare for your birth is to listen to birth stories of all kinds. Listen with a careful ear that accepts each story as someone else’s experience, not prescriptive of what yours will be like. When we hear a variety of ways that birth can play out and see the meaning that people draw from these experiences, positive or negative, we are better prepared for to accept our own birth stories. They also expose you to some terms and information that you may encounter in your own birth experience. Birthing Outside the Box, The Birth Hour, The Homebirth Midwives, and Birthful are some of my favorite podcasts that share birth stories.
There are many more areas of education to dive into based on your interest and bandwidth, such as how the baby’s position can affect the progression of labor and your perception of pain, how to use different methods of cervical ripening to prepare your body for when labor begins, and how overall health, including nutrition and movement, can lead to an “easier” labor. While pregnant, get curious about your baby, your body, and birth.
2. The Inner Work of Spiritual and Mental Preparation
People have a variety of reasons for pursuing an unmedicated birth — avoiding certain side effects or complications that may arise with the use of pain medication, wanting to feel present to the birth through their senses, desiring a sense of empowerment and accomplishment, etc. My own desire for unmedicated births was to fully feel and be alive to my transition into motherhood. Identify your motivation and let it guide your decision making. You can also cling to this if you decide to opt for pain medication. If your desire is to feel present to your birth, you can still accomplish this goal even with an epidural by hanging up ultrasound pictures, talking about your baby as you labor, playing meaningful music, and engaging your senses in other ways.
Journal or talk to your partner, friend, or counselor about any fears you have about the birth and postpartum experience. The fear-tension-pain cycle explains how unaddressed fears can lead to increased tension in our bodies, which then increases our pain and fuels our fear, thus creating a negative feedback loop. Digging into where these fears may have originated and creating a plan for combating these fears in the birth space can make all the difference in helping you cope with pain as it arises.
Throughout your pregnancy, practice coping through discomfort using breath and self-talk. Before an uncomfortable conversation, during a particularly challenging workout, in moments of frustration, even on the toilet… notice how you talk yourself through the discomfort and practice using your breath to guide you through to the other side. Remind yourself that the discomfort passes, just like labor.
Not everyone sees childbirth as a spiritual event, but if you do, exploring this side of birth can provide meaning, motivation, and encouragement during your labor. Consider how your spiritual or religious framework speaks to the transformation of becoming a parent, as well as the purpose behind enduring hardships, and what strength that may lend you during birth through prayer, affirmations, etc.
3. Creating (and Maintaining) a Supportive Environment
Oxytocin plays a CRUCIAL role in childbirth, helping the cervix dilate, labor progress, and minimizing pain. It is essential that our birthing environment and the people present are not inhibiting our flow of oxytocin by raising our cortisol, which will contribute to fear and stress, thus elevating our pain levels.
Choose a provider that you trust and a birth location that you feel comfortable in. Find out what options are in your area and transfer your care if you have hesitations about how you’re being supported. Does your provider give you time and respect? Do they align with how you think about birth? Do you trust that they will give you all your options and guide you through making your own decisions?
Think of how you can make the environment feel safe and comfortable. Some people bring their own blankets and pillows or other comfort items from home, utilize ambient and warm lighting, hang birth affirmations or pictures of older children, bring their favorite snacks, etc. Engage in as much pleasure stacking as possible to encourage the oxytocin to flow.
Carefully consider who will be present at the birth. Each person should be confident in your ability to birth your baby, be supportive of your goals, and have addressed their own fears. You should feel totally comfortable with them seeing you in full vulnerability giving birth. Surround yourself with as many or as few people meet this criteria. If you’re looking to add a confident, calming, and supportive presence to your space, consider adding a doula to your care team.
“No suffering is meaningless and no suffering occurs apart from the watchful and caring eyes and ears of God.”
A takeaway note, inspired by a conversation with my midwife:
HOWEVER you experience and respond to the sensations of birth is OKAY. Accept how you manage and cope with the discomfort. For those saturated in the unmedicated birth world, there can be a desire to labor and birth calmly, even quietly, and some walk away from their birth experiences disappointed, feeling that they should have exhibited more control or a more peaceful demeanor. I have heard it said that some women breathe their babies out and others roar them out. However you birth is okay, normal, and what brought your baby to you.
