Some women choose to give birth using no medications at all, relying instead of techniques such as relaxation and controlled breathing for pain. With natural childbirth, the mother is in control of her body, usually with a labor assistant gently guiding and supporting her through the stages of labor.

For many moms-to-be, having a natural childbirth isn't about being "brave" or a "martyr" — it's about treating labor and delivery as a natural event. Many women find the experience, despite the pain, extremely empowering and rewarding.

About Natural Childbirth

Natural childbirth is a "low-tech" way of giving birth by letting nature take its course. This may include:

• going through labor and delivery without the help of medications, including pain relievers such as epidurals
• using few or no artificial medical interventions such as continuous fetal monitoring or episiotomies (when the area between the vagina and anus, called the perineum, is cut to make room for the baby during delivery)
• allowing the woman to lead the labor and delivery process, dealing with it in any way she is comfortable

Many women with low-risk pregnancies choose to go au natural to avoid any possible risks that medications could pose for the mother or baby. Pain medications can affect your labor — your blood pressure might drop, your labor might slow down or speed up, you might become nauseous, and you might feel a sense of lack of control.

But many women choose natural childbirth to feel more in touch with the birth experience and to deal with labor in a proactive manner.

Where Is It Done?

Some women who opt for natural childbirth choose to deliver in a non-hospital setting such as a birth center, where natural childbirth is the focus. Women are free to move around during their labor, get in positions that are most comfortable to them, and spend time in the tub or jacuzzi. The baby is monitored frequently, often with a handheld ultrasound device. Comfort measures such as hydrotherapy, massage, warm and cold compresses, and visualization and relaxation techniques are often used. The woman is free to eat and drink as she chooses.

A variety of health care professionals may work in the birth center setting — such as registered nurses, certified nurse midwives, and doulas (professionally trained providers of labor support and/or postpartum care) who act as labor assistants.

Studies indicate that getting continuous support during labor from a trained and experienced woman, such as a midwife or doula, can mean shorter labor, less (or no) medications, less chance of needing a C-section, and a more positive feeling about the labor when it's over.

These days, it's also possible to have a more natural childbirth in many hospitals. Some hospitals have birth centers, where a natural approach is taken, but medical intervention is available if needed. Many hospitals have modified their approach for low-risk births, and have rooms with homelike settings where women can labor, deliver, and recover without being moved. They may take their cues from the laboring woman, allowing labor to proceed more slowly and without intervention if all seems to be going well. They may use alternative pain-management techniques if requested and welcome the assistance of labor assistants like midwives or doulas.

In addition to the father, other children, grandparents, and friends may be allowed to attend the births (which is also common practice at birth centers). After birth, babies might remain with the mother longer. In its fullest form, this approach is sometimes called family-centered care.

If you're having a high-risk pregnancy, it's best to give birth in a hospital, where you can receive any necessary medical care (especially in the event of an emergency).

How Is It Done?

How you choose to work through the pain is up to you. Different women find that different methods work best for them. Many can control the pain by channeling their energy and focusing their minds on something else. The two most common childbirth philosophies in the United States are the Lamaze technique and the Bradley method.

The Lamaze technique teaches that birth is a normal, natural, and healthy process but takes a neutral position toward pain medication, encouraging women to make an informed decision about whether it's right for them.

The Bradley method (also called Husband-Coached Birth) emphasizes a natural approach to birth and the active participation of a birth coach. A major goal of this method is the avoidance of medications unless absolutely necessary. The Bradley method also focuses on good nutrition and exercise during pregnancy and relaxation and deep-breathing techniques as a method of coping with labor. Although the Bradley method advocates a medication-free birth experience, the classes do prepare parents for unexpected complications or situations, like emergency C-sections.

Other ways women handle pain during labor include:

• hypnosis (also called "hypnobirthing")
• yoga
• meditation
• walking
• massage or counterpressure
• changing position (such as walking around, showering, rocking, or leaning on birthing balls)
• taking a bath or shower
• immersion in warm water or a jacuzzi
• distractions via activities that keep the mind otherwise occupied
• listening to soothing music
• visual imagery

What Will It Feel Like?

Although labor is often thought of as one of the more painful events in human experience, it varies widely from woman to woman and even from pregnancy to pregnancy. Women experience labor pain differently — for some, it resembles menstrual cramps; for others, severe pressure; and for others, extremely strong waves that feel like diarrheal cramps. First-time mothers are more likely to give their pain a higher rating than women who've had babies before.

How Long Will It Take?

There's no magic timetable when you're giving birth. For some women, the baby comes in a few hours; for many others it may take all day (or longer). Whether you opt for medications or not, every woman's body reacts to labor differently.

Risks and Precautions

Natural childbirth is, in general, very safe. It only becomes risky when a woman ignores her health care provider's recommendations or if she refuses medical intervention if everything doesn't go as planned.

It's important for the well-being of you and your baby to be open to other options if complications occur. In an emergency, refusing medical help could put your life and your baby's at serious risk.

After Delivery

Like any woman who's given birth, you'll probably feel:

• exhausted — both you and your baby will probably want to sleep as much as possible
• shaky or cold — many women shiver after delivery; this is a natural reaction
• sore — you'll probably feel cramping in your uterus, especially with breastfeeding, and you'll have some pain and discomfort in and around your vagina
• elated and empowered — you may feel an overwhelming sense of accomplishment knowing that you did it on your own

What If I Can't Handle the Pain?

Labor might hurt more than you had anticipated. Some women who had previously said they want no pain medicine whatsoever end up changing their minds once they're actually in labor. This is very common and completely understandable.

You should be applauded for your willingness and enthusiasm to try to deliver naturally. But if it turns out that the pain is too much to bear, don't feel bad about requesting medications. And if something doesn't go according to plan, you may need to be flexible as circumstances change. That doesn't make you any less brave or committed to your baby or the labor process. Giving birth is a beautiful and rewarding experience, with or without medical intervention.

Reviewed by: Larissa Hirsch, MD
Date reviewed: July 2010