I do attend a fair amount of normal births.  My routine delivery orders do
not include IVs, bedrest, or continuous monitoring, and epidurals are not
routine here (although they are common -- we have to call an
anesthesiologist in from home at night to get an epidural.)  However, I find
that many of my patients really push for pain meds.  I am the doc patients
tend to seek out if they want an unmedicated birth here, but I also have a
lot of patients who tell me they see no point in having pain if they can
avoid it.  No amount of describing side effects and potential complications
changes their minds.  They are often the same folks who start supplementing
after the second feed (I try to always be present for the first, shortly
after birth and can usually head off the supplementing) no matter what I
tell them about potential complications of that!
Just like treating breastfeeding as the norm, when prenatal patients ask me
about pain relief, I always start by describing all the non-drug pain relief
methods we are equipped to offer (position changes, walking, heat, massage,
shower -- and soon tubs when our remodel is complete) and then tell them
what pharmacologic methods are available and what their risks are.  I had a
mom expecting her second the other day tell me that there is no way she can
give birth without an epidural.  We have lost the culture of normal birthing
in the US almost more than we have lost the culture of normal breastfeeding.
My own 4 were all normal births, although 3 were born in hospital settings.
 No IVs, no pain meds, no continuous monitoring, free to choose any position
for labor or birth, baby instantly to my arms and always with me.  It can be
done.
Jennifer Tieman
Family Physician
Mom to 4, including nursling Caroline Rose born 5/31/03

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