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As an ob-gyn, I often talk with patients who want to experience labor and delivery without pain medication. This is a reasonable choice for many pregnancies, and it helps to prepare from the beginning. Here’s my advice for those planning to give birth this way.

Take care of your body. Try to stay active and eat well throughout your pregnancy. The healthier you are, the better prepared you will be for childbirth. Strengthening your body with regular exercise can help with labor and may lower your risk of needing a cesarean birth.

Talk with your health care team about your goals. We want to be on the same page as you, so we need to know that you want to avoid pain medication. You can write down your goals and share them with your ob-gyn and health care team. (But keep in mind that childbirth is full of surprises.)

Learn about your hospital or birth center. When choosing a hospital or birth center, ask how many deliveries they manage without pain medication. Find out what tools they have to support this type of labor and delivery. Special equipment can help soothe and comfort you during labor. These tools may include birthing stools or balls that allow you to sit and squat, and warm baths or showers to help provide relief.

Attend a birthing class. Go into the labor and delivery process fully informed. Childbirth classes can help you learn how to cope with pain using different techniques. You should also learn about pain medication, in case there is an unexpected situation that may call for it. You’ll want to be able to make informed choices if the need arises.

The Lamaze method and Bradley method are examples of popular birth programs. SisterSong has an online class on giving birth during the COVID-19 pandemic. Some classes, such as hypnobirthing, encourage a calm and relaxed birth process. You can ask your ob-gyn for recommendations.

Decide which pain relief techniques to try. Common options for coping with pain include massage, water therapy, and breathing exercises. Music and calming smells (aromatherapy) can help relax you. Consider taking short walks and changing positions during labor—moving around can reduce pain. I’ve even seen patients put signs on the wall with words of encouragement. Some use prayer. Decide in advance what’s important for you to get through labor and delivery.

Consider who will be there to support you. It will help to have a support person with you, whether that’s a partner, friend, family member, or labor professional. Nurses, midwives, and doulas can give you professional labor support. Support people can advocate for you and remind medical staff what your wishes are. They can be your coach and help with relaxation techniques, massage, and other pain relief tools.

Doulas are trained support people who can offer advice, comfort, and encouragement (but not medical care). If you are using a partner, friend, or family member as your main support person, they can take childbirth classes with you to help them prepare.

Whoever is there to help you, think of them and your ob-gyn as members of the same team—your birth support team.

(Be sure to ask your hospital or birth center how many people can be with you when you give birth. Policies may change if COVID-19 is spreading in your area.)

Know the signs of labor and when to go to the hospital. If you are healthy, your ob-gyn may suggest that you labor at home for some time before coming to the hospital. During early labor, you can go for a walk, take a shower or bath, and do the other relaxation techniques you have learned about. Slow, relaxed breathing can help you through contractions. When your contractions get stronger, closer together, and regular, it’s time to go to the hospital.

Remember that things might not go according to plan. You never know who’s going to have a 6-hour labor or a 26-hour labor. We hope for a vaginal delivery that aligns with your birth plan, and we do what we can to make that happen. But sometimes things can’t go as planned. If your body is exhausted and we need to give you some relief and comfort, that’s okay. Sometimes you need other tools to safely deliver, and your ob-gyn is there to help offer you that guidance. The ultimate goal is a healthy baby and a healthy mom.

Trust your team. Your ob-gyn—and your whole birth support team—has your best interests at heart. They know you and support you. If something goes awry, they’ll be looking out for you and your pregnancy, and they’ll work with you to make smart decisions.

It’s okay if you end up needing pain medication. I hear women say that they didn’t have a “natural” birth because there was some kind of intervention. This is not true. Even if you chose pain medication, or if you ended up needing a cesarean birth, you still gave birth to your baby. That’s something to celebrate, no matter how you did it.

Published: March 2022

Last reviewed: March 2022

Copyright 2022 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.

This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.

About the Author
Dr. Christine Isaacs.
Dr. Christine Robillard Isaacs

Dr. Isaacs is a professor and the interim chair of the Department of Obstetrics and Gynecology at Virginia Commonwealth University School of Medicine. She serves as a board member for the Society for Academic Specialists in General Obstetrics and Gynecology and a board examiner for the American Board of Obstetrics and Gynecology. She is a Fellow of the American College of Obstetricians and Gynecologists.