A woman's decision to labor and birth unmedicated is heavily dependent on many factors, including the her culture, her support system, her chosen provider, site of birth, availability of options—even region of the country where she gives birth.
Women who intend to have an unmedicated labor and birth can help increase the chances of being successful at doing so by doing the following 3 basic things:
Get smart on birth
First and foremost, educate yourself on the process of labor and birth.
The fear-tension-pain cycle, specific to labor and birth and first written about by Dr. Grantley Dick- Read in the 1940's, is most applicable for those women who are most fearful—those who come to labor unprepared for what lies ahead.
The more fearful a woman is, the more muscular tension she displays (for example, what many may think of as “white knuckling"—mightily gripping the bedrails as they tighten every muscle in response to pain).
The more muscular tension that a woman displays, the greater her degree of expressed pain, and the more pain she has, the more muscular tension she displays, and it goes on and on.
This is a cycle that can be broken, however; the more informed a woman is, the less fearful she is about the whole process.
Hint here, look at the author's credentials of any texts you are thinking of picking up at the bookstore; someone may be a fine actor or comedian – doesn't mean they are an expert on pregnancy and birth and qualified to be giving you advice!
There are many excellent childbirth education philosophies: Birthing from Within, Lamaze, Bradley Method, Hypnobirthing and Hypnobabies to name a few – the key is to do your homework and decide what appeals to you.
There is not one perfect childbirth education philosophy for everyone and you are far more likely to utilize a method that fits your personal philosophy.
Have a "plan"
Have a birth plan, and by plan, I think of that in the same way I think of vacation plans.
Whenever we venture out on vacation we have a “roadmap" of sorts; where we are going to stay, things we want to do, sights we want to see.
That said, I have never been on a vacation that didn't involve some change of plans, whether it was a minor glitch when our hotel reservation ended a day earlier than we thought it did, or something major, like the time a pending hurricane turned us back towards home after only been on vacation for a day!
The best laid plans have provision for the unexpected, and so it is with birth plans; women who go into labor and birth with a plan that has room for change tend to be more satisfied with their ultimate experience.
Interview your birth team—then trust them
When first seeking providers important questions to ask include: what percentage of the provider's patients attempt unmedicated births, and how many succeed; the provider's epidural rate, cesarean rate, their thoughts on continuous electronic fetal monitoring vs intermittent for the low risk woman, their practice as far as women being out of bed and active during labor, eating and drinking in labor, use of the shower/bathtub in labor/birth, and use of birth positions other than supine (lying on one's back).
Hearing their responses should give one a pretty good idea of their practices, including support for unmedicated labor and birth.
Be confident that you have chosen the provider best suited to help you achieve your goal of an unmedicated birth.
Michelle R. Collins PhD is director of the Nurse-Midwifery Program at Vanderbilt University School of Nursing