Ep 160: 9 Tips for an Unmedicated (Often Referred to as “Natural”) Birth

In today’s episode you’re going to learn 9 tips for having an unmedicated birth. This is an episode I initially did over 3 years ago. From time to time I like to go back and revisit older episodes as new information comes out or I learn new things. So we are revisiting those 9 things with some additional tidbits of advice.

Why do I say unmedicated instead of natural? Well, because that’s what it is! It’s giving birth without medication (most often people mean without an epidural). All birth is natural - procreation, continuing the species, that’s natural. The way that you manage pain doesn’t affect whether it’s natural or not.

In this Episode, You’ll Learn About:

  • What are some questions you should ask yourself before committing to an unmedicated birth
  • Why unmedicated birth requires a commitment
  • Why you need to communicate your wishes to your support team in advance
  • What makes preparation so vital to an unmedicated birth
  • Why it’s a good idea to stay home as long as possible
  • How to know when it’s time to go to the hospital
  • Why you want to stay with the pain instead of fighting it
  • What are the advantages of seeking out a nurse who has experience with unmedicated birth

Links Mentioned in the Episode


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Ep 160: 9 Tips for an Unmedicated (Often Referred to as “Natural”) Birth

Nicole: In this episode, you are going to learn some tips for having an unmedicated hospital birth. Welcome to the All About Pregnancy & Birth podcast. I'm Dr. Nicole Callaway Rankins, a board certified OB GYN who's been in practice for nearly 15 years. I've had the privilege of helping over 1000 babies into this world, and I'm here to help you be calm, confident, and empowered to have a beautiful pregnancy and birth. Quick note. This podcast is for educational purposes only and is not a substitute for medical advice. Check out the full disclaimer at drnicolerankins.com/disclaimer. Now let's get to it.

Nicole: Hello. Hello. Welcome to another episode of the podcast. This is episode number 160. Thank you for being here with me today. In today's episode, you are going to learn nine tips for having an unmedicated hospital birth. This is an episode that I actually initially did over three years ago. It was one of the first episodes of the podcast. And from time to time, I like to go back and revisit older episodes as new information comes out, or I learn new things or I grow in the way that I practice. So we are revisiting those nine tips today with some additional tidbits of advice. Now, before we get into the episode, let me do a listener shoutout. This is to me H five two, and the title of the review says informed and prepared for a complicated birth. And the review says, I loved Dr. Rankin's podcast.

Nicole: She prepared me for a complicated birth, including a 20 hour labor, forceps, meconium aspiration, and NICU stay and postpartum depression. Because I listened to her podcast, I was informed and prepared for all of those things. I don't know how I would've gotten through it, if it weren't for her. Well, first off I am sorry that you had a difficult experience and had to have all of those complications, but I do appreciate you taking the time to let me know that listening to the podcast helped you through those difficult circumstances. And I hope everything is well. Now, now this brings up the fact that birth is an unpredictable process, and you really want to be prepared for the possible curve balls that come your way. No one can plan birth. You can't plan birth. Your doctor can't plan birth. Your baby has the most control over the birth process and, and they don't tell us their plans, but there are some things that you can control about birth, especially how prepared you are with information.

Nicole: So although you can't plan it, you certainly can be prepared for it. And that is what childbirth education will do. If you want unbiased evidence based child birth education, you can do it from the comfort of your own home, on the couch, in your PJs with your partner, watch it on your TV, then do check out the Birth Preparation Course. That is my online childbirth education class that'll get you calm, confident, and empowered for your birth. Check out all the details of the Birth Preparation Course at drnicolerankins.com/enroll. All right, so let's get into the episode with tips for an unmedicated birth.

Nicole: So the first thing I want to talk about is why do I say unmedicated instead of natural, a lot of people say natural childbirth or natural birth, and that's a common term. But the reason that I say unmedicated is because that's what it is. People are talking about having birth or giving birth rather without an epidural or even without any medication at all. So it really is unmedicated birth. And also all birth is natural procreation. Continuing our species. All of that is natural. The way that you manage pain during your labor doesn't affect whether or not that birth is natural or not. It's still a natural process regardless of how you manage pain. And also regardless of how your baby gets here, some people also say the term natural and what they mean is vaginal birth, even vaginal with an epidural, but really all birth is natural and we call things what they are. So we know that we're all talking about the same things. So vaginal birth, unmedicated birth, I'm gonna be talking about unmedicated vaginal birth in the hospital in this episode. Okay. All right, let's get into it. So the first tip is what is your motivation for having an unmedicated birth?

Nicole: Do you want an unmedicated birth because it seems to be the popular thing to do. Do you want an unmedicated birth because you have beliefs about women who do not use pain medication in labor, like somehow they are stronger? Do you have certain beliefs about women do use pain medication in labor, like somehow they are weaker? Is your decision being influenced by people around you like is your mother or your sister or a friend saying you better not get that epidural because of X, Y, and Z reason? I want you to be clear on the motivation for an unmedicated birth and that it is your decision to make, okay, you may seek the opinion of others, but it is ultimately your choice. And there's no right or wrong answer to this. Don't let a blog or a friend or an Instagram post make that decision for you.

Nicole: It can help you in your decision making process, but the decision is ultimately yours because know that things like your strengths are not determined by how you manage pain in labor. Now don't get me wrong, that having an unmedicated birth takes a tremendous amount of strength. But if you choose to give birth with medication, that doesn't mean that you aren't strong, like how you manage pain in labor is not the single determinant of your strength as a human being, as a woman. Okay? You are strong regardless of how you choose to manage pain in labor. So really just take a step back and think about why you want to have this unmedicated birth. And if it's really something that you want for yourself, when it's something that you want your for yourself, that's how you're gonna set yourself up for the best chance of success.

Nicole: Okay. Number two, what is your level of commitment to having an unmedicated birth? Do you mean that you want an unmedicated birth as long as it's not too difficult? Do you just kind of wanna play it by ear and see how things go or, or do you mean that you are ready to dig deep and scrape the bottom of your soul to give everything in you because you really, really want an unmedicated birth? There's no right or wrong answer to this. The point for this question is that your level of commitment becomes important. If or when I should even say your labor potentially gets tough, will you be okay with, you know what? I went, as long as I could, I'm gonna get an epidural and I'm cool. Or will you need your support people, whether that's your partner or doula, or even the nurse or your doctor to help you push through, because it's so important to you and remind you that this is something that you really, really wanted to do, because actually sometimes that support when you're in those difficult circumstances that push that encouragement to keep going forward can be just what you need to get you over the hump to get you over that little speed bump so that it can be really important to have the people around you supporting you.

Nicole: So that's why I need you to think about it. Let the people know so they can assist you accordingly because it really can make a difference.

Nicole: All right, number three, unmedicated birth generally requires preparation. Now there are some people, a few people who come in and they just have a baby, and it's not perceived by them as being particularly painful. I would say that that is the exception, rather than the rule. I can count on one or two hands the number of times that I have seen that throughout my 15 plus years of practicing. So it is unusual for folks to come in and be like, I didn't do anything. And I'm just gonna cruise through and have this baby without any medication. And they haven't prepared for it. Okay. So unmedicated birth generally requires some preparation. Now the level of preparation will vary. All right, you may need to read some books and that's okay with you and watch a few YouTube videos. Or maybe you take a class that is geared towards unmedicated birth.

Nicole: You like, because you wanna really organized and structured approach to it. You have to do what you believe works best for you, but know that you do need to do something to prepare, because what happens if you don't prepare and you don't have an idea of what to expect with an unmedicated birth, the pain can quickly become overwhelming. And when you are in the hospital and it becomes overwhelming, it's really easy to reach for that epidural, even if that's something that you weren't initially planning to do. So if you want to give birth without medication, be sure you prepare, you also want to know what your options are for managing pain. You need to know the whole gamut of options so that you can plan accordingly. So there's options for managing pain that don't involve medication like hydrotherapy, movement and position hypnosis. Those are all ways that folks commonly manage pain.

Nicole: Having a doula can help as well. Um, massage, affirmations. Uh, these are things that I talk about in my, uh, free guide on how to manage pain in labor. You can grab that at drnicolerankins.com/pain, but you wanna think through what the, uh, options are because there are, there's also nitrous oxide, which is an inhaled gas, and people don't necessarily consider that like in the spectrum of the same as an epidural, but it's not exactly quite the same as unmedicated because it is medication, but you may feel comfortable with nitrous oxide. Also, you may feel comfortable using IV pain medication. Typically that's gonna be narcotics. And I talk about that and that guide as well when, when those can be used. And when there's a, um, good idea, circumstances, risk, benefits, all that good, great stuff. So you may feel comfortable using IV pain medication, but still don't necessarily want the epidural.

Nicole: So that's, that's where that preparation is going to be key to help you know, what your options are and then plan accordingly and have all of those tools in your tool bag for managing pain. And you can have 'em right there when you need them. All right. Tip number four is to stay at home as long as possible. And I actually recommend this for everyone who is having a baby to stay at home as long as possible. That is, I wish I, I should say I recommend it for anyone who wants to limit the amount of interventions that happen. Definitely stay at home as long as possible. So when I say staying home, as long as possible by that, I mean, your contractions need to be five minutes apart or less. All of the contractions need to be strong enough that you're having to work, to manage them.

Nicole: And it needs to be for at least two hours that you are doing that, before you go to the hospital. Now, of course, there're gonna be some caveats to that. If you live a long distance away, then it may be one hour. And I'm talking about for your first baby, especially. Um, but typically you can wait for two hours and by working to manage them, I mean that you have to stop, you can't talk through it. All you can do is focus on getting through the contraction. Okay. And I'll be honest, especially for first time moms, a lot of folks see that, or they experience contractions that are in the early part of labor and they're oh yeah, this is definitely it. And then as labor gets going in the contractions ramp up and intensity, then it's like, okay, this is what you meant. So you really need to be at the like, oh my goodness, this is very intense stage for two hours before you go to the hospital. And if your contractions are sometimes five minutes apart, sometimes eight minutes apart. It's not time. If they're irregular, it's not time. If there's sometimes strong, sometimes not. It's generally not time, especially for your first baby.

Nicole: See if you go to the hospital too early, then you may get sent home, which is actually it. If you wanna do a low intervention birth, or if you go to the hospital too early, you may be offered interventions like Pitocin or breaking your water to help get things going. Or you may be offered pain medication. And not that those things are inherently bad, but if you want an unmedicated birth, you generally want to limit intervention. So to have the best chance of having labor unfold on its own with minimal intervention, stay at home as long as you can. You'll also be more comfortable at home in those that early part of labor, where, which can last quite some time, actually, depending on how the labor goes, and you're gonna be more comfortable at home where you can move in your own space and all of those good, great things. Now, I know there's always that thing in the back of people's mind where people are worried that, oh my God, I'm going to have my baby in the car if I stay home too long.

Nicole: And I believe that that stems from the myth of how TV and movies portray labor, that is this super fast thing that happens in five minutes. You know, your contractions start. And then five minutes later, you're at the hospital. And five minutes after that, baby's out. That is not how labor unfolds. The average active labor is eight hours. And if it's gonna be a lot shorter than that, then typically the intensity is gonna wrap up fast and your body is telling you that this is really, really intense. Something is happening. It's going very quickly and I need to go in all right. You're just not likely to have your baby at home or in the car. If you stay home in consistently strong labor for two to three hours,

Nicole: If you stay home until you're in good labor, you're much likely to be a good, like five or six centimeters when you get to the hospital. And by that point, like you're over halfway there. All right, you're over halfway through your labor process because on the other side of five centimeters, and this is again, things that you can learn in childbirth education, things tend to go faster than from getting from zero to five or six, six to 10 is faster. So you're like over halfway there, by the time you get to the hospital. And yes, I know that it does happen that babies are occasionally born in the car or, you know, in the right out in front of the, the, uh, hospital or things like that. But, um, honestly those babies often come so fast and furious. It's not a whole lot that anybody could have done to get to the hospital.

Nicole: Fast enough, those babies who just come and come and come. And like, it's not that people are sitting at home for hours and hours and hours. It's just that things hit so quickly and those babies come quickly. So again, you are not likely to have your baby in the car. Stay home as long as you can. Now, this is a, uh, where a doula can be a really great resource for you with this, if she's experienced. And she knows what a laboring woman looks like, sounds like even over the phone, I would say it used to be more frequent that doulas would maybe come to your home in the early part of labor. I'll be honest. I don't see that happen as much. Most often, I see that people will, your doula will talk to you on the phone and help you think through what's going on, which is perfectly fine, because you can actually tell, uh, or get a sense for how people are managing labor. By listening to them, going through a contraction. If you go through a contraction and you're still talking and having a conversation, and you're probably not in active labor yet, so they can give you an idea of whether or not it's time to go in. A good doula can definitely help you with that.

Nicole: Okie dokey, Tip number five is, do not fight the pain in labor, surrender to it. So this can be challenging because pain in our bodies is usually a sign that something is wrong. When you cut yourself, if you break a bone, if anything is happening that is painful in your body, that is usually a sign that something is wrong. So it's counterintuitive to not fight pain when you're in labor, but it is so important that you don't fight that pain during labor. And let me explain why. When you are fighting contractions, you are thinking that they are bad and all you want is for that pain to stop each contraction. When you're fighting it can bring on a sense of panic. It can bring on a sense of anxiousness, can bring on a sense of dread. This leads to increased tension and tightness in your body and will actually increase your perception of pain. It's going to feel more painful.

Nicole: And then that will in turn amplify the dread, the panic, the anxiousness with the next contraction. And when that happens, you can get overwhelmed and start looking for escape routes from that pain, escape in the hospital is gonna mean an epidural. Okay? Now let's contrast that with what happens when you surrender to pain and you work with your body and work through the pain. When you surrender to the contractions, you recognize that this pain, this sensation, what you're feeling in your body. And I know some people like to refer to it as surges, or waves or things like that. If you find that helpful for you, that's perfectly fine, but most people will perceive it as pain. But when you recognize, when you surrender to the pain, you recognize that the pain is not the enemy. What you're feeling in that moment has a purpose. And that purpose is to open your body and birth your baby. You understand, in that moment that the pain is not permanent. You know that it is not damaging your body, even if it is intense. You know, that those contractions are actually a natural part of labor.

Nicole: You understand that the pain that you're feeling is not permanent, you know, that it is not damaging your body. Even if it's intense, you are able to flow with the pain and you are, are able to accept support to help you cope with it. You find a rhythm from managing the contractions and that will in turn decrease the perception of pain. So don't fight the contractions, surrender to them, work with them. So along with that is number six, which is approach labor one contraction at a time. When you surrender to labor, you take it one contraction at a time. I've had so many people tell me that they didn't realize how much time had passed by during their labor, because they were really approaching it one contraction at a time, and then get through one, get through the next. You don't want to think about how much labor is left.

Nicole: You don't want to think about how long it's going to take you get through one contraction and then the next contraction. And then the next contraction realizing that each contraction is going to get you closer and closer to meeting your baby. So again, definitely definitely approach labor as one contraction at a time. Get through that moment. Then the next moment, then the next moment know that knowing that each moment is bringing you closer to meeting your sweet baby. Number seven, request a nurse who has experience caring for women who want an unmedicated birth, or at the very least enjoys taking care of women who want an unmedicated birth. Your nurse is the one who is with you during the majority of your labor, not your doctor. This is something that people are sometimes taken aback by. Like they see their doctor a couple times during the labor process.

Nicole: That is really, really common in hospital birth because you know how, when you're in the office in an appointment, and like when you're in the office in an appointment, your doctor may have somebody who's in labor. So there's still like seeing patients and doing things. They really typically come maybe to get you settled in the hospital. And then also maybe check once or twice during the labor and then back for the delivery. So your nurse is the one who is with you the most during the majority of your labor and having a nurse who is experienced in caring for women who have an unmedicated birth, or is at least interested in, wants to care for women who are having an unmedicated birth can make such a huge difference.

Nicole: Another thing that people don't realize is that not all labor and delivery nurses like to do unmedicated birth or have any experience in caring for people that are having an unmedicated birth, like not all nurses like it, or do it. Now, if you have a good nurse, she can help you try different techniques to cope with contractions. She can support you during difficult parts. She can advocate for you if needed. A good labor and delivery nurse, who's comfortable with unmedicated birth is gonna encourage you to get up. They're gonna encourage you to walk around. They're gonna offer you to get in the shower. They're going to do different positions with you. They may know things like spin babies techniques, which will help get the baby in a better position. So definitely ask for a nurse who has experienced caring for women who want an unmedicated birth.

Nicole: And along with that, actually you actually wanna know, or maybe have a sense. You can ask your, your doctor, like does the hospital or call up to the hospital and ask like, how many people give birth there, who don't do you know who do it without an epidural? You want to be in an, be in an environment where there are people who are comfortable taking care of folks who have an unmedicated birth, because it is just not, um, it's just so much better if you have that nurse. And if you have that hospital who is comfortable with those things.

Nicole: Number eight politely request that no one offers you pain medication, that you will ask for it. If you need it, you really wanna be in control of the decision to accept pain medication. And you don't want someone in your ear saying like, do you just wanna get the epidural? Do you just wanna get the epidural? Do you just wanna get the epidural? Because that's annoying. And it throws you off of your concentration in your game. So tell people that you will ask for pain medicine, if you need it, you don't need them to bring it up.

Nicole: Okay. And then the last thing I will say about giving birth without medication in the hospital is that if you change your mind and you decide to use pain medication, if you decide to get an epidural, that is okay, that is okay. There's nothing wrong with that. You are not a failure. You are not weak. You have grown a whole entire human being inside of your body. And that is pretty freaking spectacular. There is nothing that is a failure about that and how you manage your pain during labor does not take away from that spectacular display of growing a baby. So if you decide that you want to get IV pain medication, when you thought you weren't gonna do that, that's fine. If you decide that you want an epidural, that's fine. Perfectly. Okay. If you change your mind, don't beat yourself up. It doesn't say anything about you other than you changed your mind. Okay.

Nicole: Remember how you choose to manage pain in labor is not a reflection on your character or your being or anything like that. All right. So just to recap, those nine tips for an unmedicated birth in the hospital. Number one, think about what is your motivation for having an unmedicated birth. Make sure it is something that you want to do. Number two, what is your level of commitment to having an unmedicated birth, so you know that you have the right support with you for your goals. Number three, unmedicated birth requires preparation. It is not typical that you can just stroll on into the hospital and have a baby without medication. You gotta be prepared. Number four, stay at home as long as possible. You want to be in good, strong, active labor by the time you get to the hospital.

Nicole: Number five, don't fight those contractions, surrender to them and work with them. Number six, approach labor one contraction at a time, get through one contraction. Then the next contraction, then the next contraction. Number seven, request a nurse who has experience caring for women who want an unmedicated birth or at the very least is interested in caring for women who have an unmedicated birth. Yes, it is the case that there are some labor and labor and delivery nurses who don't wanna do it. All right. Number eight politely request that no one offers you pain medication. And number nine, if you change your mind and decide to use an epidural, that is okay. Now inside the Birth Preparation Course, I have a whole, um, lesson on giving birth without medication in the hospital.

Nicole: It includes information with more specifics on important questions to ask yourself, questions to ask your doctor, questions to ask about the hospital. You learn about the importance of support, some additional powerful tips to rock that unmedicated birth in the hospital. You'll learn how labor induction impacts unmedicated birth, and then tons more detail about medication free pain management techniques, including a downloadable guide with illustrations, description of techniques. You can use. You can check out all the details of the Birth Preparation Course at drnicolerankins.com/enroll. All right, so there you have it, please do me a favor, share this podcast with a friend. If you enjoy it. My goal is to reach and serve as many pregnant folks as possible. And I so would appreciate your help in doing that. By having you share the podcast with a friend, also be sure to subscribe to the podcast in Apple Podcast or wherever you're listening to me right now and leave me a review, in Apple Podcast. I love to hear what you think about the show. And I do shoutouts from those reviews and come follow me over on Instagram. If you wanna continue the conversation after the podcast, I'm on Instagram @drnicolerankins, lots of great information there as well. So that is it for this episode, do come on back next week and remember that you deserve a beautiful pregnancy and birth.