This was not on the list of regularly scheduled programming, but I got tagged like 3 times in a post about natural birth and I've had to give this response before, so I figured it would be best just to keep all these thoughts together and accessible. So, as someone who had a natural birth and who is also a certified childbirth educator, here are the things I think are important to know:
1) We will start with anecdotal evidence. My birth. I loved it. It was loooong (78 hours) and my baby was BIG (9lb. 14oz.), but I would not describe my birth as painful. Contractions were uncomfortable (although I have endometriosis and not a single contraction hurt worse than my period cramps), pushing was really hard work (not only was he big, he wasn't ideally positioned), and crowning felt intense, but never once did it feel like I was suffering or needing additional assistance in any way. Now, to hedge, I had a homebirth. I could move freely, eat what I wanted, rest on my own bed or in a birthing tub in my living room. We could come and go from the house as we pleased and be left completely alone when I needed some space. I imagine if I had been in a different environment I would have faced some unique challenges that may have changed how the birth progressed and my perception of it, depending on the limitations of the space.
2) Let's be clear- No medication does not mean no pain relief. It simply means using other tools to cope with discomfort during labor. In my classes, we go over all the different pain relief options and they fill in a tool box with the ones that appeal to them and then have a separate space for ones they want to avoid. Massage, hydrotherapy, positioning, activity, relaxation and mediation, TENS units, aromatherapy- all these things can offer pain relief during labor and help labor to progress optimally. Some people think natural birth just means showing up and gritting through it, and that usually results in the stories you hear about it was so awful or they had to get medication or they were so exhausted after they couldn't function.
3) It's like running a marathon. Ask any long distance runner and they will tell you running can hurt. Your muscles are working hard, your body is taxed, there can be discomfort. But they still run because they know they are working towards a goal. They also know that the pain is PRODUCTIVE and not INJURIOUS, and that is an important distinction. Some people who aren't familiar with extensive physical exertion may not readily understand the difference. You can feel pain when you are injured- like stepping on a nail or breaking a bone. It hurts and it signals your body to have a adrenal response to the situation to cope. However, you can also feel pain during things that are not injurious but actually productive, like running. It may be uncomfortable, but your body is not being harmed or damaged, it's simply working hard. Same thing with birth. Nothing is happening TO you; you are ACCOMPLISHING something. And when the body perceives that kind of discomfort, it does not initiate a stress response, which is good because those stress hormones can actually make pain worse and make you feel panicky. Mentally preparing for this distinction during pregnancy can keep you from panicking when you feel a contraction and stimulating an injurious pain response. Telling yourself or having other people remind you that the discomfort is normal, your body is working hard, your baby is on it's way, etc., can help keep you calm and the discomfort in perspective.
4)One of my pet peeves is when people say "You can't plan labor." Well fucking duh. Everyone knows this. It peeves me because it is usually said in response to a mother trying to prepare herself for her labor or gain more knowledge. It sounds discouraging and frankly really patronizing. The mom knows she can't plan. But she's trying to prepare. And that is GREAT. Our culture does not prepare us for birth at all, but especially not for natural birth and it does take some effort to rectify that. While some people may feel more comfortable with a medically managed pregnancy where they don't have to participate, many others want bodily autonomy and the ability to allow their body to do what it needs to do. What I recommend to my students is this: Make a birth plan- the one you want. The one you envision and hope for. Then make a separate contingency plan. Talk with your birth partner about what you would do in certain circumstances, such as if you medically needed an induction (which is not common) or medically needed a cesarean (also not common). Write those things down so you both are on the same page and know what to do if a situation arises. But then put it away. Don't look at the contingency plan again. You have addressed the "what ifs", now focus all of your energy on your original birth plan. Say affirmations, read birth stories, watch videos, surround yourself with positivity.
5) It doesn't have to be all or nothing. Most people are interested in natural birth for the experience and the health benefits to mom and baby. However, at some point you may decide you want a different kind of experience and that's okay, but you can mitigate the risk to you and baby by knowing about interventions and how to use them. Timing of epidurals, method of induction, etc. can make a big difference in how much risk you are adding on with these interventions. Also, as I tell my students- you can't get an epidural in the parking lot. Chances are even if you plan the most medicated labor in the history of childbirth, you are going to have to deal with a few contractions on your own. So it behooves you to know about how to handle birth in the event that medical interventions aren't readily available.
So there you have it. Per usual, feel free to ask questions, email, facebook, etc.