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Natural vs. Epidural: What to Expect

Medically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT — Written by Kristeen Cherney on January 11, 2018

Using an epidural
Natural birth
Takeaway

Choices for childbirth

Giving birth can and should be a beautiful experience. But the prospect of delivery may give some women anxiety because of the anticipated pain and discomfort.

While many women opt to receive epidurals (medication for pain relief) to have a more comfortable labor, many more are choosing “natural” or unmedicated births. There is growing fear about the side effects of medicated births and epidurals.

Discuss the options with your doctor or midwife to determine which method is best for you and your child. In the meantime, here are some of the most important points to consider.

When is an epidural used?

An epidural decreases pain in a specific area — in this case, the lower part of the body. Women often choose to have one. It’s also sometimes a medical necessity if there are complications, such as those resulting in a cesarean delivery (C-section).

An epidural takes about 10 minutes to place and an additional 10 to 15 minutes to work. It’s delivered through a tube via the spine.

Benefits

The greatest benefit of an epidural is the potential for a painless delivery. While you may still feel contractions, the pain is decreased significantly. During a vaginal delivery, you’re still aware of the birth and can move around.

An epidural is also required in a cesarean delivery to ease pain from surgically removing a baby from the womb. General anesthesia is used in some cases as well, where the mother isn’t awake during the procedure.

The National Institutes of Health (NIH) report a 72 percent increase in the number of cesarean deliveries from 1997 through 2008, which might also explain the enduring popularity of epidurals.

While some cesarean deliveries are elective, most are required if vaginal delivery can’t be accomplished. Vaginal birth after cesarean section is possible, but not for all women.

Risks

Some risk factors of an epidural include:

back pain and soreness
headaches
persistent bleeding (from puncture site)
fever
breathing difficulties
drop in blood pressure, which can slow down the baby’s heart rate

It’s important to note that, while such risks exist, they’re considered rare.

The fact that mothers can’t feel all of the elements of delivery with an epidural can also lead to a host of other problems, such as increased risk of tearing during vaginal delivery.

Risks with cesarean deliveries aren’t necessarily related to the epidural. Unlike vaginal births, these are surgeries, so recovery times are longer and there’s a risk of infection.

Cesarean deliveries have also been linked to greater risk of childhood chronic diseases (including type 1 diabetes, asthma, and obesity). More research is needed.

What constitutes a ‘natural birth’?

The term “natural birth” is usually used to describe a vaginal delivery performed without medication. It’s also sometimes used to distinguish between a vaginal delivery and a cesarean delivery.

Benefits

Unmedicated births have increased in popularity due to concerns that epidurals can interfere with natural body responses to labor and delivery. Ashley Shea, a birth doula, yoga teacher, student midwife, and founder of Organic Birth, has also witnessed this trend.

“Women want to be able to move around untethered to machines, they want to stay home as long as possible before heading to the hospital, they don’t want to be disturbed or excessively monitored, or have too many cervical checks (if at all), and they want to have immediate and uninterrupted skin-to-skin contact with their newborn and wait until the cord stops pulsating to clamp and cut the cord,” said Shea.

As she pointed out, “If you found out you could have a baby in a warm, deep pool of water compared to flat on your back with people yelling at you to push, what would you choose?”

And in case you didn’t already know, mothers do have the right to elect unmedicated births at hospitals.

Risks

There are a few serious risks associated with unmedicated births. Risks often arise if there is a medical problem with the mother or if an issue prevents the baby from naturally moving through the birth canal.

Other concerns surrounding a vaginal birth include:

tears in the perineum (area behind the vaginal wall)
increased pain
hemorrhoids
bowel issues
urinary incontinence
psychological trauma

Preparation

Preparing for the risks of an unmedicated birth is important. Mothers might consider having a midwife come to their home or perhaps complete the delivery process at the hospital.

Childbirth education classes help prepare you for what to expect. This provides a safety net should any complications arise.

Nonmedication methods used to ease labor and delivery can include:

massages
acupressure
taking a warm bath or using a hot pack
breathing techniques
frequent changes in position to compensate for changes in the pelvis

The bottom line

Due to the complexity of labor, there is no one-size-fits-all method when it comes to birthing. According to the Office on Women’s Health, these are just some of the factors doctors and midwives consider when making a recommendation:

overall health and emotional well-being of the mother
the size of the mother’s pelvis
the mother’s pain tolerance level
the intensity level of contractions
size or position of the baby

It’s best to understand all of your options and to know when you might need medication to make sure your baby can enter the world without complications.

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How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

BlusteinJ, et al. (2015). Time to consider the risks of caesarean delivery for longterm child health.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4707565/
Laborand birth: managing labor pain. (2018).https://www.womenshealth.gov/pregnancy/childbirth-and-beyond/labor-and-birth
MayerD, et al. (n.d.). Epidural analgesia for pain relief in labor: Frequently askedquestions.https://www.med.unc.edu/anesthesiology/patients/childbirth-1
Medicationsfor pain relief during labor and delivery. (2017).http://www.acog.org/~/media/For%20Patients/faq086.pdf
Ranganathan P, et al. (2016). Chronic headacheand backache are long-term squeal of unintentional dural puncture in theobstetric population.https://journals.lww.com/obstetricanesthesia/Abstract/2016/03000/Chronic_Headache_and_Backache_are_Long_term_Squeal.5.aspx
SheaA. (2015). Personal interview.
Vaginalbirth and cesarean birth: How do the risks compare? (2016).http://www.pqcnc.org/documents/sivbdoc/sivbeb/8ChildbirthConnectionVaginalBirthandCesareanBirthRiskComparison.pdf
Whatis a cesarean delivery? (2017).http://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/Pages/cesarean.aspx

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Medically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT — Written by Kristeen Cherney on January 11, 2018

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