What to do in 8th month of pregnancy for normal delivery

While "natural birth" is an outdated term, it often refers to an unmedicated vaginal delivery with minimal interventions. This type of childbirth isn't for everyone, but going medication-free might have some advantages for some pregnant people. For example, past studies have found that those who get an epidural have a greater incidence of interventions to get the baby out, such as vacuum extraction, delivery by forceps, and emergency C-section, according to a study in National Vital Statistics Reports. An epidural can also mean short-lived but unsavory side effects for the birthing parent, including low blood pressure, headache, and fever. But on the other hand, a February 2022 study found that epidurals are also linked to decreased maternal mortality, so there is always a time and place for medications.

If you choose to deliver without medications, your recovery may also be different than those who deliver with drugs or anesthesia. "These parents are up faster, feel better, and often experience less tearing and swelling," says Ryan Dickerson, M.D., an obstetrician in Baton Rouge. Pregnant patients who skip the meds might also feel more of a strong urge to push and may not require help getting the baby out, both of which can translate into less pushing and less tearing, Dr. Dickerson explains.

An unmedicated childbirth is an entirely achievable and reasonable goal for many pregnant people. But for other parents, such as those in a high-risk category, certain interventions such as a Cesarean section can make birth safer for everyone.

The key is knowing your own risk and making a plan for what is best for you and your baby. If you do want to try for a drug-free delivery, tap into these "natural birth" tips from experts. (Note: The term "natural childbirth" is problematic. Labor and delivery are natural processes for all pregnant people, whether they have a C-section, a medicated vaginal delivery, or an unmedicated one. No method of delivery is superior to others. When referring to a low-intervention birth, a better term would be "drug-free birth" or "unmedicated birth.")

Regardless of what you decide and even if you do opt for the epidural (remember, it's your choice and you are always allowed to change your mind during labor!), these strategies can help you stay calmer and more comfortable until the anesthesiologist arrives.

1. Know why you want an unmedicated birth.

What does "natural birth" mean to you—giving birth without any intervention at all or just without pain medication? Do you want to limit intervention because of possible side effects, previous experiences with medical settings, or a sense of personal accomplishment? Every person will have a different reason why, and finding yours will help you address that concern, no matter what happens in your labor.

2. Enroll in childbirth classes.

Wondering how to prepare for "natural birth?" Start by getting a solid prenatal education with classes that include how labor and birth work, as well as natural labor pain management techniques like breathing, self-hypnosis, and relaxation. Some popular options include Lamaze, the Bradley Method, Hypnobirthing, and Hypnobabies.

3. Create a "natural birth" plan.

Once you have an idea of your ideal birthing experience, the next smart step is creating a birth plan that details what you'd like to happen before, during, and after labor. Along with general preferences such as who you'd like to be in the hospital room during delivery, what the physical environment should be like, and your feeding plans, your "natural birth" plan may include extra preferences like the following:

• No medication
• Free movement
• Natural water rupture
• Intermittent monitoring
• No episiotomy
• Preferences for baby medications
• No bath for baby
• No IV
• No membrane sweep
• Pitocin only if necessary

4. Pick a health care provider who's into "natural birth."

"Look for a midwife or doctor who is just as invested as you are in 'natural' childbirth," advises Maria Lorillo, Licensed Midwife (LM), Certified Professional Midwife (CPM) at wisewomanchildbirth.com, in San Francisco. "[They] will manage the entire birth in a way that's most conducive to success." You can also consider hiring a doula, who acts as your own personal cheerleader and supports you before, during, and after labor.

5. Learn to face contractions.

One of the secrets to an unmedicated birth is being able to relax in response to pain—a tall order, we know. When you're afraid in the throes of contractions, your body's reaction is to stiffen, which tends to exacerbate discomfort, explains Heidi Rinehart, M.D., an obstetrician in Keene, New Hampshire. Fear increases tension, which ups the agony. "When you're tense, some muscles are tightening and trying to hold the baby in, while the muscles in your uterus are tightening to try to push the baby out," says Dr. Rinehart. "The muscles are fighting with each other, which makes it hurt more."

If you can stay (somewhat!) relaxed in the face of strong contractions, you'll have less resistance to opening up for the baby to come out. One trick? Try an exercise called The Grip throughout pregnancy. "It simulates contractions and allows you to up your pain threshold," says Julietta Appleton, certified childbirth educator, hypnotherapist, and labor doula in Bedford Corners, New York. Lie down on your side with a pillow between your knees, and if you're in your third trimester, with one supporting your belly too. Have your partner apply steady pressure to the muscle between your neck and shoulder for one minute. Focus on relaxing that muscle beneath your partner's gasp. Wait for the pressure to grow very strong before tapering off. The idea is to get used to relaxing your muscles rather than tensing them in response to pain. You can also try the space between your thumb and index finger, or an even more sensitive area, such as the Achilles tendon at the back of your ankle.

6. Know how to squat.

Contrary to what you see in most movie birthing scenes, you don't have to be lying in a hospital bed to have a baby. In fact, many people are more inclined to squat during labor. Squatting opens the pelvis and helps the baby get into the ideal birthing position (head down, face toward back, chin tucked in), explains Henry Dorn, M.D., an obstetrician in High Point, North Carolina. It's most effective if you've been practicing your squats throughout your pregnancy and building those muscles in your legs.

It's safe to practice squatting throughout pregnancy as there's no evidence it can induce labor. "If your doctor tells you the baby is not in an optimal place in the last trimester," says Dr. Dorn, "try kneeling, sitting cross-legged, or perching on an exercise ball for as much of the day as possible." Or, open a door, hold onto the doorknobs on either side, and drop into a squat for one or two minutes with your knees wide apart. Pull yourself back up using the doorknobs.

7. Start an exercise routine.

Like long distance running, childbirth calls for energy and stamina. "You increase your chances for success (of drug-free birth) by being very physically fit," Dr. Dickerson says. You'll want to consider the nine months of pregnancy your training period, and start preparing for labor early on by working out regularly, he says. Dr. Dickerson's prescription: 30 minutes of movement, seven days a week. Hit the elliptical machine or stationary bike and aim to get your heart rate up, or lace up your sneaks and walk whenever you can. (However, if you were not physically fit before becoming pregnant, check with your doctor to come up with a safe cardio plan for you.)

Flexibility, especially in your hips, will help you when it comes time to push, so stretching sessions are important, too. Shoot for 30 minutes of prenatal yoga one or two days a week. Cautionary word to the wise: Your body produces relaxin in pregnancy, which makes you more flexible, so be careful not to overstretch or work yourself too hard.

Exercise will also help you maintain a healthy weight during pregnancy. The larger the baby, the harder they'll be to get out, emphasizes Dr. Dickerson. Of course, following a healthy diet is also key. Pass the veggies, please!

8. Spend early labor at home.

If you want an unmedicated "natural birth," you might want to stay home from the hospital as long as possible, especially if this is your first baby. That's because the best strategies for achieving a drug-free labor are often easier to put into action at home than in the hospital.

Most low-risk pregnant people are perfectly safe spending early labor at home. During early labor, which can take an average of eight hours or more for a first-time parent, the cervix softens, thins, and eventually dilates. Doctors used to say that pregnant people should head to the hospital when they were in active labor, which was defined as starting at four centimeters. But a 2020 study out of Australia does suggest that people admitted early in their labor may end up with more Pitocin and C-sections. The American College of Obstetricians and Gynecologists (ACOG) has now taken into account the fact that early labor may take longer, especially for first-time pregnant people and that heading to the hospital too soon may come with an increased risk of unnecessary interventions.

If you're spending early labor at home, give your midwife, doctor, or hospital a call when your contractions are at least five minutes apart for an hour or more. Also call your doctor if contractions are getting progressively stronger and closer together no matter how you move. If they're five minutes apart while you're lying in bed but spaced further apart when you move to the tub or go for a walk, it's probably not time to go to the hospital yet.

9. Move around during labor.

When you begin labor, keep moving to stay comfortable. Walking, rocking, squatting, sitting, swaying, and switching sides while resting can help your body work with your contractions as gravity and mobility help the Baby move into the birth canal. Plus, movement eases tension and gives your mind something to focus on other than pain.

"Walk and stretch, sit on a birthing ball, and hop in and out of the birthing tub if it's available," says Dana Gossett, M.D., an OB-GYN at Northwestern Memorial Hospital in Chicago. And use a combo of gravity and hip movement to help the baby come down, advises Dr. Rinehart, who delivered two of her own three children without medication. "When you take the cork out of a wine bottle, you don't take it straight out, you jiggle it back and forth to get it to ease through," says Dr. Rinehart. "Movement of the hips, belly dancing, hula dancing, squatting, rocking, pelvic tilts, and such help maneuver the baby down and through to find the easiest path out," she says.

10. Use water to manage labor pain.

Even if you're not having a "natural water birth," you can use a shower, bathtub, birthing pool, or hot compresses for easing pain and helping you relax. Some pregnant people love spending as much time as possible in water during labor.

11. Remember to relax.

Rhythmic breathing, meditation, self-hypnosis, and other relaxation techniques are excellent tools for all stages of labor, but they're easier to manage when you're not being interrupted. Once you're in the hospital, your nurse will frequently check your vital signs, hook up monitors, draw blood, start IVs, and do other interventions that may clash with your Zen. At home, you can light candles, close your eyes, follow your breath, meditate, and create an ambiance that promotes relaxation.

12. Practice patience when following "natural birth" tips.

Some labors start with days of on-and-off contractions that wear moms out long before "real labor" begins. Even after contractions get organized into a regular pattern, early labor takes an average of eight hours for a first-time parent and five or more for people who have given birth before. As much as you'd like labor to be over, there's usually no need to rush things. Keep yourself entertained, relaxed, hydrated, and nourished and plan on labor being a marathon, not a sprint. Be sure to let your midwife or doctor know if you're becoming exhausted. They'll help you decide on the next steps, whether that's at home or in the hospital.

If you're bleeding heavily, your baby's not moving, you feel ill or have any other concerns that your labor isn't progressing normally, then forget about staying home and go to the hospital, where your provider can evaluate you and your baby. And, if you arrive at the hospital only to discover that everything's normal and your doctors recommend you return back home until you're further along in your labor, remember that there's no shame in that and you're one step closer to meeting your baby.

13. Decide when to get an epidural.

If you can't focus during contractions or relax between them, doctors agree it's probably a good idea to ask for pain meds, which at this point may help move things along. Your pelvic muscles can tighten if you're in too much pain, making it difficult for the baby to descend. An epidural, by relieving your pain, can let the pelvis do its job. Have an open mind (which can help you open the birth canal too): "If you reach the point where a [drug-free] labor is just not happening, you have to accept what's good for your child," Dr. Gossett. "The goal is a healthy baby."

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