Birth can leave a mother with a euphoric high, especially when it is unmedicated. However, now a days, a natural unmedicated birth has become somewhat difficult to come by. This leaves a lot of mothers asking themselves what they should do to ensure a natural birth, or to put it more precisely, an unmedicated vaginal birth. First off, it’s important to keep in mind that birth is not something we can control. More often than not, we just have to ride the wave and go with the flow. That being said, there is no way to really ensure you will have a natural birth, but there are definitely somethings you can do to increase your chances of having the birth you are hoping for.

1. Stay home as long as you can. The less time you spend in the hospital, especially in early labor, the less time you have for any interventions to occur. Not to mention that you want to be comfortable during early labor to allow your body to do its work, and I am certainly more comfortable in my own bed with the lights down than in a hospital room with beeping machines and bright lights. Keep in mind, that even if you know this and are trying to follow this advice, chances are you will still arrive at the hospital earlier in your labor that you thought you were, especially if it is your first birth. Just make sure you know the emotional signposts of labor so that you and your partner know what to look for to let you know it is time to go to the hospital. If you’re having a home birth, feel free to ignore this bullet 🙂
2. Select a care provider who is supportive of your wishes. I can not emphasize this enough. No matter how well you plan and how much you educate your self, if your care provider ‘s policies are at odds with your wishes it will be difficult, if not impossible to convince them of your choices. This means that first off, you need to know what you want to happen during your labor and delivery, and more importantly, you need to know what you DON’T want to happen. For example, if you don’t want to have a cesarean (unless medically necessary), then make sure you know your providers cesarean rates. If they are high, or if he/she doesn’t know them, then they are not the best provider for you. As the patient, you need to educate yourself about the practice you have chosen, and if the reality isn’t looking good, it’s ok to cut your loses and find a provider whose culture reflects what you envision for your birth.Some red flags of an OBGYN office or provider who is not very supportive of natural birth are:
   • High cesarean rate
   • A doctor who will not allow you to go past your due date
   • A doctor who wants you hooked up to continuous fetal monitoring, i.e. not able to move around or change positions.
   • A practice or doctor with a high elective induction rate.
3. Have a birth plan. In fact don’t just have one, have one that your provider has signed. This way, if the hospital staff question your birth plan, they will see your provider’s signature and clarify with him/her before denying you anything you have listed on there. Having a birth plan requires a lot of research on your part, but it also prepares you to understand all the interventions and options that exist, especially in a hospital setting. Knowing your options is essential to providing informed consent to any interventions that may end up being necessary. Writing a birth plan can be daunting, especially for a first time mom. A doula can be a huge help with this. Doulas have a wealth of knowledge and statistics on birth, interventions, and the choices you have. They can help you come into your birth confident and informed. Here is a sample birth plan if you’d like to take a look..
4. Go into labor naturally. That is avoid induction unless it is truly medically necessary. It has been shown that women who are induced before their body is ready to go into labor are at a higher risk for Cesarean Section and babies are at higher risk for needing to spend time in the NICU. If your care provider recommends induction, make sure you are knowledgeable about the circumstances under which induction is necessary and those under which it is not.  Situations in which induction is medically necssary are diabetes, pre-eclampsia, infection in the uterus, when baby is not growing properly in the uterus, when a placental abruption occurs, or premature rupture of membranes. If your caregiver gives reasons other than this, such as a “big baby”, you have the right to decline. Basically if mom and baby are doing well, let baby tell you when it’s time for him/her to come.
5. Take a childbirth education class, preferably one that focuses on having an unmedicated vaginal birth. It is important that you are educated about the process of birth, whether you plan to give birth at home or in a hospital. Taking a childbirth class is a great way to begin this education. I would recommend taking a class that is more than just a few hours at the hospital. The short hospital birth classes generally just give you an idea of what the hospital’s policies are, and how they handle birth. This is not bad information to have, but it’s even more important to know about the process of birth, its stages and signposts, and how to manage pain during labor without analgesics if this is your goal. Some great options are Lamaze, Bradley Method, and Hypnobirthing. These courses will teach you techniques for managing labor as well as offer you lots of evidence based information about labor and common interventions. This leads to my next point.
6. Educate yourself. If you are going to walk into a providers office with a well laid out birth plan that states the many things you would like to have, and would like to avoid during birth, you need to be armed with evidence based information as to why you do or do not want them. Know ACOG’s most recent guidelines. Visit Evidence Based Birth‘s website, and others that offer statistics and information in regards to birth and interventions. This information will prepare you to have an educated discussion with your care provider knowing that the facts are on your side. If you’re going to read books, and I recommend you do, choose books that support your vision of a normal unmedicated birth. Any book by Ina May Gaskin is wonderful (I particularly love Ina May’s Guide to Childbirth), as are many others.
7. Be prepared with techniques for handle pain without analgesics (medications).  If you’ve taken a Bradley Method or Hypnobirthing class, then you are already going into your labor with some great tools. Add to that some music or hypnosis playlists, aromatherapy, massage techniques, and access to shower/bath, and you will have a great toolkit for handling pain throughout labor.  A doula can be a great help with this. Doulas will know how to massage, apply counter pressure, get you in a better position, and help you feel as comfortable as possible throughout labor.
8. Hire a doula.  Doula’s are trained to understand labor and birth, and they are trained to offer emotional and physical support to the laboring mother throughout labor and during the immediate postpartum period. A doula can also support your partner and help him be a greater asset to you. Also, a doula can be a huge asset well before you go into labor. Most doulas help with writing birth plans. They also offer education and evidence based information so that you can walk into each appointment with your care provider ready to ask the right questions so that you can be sure you and your care provider are on the same page when the big day comes.

Hopefully you found this list helpful. Feel free to comment below with any questions you might have.