What to Expect for a Drug-Free Birth

Before you're pregnant and during the first few months, it's natural to dream about how you'd like to birth your baby. Going naturally or drug-free might be an attractive option for you. You do the research, set yourself up with a supportive OB-GYN or midwife, take some classes and really prepare yourself for what's to come. Perhaps you're still on the fence about a natural birth because of one big fear: pain. Labor pain is real and it's intense, but your body was built to handle it. If you're curious about what to expect with a drug-free birth, read on…


What constitutes "drug-free"? A labor drug is any synthesized drug used as an intervention for either pain or status of labor. The most obvious component is the epidural. The American Pregnancy Association states more than 50 percent of women receive an epidural during birth. It's a regional anesthesia that blocks the nerve endings in the lower body from sending pain signals to the brain. If you have the epidural, you'll end up giving birth on your back because you won't be able to use or move your legs (unless you get a "walking epidural"). In addition to the actual anesthesia, you'll probably receive a combination of opioids or narcotics, like fentanyl, morphine and clonidine. This combo reduces the amount of anesthesia needed.

Other drugs used during birth include pitocin, which encourages labor to move along with a higher frequency of contractions. It's the synthetic form of oxytocin, which is naturally created by the body to promote mother-baby bonding. Narcotics and pudendal blocks are used for pain relief. Any type of drug that affects the pace and physical effects of your labor is considered a drug. Group B Strep antibiotics do not affect labor, but might cause an allergic reaction in the mother (10 percent chance if you're allergic to penicillin).

Why even bother with the pain? This is a great question. Why even go through a painful labor when modern medicine gives you opportunity to rest and relax until it's time to push? This a very personal decision. Most moms who plan to go drug-free do it for two reasons: one, to avoid side effects often caused by medical intervention; two, to feel present and in control of their bodies during the delivery of their child. It's a mashup of freedom and flexibility that attracts mothers to go for it. Although the intentions of an epidural are to create a relaxed experience while still being able to participant in the birth, it does have strings attached. Some of the side effects include shivering, backache, nausea, difficulty pushing, numbness for hours in lower extremities following removal of epidural, a groggy baby or a sudden drop in blood pressure. You also get a catheter.


Either way you go, the goal is to have a positive experience and a healthy baby. Some women have wonderful experiences with an epidural while other moms make a choice to avoid it. Here are some of their personal anecdotes from a natural, drug-free birth:

"Once active labor started and I was in the tub getting close to pushing, I remember telling my husband that I couldn't do it — I was doubting myself — he and the midwife did a great job at encouraging me. Once she crowned and I felt 'the ring of fire' I knew the pain would finally be done if I just pushed a bit more. It was an instant feeling of relief once the head was out and I swear it erased the memory of the pain from the previous 11 hours. Once she was out completely it's like my mind forgot the labor completely. I didn't think of it again until a few weeks later when someone asked me how it went. Describing it, it sounded a lot worse than I remember it feeling. I actually decided to go natural again with my second, I lasted until I was 8 centimeters before getting an epidural but my labor with him was completely different and about 10 times more painful. Turns out he was a lot bigger than the doctors expected so of course his labor wasn't as easy as my small baby girl. Words of encouragement to anyone considering going natural would be… you're stronger than you think and you will amaze yourself." —Jacqueline, 26

"I had been in labor 11 hours at home when it was time to go to the hospital and I broke down in tears that I wasn't ready and couldn't do it anymore. My husband calmed me down and said 'you can do it, you ARE doing it' —  it was just the boost in confidence I needed to keep persevering and get to the hospital. I found out when we got there I was 8 centimeters! Four hours later and she was here. I mean, don't get me wrong, labor/delivery wasn't comfortable or 'easy' by any means and it did hurt physically, contractions were hard, pushing her out was hard work, but once I held our baby, I forgot the pain right away. And I felt great physically after having her! We were only in the hospital maybe 24 hours and we went home to drop off our bags and went over to my in-laws' for Christmas celebrations." — Kate, 27


"My initial reason for drug-free was my irrational fear of needles. Towards the end of the first, the doctor pulled out a large needle with the intent to do an episiotomy. As soon as I saw the needle, I pushed my baby out. The doctor had to scramble to catch him. After going through the first, I knew I could handle the others. All five of mine were drug-free. The pain was horrible, but I just knew that every contraction was one step closer to holding my new baby. I've been in the room with friends who were medicated and they seemed a bit out of it. I wanted to be totally into the whole experience. None of my births were very long though. I may have changed my mind if they were." — Christina, 42

"Both births were planned unmedicated births ... Second birth, which was two weeks ago was fast and flawless. Labored at home, checked into triage and I was 8 centimeters still able to breath and walk through contractions. Got to labor and delivery room, labored in the shower for 10 minutes and my water broke. I almost had our second daughter leaning on the edge of the bed but decided between contractions (while crowning) to get on the bed and lay down to push. She came out two pushes later. So, delivery was amazing BUT complications happened afterwards. My daughter came so fast that my cervix tore. I was bleeding a scary amount and doctor couldn't figure out where bleeding was coming from. Since I was unmedicated I was feeling every instrument they were shoving up there to figure out what was going on and this was excruciating for 25 minutes until they found the problem and eventually stitched me up. I lost a lot of blood and they said it would take me at least two months to regenerate the blood I had lost. Thankfully, everything is fine now, but it was something we were not expecting to go through after everything else was flawless." — Erica, 30

"I had such an easy time with the contractions the nurses told me that I probably wouldn't have any problem when it came time to push, and that most women felt the urge to push as a relief. By the time I realized what I was truly in for, it was too late! Toward the end I really was struggling, and the final push gave me a second-degree tear. The nurses were so unused to having natural labor without drugs they were pushing and pulling to stitch me up, and I was squirming around like crazy when the doctor said, 'We can give you an epidural and do this in the OR.' I said, 'Are you kidding?! I just gave birth without an EPI! I'm not getting one now!'" — Chanc, 41


"I did go into labor at home and managed until I felt like I should head to the hospital. Our doula met us there and when they checked me in I was  7 centimeters dilated and 90 percent effaced. They figured I would be pushing within a couple hours. That didn't happen. I continued to labor for another 6 hours, and wasn't making much progress. It is likely that my son was tucked in a position preventing him from moving down the birth canal easily. I managed the pressure quite well thanks to my hypnobabies techniques, my doula's coaching and the support of my partner. I eventually got very worn out, and started asking about an epidural. I felt like I just didn't have the strength to continue on for another few hours. At that point, my water broke, and I was pushing my baby out on my hands and knees about 20 minutes later." — Melody, 32

"I'm not an ultra granola type person but wanted to try an unmedicated birth so I could be fully present and hopefully have a quicker recovery. I was open to an epidural and didn't view that as failure if I needed one — I felt that was important! The toughest part was the last two hours of my 31-hour labor. By that time it was too late for meds anyway, but I was glad to be able to change positions and move around to find the most comfortable way to deliver. The last 30 minutes of pushing actually wasn't terrible though. Would I do it again? Probably. I was up and walking a couple hours later and a week later I felt like a normal human. And I was definitely fully present! My advice would be to listen to your labor support team and find a doc who supports your approach. And don't view meds as failure! You might need them to help your body relax or to make delivery easier. I was very blessed with an incredibly healthy pregnancy and delivery, which is why it made sense and worked well for us. —Kelley, 28

"I was so hopeful that I could push through and have the natural birth we wanted, and when the contractions started, I thought I could do this. But then 24 hours later, I was getting tired and weary. Thankfully, my supportive husband, excited mother and encouraging doctor and nurses assured me I could do this naturally! After 39 hours of active labor (yes... 39 hours) we welcomed our son into the world! I was only a little stubborn. It was worth every pain and concern. And I couldn't be happier we went natural! I was up and moving within an hour and went home 24 hours later!" —Leila, 26

"The short version of my first is, there was hardly time, and I was already at 5 centimeters by the time we got checked in to triage. They asked if I wanted something, but I thought, 'If I got this far without it, I might as well keep going!' My second, I was really concerned because I had developed a painful issue called vulvadynia (pain of the vaginal opening), and was sure I would use medication, if not even go for a C-section, to avoid any more pain and trauma. But, I had an amazing nurse who encouraged me to keep going, and even did some research so she was prepared to help me through it! I am so thankful for her support and encouragement to stick with what I wanted to do, and what was better for my body, too!" — Becky, 32


If you are planning to have a drug-free birth, taking some classes and reading up on techniques is extremely helpful. Make sure your partner is on the same page and check out these resources together:

The Alexander Technique The Bradley Method Hypnobirthing Lamaze Talk with a Doula