Vaginal birth

• Most women give birth through the vagina (birth canal).
• Labor occurs in three stages and feels unique to everyone.
• If you’re healthy, wait for labor to begin on its own.

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Some women want to experience childbirth as a natural process and without the use of medication. Other women may use natural methods to ease discomfort early in labor and then add epidural or narcotic pain relievers in the later stages of labor.

There are many drug-free methods for reducing the pain and stress of labor and delivery. These methods may:

• Help your body release its own natural pain relievers (such as endorphins, which are proteins that help relieve pain)
• Distract you from the pain of childbirth
• Soothe and relax you as you go into labor

Relaxation techniques
These methods help you to release the tension and pain you may feel in areas of your body. By relaxing, you give your body the opportunity to work naturally while saving your energy for when you need it most. Instead of fighting the pain, which may create more tension, relaxation techniques help you to deal with labor pain by letting it come and go naturally.

There are two kinds of relaxation techniques:

• Progressive relaxation: You relax groups of muscles one at a time during labor.
• Touch relaxation: Your labor coach touches or massages a certain group of muscles, helping you to focus your relaxation.

Using relaxation techniques takes some practice. Try these helpful tips as you learn to use relaxation techniques:

• Pick a quiet space.
• Stand, sit or lie in a comfortable position.
• Breathe slowly and deeply.
• Focus on the areas of your body where you feel the most tension and try to relax them.

Massage
Massages can be particularly helpful in easing pain during labor. You can do some massages yourself by gently rubbing your belly during contractions. You can also have your partner or labor coach give you a massage to stimulate your body’s natural release of pain relief. Massages can help soothe your muscles and block pain. Some women find that using counter-pressure (having a partner push hard on a tense muscle) on an area like the lower back can relieve tension for a good amount of time.

Try these helpful tips as you and your partner learn to use massages:

• Warming the muscle with a hot towel or heating pad can help relax the tension
• Using oil or lotion can help your hands to move across the skin more smoothly
• Keeping one hand on the area as you reach for more oil or lotion can keep you feeling relaxed and in the moment

Guided imagery
Also called daydreaming with a purpose, guided imagery involves picturing yourself in a comfortable, relaxing setting. This imaginary place can be your favorite park, the beach or a fantasy land. The point is to let your mind wander to that relaxing place as you feel labor pain.

Some helpful tips for using guided imagery include:

• Focusing on the details of this comfortable setting (the air, the smell, the sound, etc.)
• Letting your body relax as your mind takes you to your imaginary place
• Playing some soft music or other sounds that can help you feel like you’re really there

Meditation
This technique helps you to manage pain by focusing on a certain object, picture or sound. You can even meditate with your eyes closed. By concentrating on a focal point you can help your mind think about something other than the pain.

Try these helpful tips for meditation:

• Use a picture or image in your mind to focus on.
• You can also try focusing on a certain word and repeating it over and over to yourself.
• Don’t worry if you become distracted. Just try bringing your mind back to that focal point.

Breathing techniques
This is one the most familiar techniques for natural pain relief during childbirth. It involves steady, rhythmic breathing to help your body relax while distracting you from labor pain. Breathing techniques can also:

• Lower feelings of nausea or dizziness during childbirth
• Bring more oxygen to your body and baby

These techniques work best if they’re practiced before childbirth. Some breathing techniques, such as Lamaze, are taught during childbirth education classes. You can also use breathing techniques alongside other kinds of natural pain relief.

Changing positions
Changing positions during labor may give you comfort by helping to improve your circulation. Sitting in an upright position may increase comfort and speed contractions in early labor. Squatting may help you later on. Some women find sitting on a birthing ball (a large rubber ball) to be helpful. Women who have a backache may find that getting on their hands and knees can ease discomfort. Others might find rocking back and forth to be soothing.

Hot or cold therapy
Using heat or cold may be another helpful way to cope with labor pain. You can choose to use one or the other, or use heat and cold in combination.

Using a hot compress can help you relax and ease muscle tension. A warm blanket can also be helpful if you find yourself having chills or shakiness.

A cold washcloth on your forehead may help you to cool down and ease some tension. Sucking on ice chips can also help cool you off. Placing ice packs on your lower back can help ease your back pain.

Water therapy
For some women, a warm bath or shower temporarily reduces labor discomfort. Many hospitals have showers in their labor rooms, and others may offer soaking tubs for women in labor. The feeling of warm water on your skin can help you relax and soothe some of the discomforts of labor. It's important to keep the water temperature around body temperature (98-100 degrees F) to prevent fever in the mother and the baby.

A support person or doula
A support person who stays with you throughout labor and delivery can improve your level of comfort. Many women count on their partners for emotional support and for help with breathing and relaxation techniques they learned in childbirth education classes.

Some women also hire a professional labor assistant, or doula, to provide coaching and support throughout labor and delivery. A doula provides support for both the mother and the partner and can take some of the pressure off the partner during a long or intense labor.

Other options for natural pain relief
Some studies have found promising evidence for the use of other natural pain relief methods during labor. Acupuncture is an ancient Chinese practice that involves having an acupuncturist (specialized therapist) insert small needles into certain areas of your body. Although the idea of using needles to lessen pain may seem counterintuitive, some women find that acupuncture can increase relaxation during labor. This may in turn help you handle the pain better.

Reflexology is an ancient practice in which a reflexologist (specialized therapist) applies pressure to certain parts of the body, usually the soles of the feet. The goal is to positively affect other parts of the body. Reflexology may help relieve muscle tension and promote relaxation during pregnancy.

Hypnosis is another trend in natural pain relief. It works by suggesting that you are in control. If you believe you can control your pain, then you may be able to ease it. Some women learn to use this method on themselves. A specialized childbirth education class may teach women how to use self-hypnosis.

More research is needed to prove the effectiveness of these and other alternative pain management methods. Some women report good results using these methods to manage or reduce pain during childbirth. Speak to your health care provider. Do your own research to see whether any of these techniques may be right for you.

Changing your mind after natural labor
Labor pain affects each woman differently. Some women may have mild discomfort and others may experience intense pain. If you try natural childbirth and during labor you begin thinking about using pain medication or anesthesia to cope with labor pain, know that it’s okay to change your mind. Don't feel like you let your baby down or gave up. Only you know how strong the pain feels. It’s okay to talk with your provider and do what you think is best.

January 2010