How preparing for unmedicated childbirth can help you achieve a healthier, more empowering birth … even if you end up choosing an epidural.

One of the things that I get asked most often is the question, “How can I plan for an unmedicated birth?” First of all, I LOVE this question. I love a pregnant woman’s thinking to ask these kinds of questions as she gets closer to the time of her baby’s birth. ASKING QUESTIONS IS SO GOOD. Ask all the questions, and once you’ve got the best answers, follow your heart.

I also love the wording of this question (“How can I PLAN an unmedicated birth”) because it is so deeply intelligent. I sometimes hear, “I think I’ll try for an unmedicated birth, but we’ll see what happens.” There’s nothing wrong with saying or thinking this, but it really shoots down your chances of actually ACHIEVING an unmedicated birth.

Sometimes I hear skeptics compare unmedicated childbirth to some horrific injury. That’s not true at all ~~ labor sensations can not be equated with an injury. I’ve witnessed so many babies slide sweetly out while barely leaving their mamas with a mark. 

The sensations of labor are incredibly INTENSE … and withstanding / coping / diving into them for hours is one of the most physically, mentally, spiritually, psychologically intense experiences of being alive. Giving birth unmedicated, for me and for many women I have helped, is like ice climbing a giant mountain.

 

 
Are you gonna wake up one day in your every day life and suddenly decide to buy a plane ticket to climb the Himalayas? Probably not. That kind of endeavor takes PLANNING. Training, planning, prepping … and in the end what it takes to do it is like nothing you could ever imagine. Ridiculous! The thing is, if you don’t make a map, you’re gonna just end up driving in circles around the airport.

SHOOT FOR THE MOON, END UP AMONG THE STARS.

If that sounds impossible, don’t give up hope.

1) I, Kate, had an unmedicated birth. I’m not the strongest, bravest or most physically endurant person I know. Not by a long shot.

2) I’ve seen many other women do it, and am confident it can be done.

3) Even if you get halfway up the mountain (or one-third, or a hundred feet) and then decide/need to be airlifted off, YOUR INTENTIONS WILL NOT BE IN VAIN.

Here is how to prepare, and here is why you should.

SAY OUT LOUD: I’M PREPARING TO HAVE AN UNMEDICATED BIRTH.

Please don’t “try”, or “see what happens.” PREPARE. 

Real life always, always, always ends up more beautiful, more complicated, and more what we need than our dreams could ever be. Even if we don’t see it at the time.

WHAT ARE THE TWO MOST IMPORTANT THINGS YOU CAN DO TO OPTIMIZE YOUR CHANCES OF AN UNMEDICATED BIRTH?

NO. 1: CHOOSE YOUR PROVIDER

Interview several providers, physicians  and midwives, early on in your pregnancy and ask some real questions.

Are you supportive of natural childbirth?

More specifically, what positions are you comfortable delivering/catching my baby?

Many providers state that they’re supportive of natural birth, then force their completely unmedicated patients into lithotomy position (on their back, in stirrups) as their babies are crowning. Trust me, this is not something you will want to do. Nor is it something you should be forced to do. A truly supportive provider can deliver/catch your baby in whatever position YOU choose to be in when the baby HAPPENS to come out.

At what point do you recommend induction of labor?

If a provider pushes his/her patients towards induction at 39 weeks, or 40 weeks, or at any other time without medical indication, then that provider is not truly supportive of physiologic birth. A supportive provider will answer, “I prefer to let labor start on its own, as long as mom and baby are healthy.”

Do you have any doula recommendations?

This is a great question! If your provider not only 1) tolerates but 2) appreciates working with doulas, and 3) has doula recommendations, then they most likely see the value of labor support and understand the actual ingredients of true, supported unmedicated labor and birth. NOTE: You don’t *have* to work with a doula just because your provider prefers them.

NO. 2: CHOOSE YOUR BIRTH SETTING

Planning a homebirth, birth center birth, or birth at a (natural-childbirth) friendly hospital is imperative for the majority of women who wish to achieve unmedicated birth.

Personally, I would never have been successful at achieving my unmedicated birth if I had known there was a kind, gentle and very skillful anesthesiologist a mere phone call away. I’m not that strong.

I also felt safe at home, trusted homebirth, and knew deep inside my heart that homebirth was the best choice for me and my baby.

Homebirth and birth centers offer unique comfort resources during labor, including intermittent monitoring, hot showers, the ability to eat and drink whatever you want, the ability to cry/puke/poop without feeling judged, REAL privacy and deep, luxurious pools of water made just for labor to help you relax.

Regardless of how crunchy or natural-childbirth-friendly your doctor or midwife is, if they are going to deliver your baby at a hospital that is not equipped to support your unmedicated labor, your chances of being successful at unmedicated birth are very small.

Choose out-of-hospital birth if it feels right to you, or do your research on your local hospital. TOUR the hospital and ASK HARD QUESTIONS. (Ask to speak to the nurse manager or charge nurse.)

• Do you offer waterbirth?
• Do you offer labor in water? Can I bring my own pool?
• Do you offer intermittent monitoring?
• How does your intermittent monitoring policy actually work (do you use dopplers for heart tones, or do you require multiple NSTs? Do you follow AWHONN and Lamaze International recommendations?)
• Do you have birth balls or peanut balls?
• Are you supportive of me using a doula for labor support?
• Do you offer family-centered Cesarean in the case I need a C-Section?
• Will you let me take my placenta home? (This is my favorite question. If they answer, “Ew yuck no,” then keep up your search!)

PREP YOUR MIND/BODY/SPIRIT FOR UNMEDICATED BIRTH

• Keep physically active. Swim, yoga, 30-minute walks several times a week, and a regular squatting practice are all great ideas to enhance your stamina and strength.
• Find an amazing chiropractor that specializes in Webster Technique / care of pregnant women (especially if you are planning a VBAC).
• Get regular acupuncture treatments.
• Eat good food.

Read: How Not to Induce Labor.

HIRE AN AMAZING DOULA

A doula worth her salt understands that birth is a physical as much as mental process. The best doulas I’ve worked with are combination sherpas/psychics/therapists/massueses/personal trainers. If you can find a doula who is trained in Spinning Babies and/or Use of the Rebozo, hire her. And pay her well, because she’s worth every penny.

KNOW THAT WHATEVER HAPPENS, WILL BE JUST WHAT WAS SUPPOSED TO HAPPEN

Some of the most well-prepared pregnant mamas I’ve ever met have planned unmedicated childbirths, then ended up needing epidurals. Some also needed C-Sections. That didn’t make them any less strong, brave, or powerful … in fact they are some of the bravest women I will ever meet.

Preparing for an unmedicated birth is still of HUGE benefit, regardless of the outcome, for several important reasons.

1) Many of the complications associated with epidurals can be prevented by waiting until active labor before getting an epidural. (WATCH PENNY SIMKIN’S VIDEO ON THE SUBJECT.)

2) Active, physical movement during labor, for as long as you can do it, can optimize your chances of a healthy vaginal birth.

3) Even if you need a C-Section, the process of labor is GOOD FOR YOUR BABY. The more advanced the stage of labor prior to the C-Section, the better.

Bravo, mamas! I’m so proud of you already for being curious and asking hard questions. You are already 1/8 of the way up that icy mountain … only 7/8s left to go.

LOVE, KATE

All Photographs courtesy Whitney Patterson, Birth Doula / by Red Plum Photography