Natural Childbirth

Dick-Read and the English-language origins

A historical analysis published in 1979 in Psychosomatic Medicine traces contemporary childbirth preparation methods to diverse and complex origins. It credits the English obstetrician Grantly Dick-Read, whose books Natural Childbirth (1933) and Childbirth Without Fear (1944) it cites, with the most substantive contributions, and notes that many training manuals present their content as the Lamaze method.

A 2017 article in the British Journal for the History of Science describes Dick-Read as a controversial physician who gained international fame with bestselling books arguing that relaxation and education, not drugs, were the keys to freeing women from pain in childbirth. It examines a film he made in South Africa around 1950, which it says taught his method to doctors and to the first generation of Western women to voice dissatisfaction with heavily drugged, hospitalized maternity care.

Psychoprophylaxis from the Soviet Union

The 1979 analysis reports that a comparison of Fernand Lamaze's 1958 text with its Soviet source, a 1960 volume on painless childbirth through psychoprophylaxis, showed that he deleted and modified substantial portions of the regimen. It adds that none of these authors presented data allowing cause-and-effect conclusions about treatment and outcome.

A 2016 history in Medical History states that the psychoprophylactic method originated in the USSR and became known in Western English-speaking countries as the Lamaze method. In socialist Czechoslovakia it was imported in the early 1950s, spread in practice in the 1960s, declined in the 1970s and was revived in the 1980s by a few enthusiasts, most of them women. The author notes that in the USSR it ceased to be pursued as a scientific method in the 1950s.

The home birth movement of the 1970s

A 2015 essay in the Bulletin of the History of Medicine analyzes three influential home birth texts of the 1970s written by self-described lay midwives, among them Raven Lang's The Birth Book and Ina May Gaskin's Spiritual Midwifery. It presents them as part of countercultural print culture that helped sustain a movement in alternative birth practices, and reports that Rahima Baldwin's Special Delivery later aimed at a wider audience.

What the sources reviewed do not cover

PubMed lists a 1985 piece in The Lancet titled Appropriate technology for birth, indexed with the World Health Organization, but the record carries no abstract, so its recommendations are not summarized here. The sources reviewed also do not cover Sheila Kitzinger's work, the founding of the Bradley Method, or the later history of the term physiological birth in midwifery.

How the word natural is used

In the historical literature reviewed, natural childbirth names an approach associated with Dick-Read that argued for relaxation and education rather than drugs. The term has since been applied more loosely, and the sources reviewed do not offer a single agreed definition of natural childbirth or a regulated meaning for it.

Physiological and normal birth

A 2018 midwifery study in Minnesota defined physiologic birth for its own purposes as term pregnancy, spontaneous labor, no epidural analgesia and vaginal birth. Under that definition 17 of its 38 participants had a physiologic birth, so the term there describes a mode and course of birth rather than a method of preparation.

A 2025 Australian qualitative study with ten participants states that physiological birth as a term lacks consistency and that the World Health Organization definition from 1997 does not consider the viewpoint of women. Participants agreed that spontaneous onset and vaginal birth belong in a consensus statement, found the word intervention amorphous, and considered physiological birth not to be a woman's term.

Debate over the word natural

None of the sources reviewed directly tests the argument that the word natural can stigmatize women who use pain medication or other interventions. NICE guideline NG235 addresses a related point of practice: it tells professionals to consider how their own values and beliefs shape their attitude to coping with pain in labour and to ensure care supports the woman's choice.

A 2026 French interview study of 14 women who initially wanted a physiological birth, defined there as birth without epidural analgesia, described the decision about an epidural as a process that changed during labor, shaped by motivation, fear, earlier birth experiences, preparation, pain management strategies and perceived support.

Preparation, settings and techniques in general terms

Sources describe natural childbirth in general terms as combining antenatal education, breathing and relaxation techniques, companions and a choice of birth setting. NICE guideline NG235 states that women may choose a home, a freestanding midwifery unit, an alongside midwifery unit or an obstetric unit, and that if a woman chooses breathing and relaxation techniques, or massage taught to birth companions, staff should support that choice.

Machipedia's Lamaze Method, Bradley Method, Hypnobirthing, Water Birth, Doula, Midwifery and Childbirth Preparation pages cover specific approaches in more detail. This page is a member of the Birth Support family page, which covers the wider range of support during pregnancy and birth.

How women describe preparing

In the Minnesota study, 38 women took part in focus groups and 14 of the 17 who had a physiologic birth were interviewed. Themes included confidence in the face of uncertainty, belief in the normalcy of birth and the body's ability to birth, researching on their own, and a supportive partnership with their care providers.

Reasons given by proponents

Dick-Read, Lamaze and the Soviet authors held theories about pain, anxiety and fear reduction, according to the 1979 historical analysis, which found that none of them showed interest in empirically validating those theories. The 2017 history describes Dick-Read as arguing that relaxation and education could free women from pain in childbirth, and 1970s home birth authors are described as reshaping expectations about the birth experience.

Reasons given by women

A Cochrane review of relaxation techniques states that many women would like to avoid pharmacological or invasive methods of pain management in labour. The French interview study reports a desire for a more intimate and active birth experience as a positive motivation among women who wanted a physiological birth.

Continuous labor support

A 2017 Cochrane review of continuous one-to-one support during labor included 27 trials, 26 of which contributed data on 15,858 women. Compared with usual care, support was associated with more spontaneous vaginal birth (average RR 1.08), less use of any intrapartum analgesia (RR 0.90), fewer cesarean births (RR 0.75) and fewer negative ratings of the birth experience (RR 0.69). The authors rated much of the evidence as low quality, noted that no study blinded women and personnel, and reported no evidence of harm.

Relaxation, yoga and music

A 2018 Cochrane review of relaxation techniques for labor pain included 19 studies with 2,519 women, of which 15 contributed data. Evidence quality ranged from low to very low. Relaxation lowered pain intensity in the latent phase in one trial of 40 women but showed no clear difference in the active phase, and satisfaction with the childbirth experience was not clearly different. One trial of 66 women found lower pain with yoga. The review noted that most trials did not report safety.

Water immersion

A 2018 Cochrane review of water immersion during labor and birth included 15 trials with 3,663 women at low risk of complications, all in hospital labor wards. Immersion in the first stage probably made little or no difference to spontaneous vaginal birth (82% versus 83%) and was associated with a small reduction in regional analgesia use (43% versus 39%). The authors found no evidence of increased adverse effects, but noted that no trial was conducted in a midwifery-led setting.

Antenatal education

A 2015 systematic review of antenatal education in small groups in Western countries included 17 studies. It found that the content of intervention and control conditions varied greatly, that studies had a high risk of bias, and that the authors could not draw definitive conclusions about obstetric and psychosocial outcomes.

No trial of the approach as a whole

The sources reviewed do not include a randomized trial or systematic review of natural childbirth as a complete package. PubMed searches run for this page on unmedicated childbirth, satisfaction and epidural comparisons, and on terminology and stigma, returned no matching records. Findings for individual components, such as support or immersion, are not evidence about the whole approach.

Place of birth and transfer of care

NICE guideline NG235 advises low-risk multiparous women that planning birth at home or in a midwifery-led unit is associated with a lower rate of interventions and no difference in outcome for the baby compared with an obstetric unit. For low-risk first-time mothers, it says a midwifery-led unit shows the same pattern but that planning birth at home carries a small increase in the risk of an adverse outcome for the baby.

The guideline also lists medical conditions and other factors that call for individual assessment when planning place of birth, and asks staff to explain the likelihood of transfer to an obstetric unit and the delay in obstetric or neonatal care that transfer may cause.

Pain relief options as bodies describe them

NICE guideline NG235 states that breathing exercises, a shower or bath and massage may reduce pain in the latent first stage, and that women should be offered the chance to labor in water. It states that opioids are available in all birth settings and give limited pain relief, with significant side effects possible for both the woman and the baby, and that remifentanil patient-controlled analgesia is to be used only in obstetric units.

For hypnosis, acupuncture and acupressure, the guideline says not to offer them during labor but to support a woman's choice to use them. For transcutaneous electrical nerve stimulation it states there is very little evidence of effectiveness in established labor and no evidence of harm.

Care boundaries

The World Health Organization's 2018 guideline on intrapartum care frames essential care as a woman-centered, rights-based package to be delivered in any setting. The sources reviewed do not support delaying or declining medical care when complications arise, and this page gives no medical advice. Decisions about pain relief, place of birth and monitoring belong with a woman and her maternity care team.