The operative word here is cope. It is important to understand the distinction between coping and suffering. When someone is no longer coping in labor, a change needs to be made. That change can often include the decision to utilize medication or an epidural. I think it is a great goal to picture yourself moving through labor on your own steam; I also think it is unrealistic and unnecessary to be rigid as you anticipate labor. Remaining open and flexible to make decisions along the way gives you room to choose as your needs become known during labor.

Don't be afraid to be vocal. The human response to pain is noisy. McMoyler Method utilizes productive sounds and moaning – either soft and chest-centered, or deep and guttural. Think about it: They call it labor for a reason! This is not a tea party; this is a gritty, primitive day out of your life. When you have the picture of yourself digging in and getting the job done, responding to the pain forcefully, moving it up and out – it helps you cope with the peak of the contraction, which can feel like a knife going in and turning. Not a pretty picture, but true.

The rhythm becomes: deep breath, as you feel the contraction beginning, slow breathing as the contraction builds; moaning through the peak where it is the toughest, and breathing slowly as the contraction subsides.

Remember to rest. In between contractions, women in labor must be reminded and encouraged to release and let go, to utilize the break. This time is essential for building up energy to ride the next contraction. Labor is not a tsunami that knocks you flat in one big wave; the contraction comes, builds, peaks, and subsides and goes away for 3, 5, 15 minutes, depending on what point of labor you are in. The importance of the rest in between contractions must be included in the "coping with labor" picture. This is when partners can really move in and make a big difference with touching, holding, massaging, hydrating, and giving words of encouragement and reassurance.

Know what to expect from labor meds. Labor medications are often overrated, giving the impression that they will provide complete pain relief or send a woman floating on a billowy cloud. Neither one is really true. The medications used for pain relief in labor are fast-acting but short-lasting drugs that are just meant to take the edge off the peak of a contraction. Some women respond by being able to release and let go in between contractions and simply be able to cope more efficiently through the contraction, or nod off in between them. Others report feeling no relief at all and opt to move straight to an epidural. (If a woman is in line waiting for her turn to receive an epidural, a dose of medication may assist her ability to wait, knowing that relief is on the way.)

Understand the epidural. Epidurals often get a bad rap – they get blamed for the inability to push or for slowing labor down or creating back pain. By and large, a labor epidural is a viable option to replace pain with a sense of pressure. I agree that it is an intervention, and the decision to have one needs to be made carefully. McMoyler Method also recommends that women make as much progress in labor as possible before choosing an epidural. Once epiduralized, you'll be in bed for the duration and will often end up being "wired for sound." (Simply meaning that a cascade of interventions will begin to unfold.) People are surprised to learn that there are many other tubes, wires, and assorted medical apparatus involved with an epidural. Also, often not included in discussing epidurals at large: they can be the mechanism that assists someone in achieving a vaginal birth! When the body can be pain-free, in a total state of relaxation, void of the tension created by pain, the uterus can then really do its job. I would not choose an epidural lightly; however, if a labor is marching on hour after hour and progress is not being made, OR if someone is not coping and is now suffering – an epidural may be a very appropriate choice.

AUTHOR BIO: Sarah McMoyler, RN, BSN and mother, is the founder of McMoyler Method. As a specialist in Labor and Delivery of more than 5,000 babies, her personal view and in-depth professional experience has been integral to McMoyler Method's success in graduating over 10,000 San Francisco Bay Area couples to confidently approach pregnancy, prepare for delivery, and care for their newborn babies. She has released The Best Birth DVD, as well as the book The Best Birth: Your Guide to the Safest, Healthiest, Most Satisfying Labor and Delivery.