The thought of natural childbirth has the power to strike both fear and excitement into a pregnant mother’s heart, possibly at the very same time. While it can be more painful than giving birth with an epidural, an unmedicated birth gives you the tremendous advantage of experiencing all the sensations of your child being born.
A successful natural birth starts well before the first signs of labor appear.
- Learning about labor and delivery and how you can intentionally work with every stage of the process can help you appreciate your body’s amazing design and give you confidence.
- Surrounding yourself with supportive people and choosing a healthcare provider that encourages natural childbirth can reassure you that you don’t have to go through this alone.
- Preparing your body with a healthy diet and exercise can help you develop strength and endurance.
- Using proper posture can make it easier for your baby to get into an ideal position for delivery.
- Practicing focused breathing and relaxation techniques can help you feel more prepared to face each phase of labor and delivery.
While all these ideas may sound great, you may be wondering how you go about actually carrying them out. Here is some more detailed information as well as a few suggestions that can help you get started.
What Happens to Your Body During Labor
The cervix is a band of strong muscle located at the very bottom of your uterus. During pregnancy, your cervix is tightly closed to protect your baby and ensure that he or she stays where they belong.
Science still can’t pinpoint exactly how your body gets the signal to begin labor, but rising blood levels of elements called prostaglandins cause the cervix to slowly soften, shorten and relax. This is the process of effacement and dilation.
Your uterus is encased by muscles, and when these muscles tighten in unison, you experience a contraction.
Effacement. Effacement refers to cervical flattening. During most pregnancies, a mother’s cervix is about two or three centimeters long. For your baby to be able to enter the birth canal, your cervix must efface completely.
Dilation. Dilation refers to the process of the cervix relaxing and opening. When you are fully dilated, the crown of your baby’s head can move past your effaced cervix and into the birth canal.
Contractions. A contraction begins with the muscles at the top of your uterus and gradually works toward the bottom. The downward pressure exerted on your baby pushes them into the birth canal and through the vaginal opening.
Stages of Labor and Delivery
Three Phases of Labor
- Early Labor. During early labor, a mother’s cervix dilates from zero to three centimeters, some effacement has occurred and contractions are irregular and short. The typical early labor stage lasts somewhere between eight to 12 hours.
- Active Labor. A mother is in the active phase of labor when her cervix is between four and seven centimeters dilated. During this phase, contractions start happening more frequently and with greater strength. Although the average amount of time a mother spends in active labor is about three to five hours, the timeframe can vary greatly from woman to woman.
- Transition. The transition phase begins when a mother’s cervix dilates to eight centimeters and continues until she reaches full dilation. Contractions are frequent and intense, and a strong urge to bear down and push signals that the delivery stage is near. This is the shortest phase of labor, and it typically lasts about a half hour up to two hours.
Delivery
Pushing. When a baby’s head enters the birth canal, the labor stage of childbirth is over and the delivery stage begins. Contractions are regular and strong, and the mother actively pushes during contractions to help the baby pass through the birth canal and out vaginal opening.
For some women, the delivery stage will be over in as little as 20 minutes, while it may take up to two hours for others. Due to safety concerns for both you and your baby, your provider will not let you push indefinitely. If your delivery isn’t progressing as it should, your provider will talk to you about the possible need for a Cesarean section or other intervention.
Afterbirth
Delivering the Placenta. The third stage of childbirth is the shortest and easiest. After the baby’s birth, the mother’s body no longer needs the placenta and will expel it. Mild contractions occur for several minutes after birth, and placental delivery usually happens fairly easily and painlessly after one or two more maternal pushes.
Preparing for Natural Childbirth During Pregnancy
Giving birth is an experience that you can never be fully prepared for, even with the most in-depth education and detailed planning. The truth is that you will have your own totally unique labor and delivery experience.
However, investing the time to learn and make advance preparations can be the difference between feeling confident in your understanding of the birth process and various laboring techniques versus being totally blindsided by the reality of childbirth.
Choose a Healthcare Provider That Supports Natural Birth
Even though the number of women interested in natural childbirth is on the rise over the last couple of decades, the majority of mothers still choose to use an epidural or other pain-relieving medication. As you select a maternal healthcare provider, be sure to ask them about their natural childbirth philosophies and experience. You may have to talk to multiple providers or even switch providers during pregnancy to find one that is on board with your wishes.
Additionally, ask about your delivering facility’s equipment and staff training in unmedicated birth techniques. If your facility doesn’t have a piece of equipment you would like to try using, ask if you can bring it yourself.
Encourage Your Baby to Get Into and Stay in a Desirable Position
A baby with their head down, chin tucked to their chest and facing your back is the goal. Most babies will situate themselves this way independently, but some remain settled in a less ideal position.
If your baby is lying in one of these unusual positions, a natural birth may be more difficult or even impossible.
Occipital Posterior. Your baby is in the occipital posterior position when they are head-down but facing your stomach rather than your back. You can still have a natural labor and delivery if your baby is in this position, but you may experience more pain.
When the back of your baby’s head puts extra pressure on your tailbone, back labor can be the result. Back labor can be very uncomfortable, and it usually means you don’t get a break from pain in between contractions.
Breech. A breech position is one where your baby is head up rather than head down.
Depending on what part of your baby’s body presents first, your baby is in either frank or complete breech position.
- Frank Breech. Your baby’s legs point straight upwards and the buttocks will present first.
- Complete Breech. Your baby has their knees bent and their legs tucked against their body. The feet will present first.
Some healthcare providers may be willing to proceed with a vaginal delivery if your baby meets certain criteria, but most prefer to do a planned Cesarean section for all breech presentations.
Transverse. A baby in the transverse position is lying horizontally across your body instead of vertically with their head pointing up or down.
It is not possible to deliver a transverse-lying baby vaginally, naturally or otherwise. All persistent transverse babies require a surgical birth.
These unusual fetal positions can happen for a few reasons, but the most common one is restricted space in the bottom portion of your uterus. Preventing your baby from going into an undesirable position in the first place is usually the best strategy, so try these ideas to help keep your pelvic area open and give your baby the uterine room they need.
- If your job requires you to sit, make sure you take frequent breaks to get up and walk around.
- Use a pillow to support your lower back and try to use good posture while sitting.
- Avoid crossing your legs and sit with your knees apart whenever possible.
- Even though it may feel comfortable, try not to lie in a reclined position. Do your best to either sit up straight or lie down flat.
Consider Hiring a Doula
A doula is a professional birth attendant whose main job is to make you feel as confident and comfortable as possible during childbirth.
Doulas aren’t nurses or doctors, but they have gone through training that enables them to understand medical terminology. They are also familiar with multiple labor and delivery positions and pain-management techniques.
Your doula will meet with you during pregnancy and help you develop a plan for your ideal birth. They will also be available for you to ask questions or seek support throughout your pregnancy. When your actual labor begins, your doula will meet you at the hospital and stay with you for the entire birth process.
These are a few ways that a professional attendant can help:
- Explaining what the nurses and doctors say and making sure you understand.
- Can provide suggestions for different natural comfort techniques.
- Be a caregiver who gives you their full attention. Your nurse and doctor have multiple patients to see, and they will check on you only periodically during labor.
- Speaking up for your wishes and serving as a go-between.
Take a Natural Childbirth Class
Childbirth education can help you and your support person better understand what is happening and what to expect during labor and delivery.
You have your choice of several methods that teach different techniques for relaxation, breathing and pain-management. Here are some details on a few of the most popular methods.
Bradley Method. This method encourages mothers to have a good diet and proper exercise throughout their pregnancy in preparation for a natural birth. It also teaches relaxation and focused breathing as labor techniques.
The Bradley method also emphasizes the important role of a birth coach. Your coach could be your partner, a family member, a friend or your doula. The coach will take the class with you and learn techniques to help support and guide you through the labor process.
Lamaze. The Lamaze method takes a more education-centered approach. It focuses on helping the parents see pregnancy and childbirth as a perfectly natural event rather than a medical condition. The Lamaze philosophy holds that a mother who understands both her body and the labor process itself is better equipped and feels more confident going into birth.
Hypnosis. This is not the “You’re getting sleepy” hypnosis you may have seen on television. Rather, hypnosis during childbirth refers to a deeply relaxed state where the mother is in control of her emotions and bodily responses.
This method teaches that fear associated with birth causes a mother to hold tension in her muscles and fight against what her body is trying to accomplish, leading to great pain.
Hypnosis proponents claim that when a mother has spent several months during pregnancy training herself to control her body, she should be able to intentionally relax during labor, experience much less pain and have a calm, natural birth.
Eat Well and Exercise
A balanced diet of proteins, fruits, vegetables, healthy fats, good carbohydrates and plenty of water gives your body the energy it needs for meeting the demands of childbirth. Eating well can also help you avoid gaining too much weight during pregnancy, which could affect your endurance and make a natural birth more challenging.
Exercise during pregnancy can help strengthen and train muscles for the task of labor and delivery. If your body is accustomed to being active, it’s less likely that labor will tire you out quickly.
Develop a Birth Plan but Hold it Loosely
It’s smart to identify and write down your goals and wishes. However, you have no way of knowing exactly how your labor will go and what interventions you may need for safety.
Go into your birth with a positive and hopeful attitude, but never forget that a safe delivery is always of the utmost importance.
Pain Management Tips
In the midst of a painful experience, it can be easy to start thinking that the pain will literally never end. The good news about the discomfort of childbirth is that it will in fact end, and when it does, you will have your precious baby as the reward.
Try some of these ideas to manage labor pain naturally.
Warm Compresses. If your back is aching from contractions or back labor, a warm compress may help bring some relief. Use a heating pad, or make your own heat pack at home and bring it along.
Positioning and Movement. In movies, television shows and most photos, a laboring mother is usually shown lying flat on her back in a hospital bed.
One of the great things about natural labor is that you aren’t tethered to an IV pole. This allows you to have more freedom to move around your room or in the hallway.
- Standing. The closer you can be to an upright position, the more you can take advantage of gravity and encourage your baby to move down the birth canal.
- Sitting. Sitting on a chair or on an exercise ball can let you open your legs up and lean forward. This position can help encourage your pelvis to open and can help maximize the effectiveness of each contraction.
- On hands and Knees. This position can be especially helpful if your baby measures larger than average. Position yourself either on all fours or rest your upper body on an exercise ball or another stable surface. This posture can reduce pressure, keep your pelvis as open as possible and give your baby more space in the lower part of your uterus.
- Lying on Your Side. With this position, your pelvis remains open while the rest of your body has the chance to rest a little.
Massage and Counter-pressure. Having your support person massage your back, shoulders, hands or feet may help you relax and soothe some soreness away. However, don’t be surprised if a light massage feels good at one point during labor and you absolutely hate it at other times.
Counter-pressure is pressure applied to the outside of the body to oppose pressure from the inside. This technique is most often used for mothers experiencing back labor from a posterior occipital fetal position. The support person pushes firmly on the mother’s back or hips to relieve some of the pain coming from pressure on the tailbone.
While it can certainly help reduce pain, counter-pressure doesn’t do anything to help your labor progress, and too much outside pressure could actually interfere with your baby’s descent through the cervix and birth canal. Counter-pressure can be helpful to give you an occasional break and a chance to rest, but make sure you use it sparingly.
Warm Water. The natural buoyancy of water can help relieve pressure, and warmth can help soothe tight muscles.
If your facility has a birthing tub, feel free to use it during active labor. You can also stand in a warm shower as long as someone is there with you so you don’t slip.
Dealing With Each Stage of Labor Naturally
Early Labor
Some mothers begin to feel uncomfortable contractions as soon as they begin to efface and dilate, while others may be a few centimeters dilated and significantly effaced before their daily activities become difficult.
Stay Home as Long as Possible. Since you aren’t planning on getting an epidural, there isn’t any reason for you to rush to the hospital. Relax and try to get as much rest as you can.
If you feel restless, keep yourself busy with some simple tasks that won’t tire you out too much. Try some light cleaning or preparing some snacks or easy meals for the coming days.
Eat and Drink. It is particularly important to stay well-hydrated, so keep a glass of water handy and take frequent sips.
Your body will need energy for the upcoming task, so eat some healthy light snacks. Just be sure to avoid heavy meals that could lead to nausea or indigestion later on.
Active Labor
Contractions in active labor are regular, frequent, stronger and last longer. Make sure you are familiar with and follow the instructions your healthcare provider gives you for when you should leave for the hospital.
Take Labor One Contraction at a Time. The thought of potentially having to endure hours of painful contractions can easily feel overwhelming, so don’t give that anxious mindset a chance to take hold. Keep this in mind: Each contraction you go through is one more that will never happen again.
Between contractions, try to rest and relax as much as possible. As each contraction starts, tell yourself that you can make it through this one. Don’t worry about the next one, just focus on the contraction that is happening right now.
Instead of seeing contractions as useless pain that you simply have to endure, try to think of them as a proof of how absolutely amazing your body is. It is definitely easier said than done, but try to remember that each contraction means your uterine muscles are working in synchrony to push your baby toward the birth canal and closer to being held in your arms.
Relax and Work With Your Body. The pain of labor is due to the force with which the uterine muscles contract. Most people have a natural tendency to tense up when they experience pain, but tightening your muscles is counterproductive to what your body is trying to accomplish.
As hard as it can be, try to maintain a relaxed posture and let the contraction do its job. It can be very difficult to try to keep your entire body relaxed, so just focus on one small area. Choose whether you want to focus on keeping either your hands or your face as relaxed as possible, and the rest of your muscles should follow suit.
Don’t be Afraid to Make Noise or Remain Silent. Some women find that making low groans or grunts helps them release tension, while others find it easier to relax in silence. Follow your instincts, and don’t worry that you aren’t doing it “right”.
Even though making noise can be helpful, do your best to avoid high-pitched vocalizations. Tensing your jaw can lead to tension in your lower body, and could slow the progress of your baby’s descent. Additionally, screaming or yelling could also drain significant amounts of energy.
Use the Restroom Frequently. A full bladder can exert painful pressure on your lower abdomen, and pelvic muscle tension from trying to hold in urine can be counterproductive to your labor progress.
Additionally, making frequent trips to the bathroom can be helpful in several other ways:
- Sitting in on the toilet in a forward-leaning posture with your knees apart is an ideal position to help open up your pelvic area.
- Urinating requires you to relax your pelvic floor muscles.
- Walking to and from the bathroom can encourage dilation by allowing you to take advantage of gravity and movement.
- You may find the private bathroom setting calming.
Always have a nurse or your support person help you get to and from the bathroom. You can have some privacy while sitting on the toilet, but make sure someone is waiting outside the door.
Be Honest About How You Are Feeling. No one knows exactly how your body feels except for you. Don’t be afraid to tell your nurse or support person that a technique doesn’t seem to be working or you want to try something else.
If you prefer to have your room quiet and dark, say so. On the other hand, if you find upbeat music to be an effective distraction, play your favorite songs.
You don’t need to be rude and demanding, but everyone will probably also cut you some slack if you aren’t as polite as you normally are. You are in labor, after all!
Transition
For many women, this final phase of labor can be the most challenging. Fortunately, it is usually doesn’t last as long as the previous two phases. As you approach full dilation and the end of transition, you will start feeling the urge to bear down and push.
Continue Focusing on Relaxation and Breathing. Your water has probably broken by now, or your practitioner may break it manually. Without the cushioning that amniotic fluid provides, you will probably feel increased pressure from your baby’s head, and contractions are strong and frequent.
Continue to focus on your breathing and keeping your muscles relaxed. It may be difficult to think rational thoughts during this time, but try to remember that reaching this tough phase means you are almost past the entire labor stage.
Don’t Start Pushing Until It’s Safe. Even though your urge to push may be hard to ignore, your nurse or maternal provider may direct you not to push right away.
With that first desire to bear down, your baby’s head has just begun to pass through the cervix. Letting one or two contractions happen without active pushing can give your body a chance to slowly move your baby into the birth canal and help you avoid tearing internally.
It can be very difficult to go against an urge that feels so strong, but just try to hold back and focus on breathing through the contractions until you get the green light to push. Concentrate on keeping your hands or face relaxed, just like you have been doing. You can also try repeating a phrase that helps distract you.
Pushing
You have made it through the laboring process, and you will be holding your baby soon! Up to this point, you have been simply focusing on relaxing while each contraction does its work, but now you become an active participant.
This stage of childbirth may be when going the natural route can bring some of the biggest benefits. With an epidural in place, a mother may feel some pressure, but she does not feel her contractions. The hospital staff must tell her when to push based on the readings from the maternal monitor. Since she can’t feel her contractions or the urge to bear down, it can be harder for the mother with an epidural to push effectively.
Breathe Efficiently. Proper breathing can make a huge difference in the amount of progress you can make with each push.
Your nurse or provider will usually want you to push for at least ten to twenty seconds, and you probably won’t be able to inhale much during this time.
When you feel a contraction beginning, take the biggest deep breath you possibly can. This breath fills your lungs with enough oxygen to last through the push. Additionally, having a chest-full of air increases your upper body mass and can help you give more a powerful effort.
Pick an Object in the Room to Focus On Between Pushes. It could be your support person’s face, a piece of furniture or the window. You could also place a toy or outfit for your baby in a spot that you can easily see. This special item can be both your focus point and a reminder that your reward for all this hard work will be here soon.
Delivery Positions. Since you have greater freedom of movement, a natural birth gives you more options for pushing in a variety of positions.
Discuss your wishes with your healthcare provider during pregnancy, and try to get an idea of what you might be able to expect at the hospital. Let your labor nurse know immediately upon your arrival to the facility if you would like to try an alternate pushing position.
- Supported Sitting on the Hospital Bed. This is by far the most common position for all mothers, whether they are having a natural birth or not. Hospital birthing beds are designed with adjustable head height and a removable bottom portion. The staff will raise your head as high as it is comfortable for you and place your feet in stirrups so you have something to push against. Your healthcare provider will stand at the foot of the shortened bed to guide your pushing and deliver your baby.
- Lying on Your Side. You will lie on your left side with the head of the bed nearly flat. You or a support person will hold up your right leg. Your healthcare provider will stand at the foot of the bed.
- Kneeling on the Hospital Bed. The head of the bed will be raised as high as possible to support your upper body. Facing the mattress, you will rest on your knees and drape your shoulders, head and arms over the head of the bed. Your healthcare provider will probably stand at the side of the bed.
- Squatting. This position used to be the standard in times of old, and it is the most physiologically ideal. Squatting forces you to open your knees wide and keeps your pelvis open, and gravity also works in your favor to help your baby descend through the birth canal.
- Your nurse and support person can steady you in a squatting position on the hospital bed, and some facilities have a bar that fits over the bed to allow you to be in squatting position while supporting your upper body. Your healthcare provider will stand at the foot of the bed.
You are Not a Failure if Your Natural Birth Plan Doesn’t Work Out
Wanting natural childbirth is a good goal, and no woman should ever have to think she has no choice but to have an epidural immediately upon arriving at the hospital. However, don’t make the goal of having intervention-free labor and delivery paramount.
The most important thing in any birth is a healthy baby and a healthy mom. Whether that means you take pain relief or end up needing a surgical birth, whatever makes for the safest and healthiest outcome for you and your baby is always the right choice.
Chances are good that no mother has ever said her birth experience was effortless, and women who choose natural labor and delivery are no exception. Bringing a child into the world takes time, preparation and work, but it is an investment that pays great dividends.
What was your birth experience like? Do you have any other suggestions for natural childbirth? Let us know in the comments!