Is Unmedicated Birth Worth it? Part II: How To Go About Achieving An Unmedicated Birth
A few years ago, an old friend of mine called me and asked me to be her doula. I had since moved away from where she lived, but I was only two hours away and she was excited to have me on her team. She took a HypmoBirthing class with the same instructor I had taken my first class with and she was doing all the things to prepare for her birth. When she headed into the hospital, when contractions were consistently 4 minutes apart, lasting for around a minute for two hours, she called me to join her (we had been talking on and off throughout the early labor process). She didn’t want me to get off the phone with her at that point, so I drove up on 695W to 83N in my husband’s beater car—a 1996 Toyota Camery—I held the phone to my ear the whole ride because one of the back windows was broken and stuck down (speaker phone wouldn’t work). I talked for 2 hours straight, walking her through each contraction and giving her position ideas. I remember parking the car and bolting through the walkway to the hospital, nearly hoarse from the nonstop HypnoBirthing affirmations and relaxations I spoke over and over and my ear being so sore from holding the phone. When I got there, she said she thought I was only on the phone with her maybe 10 minutes. Time shifts in labor, the way a ship lists and a crew member moves their body to accommodate the new center of gravity. It takes a bit for a woman in labor to get her sea legs.
Several hours of hip squeezes, position changes, the shower, the bed, the squat bar—this mom was up for it all, trying out every suggestion, and roared and growled her baby down and out and into her arms in the way that can only happen in that haze of unmedicated, untamed, insane, raw birth. I remember how vindicated she felt, being able to birth her baby the way she wanted, without ever even getting an IV port hooked up to her in the 12 hours she labored at the hospital. It is always a miracle to me, however people birth. But it does mean a lot when you as the doula are told that they couldn’t have done it the way they wanted without your knowledge, support, and encouragement.
The freedom of an undisturbed, unmedicated labor is honestly so incredible.
You eat what you want, you move how you want, you let it all flow through and with you. Surrender is never passive. It is one of the hardest things in life, but also, in labor. With unmedicated birth, you just need to surrender to it completely.
I know not everyone who reads this is as in love with birth as I am. I know not everyone who reads this believes in the ability of HypnoBirthing to get you pretty close to a pain free birth. That’s ok. We are all starting at different points going into our pregnancies and everyone has their own histories they bring along with them into the labor room.
My car baby was as close to pain free of a birth as possible, to my body, anyway. It was wild.
When someone asks me why I wanted an unmedicated birth with each pregnancy, years ago, I was the type of person to launch into a TED talk about the medical industrial complex robbing women of their autonomy (a hot button issue especially in today’s political climate), and how birth without interference is a literal birthright. I talked a lot in the last post about the reality of epidurals—that even the recovery the next day is quite different than without one. Beyond the way it changes labor (75% of people who get an epidural get Pitocin), it can change recovery. Often during pushing, you do like a 1,000 sit ups with an epidural birth to move your baby down and out, which leaves you very sore the next day. Your legs are stretched beyond their limit because you’re numb and can’t tell us, ‘I can’t bend that far.’ At least for me, my first birth, which included 4.5 hours of pushing because little miss was sunny side up and had no intention of turning (came out staring into my soul), I felt like a train hit me the day after I gave birth. BUT, I think I would have ended up with a csection without that epidural, so it was the absolute right choice.
My first pregnancy, I took HypnoBirthing classes. I absolutely loved the course; however, the class never talked about anything except J breathing (the breath you use to help push your baby down) as a pushing option. When I teach classes, we talk about what other kinds of pushing are out there and what you might need to use if you do have an epidural birth. For my first birth, it built all day long the day before, but once I hit ten hours of minute long contractions, three minutes apart, and not a single one felt in my front, but all in my tailbone & sacrum, I decided I needed an epidural when I was 7cm dilated, 100% effaced, and baby was at zero station. I agonized over the choice to get an epidural, but I hadn’t slept in over 24 hours because labor started the night before with mild cramps that just kept me awake. When it’s your first, you just don’t know what to expect. I thought I had more time—that I could sleep the next day before labor started.
When it was time to push, I remember everyone yelling at me at once to “push!” which was my literal nightmare and I started crying when pushing. I couldn’t feel my contractions, I couldn’t feel what I was doing, I wanted the breathe my baby down, like they said in class. I felt overwhelmed, like I failed, and it was NOT a calm environment. We paused pushing and I had to reset. I told the room I need only one person to talk to me (the midwife) and that I needed relaxed encouragement—not military style counting. This helped immensely. I make it part of my HypnoBirthing classes to talk about all scenarios—not just the perfect ones. When I finally did push her out, her head came out and once her shoulders were free, my midwife told me to reach down and grab my baby. It was incredibly healing to catch my own baby after the labor did not go as I thought it would.
What really shifted for me in my approach to things with my second pregnancy was truly preparing my mind and body.
I didn’t sit much because I was chasing a toddler around (my girls are 19 months apart), and I was power walking with a stroller throughout the whole 9 months. With my first pregnancy, I gained around 60 pounds. With my second, it was about 30. I think that says a lot about the physicality of my second birth. I was a teacher for my first pregnancy, so I did stand a lot. But I didn’t have a regular exercise program or classes that I went to. Movement is so important to a healthy pregnancy and birth.
Practicing the HynoBirthing tracks and really getting into my birthing mindset helped the most. I just didn’t practice as much as I should have the first time around. I was 100% committed to doing mental prep every day with that second birth. For me, switching from a hospital to a birthing center for my birth also helped so much. The trust I had that I could do this, just like the other women here do it, was inspiring and helpful for me. At one of my last appointments at the birth center, a midwife told me second babies can be fast and that someone almost had a baby in their parking lot last week. I vividly remember thinking ‘that’ll never be me!’ and then I gave birth in my car, in my driveway, a week later. Birth is funny that way. My first labor was around 23 hours, counting active labor and pushing. My second was …by the time I knew it was truly GO time, I birthed her maybe 30 minutes after thinking ‘Hey, I’m going to meet my baby sometime today.’ I thought, Ok, I’ve got like 6 hours. I can do this. Yeah, no. Car baby. In our driveway.
Is unmedicated birth worth it? In a nutshell, hell yes. I can’t even adequately describe the sensations of birthing in that car. She came to me. I didn’t push her out. My daughter’s name means ‘one who knows her path’ and we picked out that girl name at 20 weeks along (we didn’t find out what we were having until she arrived). She still does things in her own way, mostly on her terms. When the ambulance arrived, probably ten minutes after she was born, I stood up and walked into the ambulance with the placenta still attached, umbilical cord going from baby back up me. I felt like Wonder Woman. Unstoppable.
HOW TO HAVE AN UNMEDICATED BIRTH
I say again—Is unmedicated birth worth it? In a nutshell, hell yes. But only when your birth calls for it. If you need to switch things up and use an epidural, do what you need to do. If you want an unmedicated birth, don’t go into your birth without preparing for it. I know a lot of people who say, you can’t really practice for it because it’s not like throwing a basketball at a hoop. That is true. You can’t simulate contractions exactly, but you can try sitting with uncomfortable sensations (ice on your wrist, a literal wall sit) and see what your mind does—does it try to get away, or are you able to keep yourself calm, relaxed, and loose through it? Getting comfortable in the uncomfortable will help immensely. Learning how to relax deeply and practicing it will go far for you for labor.
As a doula, when someone I meet says they want an unmedicated birth, I ask them what childbirth education classes they’re taking. If they say they don’t plan on taking any, that’s a red flag to me. Birth is natural. But, and I don’t want to send like a boomer here, there are a number of people who haven’t had to develop much grit in their lives. If you are a marathon runner, you’re in the top 1% of the world—even if it takes you 4 more hours than the other elite first place marathon finishers—running that far, putting your body through that physical feat is not common. About 75% of US mothers use epidurals during their births. If you don’t want an epidural, you need to prepare for that and train like marathon runner train.
There is this misconception that birth is only hard because of the way OBs and our hospital system manages it—by pushing augmentation of it. Reality check. Birth is hard no matter how you’re doing it. You’re less likely to have any of those interventions if you just birth at home with a midwife, but I’m talking about those people who have to or who choose to birth in a hospital.
Just trying to wing it and figure it out on the fly most likely isn’t going to work out for you. I am of the belief that everyone deserves a doula. Besides the statistics that show that doulas lower csection rates, lower intervention rates, shorten length of labor, and women who birth with a doula have overall more satisfaction with their births, doulas really are the sherpa to your birth. You could climb Mt Everest without one, but why would you? Especially with unmedicated births, GIRL, get you a good doula. You’re playing with fire by not. Stack your deck so you have hands-on help at the ready.
Let me tell you, unmedicated birth is not morally superior to medicated birth. I’m sure there are those out there preaching a litany of things that sound like that. I’m not here to do that. I’m suggesting understanding the benefits of a labor where you get to move more, where you don’t need constant fetal and maternal monitoring, where you aren’t augmenting with pitocin (75% of those with an epidural will get pitocin), when you feel what is happening in your body so you know when and where (in your body) to push—all of that—knowing what birth can be like, can make a big difference in how you approach your birth. If you get to see birth stories and videos that show the power of birth instead of using fear (like all the fictionalized accounts of birth in movies and tv shows you grew up with), if you get to know that unmedicated birth can be a beautiful, intense, labor of love, you’ll feel less afraid. Which can completely change so much about your birth. It doesn’t have to be this chaotic screaming, insane scene. You can be loud (I roared my babies down), but movies and tv shows don’t show what birth CAN be. You should learn about this and learn how to achieve that—whatever that looks like for you.
Classes that meet weekly in-person build on each meeting and dive into things on a much deeper level than a one-off hospital class can. You need to prepare for your unmedicated birth like you’re going to war. You don’t just show up on the battlefield. You have a plan that is practiced and drilled into you.
You have to physically prep and mentally prepare your mind for what will be the hardest thing you’ve ever done.
1. Go to Classes. A few hours of birth prep is not going to cut it for unmedicated birth. You need comprehensive classes to talk you through everything and give you skills to practice before you are in labor. Going to a weekly class helps to develop relationships between other expectant parents, which puts you well on your way to having a supportive village in your parenthood. I love the HypnoBirthing course because it’s 5 weeks of coming together to watch births, ask questions, learn about the different options, and in-person guided relaxation exercises. That is really powerful.
2. Get a doula. I am of the belief that everyone deserves a doula. Besides the statistics that show that doulas lower csection rates, lower intervention rates, shorten length of labor, and women who birth with a doula have overall more satisfaction with their births, doulas really are the sherpa to your birth. You could climb Mt Everest without one, but why would you want to? Birth is better with a doula.
3. Prepare your Body- Birth truly is like running a marathon. It is exhausting. Even when it’s fast, it’s exhausting. You will be using all of your energy to bring your baby here. It pushes you to your limit and asks for more. If you are not used to standing for 30 minutes on a regular day, how will you stand and sway through contractions? Motion is lotion and being up and out of the bed is a huge part of unmedicated birth. If you don’t move your pelvis during pregnancy, you are going to have a harder time moving your pelvis at the birth, which is exactly how you will bring your baby here.
4. Prepare Your Mind- Birth is not just about the physical things happening in your body. It is deeply mental. Learning different mind strengthening exercises to relax into the sensations of contractions will help immensely. Training your mind to be strong and resilient will go a long way not only through the labor, but into your parenthood. This is often where you become emotionally dysregulated while being in charge of teaching a child how to emotionally regulate themselves. I still use my HypnoBirthing techniques to parent my now 6 and 7 year olds.
5. Be Fluid. That doesn’t mean you can’t have an unmedicated birth. I 100% believe in your ability to give birth without medication or interventions if you’re having a healthy, low risk pregnancy. But sometimes people get diagnosed late in the game with high blood pressure, fetal growth restriction, and other medical conditions that may affect delivery. Unexpected inductions, water breaking and labor not starting for a long time, etc. Things come up and you need to be fluid about your plans. If you chose your providers well, you’ll have learned that they’re not the kind to bully you into things. They’ll give you your options and, a good doula will also help you along that path.
You need a team that surrounds you, supporting that plan, helping to make that happen.
Your partner needs to know what’s going on, how to best help you cope, they need to know how to not make the birth about them. You need a third party in that room, not employed by the hospital, on your team to support you both. Doulas can work some miracles sometimes with their knowledge of positions and how skilled they are at reading a room and knowing how to say exactly what you need to hear in that moment, as well as supporting partners to better support the birthing person.
So if you’re thinking about going unmedicated, know that you can’t just manifest it out of nowhere. It takes dedication to prenatal prep to get you there. I believe in your ability to do it and I would love to be on your team, helping make it happen! Everyone should feel supported and loved during their births, however they unfold.
