7 Alternatives to Epidurals During Labor

04.21.2021 Home & Motherhood
Jennifer Margulis
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“I’m afraid of the pain.”

Maybe you’ve heard a pregnant woman say this.

Maybe you’ve thought it, or said it — yourself.

Labor can feel scary to some first-time moms because it’s something you’ve never experienced before. You have no idea how to think of it. Or what to expect. But chances are you are sure you’ll be in pain. So you aren’t thinking about epidural alternatives. Your main worry is how many centimeters dilated you need to be to get your epidural to help you manage the pain.

Stop. Wait a minute.

What if having a baby doesn’t have to be painful? How about if you don’t have to be in pain? What if you don’t need an epidural—or any other medication—during labor? How about if all you need is a change in mindset and some epidural alternatives?

If you’re interested in finding out about epidural alternatives and how to have a natural childbirth, read on.

Labor Doesn’t Have to be Painful

In America we’re conditioned to think of labor as pain. We see women in labor screaming in pain on television. We participate in chat groups where moms talk about how much they suffered, how the pain was excruciating, and how the pain relief was life-saving. Our doctor looks us earnestly in the eye and says, “Don’t be a martyr. It’s better to have your epidural.”

We don’t have a lot of people knocking at the door suggesting epidural alternatives. But science tells us that when we expect something to hurt, it does. We also know, from a variety of experiments in different fields, that expecting less pain actually leads to feeling less pain. Not only that, but the negative anticipation of pain is almost always worse than the actual pain itself.

What does all this mean? It means that if you expect labor to be excruciatingly painful — which most of us do — then it will be. But if you expect labor to be interesting — a pain that gives you information that you should pay attention to, be curious about, and respond to (by swaying your hips, moving your body, changing position) — then childbirth will be interesting.

Interesting. Messy (poopy!). Bizarre. And also fun.

That’s the secret about labor that your doctor doesn’t tell you — having a baby when you feel held and protected is actually fun. 

After all, you’ve grown an entire human being — complete with toe nails and hair follicles — inside your body. That tiny human, who shares your DNA but is completely separate from you, emerges from your body into the world. It’s miraculous. And absurd.

When it comes to labor pain, what matters most is our thoughts and expectations, how safe we feel, how much we trust the people around us, and how supportive, kind, and responsive those people are.

Heightened Pleasure During Labor and Childbirth

Everything is heightened during a natural childbirth. Your sense of smell, your hearing, your eyesight.

The hormones that cascade through your body, oxytocin, endorphins, adrenaline, and prolactin, create intense feelings of awareness and are part of the reason why the world becomes a sensuous, intense, and fascinating place for women who have unmedicated un-interfered with births.

At the same time, your focus turns inward. You merge with and surrender to your body. Your body was made to do this. Your body knows how. The energy of every woman who came before you, your mother, your grandmother, your great grandmother, has brought you here.

When you allow yourself to enjoy it, you realize that labor is pleasurable. For some it even feels like the sensuous pleasure you experience during lovemaking.

Labor sounds like lovemaking too. You may recognize the same noises during labor, the panting, groaning, pleading, and exclaiming, that you make while making love and orgasming.

7 Reasons to Avoid an Epidural and Choose Epidural Alternatives Instead

I wrote about just one key reason to avoid epidural anesthesia during labor and choose epidural alternatives instead in a recent post. I’ll give you just a few more highlights about why avoiding an epidural is a good idea:

  1. If you have an epidural, you will essentially be strapped to the bed.
  2. Being tethered to the bed means you basically can’t move. When you have an epidural, you can’t walk, you can’t get down on your hands and knees, you can’t hang off your partner or you mom. You’re stuck in one place, uncomfortably, unable to respond to the baby or your body.
  3. Epidurals sometimes fail. Sometimes they only block pain on one side; for some women they block no pain. Sometimes they are simply put in wrong and don’t work at all. This research estimates that 1 to 2% of epidurals fail. While that may seem like good odds, the numbers tell a different story. These are rough estimates but stay with me. About four million women give birth each year in America, and approximately 98% of them birth in the hospital. That’s 3,920,000 women giving birth every year. Approximately 80 percent of those women laboring in hospitals get epidurals (some say the numbers are much higher but that’s a local statistic from the largest hospital in our area; each hospital is different), so about 3,136,000 women opt-in to epidural anesthesia during labor. With just a 1% failure rate, which is a conservative estimate, over 31,000 women a year experience a failed epidural.
  4. Epidural anesthesia contains a cocktail of highly addictive and neurotoxic drugs that you would never take during pregnancy or give to your baby under any other circumstances.
  5. The chance of a spinal headache after an epidural is about 1 in 200 (source). That kind of headache, which can happen up to a week later, is excruciating. A close family member suffered from this side effect. The pain is indescribable. You will not be able to move or hold your baby. Tens of thousands of women go through this agonizing pain.
  6. Having an epidural practically guarantees that you will also be catheterized. That means a tube will be threaded into your urethra to drain your urine. This is painful, embarrassing, and carries a risk of infection. A catheter associated urinary tract infection is one of the most common infections you can get in a hospital. So you’re not “just” getting an epidural. You’re likely getting a whole lot more.
  7. An epidural is the pain relief that causes pain: In addition to a headache more painful than you’ve ever imagined (see #5), epidurals can cause several long term side effects. Just ask Nicole Dennis, a genetics counselor from Pleasanton, California. I interviewed for my book, Your Baby, Your Way. Nicole suffered such bad nerve damage after having an epidural, and being left immobilized in bed for 11 hours, that she couldn’t walk for weeks. Four years after her daughter’s birth she still had little sensation in her leg.

What are the Epidural Alternatives? How can you manage labor pain without an epidural?

In the midst of the addiction epidemic we’re experiencing right now, alternative methods of managing pain have come under intense scientific scrutiny lately. Public health officials have been eager to find out if non-pharmaceutical pain management is a viable option.

The data emerging is no surprise to midwives and other more holistic minded health practitioners who have been using alternative techniques for years: non pharmacological pain management is as effective or often even more effective than pharmaceuticals for managing pain.

In many countries around the world, including Japan, Iceland, Norway, and the Netherlands, birthing women are attended primarily by midwives. The vast majority of babies are born vaginally and women usually opt out of pharmaceutical pain management.

A “pain-free” childbirth is not the goal for most Japanese women, who expect delivery to be painful (and see that pain as a rite of passage into motherhood). Japan has the lowest rates of epidural use among developed countries. In other countries when women need help managing pain, they opt for non-pharmaceutical interventions.

Here Are Some of the Best Epidural Alternatives:

Hydrotherapy (laboring in the water)

Warm water — either a bath that you soak in or a shower — offers tremendous relief for many women during labor. If you are having back labor pains, spraying warm water as counter pressure often helps. Laboring in the water and using water to help with pain are effective epidural alternatives.


Acupuncture is used to help women in labor in countries all over the world and hundreds of studies over the last several decades have shown that acupuncture is an effective way to reduce pain. I was a quiet observer in the room during a beautiful hospital birth in Norway. When things got really intense, the second-time laboring mama asked for acupuncture. Norwegians midwives are trained in acupuncture. The acupuncture helped the mom become deeply relaxed and then fall asleep. She gave birth easily and quickly after she woke up and had the needles removed.


You can train yourself to stay calm and focused, the eye in the middle of a storm, by taking a class in hypnobirthing or by learning hypnosis or meditation techniques on your own that you then apply during childbirth. Before you dismiss self-hypnosis as a hooey-wooey suggestion, keep in mind that studies, like this one, have found that hypnosis makes measurable physiological changes in the parts of the brain that perceive pain.

Eating During Labor

Sometimes a labor slows down or a laboring woman feels exhausted or in pain simply because she’s hungry. In Japan midwives will often pop a piece of sesame candy in a laboring woman’s mouth during transition as a way to distract her and give her a boost of energy. The Norwegian midwives I shadowed encouraged women in labor to take the stairs down to the cafeteria to get something to eat. Some women vomit during labor (don’t panic or let anyone else panic you if you throw up. Vomiting is a good thing — a sign that your hormones are kicking in and your body’s doing what it needs to to create space for the baby to come out.) The best way to use food to help you during labor is the common sense one: If you’re hungry, eat as much as feels good. If you’re not hungry don’t eat. A few sips of fresh vegetable juice during my last labor helped me through transition.

Kissing During Labor

Ina May Gaskin, perhaps America’s best known midwife, recommends smooching with your partner during labor. It took love to get the baby in, midwives often tell their clients, and it takes love to get the baby out. The idea of kissing appeals to women who feel highly sensual during labor and provides an amazing distraction. If you feel like murdering your partner, or you don’t have one, this pain management technique won’t work. But Gaskin’s idea is that if you relax your lips up there your lips down there will also relax and your vagina will become more open. Next time you smooch with someone, notice how much it relaxes you. It’s hard to make out and be uptight. This labor hack, I think, is brilliant.


In one study on labor pain women receiving massages had less pain and shorter labors than women who did not get massages. They also had less postpartum depression and lower level of stress hormones (source). Other studies have shown similar results. Perhaps this is why some midwives and doulas, along with chiropractors and massage therapists, exalt the use of massage during labor. If massage is something that relaxes you and increases your sense of security and wellbeing, find someone to be at your birth you can massage you when you need it.

Positive Affirmations

In the months leading up to the birth of my fourth baby I taught myself to meditate and pay attention to my breathing. I would run a bath most evenings and practice taking long deep breaths, emptying my mind of any worries or worldly concerns. My six-year-old son often joined me in the tub. While I practiced breathing slowly and deeply, I filled my mind with positive thoughts about the upcoming birth, repeating positive affirmations to myself. I told myself over and over things like: “I will enjoy being in labor,” “My body is healthy and strong,” “My baby and my body know just what to do.” I would not describe that fourth birth as pain-free, because it wasn’t.

Full disclosure: I was actually startled by how painful it was! But the pain was productive. The labor was exciting. My husband and I caught our baby. And repeating back the affirmations I had practiced, reminding myself that the pain I was experiencing was productive and interesting, and remembering the women who had come before me.

Jennifer Margulis, Ph.D., is an investigative journalist, book author, and Fulbright awardee. She is the author of Your Baby, Your Way: Taking Charge of Your Pregnancy, Childbirth, and Parenting Decisions for a Happier, Healthier Family, co-author (with Paul Thomas, M.D.) of The Vaccine-Friendly Plan, and The Addiction Spectrum: A Compassionate, Holistic Approach to Recovery. Follow her on Facebook, Twitter, and Pinterest.

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