What is the most natural birth plan without medical intervention, unless absolutely necessary, utilizing minimal interventions and emphasizing spontaneous labor and delivery?

From the Guidelines

A natural birth plan without medical intervention, unless absolutely necessary, should prioritize spontaneous labor and delivery, with minimal interventions, as it may minimize the need for medical intervention in labor and potentially avoid maternal and neonatal complications. This approach is supported by the most recent and highest quality study, which found that allowing spontaneous labor may reduce the risk of cesarean delivery and other complications 1. To achieve this, it is essential to select a supportive healthcare provider, such as a midwife or obstetrician experienced with natural births, who respects the desire for minimal intervention.

During pregnancy, preparation is key, and this can be achieved through:

• Regular exercise to maintain physical health and reduce the risk of complications
• Proper nutrition to support the health of the mother and baby
• Childbirth education classes that teach coping techniques for labor pain, such as breathing techniques, massage, and hydrotherapy As labor begins, it is recommended to:
• Stay at home during early labor, where you'll be most comfortable, using techniques like walking, position changes, and warm showers to manage discomfort
• Bring a written birth plan and a support person or doula when transitioning to the birthing location
• Use natural pain management methods, including breathing techniques, massage, hydrotherapy, visualization, and position changes, during active labor
• Consider laboring in water, if available, as it may help reduce pain and discomfort
• Follow your body's urges to push in positions that feel comfortable, such as squatting, side-lying, or on hands and knees, during delivery
• Request immediate skin-to-skin contact and delayed cord clamping after birth, as these practices have been shown to have numerous benefits for the mother and baby, including improved bonding and reduced stress 1.

It is essential to remain flexible, as complications can arise requiring medical assistance, and to prioritize the health and well-being of both the mother and baby above all else. By following this approach, women can work with their body's natural processes, potentially reducing stress hormones that can slow labor, while the freedom of movement can help the baby navigate the birth canal more effectively 1.

From the Research

Non-Pharmacological Interventions for Labor Pain Management

• Non-pharmacological interventions, such as relaxation techniques, manual techniques, acupuncture, and birthing ball, are considered safe and can be used as a complement to pharmacologic agents or as the principal therapy for pain relief during labor 2
• These interventions have become popular over the years, with methods like yoga, hypnosis, and music being used to alleviate labor pain 2
• Nurses and midwives have reported using non-pharmacological interventions, such as massage and reflexology, to manage labor pain, and have perceived these interventions to be beneficial 3

Effective Non-Pharmacological Therapies for Labor Pain Relief

• Techniques that reduce painful stimuli, such as assuming upright positions, can ease pain and encourage labor progress 4
• Intradermal injection of sterile water (ISW) has been shown to result in over 50% of pain relief compared to 18% in the 'dry needling' group 4
• Transcutaneous electrical nerve stimulation (TENS) has been found to provide good to moderate pain relief in labor 4
• The use of essential oils, such as lavender and frankincense, has been favorably reported for relief of anxiety and fear during labor 4
• Non-pharmacological therapies, such as massage, perineal massage, and breathing techniques, have been shown to reduce pain in labor and improve labor outcomes 5

Most Effective Non-Pharmacological Coping Strategies for Reducing Labor Pain

• A systematic review and network meta-analysis found that non-pharmacological coping strategies, such as the Bonapace Method and acupressure, can reduce labor pain while maintaining an effective and satisfactory delivery experience 6
• The Bonapace Method, which involves the father in modulating birth pain, has been suggested to be the most effective non-pharmacological intervention for reducing labor pain 6
• Other non-pharmacological coping strategies, such as supportive care, childbirth preparation groups, and pelvic floor exercises, have also been found to be effective in reducing labor pain and improving labor outcomes 5, 6