What Does It Really Feel Like to Give Birth Without an Epidural?
Dealing With Natural Labor Pain Without an Epidural
Last year, I gave birth to my second daughter, a beautiful bundle of sunshine and blonde love wrapped up in the sweetest disposition I've ever encountered sans pain medication. I'm pretty vocal about my difficulties with hyperemesis or severe morning sickness during both of my pregnancies, so why not be vocal about my two very different birthing experiences? I hope my account will help to decrypt some of the confusion so many moms feel leading up to delivery day.
Before birthing both of my girls, I Googled nine month's worth of the many, many inquiries women ask during pregnancy, some of which included:
- Why can't I stop throwing up?
- Has anyone ever died from morning sickness?
- Does birth hurt and how badly?
- What does natural childbirth feel like?
- What are the pros and cons of getting an epidural?
I asked about the ways women choose to give birth in hopes of solving the magical mystery that is childbearing. Some of the answers helped, and some of them didn't. Most of my questions went unanswered in the form of vague responses meant to soothe the panicked and the curious. I personally didn't find anything helpful. So, here's a list of the questions I most often asked Google regarding labor and delivery without an epidural in the detail I was looking for, and my personal experience giving birth drug-free.
Always consult with a medical professional when making medical decisions.
Does It Hurt to Give Birth Without an Epidural?
Yes, it does. It hurts badly, but not for the entire process. Before I had kids I kind of thought of birth as one long, linear experience, but it's not. There are several stages of labor and each individual's experience may vary. Below, I've incorporated the various stages of labor and what to expect in each. I also cover the transition phase of labor, which was the most challenging time for me and for many mothers.
Why Did I Decide to Give Birth Naturally?
Long story short, I didn't decide to give birth naturally (it was all natural, by the way). I was staying open to the idea, and actually missed my big chance—the window during which you can decide—and headed straight into the "transition phase" and had my baby without medication. The cervix dilates between 7-10 cm during the transition phase and you will definitely want to make your decision before then. It may help to establish a birth plan weeks prior to solidify your decisions.
Under What Circumstance Will You Not Be Given an Epidural?
The main reason most women don't get an epidural is because they miss their moment, just like I did. Other reasons for not receiving an epidural would be:
- You heroically chose from start to finish not to have one and you stuck to your word even through the most physically painful moments of your life because you're a saint, wow. Good job, gold medal. You probably didn't scream at your nurse for tricking you. You probably also didn't shove another nurse away from you as she tried to monitor your precious baby's life. You probably didn't wish the fiery pits of hell on the nurses. Good for you for being that kind of person. I'm not.
- Low platelets which could complicate the epidural. The main risk here is a spinal epidural hematoma.
- Medications that would disagree with the epidural (i.e. blood thinners).
- An abnormality in your spine which can make locating the correct site and placing an epidural dangerous.
Do You Still Get an IV Catheter Even If You Don't Get an Epidural?
In some situations, yes. Some hospitals require a catheter—this is a mechanism that is put in place intravenously in case you require fluids or the rapid administration of an emergency drug. I did have a catheter placed in my arm in my non-epidural birth as protocol because I passed out after my first delivery (thanks to my epidural!) They used it to fill me full of fluids and hey, it was actually great . . . I stayed hydrated and I believe the IV fluids helped me to have the energy I needed to push and recover. You could ask for fluids too, even if you don't want medication!
The Stages of Labor and Delivery Without an Epidural
Early labor occurs when the cervix dilates up to 3 cm. Early labor triggers cramps that may make you wonder, "Okay, either I'm about to poop or I'm having Braxton Hicks contractions." Then, the cramps keep coming and maybe you do poop but it doesn't stop them. The cramps may be uncomfortable when they're happening and then they're over and you're super relieved. Some women may not even realize they're in labor at this point.
What Are Braxton Hicks Contractions?
The term "Braxton Hicks contractions" originated in 1872 when Dr. John Braxton Hicks, an English doctor, derived the phrase to describe false labor. Here are the characteristics of Braxton Hicks contractions:
- They can start as early as the 2nd trimester but typically occur in the 3rd
- Contractions last between 30-60 seconds and upwards of two minutes
- They are infrequent, unpredictable, and uncomfortable
- They are irregular in intensity and disappear unpredictably
- Many midwives theorize these contractions prime the uterus and soften the cervix
- Triggers include contact, activity, intercourse, and dehydration
True early labor lasts approximately 8-12 hours and is most commonly associated with your "water breaking" during which the amniotic sac ruptures. It is important to note the color and odor of the fluid and at which time your water broke. Contractions will then occur everyone 30-45 seconds with 5-30 minutes of rest in between. Contractions may progressively become stronger and feel like menstrual cramps, pelvic tightness, or pain in the lower back.
Tips for coping with the early stage of labor:
- Relax during this phase
- Drink water and eat small snacks
- Keep track of the time of your contractions
- You do not need to rush to the hospital or birth center (unless a high-risk pregnancy)
- Your support person can help keep you stay distracted with simple tasks (e.g. calming support or assistance timing the intervals of the contractions)
Whoa boy, things are intensifying. Active labor lasts 3-5 hours and happens when the cervix dilates to 3-7 cm. This is the time when most women realize they need to get to the hospital. At this point, it's hard to deny you're in labor, even if you are a champ. Contractions are consistent, and occur every 45-60 seconds on average with a 3-5 minute rest in between. It feels as if you're getting a stomach cramp that takes your breath away. Holding onto something helps, whether it's your partner's hand, an armrest, or in my case, the roof handle of our car en route to the hospital.
Tips for coping with the active stage of labor:
- Switch positions frequently
- Try walking or take a warm bath
- Drink water
- Urinate frequently
- Your support person can offer you verbal reassurance, help make you comfortable with props and pillows, keep track of the contractions, and provide distractions (music, simple games)
The Transition Phase
The transition phase is when the cervix dilates to 7-10 cm (fully dilated). This is the scary part, and the peak of the roller coaster. The whole time you were just chugging up that steep incline, and now here you are staring the endless reality that is motherhood right in the eyes. This is undeniably the most painful stage of labor, but it also goes by pretty fast—between a half an hour to two hours for most women—and at this point, your contractions are overlapping. This is the part to mentally prepare yourself for if you forego an epidural. Hot flashes, chills, nausea, vomiting, and gas are common occurrences during this phase.
Tips for coping with the transition phase:
- Have your support person offer encouragement and praise
- Avoid small talk
- Focus on relaxation throughout the contractions
- Know that anger and strong emotions are common during this phase
What Is Epidural Anesthesia? What Are the Risks?
There are many benefits to epidural anesthesia, but some mothers elect to forgo this option in order to experience all that childbirth has to offer—the good and the bad. Epidural anesthesia allows for regional analgesia or pain relief. The nerves of the target area of the spinal chord are blocked with local anesthetics which are often combined with opioids or narcotics to extend the efficacy of the block. The epidural is usually placed when the cervix is dilated at 4-5 cm and numbness occurs within 10-20 minutes upon first administration. The anesthetic drugs are administered via syringe pump or by periodic injection.
One such concern for epidural anesthesia is the risk of low blood pressure or hypotension. Hypotension is thought to occur due to the suppression of the sympathetic nervous system in the body and the blockage of the cardiac branch of the sympathetic nerve, thus lowering heart rate and causing a rebound effect on blood pressure.
Side Effects and Risks of Epidural Anesthesia for Labor
Low blood pressure or hypotension
Requires IV fluids, oxygen, drugs, monitoring
Temporary respiratory depression, lethargy, heart rate variability
Increased monitoring, emergency intervention
Extended duration of labor; fetal malpositioning
Intervention with forceps, vacuum, cesarean or c-section delivery, episiotomy or enlargement of the vaginal opening
Permanent nerve damage (rare), ringing of ears, backache, nausea, numbness; post-dural headache (due to spinal fluid leakage in 1% of women)
Endure symptoms until faded; urinary catheterization
What Do Contractions Feel Like Without an Epidural?
Contractions without an epidural are not a big deal, rather, they are annoying and painful. I'd compare them to the worst period cramps you've ever felt or the pain you experience during a stomach bug. They're fleeting, they come, they leave, you breathe, and so on. Walking, bouncing on an exercise ball, and stretching helped relieve them for me.
Roll With It
One of the things my maternity nurse had me do to alleviate pain and focus on my contractions in the early stages of my epi-free labor was to bounce and roll on a giant inflatable exercise ball. The cool thing about these peanut-shaped exercise balls is that you'll be able to really press your back into the curves for a deeper, more relieving stretch. Plus, give 'em a good wipe down when you get home from the hospital and you can use them for some gentle post-partum exercise while baby naps.
Tips for Handling the Transition Phase of Birth Drug-Free
Here are things that helped me to navigate the murky waters of an epidural-free transition:
- Find a Focus Point: Whether it's a neutral object, like the telephone on your bedside table, or even something more motivating like the outfit you've brought to bring baby home in, use a focus point to remind you that all of this work culminates in something worthwhile . . . just don't stare at the clock like I did. It will just frustrate you!
- Get Off Your Back: Have the bed adjusted so that half of it is at a 90-degree angle. Position yourself on your knees and brace your arms and body against the angled part of the bed.
- Use Your Voice: Make noise. It's embarrassing, but you're bringing a new life into this world, you're entitled to humiliating yourself a bit.
- Practice Aromatherapy: Consider placing a few drops of lavender oil on a cotton ball so you can inhale it if it seems soothing, or diffuse a couple of calming scents using a portable essential oil diffuser.
- Darken the Room: Get the room as dark as you can, shut lights off, and close the blinds. Too much light can be overwhelming at this point.
- Ask Your Partner Not to Touch You: Just trust me. S/he is safer that way.
- Get Naked: At this point, clothes are probably just going to literally rub you the wrong way. Get them off. You're a wild woman! You're about to bring forth another life! Dress the part.
- Grab a Rubber Band: If you have long hair, whip that mess up into a bun. The less distractions for your body, the better.
What Is The Worst Part About Not Getting an Epidural?
The worst part about not getting an epidural is the transition stage of labor. In my opinion, this was the darkest part of labor and delivery. It's also the shortest stage of labor prior to pushing.
What Does Pushing Without an Epidural Feel Like?
Pushing without an epidural feels pretty awesome and I don't mean that sarcastically. Pushing med-free is great because it alleviates the pain and pressure of labor. You feel every muscle and contraction needed for productive pushing and it's physically on par with taking a really tough poop at this point. In fact, if you want an idea of what pushing without an epidural feels like, pooping is the closest thing you're going to get: discomfort and relief at the same time.
I didn't use an epidural or any pain medication. I kept my eyes closed and concentrated on my husband's voice and hummed through the contractions. It was the most empowering thing I've ever done. I would do labor over again in a heartbeat; the nine months preceding it is the hard part.— Meredith, Bradenton, FL
What About "The Ring of Fire?" Does That Hurt Without an Epidural?
No, in my experience, the "ring of fire" is some weird myth. The pain of labor cancels out all lesser pains, "ring of fire" included. It's nothing more than a sensation, even without an epidural. The "ring of fire" is a term used to describe what some women feel when the baby enters the vagina and their labia and perineum (between the vagina and rectum) stretch to accommodate the baby's head; it is a burning sensation, and an episiotomy or incision may be made to ease delivery.
What Is Recovery Like After Not Receiving an Epidural?
Recovery is like listening to the opening of Florence + The Machine's "Dog Days Are Over." Thanks to all of that oxytocin your body releases during delivery, the first moments after giving birth unmedicated are nothing short of euphoric since there's nothing there to dull it. I, like many women who give birth without an epidural, physically and emotionally recovered quickly, and I was sent home feeling fairly strong and healthy just 24 hours after delivering my daughter, with no side effects or lasting issues.
In contrast, my recovery with my medicated birth was sluggish and hazy, and while I did recover fully, it took much longer. That's okay, but it wasn't as enjoyable as my experience unmedicated.
Labor was by far the hardest physical activity I have ever participated in. But once you get to the pushing stage and have that feeling that is similar to having a bowel movement, you are almost done. And you know that if you can just make it through the last little part, you will meet this wonderful little person you have dreamed about for so long!— Kari, Onalaska, WI
What Is the Best Part About Not Getting an Epidural?
The best part about not getting an epidural is pushing and the recovery. As I said before, pushing was so easy and unexpectedly joyous. My first experience had been traumatic in that I couldn't feel the lower half of my body post-epidural, but my second birth was amazing. I loved feeling what my body was telling me to do, and I was empowered by how easily it happened when my body was left to its own instincts.
Would I Give Birth Again Without an Epidural?
Some women experience birth and claim, "I never want to give birth again," but yes, I most definitely would give birth without an epidural again. The transition phase was awful, however, it was just one hour out of many, and the remaining hours were much better because I was unmedicated. Plus, I have THIS amazing person to show for it (pictured below).
Many women want to know whether or not they can tolerate labor pain without an epidural or pain relief. Unfortunately, the only way to truly know is to experience it.
So, What About You?
Have you had at least one medicated and one unmedicated birth? What overall experience did you prefer? If you had a medicated birth by means other than an epidural leave a comment below!
Have a Question About Going Sans Epidural?
Ask away in the comments below!
- New Moms Describe What Labor Is Really Like
If you want to know what labor is really like, listen to what these new moms have to say about childbirth.
- Using Epidural Anesthesia During Labor: Benefits and Risks
Epidural anesthesia is the most popular method of pain relief during labor. Epidural anesthesia is regional anesthesia that blocks pain in certain areas.
- Effects of Spinal Anesthesia . . .
- Braxton Hicks Contractions: Causes and Treatment
Braxton Hicks contractions are described as the contractions that occur before real labor. Braxton Hicks can begin as early as the second trimester.
Questions & Answers
I've been on modified bed rest during my entire pregnancy, and I am somewhat overweight. Is it wise to give birth without medication if you are out of shape?
This would definitely be a good question to ask your doctor. However, from personal experience, I wasn't in shape when I gave birth unmedicated. I'd been in bed for the first four months of my pregnancy because of hyperemesis gravidarum, and for the rest of my pregnancy, I didn't move around much either because too much activity would stir the HG back up. I didn't have any complications.
© 2016 Kierstin Gunsberg