One of the biggest decisions that go into making a childbirth plan is choosing an unmedicated, natural childbirth vs epidural. It is a personal decision that each woman must make for herself. But let’s explore the two options so you can have a better understanding of the reasons for each.
Natural Childbirth vs Epidural: What is an Epidural?
An epidural block decreases feeling in the lower body. An anesthesiologist or nurse anesthetist administers it by inserting a needle through the skin on the lower back into the epidural space in the spine, placing a catheter (a small tube) through it, and then withdrawing the needle. The catheter is left behind, and medication can be delivered through it. The medication is absorbed into the nerves and blocks pain signals from traveling through the spinal cord to the brain.
In a nutshell, women choose epidurals because they decrease the pain associated with childbirth. Most women who receive an epidural have significant pain relief for at least some of their labor (1). Labor can certainly be intense and exhausting, and epidurals offer one type of assistance in managing what can be an overwhelming experience.
While an epidural comes with the more potential complication than an unmedicated delivery, there are fewer side effects for both mom and baby than with other pain medication options. So it is often the best choice when a woman needs something to help her through the process. This is why it’s considered the safest of the intervention options, and why most women are able to narrow their choices down to just natural childbirth vs epidural.
Epidural Drawbacks and Risks
Most women do not have major epidural complications. There are some drawbacks even when things go smoothly, though, and there is the potential for complications. Let’s discuss those things so that you can have some knowledge to help you make the most informed decision.
Low Blood Pressure
Some women experience a decrease in blood pressure with an epidural. This can cause baby’s heartbeat to slow (2, 3). Your provider will reduce this risk by giving IV fluids before administering the epidural. If pressure still drops, things like lying on your side to improve blood flow can help.
Back and Head Aches
Your back may be sore from the injection for a few days. Some women (around five percent) experience accidental dural puncture during insertion of the epidural, causing cerebrospinal fluid to leak into the epidural space. This fluid loss causes a pressure imbalance resulting in a severe headache. It may persist for a few days.
Loss of Freedom During Labor
Additional precautions must be taken in order to maintain safety with an epidural. Epidurals come along with IV fluids, and continuous monitoring of blood pressure, contractions, and baby’s heart rate. You are confined to bed with restricted eating and drinking and a bladder catheter.
Difficulty in Pushing and Longer Labor
Ideally, an epidural lessens the pain while still allowing you to feel enough pressure to push. However, this perfect balance can be difficult to achieve, and it can be more difficult to bear down and push your baby through the birth canal after having an epidural. It can decrease the feeling of needing to push, as well as the ability to feel the muscles you’re supposed to push with. Labor progress, fetal descent, and pushing efforts can all be slowed down. Unmedicated births tend to go a little more quickly, with a 25-minute difference between the average natural childbirth vs epidural (4)
Increase in Interventions
The side effects listed above may lead to more intervention than with an unmedicated birth. Slower labor may result in the use of Pitocin, for example, and difficulty in pushing can lead to an increased chance of forceps delivery or vacuum extraction. It is always important to remember that any intervention increases the chances of others.
An epidural administered by a trained and experienced anesthesiologist is unlikely to result in serious complications. Although very rare, some women will experience long-lasting neurological injury. It is also possible for the anesthetic to accidentally be injected into pregnancy-swollen veins. This can cause dizziness, rapid heartbeat, a funny taste or numbness around the mouth. An epidural that is placed too high may affect your chest muscles, making it hard for you to breathe. Again, these are rare occurrences. Still, it is best to be educated about all possibilities when making the big decision between natural childbirth vs epidural.
Natural Childbirth vs Epidural: What Does Natural Mean?
Natural childbirth is more accurately called unmedicated childbirth. This better defines what is meant by “natural” and it also prevents the comparison that would suggest that the opposite of natural is unnatural. However, most people do describe unmedicated childbirth as natural birth, so we will stick with that phrasing here. Let’s look at some of the reasons a woman might choose natural childbirth vs epidural.
Benefits of Natural Childbirth
A woman who is laboring without an epidural has more control over her circumstances and even her own body. She is not restricted to the bed, may use the bathroom, eat and drink, walk the halls, use water or a birth ball to relax, and more. Where an epidural makes some women feel helpless, unable to make her own choices or potentially even to move her own body, a woman in a natural childbirth setting retains control.
Some women who have had both medicated and unmedicated births describe that they felt more connected during their natural childbirth vs epidural birth. Because the sensations in your body are lessened, it is easy to feel removed from the situation, like it’s something that’s happening to you rather than something in which you’re actively engaged. Some women even enjoy a feeling of connection, not only to their own birth, but to the women who have birthed babies this way since the beginning of time.
For many women, there is a feeling of empowerment that comes from an unmedicated delivery. It is, without question, one of the most physically taxing things that most women will experience in their lifetime. There is a feeling of empowerment in making it through and many experience a post-birth euphoria.
But don’t just take my word for it! Read 6 different birth stories from one mom — 5 were natural births and 1 was epidural birth.
Allowing Your Body to Listen to Itself
In an unmedicated childbirth, your body does all kinds of really cool things. Contractions send pain signals to the brain, which releases oxytocin, and that causes the contractions to increase in intensity. Pain also increases the release of powerful endorphins that not only help with pain management, but they also contribute to a shift from a rational mindset to an instinctive one (5).
When a mother is in tune with her own body, she is able to move and change positions in response to what she is feeling. Babies born in unmedicated deliveries are actually less likely to deliver with abnormal head position than those born with an epidural (6). This is likely because the mother’s movements position the baby better than if she’d been either unable to move or unable to feel. Your body’s own design and processes are more able to work unencumbered in natural childbirth vs epidural assisted birth.
Natural Childbirth Drawbacks and Risks
There are no risks to delivering without medication. However, there are valid reasons why some mothers choose an epidural. Mom may feel overwhelmed or panicked to an extent that she can’t manage with the tools she has. She may have exhausted all the coping mechanisms and still feel that she is unable to manage what she’s currently facing. She may have faced a long labor and feel that her body has given all it can, but be unable to rest through the pain, and choose to take something that will allow her to rest and regain some energy. There are so many valid reasons for choosing an epidural, and making that choice is not a failure.
Read more about natural birth pros & cons.
I Want an Epidural. Do I Need Childbirth Classes?
Some women know ahead of time that they will likely choose an epidural, and wonder if there’s any reason for them to consider childbirth classes. The answer is that a good childbirth class contains great information and tools for everyone! Childbirth classes are not only for those who choose natural childbirth vs epidural assisted delivery. You will get an education in what is happening to your body and your baby’s during your pregnancy. You’ll learn what to expect as labor draws near and begins. You will gain coping skills and pain management skills that will be valuable even with an epidural.
Want to learn more about preparing for birth? Check out “5 Ways to Prepare for Natural Childbirth in Just 8 Weeks.” Or get your feet wet by taking a free 1-hour long online birthing class through Kopa Birth!
Skills for Every Birth
Remember, an epidural is not a magic get-out-of-pain-free card; you will still need to get through some discomfort. Some hospitals require that you reach a certain point of labor before you can get an epidural. It takes time for the anesthesiologist to come once you’ve asked for an epidural, and then it takes time for the epidural to start working after. It may wear off before the end of labor and leave you suddenly in pain. (Some hospitals use a pump to administer medicine quickly when needed, but in some cases, you have to wait for the anesthesiologist to be available again to give more.) The knowledge and skills gained from a good childbirth class are valuable to all laboring women.
Kopa Birth’s online childbirth classes allow you to prepare for a natural childbirth in the comfort of your own home, 24/7. Enroll today in our free online childbirth class to learn more about preparing for natural childbirth.
1. Simkin, P. (2010). Pregnancy, Childbirth and the Newborn, 4th edition. Meadowbrook Press
2. The American College of Obstetricians and Gynecologists. (2010). Your Pregnancy and Childbirth Month to Month, 5th edition
3. Glade, B.C., Schuler, J. (2011). Your Pregnancy Week by Week, 7th edition. First Da Capo Press
4. Ladewig, P.A., London, M.L., Davidson, M.R. (2006). Contemporary Maternal-Newborn Nursing Care, 6th edition. Pearson Prentice Hall. Upper Saddle River, NJ.
5. Lothian, J. A. (2000). Questions from Our Readers: Why Natural Childbirth? Journal of Perinatal Education,9(4), 44-46. doi:10.1624/105812400×87905
6. Weiniger, C. F., & Ginosar, Y. (2005). Changes in Fetal Position During Labor and Their Association With Epidural Analgesia. Obstetrics & Gynecology,106(3), 642. doi:10.1097/01.aog.0000177660.93468.d6