Pain Management in Unmedicated Childbirth

sign on a concrete wall that reads everything is going to be alright

I decided I wanted to attempt an unmedicated childbirth when I was pregnant with my first daughter. Shortly after I discovered I was pregnant, one of my best friends sent me Ina May Gaskin’s Guide to Childbirth. Ina May is THE leading midwife in the US and I learned a ton from reading her book. The first half is a collection of various birth stories ranging from un-medicated to c-section and the second is her tips for managing pain and avoiding interventions during an unmedicated labor and delivery.

What I found most helpful in labor:

Squatting into every contraction – at least for the first few hours. My active labor started at 10pm and by around 3am or so my legs turned to jello and I no longer wanted to stand. So I opted to lean face first into the reclined side of the hospital bed in a semi-child’s pose so my hips were still open creating space for my pelvis and my back was accessible for the much needed massage. After a bit my nurse checked my progress and when I sat up afterwards, I ended up staying sitting at the end of the bed in a wide legged position, one knee bent with foot on bed and one leg dangling and then I would lean forward into the contractions. Leaning forward with wide legs helped a lot, while leaning back during a contraction was unbearable for me (like when in the car or when I would be reclined while the nurse would be manually checking and a contraction would begin).

At home I found hanging onto an edge of a countertop or a piece of stable furniture helped as I went into a deep yoga squat (malasana). Holding onto and hanging from both sides of the door knobs of an open door is another option. Having something to anchor to as I squatted felt significantly better than letting my hands be free in a squat. When I was at the hospital I used the side of the bed or my husband to hang onto. Towards the end when I was sitting on the bed I would dig my hands into the bed and push it away while I simultaneously leaned forward with my torso.

Counter-pressure applied to my back thru deep massage – this was critical. While I squatted or leaned into each contraction I would have not one but two people (my husband and my sister) applying deep counter-pressure to my lower back. My sister has a natural talent for massage and having her there was absolutely critical for me. At first I only needed my sister since the contractions were not as intense or close together. But as time wore on they were both applying intense pressure to my back. I don’t really think I even asked for this, they just saw that I needed more support and did it on their own. Sometimes I would hang onto my husband as I squatted and my sister would work on my back.

Deep breathing and deep guttural sounds – I spent most of my time concentrating on my breath and making deep guttural sounds. I was no holds barred – literally roaring and mooing as much as I could. The respiratory diaphragm, which is a dome shape that presses down towards the abdomen and uterus on an inhale, creates intra-abdominal pressure which pushes down on the pelvic diaphragm. By breathing deeply and making low deep sounds I was encouraging the pelvic floor muscles to relax and open. I was really hoping to move the process along as quickly as I could! Focusing on the breath also allowed me to go deeply inwards as a kind of meditation to handle the intense sensations during a contraction.

Reminding myself CONSTANTLY that it was all temporary – I was NOT being injured, it was LABOR, as in physical exertion, and after it was over it would be over.

Knowing my progress (dilation, effacement, baby’s station) gave me encouragement to keep going – I could really see this going both ways, as in thinking “why am I not MORE progressed?” but I chose to take any progress as a win and focus on continuing to relax my body and trust in the process.

Encouragement from my support team, including my labor and delivery nurse – Being told I was doing well and capable of continuing without drugs helped me stay focused during the really challenging contractions and the lack of break in between due to intense nausea. During pushing it was incredibly helpful to hear the supportive cheers of my doctor and nurse telling me I was doing great and giving very specific guidance about how to effectively push.

What about you?

Do you think you’d try an unmedicated labor or are you really looking forward to that epidural? If you are planning on an epidural it’s still really good to have some tools to manage contractions if you end up laboring at home or even at the hospital for a while waiting for the anesthesiologist (I’ve heard some have waited 1.5 hours!). Or if you have an experience already, I’d love to hear, please share below!

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