Giving birth is a natural process, but what's called natural childbirth is the experience of labor and delivery without the use of any medication or anesthesia. Instead, you rely on natural methods of pain relief, like breathing and visualization.

There are some very good reasons for wanting to prepare yourself to give birth naturally, without the use of pain relief or local anesthesia. These are the two reasons most commonly cited by women who choose natural childbirth:

• By skipping pain medication you can be more aware of the birth process.
• Babies delivered without medication are more alert, since there are no drugs to get into the bloodstream.

Labor does hurt, and everyone has a different threshold for pain. Fortunately, many pain-management options are available to you—you're not restricted to the standbys of traditional western medicine.Let's take a closer look at some natural pain relief methods during labor.

TENS

TENS stands for Transcutaneous Electrical Nerve Stimulation, and is a small electrical device that reduces pain signals sent to the brain. The device can also be used at the end of pregnancy (after 36 weeks) if you have a backache or uncomfortable Braxton Hicks' contractions.

How It Works

The battery-operated TENS machine has thin wires that are connected to four electrodes, or sticky pads, which are taped to the lower back. The machine is thought to work by sending electrical pulses from the machine along nerve roots to the pain pathways in the brain, thereby blocking pain impulses.

It's also thought to stimulate the brain to produce "feel good" encephalins and endorphins, which can modulate the pain.

You can hold the device or have it near you in labor and can increase the strength of the electrical impulse with a button as your contractions get stronger.

TENS is most effective in early labor, particularly for lower back pain, so it's important to have the device available at the beginning of labor. Find out if your hospital has TENS machines or whether you need to rent one in advance.

Advantages and Disadvantages

There are several advantages to TENS. It has few side effects; it allows you to remain active; and it can be used in combination with other types of pain relief.

The disadvantages are that there hasn't been much research done about its safety for the baby, so a theoretical risk exists. It's usually effective with just mild to moderate pain. The sticky pads mean that a back massage isn't possible, and you can't labor in water or have an epidural inserted while using the device.

Activity

Staying active during labor can help women deal with pain and reduce the length of labor. Women have been active in labor for centuries, but a medicalization of childbirth in the West led to an acceptance that women lie in bed.

Although you may want to rest on a bed between contractions, many women find that when they feel supported, they'll instinctively want move around and don't cope well lying down, which can increase pain and hamper the progress of labor as your baby pushes against gravity.

You may find it helpful to take a walk, roll on a birthing ball, rock in a rocking chair or change positions when you get too uncomfortable.

Keep in mind, though, that there are certain interventions, such as the use of electronic fetal monitoring, IVs and some types of analgesia, that will limit your mobility.

Hypnosis

Self-hypnosis, using visualization and breathing techniques to induce a state of deep relaxation and banish fear, is an increasingly popular way to deal with labor.

How It Works

"HypnoBirthing" is based on the "fear-tension-pain" syndrome of childbirth first described by the English obstetrician Grantly Dick-Read (see Birth ideologies), who believed that fear prevents the release of the "feel-good hormones," endorphins and encephalins. He theorized that when fear is eliminated, most women can give birth naturally.

With HypnoBirthing, you're fully aware of what's happening around you, but may feel as though you're daydreaming or drifting off to sleep. You and your birth partner can attend HypnoBirthing classes anytime during pregnancy to learn the techniques before labor.

The most important thing to do is to relax and worry less about the process. Childbirth is something that's been going on for eons and will continue to occur long after your childbearing years are over.

Your mind and your body are totally connected, and if you are worried and anxious when it is time to give birth, you will make your body tense and your contractions will be that much more painful. You are capable of talking to your body and telling it to use its natural pain relievers to ease your process.

Water

Many women find being in warm water during labor very soothing and an excellent way to cope with labor pain. The warmth of the water relaxes muscles, and being in water aids buoyancy, which can help relieve the pressure on your pelvis.

This natural method has become more and more available for women and many hospitals and birth centers provide bathtubs.

Whether or not you can actually deliver your baby in the water will depend on the hospital's policy and whether there are any doctors or midwives trained in water births. You can also purchase or rent a birthing pool.

Relaxation and Breathing Techniques

If you're relaxed, it will be easier to stay calm and in tune with your body.

There are various techniques you can use to help you relax during labor. These techniques include focusing on your breathing, listening to music and listening to a meditation CD.

Learning how to breathe slowly and steadily in labor helps you focus and stay calm. Usually, your breathing responds to how you're feeling and may increase slightly during a contraction, or you may hold your breath, which can make you feel light-headed. If that happens, you need to focus and steady your breathing.

Homeopathy

This is based on the principle of treating like with like. Talk to your doctor before using any homeopathic products during pregnancy or labor, since homeopathy is an area of complementary and alternative medicine that's associated with much debate and scientific controversy.

If your doctor gives you the okay, a certified homeopath can prescribe remedies based on your individual needs. There is a lack of scientific evidence on the effectiveness of homeopathy, although many women find the remedies helpful.

Your nurse will remind you to breathe slowly and steadily. Breathing in for five and out for seven slows your breathing down, helps you relax and stops you from panicking.

Acupuncture

Acupuncture uses fine needles placed at specific points on the body to reduce pain by stimulating the production of endorphins.

How It Works

Acupuncture is a traditional form of Chinese medicine that believes there are channels within the body through which energy, or "chi" runs. Blockages can occur in these channels, and so by inserting needles at certain points, energy is unblocked, relieving pain and restoring balance to the body.

Many women find acupuncture helpful to treat mild pregnancy symptoms, and some women use this therapy during labor.

Side-Effects

Acupuncture has no harmful side effects for the mother or baby and in labor, needles will usually be inserted in points that do not restrict your movement, for example in the ear.

If you want to have acupuncture during labor, you will need to look for an acupuncturist who specializes in this area and arrange to have him or her with you during labor.

Aromatherapy

Aromatherapy (essential) oils are derived from plants and used for their therapeutic properties. The use of these oils in childbirth can stimulate, refresh and soothe you and, to some extent, your partner.

There is some evidence that oils like lavender reduce anxiety in labor, which in turn helps you cope with pain. Hot and cold compresses with essential oils can be soothing and massaging diluted essential oils (in a carrier oil) into the skin is therapeutic, too.

Many experts, however, recommend against aromatherapy during pregnancy and labor because some scents may be hazardous to pregnant women. The effects of most plant oils on pregnant women is unknown.

Reflexology

Reflexology involves massaging reflex zones on your feet that correspond with different parts of your body to improve your blood circulation and relax any tension you may be feeling. Because many women naturally want to be active and move around during their labor, it may be more helpful in between early contractions.

When it comes to pain management during labor, the choice is entirely yours. If you're interested in natural childbirth, but you're not sure what's best for you, talk to your doctor. She may have suggestions and insights that will help you make the best choice for you and your baby.