There are several birthing options to choose from when bringing a newborn into the world. One of the oldest options is through an unmedicated birth. An unmedicated birth, otherwise known as natural childbirth, is a route that some expectant mothers gravitate towards. Unmedicated birthing is an experience with little to no pain management. It also refers to allowing the birth to start on its own without inducing labor.

There are many decisions to make when that final trimester comes closer into sight. Of the many decisions is the choice between a medicated or non-medicated birthing experience. Studies have shown that there are several benefits that prompt mothers to choose the latter. The idea that their bodies are capable of giving birth without machines and assistance oftentimes plays a big part. While some may be concerned about the pain of unmedicated labor, others are interested in giving birth freely. Midwife Allegra Hill shares advice about the process and the preparation for unmedicated birthing.

21NINETY: What are the benefits of an unmedicated birth?

ALLEGRA HILL: I think the biggest benefit to an unmedicated birth is the ability to move freely [and] to allow for the baby to navigate your pelvis with cooperation between the two of you. Sometimes that requires you to get in all sorts of positions that would be impossible in a hospital with an epidural. Things like standing, squatting, hand and knees, and side lying are some common positions a person may use in labor.

Another benefit is that when you are experiencing normal physiological birth without pain management your hormones are working together, so that you go into an almost trance-like state, where you have a lot of oxytocin, endorphins and adrenaline working together to help you cope with the sensations of labor and the stamina required to birth your baby. You can interrupt these hormones with pain management. Feeling your baby move through your body can be a very transformative and empowering experience. Some people have a curiosity and others see it as a challenge.

Another benefit is that you are able to get up and use the bathroom during and after the birth as opposed to having a urinary catheter when you have an epidural.

21N: What are some disadvantages?

AH: One disadvantage is the inability to sleep. An epidural can be a very useful tool for a long labor. It’s very difficult to sleep, while having an unmedicated birth outside of using something like hypnosis. Exhaustion makes pain more noticeable which makes it harder to relax and keep muscles soft and not tense for labor.  

In some cases, the sensations of unmedicated labor may be triggering for previous sexual assault or trauma survivors. Some trauma and abuse survivors feel most comfortable being unmedicated. This is to retain control over what happens to their bodies. Others prefer pain management to be comfortable and not feel the sensations. 

21N: How can mothers prepare for an unmedicated birth?

AH: An unmedicated birth requires physical, mental and spiritual preparation.

To be physically prepared, it’s best to have an active pregnancy with lots of walking and movement. The walking will help your baby get in a head-down position for birth. It will also help with other things like your circulation, blood pressure, and even with preventing constipation. Other forms of movement may include stretching, dancing, or swimming.

Preparing for your mental health may look like journaling or visioning, talking about your fears and hopes with your doula or midwife, or meeting with a therapist. It looks different for each individual. Take a childbirth class to teach you coping techniques and positions of labor. Mentally preparing for labor is a great way to set yourself up for the birth that you want.

21N: What are some coping techniques for those who want to go down the non-medicated route? 

AH: Some coping techniques to use for an unmedicated birth are movement and touch, like counter pressure, massage and  pressure points. It’s also OK if you don’t want to be touched in labor. For instance, when I was having my first I didn’t want anyone touching me. I did want people close by for verbal encouragement, but I was overstimulated by the sensations of my birth, and I didn’t want any more stimulation. Just someone being close by and encouraging me was the perfect companion to my slow deep breath, as I rode the waves of contractions.

Some really like to use essential oils during labor. My favorite oils for this are lavender and clary sage. A lot of people who choose to give birth in a birth center use hydrotherapy in the shower or the birth tub. Even if you are planning on a medicated birth in the hospital, using the shower is a great option either in your home before you get to the hospital or in the hospital. When standing in the shower, the warm water relaxes your muscles and gravity helps your baby come down in your body.

21N: What advice can you offer to those who choose an unmedicated birth experience?

AH: Make sure you have people on your team who believe in you and can offer you guidance and support. Remember to trust that your body and your baby know what to do. Take your labor one step and one contraction at a time. Increase your chances of having the birth you want by putting in the work every day. Achieve this by getting enough rest, eating enough protein, drinking water, taking vitamins, working through any emotional issues as they come up, asking your providers questions, and making sure that they hear your concerns and wishes. Most importantly, remember it is OK if you start out wanting an unmedicated birth and change your mind.

This article has been edited and condensed for length and clarity.