6 tips to increase your chances of a drug-free delivery

More expectant mums are choosing to deliver without meds or painkillers. Here’s what you should know about drug-free birthing.


On discovering that she was pregnant with her fourth child, Calyn Lee, 37, decided to deliver without pain relief like an epidural.

Says the marketing manager, “I had a nasty epidural experience when giving birth to my older children. The epidural made the labour process very uncomfortable when the numbness and side-effects kicked in and I could not feel my legs or what I was pushing. I suffered post-epidural effects like vomiting and shivering for the other two labours.”

Though her husband and doctor were not keen on her decision to deliver without drugs, Lee had the final say. While it was an extremely painful, she says it was worth the effort.

“My overall mood was better and I recovered much faster — I could move around almost immediately after giving birth. There was no numbness in my legs or body, no nausea or shivering to deal with and no need for a catheter as I could go to the toilet!”

Delivering without meds

Like Lee, an increasing number of expectant mums are choosing a drug-free labour with minimal medical intervention.

“With more awareness and education via the Internet, more women are empowered and reminded of their ability to birth naturally.”

Notes chief doula Ginny Phang, owner of maternity care provider Four Trimesters, “With more awareness and education via the Internet, more women are empowered and reminded of their ability to birth naturally. It is an innate desire that most women have.”

Adds Dr Tan Toh Lick, a consultant obstetrician and gynaecologist at Thomson Women’s Clinic (Jurong East), “Medication is not restricted to pain relief, but includes medication to start or augment labour, to reduce the risk of infecting the newborn, and reduce blood loss.”

He says that some women want to experience childbirth as a natural process, while others perceive the use of medication as needing help in childbirth. “While natural birth can be attained in many instances, there are occasions where help can bring about a better outcome.”

In developed countries with accessible healthcare, he points out, the lifetime risk of maternal death is 1 in 4,900. In developing countries with scarce medication, this risk is almost 33 times higher, at 1 in 150.

Birthing methods that encourage drug-free birthing

Dr Tan details the following alternative non-drug interventions:

Induction of labour It’s considered normal term when you deliver from 37 to 42 weeks of pregnancy. As births beyond this time carry a heightened risk of death for the baby, you’ll be advised to induce labour. In Singapore, the hormone prostaglandins is the most common form of induction of labour. For women who wish to avoid drugs, a mechanical method using cervical ripening balloon is offered. If the mum-to-be declines to have labour induced, the pregnancy will need to be closely monitored. For women who are aiming for a drug-free birth, the doctor can perform membrane sweeping at term to promote labour, so as to avoid formal induction of labour.

Augmentation of labour Sometimes, uterine contractions aren’t successful enough to open the neck of the womb for a vaginal delivery. Interventions, such as breaking the waters (artificial rupture of membrane) and an oxytocin infusion may be employed to increase the frequency and intensity of the contractions.