Epidural vs natural birth

[Ladybug47]

Can anyone here share advice/experiences/tips about having an unmedicated birth in a hospital (especially without a doula or midwife)? Or has anyone birthed one baby using an epidural and birthed another one without an epidural? If you've done both, how do your experiences compare, and if you had to choose a way to do it again, would you choose an epidural or go natural?

Here's some background about why I'm asking, and more questions I have about natural births:

I just watched "The Business of Being Born" (Ricki Lake documentary about natural births) and although I still want to use a doctor and give birth in a hospital, I'd be interested to hear how your experiences were having a baby without medication.

What techniques did you use to get through the really painful contractions? Did you feel the "ring of fire" when the babies' heads were crowning? What positions worked the best for being comfortable and successfully pushing the baby down the birth canal? Did you use a birthing ball or get in a whirlpool or shower or anything? Has anyone here given birth in a hospital without medication and just used a doctor and support from the husband and not used a doula or midwife?

I have a low pain threshold, which is why I get nervous thinking about not using medication, but I also know that when I got the epidural with my son it was really soon after being admitted (I was five centimeters dilated -- I don't remember how effaced) and the contractions were totally tolerable and seemed to even be slowing once we reached the hospital. I probably could have taken it much farther naturally before really "needing" an epidural, so I guess I'm just wondering what's it's like to have a different kind of birth experience.

With my son, I got the epidural (which I actually was really grateful for because it allowed me to relax and sleeeeep for the first time in two days after being up the previous 48 hours with contractions all night) and then pitocin and then the contractions got so hard because of the pitocin that I needed more oxygen and more pain meds because of the intense pressure by my rib cage. Then, when I pushed, the baby was in distress and his heartrate went down, so they had me stop pushing and said they had to try the vacuum as a last option and if that didn't work they'd have to do an emergency c-section. He came out in two pushes with the vacuum, but I got a fourth-degree tear in the process (he was only 6 lbs 4 oz). It's an exact scenario from the documentary I watched, where the hospital has a time schedule and they try to rush delivery and the pitocin makes things way too stressful for the baby and makes emergency options the only way to deliver the baby safely toward the end. I just want to avoid that same scenario this next time and I'm trying to figure out a way to do it that still fits somewhat with having a doctor and a hospital birth.

I hope you have some info/advice for me. I spent most of last night watching natural birth videos on youtube and I'm a bit freaked out about how to manage the pain and get through transition! Did you have easier or faster labors with your second and third kids? I'm hoping that will be a factor for me that might help...

[lovebebes]

i recommend for you to go here (http://www.mothering.com/discussions/) and read and read and read in the pregnancy section of the forums.

the wealth of information out there is massive.

Im sorry I cannot help you further as I have never birthed without an epidural.

[nfowife]

I had a very similar experience to you with my first. DD was a very long labor, I wasn't progressing and they wanted to break my bag so I opted to get the epidural at that point (I was afraid of the pain). That turned into starting pitocin, which did get me to 10 rather quickly. I then pushed for over 2 hours and finally was a vacuum assisted delivery with a 4th degree episiotomy/tear. The recovery from that was very painful and long. It was at least 8 weeks before I felt normal "down there" for sure.

I had taken the Bradley method classes before that delivery, and was disappointed that I ended up with all the interventions, but she was also posterior and in the end was born healthy and I don't regret making the decisions at the time. I had an OB (affiliated with the local birth center so he was supposed to be natural labor friendly...not sure he was) and delivered in a hospital.

With my 2nd (DS), I opted for a hospital-based midwife. I decided I would like to try for a med-free delivery again, but not rule out an epidural if I couldn't take it either. At around 36 weeks I asked her if I should have a birth plan and she said "I am your birth plan". :) I was 4 cm in the weeks before my due date (never made it past a fingertip with DD before labor). Anyhow, I went into labor about 4 days past my due date (1 day earlier than with DD). Started having contractions at around 3:30 am and at 7:00 am we left for the hospital, got there at 7:30 and I was at a 7. I was in triage, asking for an epidural, and they checked me and I was 9 and so they put me in a delivery room and I was about ready to push! I never got the epidural and he was born at 8:20. The midwife showed up right when I started to push. I had only a tiny tear and no stitches. The recovery was SO MUCH EASIER. I felt like a million bucks and ready to go out and party right away!

I think a lot of factors made the recovery easier- obviously not having the epi made it so I got out of bed right away after delivery. BUT the no tears, not being so tired from a prolonged labor, not as "rough" of a delivery, etc. are all factors. Each labor and delivery is different and I hope your upcoming one is super easy! Just try to stay calm and think positively. I mean, I was asking for the epi when I got to the hospital with #2 but I'm so glad I went without. But if they had been waiting there with the needle I likely would have gone for it because I was in transition and in pain! But I don't remember it being unbearable and I don't feel like I am a person with a high pain tolerance either.

Best of luck!

[SnuggleBuggles]

I have had both boys without pain medication (on purpose :)). It was very important to me with ds1 b/c I was worried about a cascade of interventions, as you likely learned about in the movie. I am not tough, I don't have a high threshold for pain. I think that is a very strong misconception that you have to be tough (or crazy) to go without pain meds. Labor is different than anything else. I can handle labor a whole lot better than strep throat, for example!! The best part of labor is that it ends. :)

I think that more important than having a high threshold for pain is having the right mindset about it all, the preparation for it and good support for your birth team. If you have even one person there, like dh, just saying "get the drugs! no reason to be in pain!" then you can have trouble. You need the people around you in labor to tell you what a great job you are doing and that you can do it. If your dh isn't onboard or even if he is have him read Penny Simkin's "The Birth Partner". It's a great book for helping them learn how to support you and helps you really think through what is important.

I had ds1 in a hospital with a CNM and a doula (and dh). It was a fantastic experience! I had no IV, no hep lock, only intermittent monitoring and had freedom to labor in any position I was comfortable in. No tubs but I sat on a birth ball in the shower. Labor was long but that's because he was malpositioned (posterior). I wish someone had talked to me about that before labor so I could have tried to correct it. I could have been fine without a doula as my dh was fantastic. The CNM, well she wasn't that great so I could have been ok with an OB. The nurses matter more and the 1st I got was wonderful, supportive and understanding. The 2nd nurse was awful but by then I didn't care that much.

Ds2 was a birth center birth and I got to use the tub for labor. Nice!

After ds1 i had such a major birth high. I was so, so proud of myself!! I felt like that for months! It was a wonderful, satisfying feeling. I loved giving birth. I look at it as a challenge- one I only get to experience a few times in life so I want to experience it all, the good and hard.

Of, the "ring of fire"- over in no time at all. I always tell myself things like "I can do anything for a minute!". Great perineal support with ds2. Warm, moist compresses really helped as well as very, very, very slow, controlled pushing.

"The Birth Book" by Dr. Sears (or his website, askdrsears.com) was what transformed my personal birth beliefs. I went from being afraid of birth to excited by it.

Beth

[edurnemk]

DS was born in a hospital, with an OB and I had no pain medication or epidural of any sort. I was very happy with the experience in this hospital because they're very laid back, borderline birth center, LOL. And I had the peace of mind of knowing they have on of the best NICU's in the region, ER for emergency C/S down the hall, etc.

I would do it again in a heartbeat. No one pushed me to get an epidural, they offered once and that's it. I wasn't even hooked to an IV, only intermittent monitoring, no unnecessary interventions, etc. They let me walk, use the birthing ball, there was a tub for laboring but my labor was FAST so no time to use it. They did break my bag of waters by the very end, because it hadn't broken and I was fully dilated.

Pain wise, it was not at all as bad as I expected. The transition phase is the worst part, it's tough but survivable. Once I started pushing there was no pain, except on my lower back because of DS's position, but the OB managed to turn him and then it was much better. I did feel the ring of fire, but it's just a few seconds. I tore but didn't feel a thing, I never knew until the OB said I needed some stitches.

Your mindset has a lot to do with it, because the last hour I was at home was awful because I thought I was still at the first stage, and kept thinking that if it was going to get a lot worse I was not going to make it without an epidural, I almost cried because it was so scary to think this was just the beginning. Turns out I was at transition - the worst part-, when I got to the hospital (thinking I would end up begging for an epi) and the attending OB told me I was almost fully dilated, my perspective changed 180º . When they asked if I wanted something for the pain or an epi, I asked "is this as bad as it gets?" they said yes, and that I had about 30 min of that tops. So I said I didn't want an epi, because I was in pain, but I could manage.

I used the techniques they taught me at Lamaze: breathing, having a focal point, walking, rocking (sort of on all 4's, I was on my knees and rested my elbows on a chair). Since the contractions don't last more than 90 seconds, the pain is "easy" to handle, you know the end is just a few seconds away. I pushed in a semi sitting position, because by then I felt I couldn't hold myself up, my labor was so fast and intense my legs were shaking big time between contractions. For next time, I'll probably try squatting or all 4's. I also think I may opt out of coached pushing for the next baby and ask for perineal support. I may also look into hypnobabies.

BTW, my original plan was to go without an epidural, so it wasn't just decided because of the time issue. So my experience is that it's really doable in a hospital, just get an OB who will be supportive and not pushy, and a hospital with the same philosophy.

[swissair81]

My stats:

1 with epidural
3 without (2 precipitous births, 1 of those with pitocin. 1 was posterior and the pushing took longer).

My advice, have support. I've had 4 babies & not a single one of the births was the same.

As for the ring of fire, I only had time to worry about it with the 2 non precipitous births (1 with & 1 without epidural). It hurts, you decide you want the pain to stop & you push through it. The pushing hurt the same for both, but I could at least push without the epidural. The 2 quick births- 1 time I pushed 3 times, the other I pushed once.

My favorite part of my last birth was after the baby's head and shoulders were out, my doctor told me to reach down & pull her out. I still feel all warm and fuzzy when I think about it. I hope that I can do that for all my future births.

[daisymommy]

Here's a good discussion of this from the Lounge here on these message boards:
http://www.windsorpeak.com/vbulletin/showthread.php?t=358787&highlight=epidural&page=2

I had my first son in a hospital with an epidural. I said never again.
My daughter and second son were born naturally, DD in a birthing center, DS at home. The differences in my birth experience and recovery were like night and day.

I posted my story awhile back. I'll try to pull it up and paste it here so that I don't have to write it all out again. Okay, found it:

Here is an EXCELLENT article detailing the hidden risks to both mother and baby of having an epidural; I encourage everyone to read it. The author is an M.D., a family physician, and a widely recognized authority on pregnancy and birth : http://www.bellybeginnings.com/Hando...fEpidurals.pdf (http://www.bellybeginnings.com/Handouts/HiddenRisksOfEpidurals.pdf)

This article really opened my eyes, and started me down the road to reading and researching more about birth. The conclusion that I came to for myself was that I future births I had, I wanted totally unmediated, with as little intervention as possible.

With my first baby, I made it to 9 centimeters without any assistance or drugs. Then he got a little stuck, with his hand up over his head, and he was face up (rather than down the way he should have been). I was a first time laboring mother, no one was in the room, my doctor was MIA, and I freaked out in pain. I yelled for a nurse, who instead of trying to have me change positions or do anything else to alleviate the pain for one more centimeter, asked me "Do you want an epidural?" "YES!" I cried. It was in before my doctor even returned to the room. It only worked on half my body, I couldn't move my lower half, couldn't feel to push, it was awful. Then DS was born and was sooo drugged up because I had gotten the epidural late. He never did latch on to breastfeed in the hospital, or at home for that matter.
Start to finish labor time: 24 hours.

I never did have that overwhelming immediate bonding experience I had heard so much about. I thought there was something wrong with me as a mother. Now I know that having an epidural often shuts down the hormonal response that accompanies the bonding hormone oxytocin that floods a woman's system after giving birth. Pitocin also blocks oxytocin receptors.

Have you ever watched A Baby Story or Deliver Me or TV? And it seems like 75% of the women get an epidural, then they can't walk around, their labor becomes stalled, they "fail to progress", so of course they need pitocin to get things rolling faster, harder, then gee-surprise, the baby's heart rate drops, and they end up with a C-section or everyone is flipping out trying to get the baby out ASAP. It happens every.single.time I watch. So predictable.

Now I know that there are many success stories where this doesn't happen, and I'm happy for the women who have a successful epidural, that get just the right amount of medication, they're out of pain, they can feel to push, their baby isn't groggy, and it doesn't impact breastfeeding. But honestly, that's one in a hundred or more I think.

With baby #2 I had her in a birthing center in the hospital, totally drug and intervention free. It was like night and day in how I felt and how my baby was after the birth. I felt empowered, invigorated like I could get up and run a marathon with all of my energy,like wonder woman--not like most people think of feeling after having a baby. It's because the drugs usually shut down all of the bounce back hormones that are supposed to flood your body to help you heal and recover, and be able to care for your baby. My baby latched right on like a pro and was wide awake, lifting her head up and looking all around the room. I had such a crazy, overwhelming, out of my mind rush of love and attachment feeling to her from the moment I saw her. I had never felt anything like that in my life. Within 2 weeks I was out shopping with 2 kids. With DS #1 it was many weeks.
Start to finish labor time: 3 hours.

With baby #3 I had him at home, and it was the same way as before--AMAZING experience.
Start to finish labor time: 5 hours. Would have been shorter, but baby was not positioned correctly and it took awhile to get him to turn just right.

I am all for women doing what is best for them and their baby. But it really bothers me that most doctors never tell anyone that their are any reasons to consider not having drugs during labor. All you hear are the positives. I think most often, the doctors themselves haven't a clue about the risks to mother and baby. And they don't believe that we as women are strong enough to birth without drugs; nor do they see any reason we should want to.


A great book for anyone seeking more information on natural birth:
Gentle Birth, Gentle Mothering by: Sarah J. Buckley, M.D.

[AnnieW625]

DD1 was born in a large public hospital with one of the best NICUs on the west coast. DD2 was born at a new smaller Kaiser hospital. Hospital 1 is very traditional, and often has nursing students attending births. DD1 was delivered by my medical group's supervising OB, while DD2 was delivered by a resident OB. I liked both drs. equally, and neither was my regular OB. Kaiser for being a large HMO is actually quite "crunchy", and employs A LOT of certified nurse midwives. Most patients see CNMs for most of their pregnancy as long as it isn't complicated.

I watched the Business of Being Born before I had DD2. It seemed a little out of spectrum for me as I am on the west coast and I just think medical practices are different out here in regards to birthing practices so I was really bummed out that they didn't include anything about hospitals on the west coast or the fact that Kaiser employs CNMs.

With DD1 I ended up with an epidural. I have a phobia of needles so I just didn't want one because of that. Prior to that I had never broken a bone (never have to this day also, except maybe a couple of toes), and the only surgery I ever had was for tubes at 5, and wisdom teeth at 20. I was knocked out for both so I didn't know my true level of pain.

So for DD1 I got to the hospital way too early, I thought BH's were the real thing, but four days earlier I was 4/1/2 cm. dialated so I could have the baby any day per my OB. I get checked in, my OB was on call and okays the admission. The BHs stop pretty soon afterwards. Three hours later thinking again this is the real thing (and ready to be done being pregnant) I am 5 cm dialated the nutty night nurse convinces me to break my water. Three hours later still stuck at 5 cm so the OB orders pitocin (after the wonderful new morning nurse comes in and says that night nurse should've sent me home; I could've managed for two weeks longer at 5 cm; DD1 was deliverd at 37 w/4 d). Less than an hour later I am in pain from the contractions, pit., and penicilin drip (for strep. B), so DH tells me I am getting an epidural. I finally agreed. About 90 mins. later I get the epidural, and less than an hour later I am 10/1/2 cm. dialated. So truth be told. I went from 5 cm with very tolerable BH to about 9 cm. dialated in less than 3 hours without pain meds. I delivered fine with the epidural I was still able to push quite well. I pushed for just over an hour.

With DD2 my water broke naturally so I went to the hospital and wasn't dialated more than .50 cm.. So after I'd been there for about an hour I started having some minor contractions. I asked for some mild pain meds., they gave me an IV of nubane. That IV lasted me from about 2 am to 6 am, it was nice because I could still feel contractions, but I was able to rest (as did DH). The meds. started wearing off at around 6 am so the contractions got a bit more intense. The nurse thought I would still need pit because my water had been broken for 7 hrs. or so by then. The on call OB comes in and says she'll order the pit. and the epidural, but then the nurse comes in and examines me again about 30 minutes later and I am 7 cm (after just a few hard contractions) so no pit. needed:), and then another half hour passes and I start having a few more contractions. The new nurse comes in and tells me there is no way I can have an epidural because I am 8/1/2 cm. now. I tell her I want to start pushing when the next big round of contractions comes on then. That happened about 15 minutes later, and DD2 was born 20 minutes later.

With DD2 the pushing hurt more than I remembered with DD1 because I had no pain meds. I tore with both girls and didn't feel it much at all, but the stitches with DD2 were a tad more painful because of the zero pain meds. I will say that with DD2 I felt like I healed faster than I did with DD1. I also had a little pitocin after DD2 was born (before my placenta dropped) in my IV and that helped with the PP pain and got a lot of the heavy bleeding out of the way (although I did have some sort of after birth bleeding for about a month vs. 2/1/2 to 3 weeks with DD1).

[brittone2]

I had 3 babies w/o pain meds. First was a hospital birth w/ CNM, 2nd a CNM attended birth in a FSBC, and third was a CNM attended homebirth.

Each of my labors had parts that were more challenging and parts that were easier. DS1 I honestly only had cramping up until transition and transition I felt a little shaky and hot. It was totally manageable. I did also have a doula present. I will say for most of my labor, the only time I was very uncomfy was when I was hooked up for intermittent fetal monitoring strips periodically. I can't be in bed during labor. If I had to be, I'd be very, very uncomfortable. For me, freedom to move, and to actively labor is the key. With that birth I paced the halls and listened to my Hypnobirthing CDs. (took an in person class). My doula encouraged the nurse to hook me up to the EFM so I could labor on all 4s on the bed or on the birthing ball, etc. vs. being in bed, which I could not stand. Moving, I was great, kwim? Pushing was 20 mins with DS1. My only regret if you can call it that is that I asked to avoid "coached pushing" and got it anyway from my CNM who was a bit overbearing. I think I might have avoided the very small tear I did have (no big deal really) if I had guided my own pushing phase. I also remember feeling really sore, like I had run a marathon, from my legs being held back, etc.

With dd, I wasn't even sure I was in active labor. Showed up 10 cm dilated. Wasn't pushy, just waited (eta: over an hour from the time I was fully dilated, but no pressure to start pushing just because I was 10cm, kwim?) to feel ready to push. My membranes were still in tact so I just didn't feel pushy. Once I was ready, 2 pushes, no tears. That time I had intermittent fetal monitoring via doppler (no strips, just intermittent doppler checks, which was NICE in comparison to the first time around). I used Hypnobabies and Hypnobirthing, but never listened to the CDs during my labor once I got to the birth center. Just used the techniques and stayed relaxed. I pushed in sidelying and guided my own pushing, breathing the baby down vs. forced strong pushing. I much, much preferred that and I was so thankful the CNM helped me achieve that (different practice, different state from my first birth).

With DS2, my contractions were more intense than with baby 1 or 2 but very manageable. I moved around freely, stayed busy in labor. I made chicken salad for the midwife and her assistant at 4 in the morning as a labor project. I went outside into the cool late night air when I got hot and my contractions were peaking. I wasn't sure I'd want a water birth (labored in the tub a bit with DS1 but didn't love it), but we had one and it was a great experience. I didn't have any check to tell me I was complete, etc. I followed *my* body. I didn't push until I couldn't *not* push. 2 pushes with one contraction and DS2 was out, no tearing. I never needed a peri bottle to go to the bathroom, etc. It was truly just not even a little bit uncomfy down there.

I don't think you have to be super woman to have a natural birth. I think you need a great support system, a care provider you trust and who is confident women can give birth without meds (sadly there are OBs out there who have seen very, very few natural births), and to educate yourself on things you can do in labor positioning wise, etc. to get some relief and comfort. Penny Simkin has some great info on different positions in labor (she's a PT, as am I, and that's part of what got me interested in natural childbirth to begin with). Look into hypnosis for childbirth (I never thought that would be for me, but I loved it. Lots of old threads on it if you search. It is just deep relaxation, no weird hypnosis stuff LOL). Some people like Bradley. Consider a doula.

Inform yourself about procedures and interventions. Realize that you can say no to a lot of things. I know for me, The Thinking Woman's Guide to a Better Birth was a real eye opener 7 years ago when I was pg with my oldest. It really got me questioning how much evidence there was for a lot of the interventions commonly used in obstetrical care. Know there is no "perfect" birth and that you may need to adjust your expectations and go with the flow.

Realize women have done this for ages and ages. Birth doesn't have to be scary, it can be empowering. You don't have to be a superhero to go without meds, but it helps to stack the deck w/ a great provider, a good support system, and a lot of knowledge and coping skills in your back pocket.

eta: length of labor: ds1-6.5 hours
DD-3 hoursn(wasn't sure I was in labor for a good portion of that)
DS2 5 hours

I remember feeling a bit of the ring of fire with DS1. With the other two I don't really remember it. I remember not pushing until I couldnt NOT push and my body took over and it felt pretty amazing and powerful to push, kwim? Intense, intense, intense but I don't remember it being painful per se.

Coping techniques: tailor sitting, all 4s, rocking on hands/knees, "swaying" while holding onto DH's neck, walking walking walking, sitting on the birth ball. Hypnobirthing/Hypnobabies. Labored in the tub a bit with DS1, labored in the water more with DS2 (he was an actual waterbirth, whereas hospital policy with ds1 was that I could labor but not deliver in the tub).
I also like to not be bothered. I like to be in my zone w/ hypnosis. DH is fine, but he knows to leave me alone LOL. With labor #1 and 2 I was able to stay in that zone well. With labor #3 I had my parents there to watch the kids, midwife, midwife's assistant, etc. in my house. I was talking with everyone, etc. but as things got more intense I found myself naturally retreating to my bedroom to be by myself (midwife would come to check on my periodically w/ the doppler, etc.). That's what works for me. I like to be in my own head, very focused as things become more intense.

My doula also had things like a visual labyrinth that some women like for labor. I was happy with my hypnosis so I didn't use that but this was essentially a maze to work through visually during your contractions. There are so many options out there. Just have a lot of ideas in mind, educate yourself about them, and then see what you are feeling in labor.

[SnuggleBuggles]

2 book recommendations...

I didn't love The Business of Being Born as much as I loved Jennifer Block's book "Pushed". It's a really good read.

"Creating your Birth Plan" by Marsden Wagner is like an updated "The Thinking Woman's Guide to a Better Birth".

Beth

[mommylamb]

Well, I'll break with the group. I'm one of those people who had an epidural. it stopped all my pain. I had no problems pushing. DS wasn't groggy. I didn't need pitocin. My labor didn't stall. I had a vaginal delivery. The minor problems I had with breastfeeding had nothing to do with the epidural. I could walk less than an hour later. And, I do not think that my experience is 1 in 100. Many people I know had epidurals and were very happy that they did. Everyone needs to make their own decision on this. No one should bully you into taking pain meds if you don't want them, but if you do, that's ok too.

[kam]

I'll join Mommylamb. :)

I had a SROM at 37 weeks. 6:30 a.m. My contractions didn't start right away, but b/c my bacteria test had been negative, my OB said that I could stay home for a while if I wanted. (I think she said she wanted me in 12 hours later if contrax hadn't started, to confirm that I had ruptured and to discuss induction). My contractions started at about 7:30, and gradually built. At 11, they were 3 minute apart and I was crying through them, so we went to the hospital.

The nurses were great. They said "whatever you want!" My "primary" nurse checked me, and hugged me through contrax to help me relax. It was amazing. At about 12:30, I called it (I was about 4-5 cm). I wanted the epidural, but I voiced my concerns re: slowing down labor, feeling to push, etc. My OBs said:

(1) Your labor is WELL established. Your contrax are strong and frequent. I have little concern that an epidural will slow them.
(2) We'll do a light one, and have a button you can push for additional meds.
(3) We have enough time to let it wear off a bit.
(4) I had one and delivered twins vaginally.

So, I had the epidural. Oh, wow. It rocked. My primary nurse later told me that it's less common for women whose water breaks to be able to go without because the water isn't there providing a "pad", so the baby just slams against your cervix and pelvis.

The epidural went in at about noon. I could still tell I was having contractions, but they didn't hurt. I could feel my foot when it itched and scratch it to make it better. (bizarre). The epidural started to wear off in transition (about 4pm), and we used more traditional coping methods to get through the end of transition. I could feel EVERYTHING to push, and pushed out an OP baby in about an hour with a minor tear (the nurse & ob also said that the OP position might have increased the intensity of the pain and contractions). I needed lidocaine for stitching. My whole labor/delivery was 12 hours. No pitocin (during labor -- I needed it to stop pp bleeding), no slow down in labor, and no other "interventions."

A few other notes -- the fetal monitoring didn't bother me. I thought it was cool. The thing did move around, but it didn't bother me, and when they really wanted to listen, the nurses just readjusted it. (My dad thought it was particularly cool, and hung around watching the monitor all the time until we kicked him out for pushing! The OB thought he was a trip, and discussed studies, causation and all sorts of stuff with him! He's a doc, but not an OB).

I also wasn't bothered by the IV, and in fact let them do that regardless of whether or not I was having an epidural. I didn't think it was that big a deal at all. (And I did walk around with it for a while before getting the epidural. I used the pole as a crutch!)


I did have minor problems breastfeeding, but they were due to DD being a touch early. (The pediatrician called her "late pre-term" and said her temp control and nursing problems were typical.) They resolved in about a month and she was EBF for 9 months.

So, my advice (for what it's worth, which may be absolutely nothing to you!) --> go in understanding your options, and your preferences. But know that things change, your needs change, and don't be afraid to make decisions based on the circumstances in which you find yourself! That's what I'm going to do!

I would -- and will -- do it the same way. I'll ask for the epidural if/when I need it, but not until then!

Good luck with your pregnancy, your labor, and to a beautiful baby. :)

[Katigre]

I had planned a natural birth with DS and only got an epidural after two days of labor, but it did provide great relief through transition and allowed me to sleep a few hours before the work of pushing him out. We did Bradley classes with that pregnancy and they were great and super helpful.

I planned a homebirth with DD and delivered her without an epidural. To prepare for her birth I did the Hypnobabies homestudy course during my last two months of pregnancy. I think I posted my birth story on here but if not I'll send you a PM :).

Basically, doing it without pain meds was doable - I never felt totally overwhelmed or 'i absolutely cannot do this anymore' during DD's labor. With DS's labor the only time I felt that I couldn't go on was during the unproductive transition contractions because since his head was cockeyed in my cervix, the incredible pressure of contractions wasn't radiating down to pull me open, and instead was staying stuck in my abdomen and felt like a literal black hole collapsing in my uterus each time - very intense, very difficult, and didn't accomplish one.single.thing toward birth happening. That said, I had the exact same type of contractions with DD during labor but recognized them for what they were and they weren't as hard that time, not sure if it was because I was a seasoned laborer or not though.

During both labors I had my DH and my mom (acting as doula) with me. I think that the labor support I had was 100% the reason I was able to have a calm, focused (still intense), successful NCB with DD. I needed physical touch and counterpressure during every contraction of DD's labor and when I didn't have that they were so much more difficult - when I had comforting touch and encouraging words I was able to do it and my experience was much better.

The minute after she was born was hands-down the most exhilirating moment of my life - the flood of endorphins was amazing, I felt like I could do anything, I felt SO GOOD (physically and emotionally). I was on the phone chatting with people shortly thereafter and they were shocked I had just given birth - I was full of energy. The recovery was the single best part about NCB (and homebirth).

I think that you absolutely can have a NCB, but it takes commitment and planning and preparation to make it happen. I would liken it to running a marathon, complete with the Runner's High at the end :).

[Roni]

Mine were all hospital births without a doula. I had an epidural for dd1. I ended up needing pitocin and had to push for an hour & a half. I also fainted later that evening--not sure if it had anything to do w/ the meds. I had back labor, so I was in a lot of pain, & it was my first, so I'm not sure I could have done it without the epidural. When the pain made me vomit, I decided to get the epidural.

The other 2 were induced, but no epidural. W/ dd2 I was about to get one, but then I felt the urge to push. She popped out in about 3 pushes. DD3 was a little harder. I spent a lot of labor in the hot tub, but that only got me to about 6 cm. It was very nice, though--I had on really relaxing music, & I found a good position, on my knees, with my head resting on the side of the hot tub. The baby wasn't in quite the correct position, so they had me lie on an inner tube on my stomach for a couple of contractions. It was awful, but I seemed to go almost instantly from 8-10 cm. I did need oxygen when it came time to push, but I was so proud of myself that I didn't have the epidural. They gave me the option when I was about 6-7 cm, & I was tempted, but I just breathed through the contractions. I did vomit, but I knew the end was near. DH really encouraged me, which helped. Also, the nurses & Dr. were very good.

[arivecchi]

Well, I guess I am a wimp, but when I get to the hospital my first words are "Can I get the epidural now?". LOL. Both of my vaginal deliveries were with epidurals. I was miserable both times before I got them and then I was in heaven. I felt pressure but not pain. I would never want to give birth without one. :)

[marymoo86]

I would also suggest reading Ina May Gaskin's Guide to Childbirth. Good read. Childbirth is natural and for most cultures outside the US - epidural and the other interventions aren't the 'normal' way. People have had babies without pain meds much longer than with them:).

I really believe it is a mind over matter issue. In the US we have been taught to be 'afraid' of pain but labor is the only pain that stops with the birth of a precious baby.

Ultimately you have to decide what direction you would like to take and there is no harm in planning for one type and then choosing another. Just be prepared and research your choices. For me, with my previous back problems I knew after I was cleared to deliver vaginally that I didn't under any circumstances want to be confined to a bed due to the epi, IV, monitoring etc. I need to be mobile and also pain meds haven't typically been great for me. I took every narcotic imaginable with my back and nothing really worked. So I have prepared myself for giving birth naturally. Just don't see any need to risk any side effects as everyone responds differently to drugs. However, should something occur that intervention is necessary I won't get in the way and will let the doctors do what needs to be done.

I just toured my hospital's birth center - hybrid of sorts. More intimate with dim lighting but still with nurses and doctors andattached to the main hospital. I was impressed b/c it didn't feel cold or sterile. If you feel your hospital may not be receptive to your birthing preferences (be sure to list them in a birth plan with your dr's agreement) then I would suggest hiring a doula to assist you. The doula would also be a great resource in helping manage labor naturally.

[WolfpackMom]

I had an epidural after 15 hrs of labor, came into the hospital at 4 centimeters, got the epidural at 7cm (for some reason even though I got there first at 5:30 4 others got their epidurals ahead of me and I didnt get mine until 745pm, I guess I didnt scream the loudest). It didnt slow things down one bit, I had DS about 1.5-2hrs after the epi and I only had to push for about 10 minutes - maybe 3 or 4 times??
I DO think I could have toughed it out without the epidural, but I don't regret my decision one bit. I was in pain something fierce before I got it and afterwards everything was so much more relaxed and I could laugh and I could still feel DS coming out etc. but I didnt feel the tearing or when they injected my with lidocain to stitch me up. I was also able to walk within the hour after having it.
I will disclaimer that the anethiesiologist hit a vessel his first try and a squirted him with blood so he had to do it over again immediately, but this didnt cause extra pain or anything because they numb the area with lidocain. When the nurse messed up my first IV and I had to have a new one, that hurt more. The only bad part of the epi was staying still through hard contractions.
I am undecided about the next LO, I may try and go without, but laboring with nothing for so long was really hard for me, and I have a pretty high pain threshold.

ETA You should do whatever is comfortable for you, and dont be upset if along the journey you change your mind. I have tried to go into labor, breastfeeding, general child rearing with an open mind that I will try and do my best, but what happens, happens, I am not committing myself to doing anything in one set way because one never knows what the future might bring. You very well may have an awesome, quick, labor and not need any pain meds because you have great coping mechanisms, and if not, and you decide you need some relief thats OK too.

[MacMacMoo]

I've done both. I probably could have done SqueekMoo with out and epidural, but the nurse walked in when my husband went to the car to get our other things. The nurse thens hand be this HUGE stack of papers and said she needs them read and signed ASAP. I'm sitting there doing my best, and she complete threw off my groove. I could never get it back. So I opted for an epidural.

Second time around there was no time to ask for one. I was completely dialated and then some when i arrived in the ER. I ended up delivering in tricage.

Know you options. Know that there is nothing wrong getting an epidural it doesn't make you any less of a mom. If you think you can make it great go for it. Know what your body is telling you. If you been up for the past 30 hours and the docs are saying it may take another 3 hours, you may want one so you can catch a nap before pushing.

[MSWR0319]

I delivered DS at a hospital with a midwife with no epidural. I labored for about 30 hours at home, got to the hospital at 8cm and then labored another 9 hours until the midwife said you can either stay here and wait ( i was stuck at 9.5 for 6 hours) or we can give you pitocin. By this point I was so sleep deprived I could barely function. I wanted to avoid pitocin at all costs based on the horror stories of pain I had heard, but by this point I didn't care! I had been pushing on and off the last 6 hours to try and get his head to push open the last .5cm. I got pitocin and was pushing 20 min later, and 20 minutes after that we had a baby! The contractions were not any different than the ones I had been having already. If I had known that I would have asked for it hours before! I will not lie though, the last few pushes I screamed. I have never been so embarrassed in my life. They did hurt but I quickly forgot about them. Oh, and DS was posterior which is why labor was so slow.

To help ease the pain I read a couple Bradley books and mainly just focused on relaxing from head to toe like the books said during contractions and it really worked. I was skeptical. I did a lot of walking and swaying through contractions at home. At the hospital I sat in the tub which really helped.

[MoJo]

I birthed two babies, both in the hospital with midwives, one with an epi and one without. I wanted a natural birth both times, but I know I did what was best both times.

With Jelly Bean, my water broke but all natural means to start labor failed. So I was doing pitocin after two nearly sleepless nights. I needed the epi, and it worked perfectly. I could tell when it was time to push, could feel myself push, felt the ring of fire. It seemed to speed labor for me. Baby had great Apgars. I had a small tear.

With Ha, I mostly labored at home using the Bradley techniques that I learned before Jelly Bean was born. My water broke in the hospital parking lot, and I was ready to push. There was no time for the epi, but I didn't want one. Ha came very quickly, but I did not tear at all.

If I were to have a third, I would hope for another natural birth, but I would be less afraid of the epi if I needed it.

[missym]

I've done both. I hated my unplanned natural birth while I was doing it :ROTFLMAO: but afterward the recovery was so much better that if I were having a third I'd try to go that route again.

My advice to all expectant moms is to prepare yourself in some way (Lamaze, hypnobabies, etc.) for an unmedicated birth even if you fully intend to get an epidural or other pain meds. My second labor was precipitous and there was just no time for anything. I was really unprepared and just felt like I couldn't handle the pain or even catch my breath. Maybe it would have all gone out the window in the craziness anyway, but I wish I'd prepared better so I wouldn't have freaked out quite so much.

[Momof3Labs]

DS1 was born in a hospital, with an OB attending, and with an epidural. The epidural didn't really take, so I still didn't get any rest, but because I had the epidural, they wouldn't let me move around to try to deal better with the pain. Labor slowed down, they added pitocin, threatened a c-section, I begged for more time because DS and I were both fine. They made me start pushing when they wanted me to push, not when I felt ready, but since I had been on my back all day with the epidural, DS was posterior and kinda got stuck. 2 hours of pushing and they had to use forceps to get him out. 3rd degree tear + episiotomy = not fun recovery. 21 hour labor.

DS2 was born in a hospital without an epidural, but with a midwife and doula for support. The OB was down the hall through my labor and in the room for the birth, but the midwife was closest to me. I spent most of my labor on the birthing ball, and most of it was back labor. Total labor was 9 hours, with 20 minutes of pushing. I loved, loved, loved feeling DS2 descend and move through the birth canal. I guess it kinda hurt when he was crowning (big, big head) but I don't really remember that much because it is over so fast. I did have a small tear which they repaired with a local anesthetic. I felt soooo much better after that labor and delivery than my first!!

I really, really wanted to have the twins vaginally without pain meds, but baby A was breech and her little bottom was blocking the whole show. So I ended up with a c-section (and an amazing epidural - wish I had that anesthesiologist with DS1!!).

[MommyAllison]

I had both of my kids in the hospital, DD with an OB, DS with a CNM (midwife). Both were epidural free, and I did not have a doula. DH was the only labor support I wanted. Both of my labors were great, and I had an amazing labor nurse with DD. She was really good at knowing what I needed and wanted, and was ok with letting me labor alone with DH and just checking on us periodically. The OB who was on call was not my favorite, and she did an episiotomy (I did not feel it), but other than that delivery was fine. I would have preferred not to push flat on my back, but that particular OB was not willing to let me try any other way. I did tear internally, so she stitched that tear as well as the episiotomy, with just a little shot of local anesthetic after I delivered the placenta. She also put pitocin in my IV after delivering DD to help the bleeding to slow from the internal tear, and to deliver the placenta faster.

With DS, I arrived at the hospital fully dilated and ready to push, so I wasn't there very long. I was able to request a hep lock rather than an IV, and pushed DS out in a side-lying position (my midwife's preferred position), which was much better for me than lying on my back. I did not get any pitocin or a local anesthetic after his birth. My midwife massaged my abdomen to help the placenta along, and put in a couple stitches in the one little tear I had.

I agree with Beth (brittone2), you don't have to be a superhero. My mom had natural births, so I grew up thinking that was normal, and had them myself, as did my sister after me. My Dh and I took a childbirth class before DD and it helped him know that he should listen to me and do what I asked during labor. :) For me, having my arms up around his neck and being able to hang on him a bit during contractions was what felt best both times. Being totally alone during contractions is NO good!! Being able to walk, sit, stand as needed was helpful too. I'd change positions every contraction with DD, and I was so glad to be able to. With DS, I labored at home and was folding laundry, showering, getting the house picked up, etc. with no problem. I didn't realize that I was so far along in labor until right when we left for the hospital and my peanut butter toast was making me nauseous (transition!). Being in the car through transition (it was a 25 minute drive) was laaaaaaaaame. Don't recommend it. :)

My 2nd labor was way shorter than my first (which was not long either). DD's labor was 9 hours, DS was 3 hours. I'm pretty sure that I could push another one out while sleeping ;) just kidding!

One other thing I think makes a huge difference is if you have an OB and a nurse who are familiar with natural births. In my hospital, the epidural rate is over 90% - so some of the nurses were coming by saying "I've never seen someone not get an epidural! You are amazing!!" uhhhh no. I'm not, really. :) A nurse who has attended a lot of drug free births may be able to somewhat act as a doula - they might know other labor positions to try, etc. The OB I was seeing with DD had been delivering babies since before I was born, and had done a lot of drug free births. The OB that delivered DD was not that far out of med school, and probably had not had as much experience with drug free births. Which nurse you get is pretty luck of the draw though...unless you know someone in L&D at your hospital. You can do it!

[american_mama]

I've had three babies in three different hospitals, all natural, although mine were mostly with midwives. I'll try to directly some of your questions, with the last one first:

>> Did you have easier or faster labors with your second and third kids?
Generally, I think everything after your first birth is faster and easier. Second births are generally much faster and then supposedly all bets are off. Your second birth had a very long beginning phase, and then a lot of interventions which hopefully won't apply the third time around.

>> Can anyone here share advice/experiences/tips about having an unmedicated birth in a hospital (especially without a doula or midwife)?
Things that helped me: choosing a provider with a good reputation for natural birth, touring the hospital, seeing if they had tubs/whirpools, 1:1 nurse to mother ratio during labor, asked every nurse I met if moms delivered in this position, that position (the more normal that seemed to them, and the more nurses that were comfortable with different positions, the more confident I was that the nurses and ob's at the hospital were used to natural birth). The hospital should also have some food available for a laboring woman. I am not an expert in birth plans, but I think they are good for getting patient and doctor talking to each other, and mother and birth partner on the same page. They also help your labor nurse know who you are and what you want.

As an example, I only wrote a birth plan for my first birth. I said I wanted to avoid an epidural but if I asked for one, I wanted someone to see if I could try something else and give it another 15 minutes. Sure enough, at one point I said (and I quote) "What would it take for me to get an epidural?" and the nurse, appropriately I think, said "Oh, well, it would take a little while... you're managing so well. Why don't you try X?" Worked beautifully, things progressed fast, and I never thought about an epidural again. I don't know if the nurse would have known to direct me that way without my birth plan.

>>> What techniques did you use to get through the really painful contractions?
Rotate hips on birth ball, squeeze DH's hand, sway with DH, get in the tub, rock on all fours, lean on something and sway, open and close one fist/tension/tight/release, tension/tight/release, moan/vocalize, say to baby "Come on, baby, come on," chant "ooooooo---pen," focus on keeping my mouth/lips/jaw loose and open (sounds crazy but seems to help the perineum stay loose and open). I wasn't into massage or counterpressure, but for some people that helps a lot.

>> Did you feel the "ring of fire" when the babies' heads were crowning?
No, not really. I've had three babies and pushing was so intense (sometimes painful, sometimes more intense/productive than painful) that's really all I felt.

>> What positions worked the best for being comfortable and successfully pushing the baby down the birth canal?
Really, whatever feels good to you. With DD1, I thought I'd love walking, but I was tired. Laying down felt good. Witt the other two, a lot of swaying while staring at the ground or kneeling on all fours felt good. Arms on the sofa, knees on the floor was great in early labor.

>> Has anyone here given birth in a hospital without medication and just used a doctor and support from the husband and not used a doula or midwife?
Yes, many. The key in that situation is to choose an OB who is supportive of natural childbirth AND for your husband to be a good labor partner - helpful to you, active, encouraging, and not afraid. I talked A LOT (for months) to my husband about natural childbirth, what I wanted and why during my first pregnancy and he was totally on board and informed by the end.

I would also suggest you do a few things: write down things that you think will help you feel better in childbirth. I love showers and tubs, so that was on my list. I really relax to this one CD, so those songs were on my list. Make it a long list, so you reassure yourself and DH that you have lots of comfort measures to try. Also, write down what you are looking forward to about childbirth. I was looking forward to bouncing on that big birth ball (it's fun), I was looking forward to finally seeing very specific things about my child's appearance, I looked forward to being the center of attention. I looked forward to going through something really big with DH and adding the experience as a brick to our marriage. Lots of thigns. It helps to put a positive spin on the childbirth experience.

Lastly, I also wrote down a long list of reasons why I wanted a natural childbirth. A friend just couldn't fathom why, so I wanted to articulate to myself all my reasons, big and small, rational and emotional, personal and broader.

If writing isn't your thing, the book "Birthing from Within" has lots of other exercises, many art related, that get at deep, sometimes unconscious, feelings about childbirth. I got the book from my library and found it fascinating.

I think natural childbirth takes a lot of mental prep beforehand and then it takes letting go once labor begins, which is really like a lot of things in life.

[MoJo]

I wrote about my experience last night, but ran out of time to answer some of your more specific questions.

For the natural birth, I got through the most painful contractions by relaxing as much as possible before each contraction arrived. I spent lots of time on my hands and knees at first, which was recommended by one of my midwives due to baby's position which was resulting in back labor. Deep but regular breathing, mouth open. As it got more intense, I laid on my side on my bed, as recommended in the Bradley book. The drive was the hardest (it's over 40 minutes on the interstate to my hospital), and that was probably made worse because I was in transition and didn't know it. There was a point when I thought, "I can't do this alone," but never a point when I thought, "I can't do this." As it turned out, I did do nearly all of it alone. All the labor at home was alone, DH couldn't do much in the car, and DH & the midwife almost didn't make it to the room in time for Ha's arrival!

I tried a ball (with both girls) but it didn't help me. I wanted a water birth, but didn't arrive in time for that. The pitocin the first time ruled out any water therapy. I took a bath at the start of the serious phase with the second, and that was nice.

#1 was pushed out on my back. #2 I was half on my side, half reclined on my back. . . the midwife just said whatever was comfortable, and that worked.

I also recommend Gaskins' books for lots of great stories on how normal natural childbirth is. And Susan McCutcheon's Bradley book.

[Ladybug47]

Thank you so much for all the great information, birth stories, advice, reading suggestions, and encouragement! The more I read, the more psyched I'm getting about labor and getting to meet this baby girl!

[Kitten007]

My advice to all expectant moms is to prepare yourself in some way (Lamaze, hypnobabies, etc.) for an unmedicated birth even if you fully intend to get an epidural or other pain meds.

:yeahthat:

DS1 I got an epidural and since it was my first, it was nice that I could relax and enjoy the experience as I was scared, anxious, and excited. That labor total was about 5 hours. No doula or midwife. Just DH, Mom, nurses, and doc.

DS2 came in less than 3 hours and I had no time for anything. The ring of fire....I won't lie it burns, but I have to say you get the strength to just blow through it and you know that the baby needs you and just a little while longer and a little pain your baby will be there....and BAM!!!! Baby out and the first thing I said, "Oh my god! I feel so much better!" My doctor laughed and I was so proud of myself and the feeling after was just fantastic. Again just DH, Sis, nurse, and doc there for my support.

I guess just go into the labor with an open mindset and make the decisions you want for yourself and don't let anyone pressure you.

[ewpmsw]

I've had an epidural and have delivered without one. If I ever have a third baby, I'd prefer a natural birth. Things went so much better for me without the epidural, esp. being able to move around while I pushed. I feel like the recovery from it has been easier.

What techniques did you use to get through the really painful contractions?What positions worked the best for being comfortable and successfully pushing the baby down the birth canal? Breathing, groaning (low "ohhhhhh's") and squats. Squatting and knee bends got me through the second labor. I also walked a lot the second time around and feel like it helped move things along. Having my leg lifted while I was in a side-lying position helped with the first (epidural) delivery. I delivered my second DD on hands/knees on a bed. It wasn't planned - It was the position that felt best when the time came to push.

Did you feel the "ring of fire" when the babies' heads were crowning? Oh, yes. Both times. Now, I don't recall the pain of it, only that it had my complete attention and my entire body was focused on pushing the baby out ASAP. I didn't feel scared then, just very focused. (And really ticked at the time that I had to stop pushing so they could suction DD #1 and so deal with the cord for DD #2.)

Did you use a birthing ball or get in a whirlpool or shower or anything? I liked the birthing ball in early labor, but preferred sitting on firmer things like a rocking chair or steps later on. At the hospital, laboring in the tub helped a lot. I had to get out after an hour and couldn't believe it had been an hour - The time flew by.

I had an epidural with my first DC and a natural birth with my second. Both labors were very long with lots of starts and stops. I got an epidural with DC #1 after 24 hours of labor so I could rest. I was dehydrated and hadn't been able to keep any food or water down for most of that 24 hour period. At that point, we were concerned that labor would slow even more if I didn't rest and rehydrate. DD was born at 33 hours (only 10 minutes of pushing). There were some minor complications following the delivery that made me so glad I'd had the epidural.

With my second, I was determined to get an epidural on the way to the hospital and then forgot about it when we arrived. Seriously - I labored in a tub, then in the delivery room, and was so focused on getting that baby OUT, I didn't want to slow things down waiting for the anesthesiologist (sp?) to get there. I waited longer to go to the hospital with #2 and only labored 2 hours before pushing (15 minutes) and delivering her. After 2 1/2 days, 2 more hours was nothing.