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Drug Free Birth

Natural birth is not for everyone, but as homebirth midwives, it’s the majority of the births that we support, witness, protect and champion. Natural birth is a worthy endeavor, not just for women who want the full experience of this important right of passage, but also for the best outcomes for both mother and baby.

It’s no secret that avoiding the need for pharmacological pain relief (epidural or IV narcotics) decreases the use of pitocin, cesarean birth, instrumental delivery and general dissatisfaction with the birth experience. Wanting to avoid pain medications and their risks is one thing, but actually achieving the natural birth you planned for is quite another.

Our parenting communities are permeated with stories from new moms who “wanted a natural birth, but just didn’t get one”, for so many reasons that are seemingly out of women’s control. While there are many circumstances in which a medicated birth is a valuable option, the discussion surrounding how to “get one” can be confusing and misleading.

What sets women up for the most success in natural childbirth? A plan. One made with educated and conscious decisions that allow women to not just cope with the discomforts of labor, but help them to embrace and work with their bodies during birth.

There is much that can be (re)learned, prepared for and anticipated during pregnancy to maximize the chances of a natural birth. (Hint: all planning should point towards ways to get your own natural hormones and endorphins flowing.)

Today we are going to talk about specific techniques shown to reduce pain in labor, which in turn can decrease the need for pharmacological pain relief, getting you to that natural birth finish line you have your eyes set upon.

We Look to 3 Main Methods for Natural Pain Relief in Labor:

  1. The Central Nervous System Control Method

  2. The Gate Control Theory

  3. Diffuse Noxious Inhibitory Control

The Central Nervous System Control Method

is essentially learning and practicing techniques that help you to perceive birth differently. You can control the unpleasantness of pain by controlling what you let yourself think. How do you control your thoughts about birth?

  1. Education: Birth is a normal life event for a woman. The body is wise, knows how to birth, and the sensations can be interpreted as a means to work with and support the natural process. Educate yourself on the normal process and variations of birth, and practice believing in and affirming your innate ability.

  2. Continuous Support: Surround yourself with a team that believes in your ability, affirms your desires for birth and makes you feel safe. This includes a supportive birth environment where you are free to move and cope in any way you need to.

  3. Attention Deviation: Distract yourself from the sensations. This may be staying busy in an activity in early labor, or adopting a mantra, visualization or ritual in active labor to keep yourself from thinking constantly about the discomfort.

The Gate Control Theory

is the concept that your brain can only interpret so many nerve signals at once, so although you may be perceiving pain in birth, you can intentionally flood your brain with pleasure signals to decrease the experience of the pain. Because the 5 senses are an easy way to get ideas for extra stimulus ideas we brainstorm from those categories:

  1. Sight: A familiar environment; a picture, graphic or special item nearby that reminds you to stay calm; watching a movie or show you love; staring into your partner’s face; an ultrasound print-out of your baby; a scenery that gives you joy.

  2. Smell: Familiar objects like your own home smells, linens and clothing; essential oils or special candles; other scents that give you peace and reassurance.

  3. Touch: Massage; hydrotherapy in a shower or tub; changing positions often and instinctually; walking, swaying, bouncing on the birth ball; your own clothing and linens; a special pillow or blanket; cold or warm packs.

  4. Hear: Your partner’s voice; music or nature sounds; affirmations or scripture; silence or white noise; your own humming or moaning sounds; rhythmic tapping, counting or your baby’s heartbeat.

  5. Taste: Ice chips or popsicles; mints or gum; water with electrolytes; ginger or citrus lozenges; any special food or drink you can stomach, plan for a variety of options.

Diffuse Noxious Inhibitory Control

is a method of using a secondary and intentional pain stimulus (heat, pressure, electrical) to modulate the primary pain stimulus; also known as the “pain inhibits pain” pathway.

  1. Acupressure/Acupuncture: Involves applying manual pressure or very thin needles to specific acupoints on the body. Many different points can be stimulated for the purpose of physical and emotional balance.

  2. Sterile Water Injections: Small amounts of sterile water are injected under the skin in 4 specific places on the sacrum. The burning sensation is effective at relieving back labor specifically.

  3. TENS Unit: An acronym for Transcutaneous Electrical Nerve Stimulation, these handheld battery powered devices use electric current to activate nerves and decrease pain.

Add Our Favorite TENS to Your Birth Supplies

Benefits of TENS Unit for Labor:

  • Versatile, can be safely used anywhere on the body in pregnancy

  • Works naturally by blocking pain signals and releasing endorphins

  • Effective, a recent study found that TENS relieved pain as well as injectable opioids

  • Can distract you and give you a sense of control in labor

  • Safe, no reported side effects to date

  • Customizable, increase the intensity at the peak of a contraction or as labor progresses

  • Affordable, a quality device is less than $35

Grab a massaging TENS Unit to try for yourself


Q: How does a TENS unit work?

A: Electric current travels along small wires from the device to adhesive pads that attach to the skin through electrodes and deliver mild pulses to the spinal cord and brain.

Q: How do you apply a TENS unit?

A: Remove the sticker backing of the electrode and place the sticky side down on the skin. Most laboring women prefer placement on either side of the lower spine. The pads are easy to remove and change their position as needed.

Q: What does a TENS unit feel like?

A: You may feel tingling or buzzing at the electrode site on your skin. You can control the level of electric pulse intensity on the handheld unit.

Q: When should you not use a TENS unit in labor?

A: TENS units should not be used near water or applied with heat. TENS can safely be used in combination with other comfort measures or pharmaceutical medications.

Q: Where can I buy a TENS unit?

A: These devices are highly available in drug stores and online. Our favorite place to stock up on labor support and tools is on Amazon. We recommend this highly rated and reviewed TENS unit.

What's Next?

The research that backs these pain management techniques proves most successful when used in combination with one another, and personalized to meet the changing needs of the laboring woman. So come into your labor with the expectation to be flexible and with a supportive team ready to make suggestions for you as needed.

You can simplify your natural birth plan in 3 specific ways:

  1. Learn what you have control over in planning for birth, and harness your decision-making power as you get ready.

  2. Discover the best ways to prepare your body and mind for the intensity of labor so that you can work with the natural process instead of against it.

  3. Understand how to confidently communicate your plans with your birth team to make your birthing day smooth and supported.

We know that labor unfolds best when it is well supported and firmly trusted. Your body was made for the intensity that brings you in, through and out of birth!

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