One of the biggest decisions of childbirth is whether you will want or need pharmaceutical pain relief. (Chapter 18 has a full assessment of your labor and delivery pain relief options.) Your provider and anesthesiologist can also shed more light on the use of painkillers if you have additional questions.

Going Natural

If you intend to go completely drug free, this section of your birth plan will be a bit more detailed than others. You'll want to outline the access you'd like to other drug-free pain relief strategies. Practices like hydrotherapy (shower or whirlpool), massage, and birth balls might be on your list. Requesting to go natural doesn't close the door on changing your mind. If you're a first-time mom, you can't predict whether or not pain medication will be necessary.

Timing of Pain Relief

Some practitioners have policies about how late (or how early) in labor they will permit an epidural. Whether their policy is grounded in research, experience, or preference will probably make the difference in whether your provider is willing to be flexible on this point. If you have strong feelings about when you want access to an epidural or other pain relief option, outline your wishes in your birth plan.

A birth ball is a large, inflatable rubber ball that you can sit on, drape yourself over, or do just about anything else with that feels comfortable during a contraction. It is available in different sizes and in oblong or ridged versions for more stability. When used in the sitting position, the natural give of the ball encourages perineal relaxation.