Giving birth can and should be a beautiful experience. But the prospect of delivery can be terrifying because of the anticipated pain and discomfort. While many women opt to receive epidurals to have a more comfortable labor, many others are choosing natural births. There is growing fear about the side effects of medicated births. Discuss the options with your doctor or midwife to determine which method is best for you and your child. In the meantime, here are some of the most important points to consider.

When Is an Epidural Used?

An epidural is used to decrease pain. Women often choose to have one, and it’s also sometimes a medical necessity if there are complications, like the need for a cesarean delivery (C-section). According to the American College of Obstetricians and Gynecologists (ACOG), an epidural takes 10 to 20 minutes to work. It’s delivered through a tube via the spine.

Benefits

The greatest benefit of an epidural is the potential for a painless delivery. While you may still feel contractions, the pain is decreased significantly. During a vaginal delivery, you’re still aware of the birth and can move around.

An epidural is also required in C-sections to ease pain from cutting the baby out of the mother’s belly. Anesthesia is used in most cases as well, so the mother is not awake during the procedure. The National Institutes of Health (NIH) report a 72 percent increase in the number of C-sections from 1997 to 2008, which might also explain the enduring popularity of epidurals. While some C-sections are elected, most are required if vaginal delivery cannot be done.

Risks

Did You Know?
Risks with C-sections aren’t necessarily related to the epidural. Unlike natural births, these are surgeries, so recovery times are longer and there’s a risk of infection. According to the NICHD, babies born via C-section also have an increased risk for breathing problems.

Some risk factors of an epidural include:

  • back pain and soreness
  • headaches
  • persistent bleeding (from puncture site)
  • fever
  • breathing difficulties
  • drop in blood pressure, which can slow down the baby’s heart rate

It’s important to note that, while such risks exist, they are considered rare.

The fact that mothers can’t feel all of the elements of delivery with an epidural can also lead to a host of other problems. This can increase the risk of tears during vaginal delivery. Also, Shea describes that not being able to fully experience a birth can lead to emotional trauma in some women — especially for those who had previously elected a natural birth.

What Constitutes a “Natural Birth”?

The term “natural birth” is usually used to describe a vaginal delivery performed without medication. It is also sometimes used to distinguish between a vaginal delivery and a C-section.

Benefits

Natural births are becoming increasingly popular due to concerns that epidurals can interfere with natural body responses to labor and delivery. Ashley Shea, a birth doula, yoga teacher, student midwife, and founder of Organic Birth, has also witnessed this trend.

“Women want to be able to move around untethered to machines, they want to stay home as long as possible before heading to the hospital, they don't want to be disturbed or excessively monitored or have too many cervical checks (if at all), and they want to have immediate and uninterrupted skin-to-skin contact with their newborn and wait until the cord stops pulsating to clamp and cut the cord,” says Shea. As she points out, “If you found out you could have a baby in a warm, deep pool of water compared to flat on your back with people yelling at you to push, what would you choose?”

Contrary to popular belief, mothers do have the right to elect natural births at hospitals.

Risks

However, there are a few serious risks associated with natural births. Risks often arise if there is a medical problem with the mother, or if an issue prevents the baby from naturally moving through the birth canal.

Other concerns surrounding a vaginal birth include:

  • perineal (area behind the vaginal wall) tears
  • extreme pain
  • hemorrhoids
  • bowel issues
  • urinary incontinence
  • psychological trauma

Preparation

Preparing for the risks of a natural birth is important. Mothers might consider having a midwife come to their home, or perhaps complete the delivery process at the hospital. This provides a safety net, should any complications arise.

Non-medication methods used to ease labor and delivery can include:

  • massages
  • acupressure
  • taking a warm bath, or using a hot pack
  • breathing techniques
  • frequent changes in position to compensate for changes in the pelvis

Bottom Line

Due to the complexity of labor, there is no one-size-fits-all method when it comes to birthing. According to the Office on Women’s Health, just some of the factors doctors and midwives consider when making a recommendation are:

  • the mother’s overall health and emotional well-being
  • the size of the mother’s pelvis
  • the mother’s pain tolerance level
  • the intensity level of contractions
  • the size and/or position of baby

It is best to understand all of your options and to know when you might need medication to make sure your baby can enter the world without complications.