The decision to either use medications for labor and birth or not use medications is a fairly recent debate believe it or not.
It wasn't that long ago that medications weren't used commonly in labor and birth, and they weren't offered or readily available. From that point we went to having them so readily available that they were given nearly without the consent of the woman.
From these radical positions we've entered a phase in the history of birth where women not only have the choice but many choices. No longer is just sit there and suffer with support or being given so many drugs that you have no recollection of the birth or first few hours of your baby's life. The choice is not an easy one to make and most women do mull over the decision for quite some time, doing research on their options and trying to figure out how they can help themselves make this decision.
How to make the decision.
First of all, don't listen to every woman who tries to tell you the horror story of her epidural or her natural birth. Chances are she had complications or a situation that she fully didn't understand and you are only going to get part of the picture.
Secondly, it's important to realize that there are many factors that will play into your decision to not use medication or to use them:
- How much sleep have you had prior to labor?
- How much energy you have. (More related to food and drink.)
- How long your labor lasts, though this doesn't mean that you can't successfully go without medications in a longer labor, just that you need to plan accordingly and pace yourself.
- What position mom is in. Lying in bed is probably the worst position for mom, it can create more pain. Even if you need to be monitored you can do that standing up or from a chair or different position in the bed.
- What type of support mom has. Is everyone with her helping her with labor or are they distracted and doing non-essential things?
- What position your baby is in. Certain positions can create more pain for the woman.
- Knowledge going in to the birth. The more you understand what is happening the less frightening and therefore painful it will be.
- When to make the decision.
My best advice to answer this question is basically that you need to prepare yourself prior to labor and be ready to make the decision at this point. Many women find labor less stressful and painful than they believed it was going to be and find that prior decision to accept medications never became a reality because they simply were not necessary for them. Other women find that their labor is longer or more painful than they had anticipated and other techniques are not effective enough and they choose to have medications. Until you are in labor you can't say before hand how you will experience it or how long it will last, both important factors in the medication equation.
Even when women anticipated a painful labor those who had studied and used the relaxation and breathing techniques from class found that they required fewer medications. One study also pointed out that what women expected tended to be what they had in labor. Anxiety of labor pain was related to pain experienced labor as well, including lack of satisfaction.
To prepare yourself you need to take a good childbirth class that will teach you about positioning, relaxation, comfort measures, and medications. Having knowledge of all of your options is the best way to be fully aware of which one is the right choice for you and your baby.