A Safe Natural Birth Plan

A quick look at natural birth

A natural birth, also known as an unmedicated birth, is a birth without any pain medication or anesthesia. Women have always prepared for the birth of their babies and we understand the importance of a mother’s experience and her memories formed.

It is important to work closely with an OB-GYN to create an individualized plan for a natural birth. A woman’s childbirth experience is often determined by personal expectations, support received by family, friends and professionals, and her involvement in decision making. For healthy women with a low-risk pregnancy, giving birth naturally may be a safe option.

Benefits of natural birth include noninvasive techniques that reduce the risk of harm to mother and child, no medications to dull sensation or alertness, and empowering the woman by being in charge of her delivery.

Risks of natural birth include a long labor that can be exhausting and potential risks to child and mother if she ignores doctor recommendations for medical intervention.

What is natural childbirth?

Natural birth is generally considered to be going through labor and delivery without medications and invasive medical techniques. In natural childbirth, the woman chooses to allow labor and delivery to proceed with very minimal medical intervention.

Natural birth can help remove a woman’s anxiety associated with labor and delivery. It is generally a safe option for women with low-risk pregnancies who are in good health. During prenatal examinations and visits, our OB-GYNs will help a woman determine if she is a good candidate for natural birth. It is essential for a woman to have a good relationship with her doctor in order to reach the proper decision.

More and more people are choosing to have a natural, or unmedicated, birth in recent years. There are more options for birth centers, home births or traditional hospital births without medication. However, few women choose to have home births, due to the lack of medical services available should something unforeseen occur. Many women choose to develop a natural birth plan that unfolds in a hospital setting, getting the best of both worlds regarding the natural process and access to advanced medical care for mother and child should these services be needed.

What are the benefits of a natural birth?

There are many advantages to an unmedicated childbirth experience:

• Techniques used in natural childbirth are often not invasive. Continuous fetal monitoring, invasive monitors and induction of labor are often avoided.
• Many women feel empowered and in charge of their birth in ways they may not in a more traditional hospital birth. This sense of empowerment can actually reduce pain for some women.
• In an unmedicated birth, the labor pain can subconsciously guide the woman to move in ways that facilitate the birth.
• The lack of medications enables the woman to feel sensations and remain alert, helping her participate in pushing the baby out.
• The pushing stage is generally shorter in a natural birth. Women can move freely during natural birth and find more comfortable positions during labor. This ability to change positions can reduce labor and delivery pain.
• Women can continue to eat and drink during a natural childbirth.
• Research shows that babies born in unmedicated birth are more alert and involved in pre-breastfeeding behaviors that make that beneficial practice more likely to succeed.

A birth plan accounting for all possibilities

Who is a good candidate for natural birth?

Natural births are a great option for women with low-risk pregnancies, which is a pregnancy during which little medical intervention is expected to be necessary. Women with medical complications in their pregnancy, such as high blood pressure or diabetes of pregnancy, might not be a candidate for an unmedicated birth.

Women with typical or larger pelvises will likely have an easier time with a natural childbirth. A small pelvis may increase the chances of the baby getting stuck in the birth canal, as well as increase the pain of labor.

Women with proper coaching on breathing techniques, pain management, low-risk pregnancies and continuous one-to-one emotional support have a better outcome in natural birth, according to the American College of Obstetricians and Gynecologists (ACOG). Birth preparation should provide women with knowledge they need to make decisions that are right for them.

Pain management without pain medication

The pain of childbirth can be prolonged and intense; although pain and pain relief often do not determine a woman’s satisfaction with her birth experience. Those who choose to have an unmedicated birth find alternatives to deal with the pain. Preparation for a natural birth can include taking a class on what to expect and learning breathing exercises such as Lamaze methods to focus on during the birth. Other methods to deal with pain include using heat packs or taking a warm bath, making frequent position changes, and practicing forms of self-hypnosis that are learned before birthing.

A birth partner can also assist with pain management by providing emotional and physical support. Emotional support can be in the form of praise, encouragement or reassurance throughout the birth. Examples of physical support include massages and assisting with breathing techniques. A study published in 2017 found that women who were given “continuous support” had a higher instance of giving birth spontaneously.

Labor and delivery pain can also be reduced using the Bradley Method, which involves coaching by a husband or partner. This is a system of natural birth preparation focusing on education, breathing, exercise, nutrition, and relaxation to prepare the woman for the experiences before and during delivery.

Planning for the unexpected

The ultimate goal of any birth plan, medicated or not, is a healthy mother and baby, and hopefully, a vaginal birth. Creating a plan with a doctor, midwife, or doula in case of unforeseen complications can keep emotions in check and ensure there is a safe, successful birth. Deviating from a natural birth to receive an epidural is not a failure. Having a healthy baby, with or without medication, is the goal.

When the mother can no longer focus during contractions, it may be time for intervention. If the mom is so exhausted from the labor process that she cannot push effectively, medication may help her rest and regroup before moving forward in the process.

If the baby is in distress, medical interventions may be recommended. These interventions might include continuous fetal monitoring, administering oxygen to the mom to help get more oxygen to the baby, or even a cesarean section. Again, if any of these interventions are recommended, please do not view them as a failure of any kind.

Doctors may also recommend interventions if there is no progress in labor. Some interventions to expedite the labor process are breaking the bag of water, Pitocin to make contractions stronger or more frequent, or possibly a c-section.

Having a natural, or unmedicated, birth in a hospital ensures that if any complications do arise, the appropriate action can be taken quickly.

Key points

• Have a plan: Meet with a doctor to prepare for the birth and how to handle any surprises.
• Consider a doula: Working with a professional doula can be helpful and take some of the stress away during a natural birth.
• Take classes: Prepare for the strain of an unmedicated birth by taking classes on pain management. These can be helpful for both the mother and birth partner.
• Ultimate goal: Having a healthy baby is more important than having a natural birth.

Considerations & risks of natural birth

An unmedicated birth can sometimes result in a long and painful labor. This process can be a demotivating and exhausting experience for the woman. But for some women, an unmedicated birth can be empowering and extremely fulfilling.

It is not recommended that women with high-risk pregnancies or who have had previous pregnancy complications pursue a natural birth. Women should make sure to discuss their pregnancy with their provider to see if they might be a good candidate for an unmedicated birth. Also, for women who are anxious or have a low pain tolerance, natural birth may not be the best option.

CU Medicine OB-GYN East Denver (Rocky Mountain)’s view of natural birth

At CU Medicine OB-GYN East Denver (Rocky Mountain), our birth plan for all of our patients is, “Healthy mom, healthy baby, and to the best of our ability, a vaginal birth.” We encourage all of our patients to go into the labor and delivery process with an open mind. Our doctors will work with them throughout labor and we will do our best to follow the mom’s plan and desires.

But, if any interventions are recommended, we will explain them, answer the woman’s questions, and come up with a plan that feels comfortable to her. Again, if a vacuum, forceps or c-section delivery is recommended, please do not consider the birth a “failure.” The baby and mom’s body just may have different plans for her!