Unmedicated childbirth at Genesis Dnepr, Dnipro.

What is childbirth without pharmacological pain relief — it is an approach to delivery that emphasizes non‑pharmacological methods of reducing discomfort, active positions, and team support. Such births may be appropriate for women with low obstetric risk who prefer natural ways of managing contractions and are prepared to take an active role in the process. It is important to discuss the birth plan and available support methods in advance with your doctor and midwife/obstetrician, and to agree on a backup plan and, if necessary, consult an anesthesiologist. The decision is made individually based on the clinical situation and may change during labor for the safety of the mother and baby.

What this childbirth format means

Unmedicated childbirth is a mode of delivery that places primary emphasis on non‑pharmacological methods of support and the active participation of the woman. It may be suitable for those at low obstetric risk and who wish to limit medications, but it is not appropriate for all patients. It is important to discuss expectations, comfortable positions, the partner’s role, and a backup plan with the doctor and midwife in advance. The decision is always based on the clinical picture and may change for the safety of the mother and baby.

• Practical meaning: focus on non‑pharmacological pain relief and comfort.
• Typical course of labor: changing positions, breathing techniques, massage, and team support.
• Pre-delivery discussion: expectations, comfort measures, and agreement on a backup plan.
• Team’s role: the doctor and midwife monitor the condition of the mother and baby and intervene if necessary.
• Conditions and limitations: this format may not be possible with increased obstetric risk.
• Alternative pain relief options are discussed in advance with the anesthesiologist and the team.

Discuss this option at a scheduled appointment. The team will explain possible scenarios and safety limits.

Who may be suited to unmedicated labor

This option may be appropriate when a woman wants to agree the birth scenario in advance and minimize pharmacological interventions. It is not suitable for everyone, so it is important to discuss expectations and possible limitations with the doctor and midwife. This option is often considered when the pregnancy is proceeding calmly and there is a clear support plan.

• A desire to discuss the birth plan and possible scenarios with the team in advance.
• Having a partner or close person whom they want present during labor.
• Questions about pain relief and a willingness to consider non-pharmacological methods.
• A desire to understand who will manage the birth and how (doctor and midwife).
• Pregnancy is progressing without serious complications and is assessed as low risk.
• An intention to remain active and freely change positions during contractions.
• Previous birth experience that they want to take into account when planning.
• A need for a calm, clear birth plan and contingency options.

This option is discussed during a routine prenatal appointment. The final decision is made taking the clinical picture into account and may change for the safety of the mother and baby.

When this type of birth may be limited

An unmedicated birth plan may need to be restricted if medical indications for a different approach arise during labor. Such decisions are made not to limit choice but to ensure the safety of mother and baby; the plan can change as labor progresses. Discuss possible scenarios in advance so you know backup options.

• Obstetric complications requiring expedited or operative intervention.
• Signs of fetal distress that necessitate an immediate change in management.
• Conversion to an emergency cesarean section, in which the chosen approach is not available.
• Contraindications to certain analgesic methods discovered during labor.
• Infectious or organizational restrictions limiting the partner’s presence.
• Maternal conditions in which safety takes precedence over the initial birth plan.
• Ineffectiveness of non-pharmacological measures and the need to discuss pharmacological pain relief.

The team (physician and midwife) will always explain the reasons for any changes and propose a safe alternative plan.

Who decides on the format of delivery

The decision about the format of delivery is made jointly by the patient and the medical team, taking into account the current clinical situation. The woman's preferences are important and are considered in planning, but the final choice is determined by the condition of the mother and the fetus. If an unmedicated birth is desired, it is recommended to discuss this in advance and agree on a backup plan. If necessary, an anesthesiologist and a neonatologist are involved in the discussion.

• The patient's wishes and priorities are discussed in advance during the appointment.
• The pregnancy assessment and test results are reviewed by the physician and midwife before making a decision.
• Ultrasound findings and the fetus's condition are taken into account when assessing the feasibility of this format.
• An anesthesiologist is consulted when discussing pain relief options.
• A neonatologist is involved when necessary to plan newborn care.
• A backup plan and the criteria for switching to a different format are discussed in advance.
• The decision can be revisited during labor if the condition of the mother or fetus changes.

The decision is always collaborative and aimed at ensuring the safety of the mother and baby. Discuss your expectations with the team — they will explain the scenarios and possible changes during labor.

Questions to discuss with your doctor in advance

At your scheduled appointment, discuss key questions so the team (doctor and midwife) understands your expectations and boundaries. Below are example questions to help you prepare for the conversation about labor and delivery. Clear answers will make it easier to agree on a plan and backup options.

• - Clarify what type of birth you prefer — are you planning an unmedicated birth?
• - Ask whether a partner or support person is allowed to be present and what restrictions apply.
• - Discuss pain-relief options and whether a pre-delivery consultation with an anesthesiologist is needed.
• - Describe previous birth experiences: any cesarean sections or complications that should be taken into account?
• - Inform them about chronic conditions and any ongoing medications that require attention.
• - Bring recent ultrasounds and test results — are there any results that need updating?
• - Agree on a plan of action in case your condition worsens or operative intervention becomes necessary.
• - Clarify when it’s best to go to the hospital when contractions start or when you notice early signs of labor.
• - Prepare a list of items and documents — what to bring to the maternity hospital.
• - Clarify the conditions for staying after birth and the expected discharge procedure.

Write down the answers and bring them to the appointment; the team will explain the options and possible changes during labor and delivery.

How preparation for an unmedicated birth proceeds

Preparation looks like a series of practical steps to align expectations and medical parameters before delivery. For an unmedicated birth, non-pharmacological support methods, possible backup options and required examinations are discussed. The process includes meetings with the team, document checks, and rehearsing scenarios in case circumstances change.

• Consultation with the physician and obstetrician to assess condition and agree on the birth plan.
• Review of the maternity record and verification of up-to-date ultrasound and test results.
• Agreeing the birth plan with the team: positions, non-pharmacological methods, and contingency options.
• Discussion of pain relief and, if needed, a preliminary consultation with an anesthesiologist.
• Preparing the partner: their role during labor and the clinic’s organizational requirements.
• Recommendations on when to go to the clinic when contractions begin or prodromal signs appear.
• Checking documents, a list of necessary items, and conditions for the postpartum stay.
• Familiarization with the criteria for switching to another delivery approach for the safety of the mother and baby.

Preparation helps to better understand expected scenarios and backup plans.

The final decision on how labor proceeds will be made according to the clinical situation at the time of delivery.

How labor proceeds without pharmacological pain relief

Labor in this format usually follows a recognizable pattern but remains flexible depending on the condition of the mother and baby. The approach is based on monitoring labor progress, supporting the mother with non-pharmacological methods, and the team's readiness to change the plan if necessary. Before and during labor, the doctor and midwife explain the stages and agree on actions with you.

• - Admission to the clinic: registration and initial assessment.
• - Examination and evaluation: checking cervical dilation, fetal heartbeat, and overall condition.
• - Monitoring contractions: tracking the frequency and strength of contractions.
• - Monitoring the baby’s condition: periodic fetal heart monitoring.
• - Support with non-pharmacological methods: position changes, breathing techniques, massage, water.
• - Involvement of the doctor and midwife: regular examinations and adjustment of tactics as needed.
• - Pain relief if necessary: discussion of options and consultation with an anesthesiologist.
• - Pushing stage: guidance and support during pushing, monitoring the mother’s condition.
• - Birth of the baby and the newborn’s first examination, followed by initial skin-to-skin contact.

This outline serves as a guide, but final decisions are made during labor based on the clinical situation. The team will explain any changes and propose a safe alternative plan.

Pain relief and contingency plan

Even if you plan to give birth without pharmacological pain relief, pain management is still discussed in advance as a backup option. Planning takes into account your preferences, health status, and test results. During labor the decision may be adjusted depending on the clinical situation to ensure the safety of both mother and baby.

• Preliminary discussion at the appointment: expectations and possible alternatives.
• Consultation with an anesthesiologist is recommended when planning pharmacological options.
• Non-pharmacological methods: breathing techniques, changing positions, massage, water support.
• Pharmacological options, including regional anesthesia (epidural), are discussed if needed.
• Joint decision: the patient, the doctor and the obstetrician; an anesthesiologist is involved if required.
• The plan can be changed during labor if the condition changes.
• Limitations: some medical conditions make certain methods impossible.
• Reality of pain: the availability of a method does not guarantee complete elimination of discomfort.

Discuss pain-relief questions in advance at your appointment — the team will explain the available options and limitations. Ultimately, the decision is aimed at the safety of the mother and baby.

Safety and monitoring during labor without pharmacological pain relief

Monitoring is an integral part of managing labor without pharmacological pain relief; it helps promptly detect changes in the condition of the mother and baby. In the clinic, maternal and fetal parameters are regularly assessed, CTG is performed when necessary, and additional specialists are involved as needed. The birth plan remains flexible: the team is prepared to change tactics for safety. The doctor and midwife will explain the monitoring process and possible actions as events unfold.

• Ongoing monitoring by the doctor and midwife of the mother’s condition.
• Assessment of the fetal heart rate and its response to contractions.
• Performing CTG when indicated to accurately assess the fetus’s condition.
• Monitoring the progress of labor and the rate of cervical dilation.
• Monitoring the mother’s vital signs and timely correction when necessary.
• Rapid readiness of the team to change tactics for the safety of mother and baby.
• Involving an anesthesiologist and neonatologist for consultations if needed.
• Discussing key decisions with you as the situation changes.

The monitoring system is intended to support informed decisions during labor. The team will explain any changes to the plan and offer safe alternatives.

If labor doesn't go according to plan

A birth plan is a guideline, not a strict instruction; if the situation changes, the team will adjust tactics for safety. If you have chosen to give birth without pharmacological pain relief, it's important to understand in advance the possible alternatives and backup scenarios. Any changes will be explained and discussed with you as necessary.

• Your partner may need to leave the delivery room temporarily for medical or organizational reasons.
• A spontaneous vaginal birth may require augmentation or an operative delivery (for example, instrumental delivery or cesarean section).
• An epidural may be technically or medically impossible in a given situation.
• A vertical or other chosen position may need to be changed to improve monitoring or management of the birth.
• A minimal‑intervention plan may be revised if there are signs of risk to the baby.
• Actions are taken with the safety of the mother and newborn as the priority.
• The team (obstetrician and midwife) will explain the reasons for any changes and offer available alternatives.

Changing the plan is a normal part of labor management, not a failure. You will be kept informed and involved in decisions whenever the situation allows.

Possible risks and limitations

Labor without pharmacological pain relief has its limitations, and it is normal to take them into account when planning. Risks depend on the condition of the mother, the fetus, and the course of the pregnancy; some decisions are made during labor. The doctor and midwife will explain in advance in which cases the plan may change and what backup options are being considered.

• Limited effectiveness of non-pharmacological methods in cases of severe pain or marked fatigue.
• Possible need for stimulation of labor or other interventions.
• Transition to pharmacological analgesia if clinically necessary.
• Transition to operative delivery (e.g., cesarean) if this is safer for the baby.
• Risks depend on the condition of the mother, the fetus, and the specifics of the pregnancy.
• Importance of agreed-upon criteria for changing the plan with your doctor and midwife.
• Someone else’s birth experience does not guarantee the same outcome for you.

Discuss these points at your appointment — the team will explain possible scenarios and backup plans. The safety of the mother and baby is always the priority.

What happens immediately after delivery

Immediately after delivery, attention is usually given to the first contact between mother and baby and to a quick assessment of their condition. In births without pharmacological pain relief this looks the same as in other situations — the team's main task is to ensure safety and provide support. In the clinic, cardiotocography (CTG) is always performed during labor and the newborn is examined by a neonatologist right after birth; monitoring then continues during the first hours.

• First skin-to-skin contact, if the condition of the mother and baby allows.
• CTG during labor and a neonatal examination immediately after birth.
• Assessment of the mother's condition: monitoring blood pressure, blood loss and overall well‑being.
• Assistance with the first latch and support with initial feeding.
• Brief medical interventions for the newborn if necessary (if indicated).
• Transfer to the postpartum ward after stabilization and when the mother is ready.
• Monitoring by the physician and midwife during the first hours to track recovery.

The sequence of actions may change depending on the clinical situation. The team will explain in detail what is happening and why certain decisions are made.

Role of the physician and the team

During childbirth decisions are made by the team: each specialist performs their role and coordinates actions. The obstetrician-gynecologist and the midwife assess the condition, make clinical decisions and explain them to you. The team is ready to involve other specialists depending on the situation, including for pain relief and newborn care.

• Obstetrician-gynecologist — assesses risks, decides on labor management and interventions.
• Midwife — provides continuous support, helps with positions and non-pharmacological methods.
• Anesthesiologist — advises on analgesia and becomes involved when necessary.
• Neonatologist — examines the newborn and is present when risk is increased.
• Operating room team — prepared if operative delivery is required.
• Coordination of actions — regular discussion of the condition and informing the patient.
• Documentation and safety — recording parameters, checking equipment and medications.

The team’s aim is to ensure safety and informed choice during labor. If the situation changes, specialists will explain the reasons and offer available options.

Benefits of this delivery format

In births without pharmacological pain relief, arrangements are made so that the patient feels informed and supported. The format allows expectations to be discussed in advance, a contingency plan to be agreed upon, and the role of each specialist to be clarified. This reduces uncertainty, but does not remove the need to make decisions based on the clinical situation.

• A clear birth plan agreed in advance with the obstetrician and midwife.
• The opportunity to discuss individual preferences and limits of intervention in advance.
• Less uncertainty thanks to clear contingency scenarios.
• Partner presence, subject to the clinic’s policy and medical indications.
• The option to choose and arrange for the presence of a specific physician.
• Availability of medical analgesia when clinically necessary and by agreement.
• Comfortable team support during the first hours after birth.
• Continuous monitoring of mother and baby with prompt readiness to act.

These benefits help with planning the birth and increase confidence. The final decision on management always depends on the current condition of the mother and fetus.

How a pre-delivery consultation works

A pre-delivery consultation is a structured conversation in which the doctor and midwife assess your condition and discuss the preferred mode of delivery. At the appointment they review your maternity record, test results, and ask about previous birth experience and chronic conditions. Your wishes regarding the birth, partner presence, and possible pain relief options are also discussed. Sometimes an additional consultation or a follow-up visit is required to clarify the plan.

• Taking medical history: illnesses, medications, previous births and surgeries.
• Reviewing the maternity record and checking the currency of ultrasounds and lab tests.
• Examining test results and deciding whether additional monitoring is needed.
• Discussing your preferences for the mode of delivery and partner presence.
• Explaining limitations and the criteria under which the plan may change.
• Helping choose a safe delivery option and agreeing on backup plans.
• Consulting an anesthesiologist and involving a neonatologist if necessary.
• Explaining when to go to the hospital and answering your questions.

The consultation helps to create a clear plan, but the final decision may be adjusted during labor. If needed, the team will order additional tests or schedule a follow-up appointment.

Please note that online consultations are available for patients from other cities. We often receive requests from Zaporizhzhia, Pavlohrad, Kamenskoye (Dniprodzerzhinsk), Novomoskovsk (Samar), Kryvyi Rih, Nikopol, Marganets, Sinelnikovo, Pokrov, Zhovti Vody, and other cities.

Preparation for Admission to the Maternity Hospital

A little preparation before traveling to the maternity hospital simplifies the admission process and allows the team to focus on you and your baby more quickly. If you plan to give birth without pharmacological pain relief, it’s useful to gather the main documents and test results in advance. Discuss details with your doctor and midwife to account for individual needs and possible changes to the plan.

• Identification documents and proof of entitlement to medical care.
• Maternity record (exchange card) and prenatal care records.
• Most recent test results and ultrasound reports.
• A list of regularly taken medications and discussion of them with your doctor.
• A small set of essential items for the mother (no detailed packing lists).
• Basic items for the newborn prepared in advance.
• Items and documents for the partner, if their presence is planned.
• Contact phone numbers and a pre-planned route to the clinic.

Check with the team at your appointment for the final list and organizational details. This will help you feel calmer when being admitted to the maternity hospital.

Conditions in the maternity ward

The maternity ward is organized to ensure safe and transparent management of childbirth, including the option of childbirth without pharmacological pain relief. The team provides monitoring, necessary support, and rapid access to specialists when needed. Upon admission you will be informed about room arrangements and procedures in the delivery room and after birth.

• Delivery rooms for active management of labor and non‑pharmacological support.
• Postpartum rooms for recovery and monitoring of mother and baby.
• Rooming‑in of mother and baby in the absence of medical contraindications.
• Continuous availability of a neonatologist for newborn examination and assistance.
• Possibility of consultation with and prompt involvement of an anesthesiologist when indicated.
• Organization of partner-supported births by agreement with the clinic and according to medical indications.
• Individual accompaniment by a physician and a midwife during delivery.
• Monitoring of the condition of the mother and fetus at all stages of labor.

Please clarify room arrangements and partner presence rules at your scheduled consultation. The team will explain how the process works and what options are available in your case.

When to seek urgent medical attention

While awaiting childbirth, it’s important to recognize warning signs promptly and not delay seeking care. If you are planning to give birth without pharmacological pain relief, these signs require immediate contact with your clinic, even if they seem minor. It’s better to be checked at the maternity unit than to remain uncertain.

• Bloody or heavy vaginal discharge
• Your water has broken, especially if the fluid has an unusual odor or color
• Regular, increasingly intense contractions that start suddenly
• Severe, worsening pain that makes it impossible to move or breathe normally
• Decreased or absent fetal movements compared with your usual level
• A sudden rise in blood pressure or a strong sensation of pressure in the head
• Severe headache or sudden changes in vision
• Marked weakness, fainting, or difficulty breathing
• Fever or obvious signs of infection
• Any sudden change in how you feel that causes serious concern

If you experience any of these signs, contact your clinic immediately or go to the maternity ward. Timely care helps protect the safety of both mother and baby.

Frequently asked questions about unmedicated childbirth

Question: Can I choose unmedicated childbirth in advance?

Answer: Yes, this option can be discussed and recorded in your birth plan, but the final decision depends on the clinical situation and may be adjusted during labor.

Question: Is this type of birth suitable for everyone?

Answer: No, not for everyone — suitability depends on the condition of the mother and fetus and the course of the pregnancy; this is assessed by the doctor and midwife at consultation.

Question: Can I change the plan during labor if it becomes too difficult?

Answer: Yes, the plan can and should be changed as needed; the team will offer alternatives to ensure the safety of the mother and baby.

Question: Can I discuss the birth format with the team in advance?

Answer: Absolutely — during prenatal visits you should discuss your wishes, backup options, and the criteria for changing the approach.

Question: Can I have my partner present with this choice?

Answer: Yes, a partner can be present subject to the clinic’s policy and any medical or organizational restrictions.

Question: Is epidural anesthesia possible with this option?

Answer: Epidural anesthesia can be considered as a backup or additional option; the team, including the anesthesiologist, decides based on indications and contraindications.

Question: Who decides about pain relief during labor?

Answer: The decision is made jointly: you state your preferences, the doctor and midwife assess the situation, and the anesthesiologist is involved if necessary.

Question: What happens if the chosen pain-relief method is not suitable?

Answer: The team will offer alternatives or other pain-relief methods as indicated and will explain the reasons for changing the approach.

Question: When should I go to the hospital when labor starts?

Answer: You should go when contractions are regular and increasing, your waters have broken, there is bleeding, or you notice any worrying change in how you feel; discuss exact guidelines with your doctor in advance.

Question: What should I bring to the maternity hospital?

Answer: Bring your ID, maternity record, basic items for you and the baby, and a list of any regular medications; a detailed list should be provided by the clinic before admission.

Question: Do I need my maternity record and test results when admitted?

Answer: Yes, your maternity record and up-to-date test results greatly facilitate admission and help make faster decisions.

Question: Can I come to labor with already completed tests and ultrasounds?

Answer: Yes — bring all current examinations and ultrasound scans; this helps the clinicians evaluate the situation and confirm the birth plan.

Question: What happens if a cesarean section is needed during labor?

Answer: If necessary, the team will promptly decide in the best interests of the mother and baby and proceed with surgical delivery; possible scenarios and procedures should be discussed in advance.

Question: How long is the usual hospital stay after childbirth?

Answer: It depends on the course of labor and the condition of the mother and newborn; expected timeframes will be explained during prenatal visits and after delivery.

Question: What is done immediately after the baby is born?

Answer: A neonatologist will examine the newborn, initial assessments and any needed care are provided, skin-to-skin contact is arranged if possible, and support for initiating breastfeeding is given.

Question: What should I discuss if I’ve had previous births or a cesarean?

Answer: Describe your previous experience, any complications, and how you tolerated anesthesia or pain relief — this affects the plan and management criteria and should be covered at the consultation.

Question: How can I prepare my partner for birth with this format?

Answer: Talk with your partner about their role, the clinic’s rules and possible restrictions, and simple support techniques (breathing, helping with positions); this will help them act confidently in the delivery room.