After reading Leo's birth story, some might wonder why a woman would choose to give birth without drugs. I cannot speak for all women, but I can give my personal reasons.
I should start by saying I'm allergic to -caine drugs, the most common local anesthesia, and so an epidural has never been an option for me. Even if that weren't the case, my low blood pressure would possibly make the epidural unwise, since it can further lower blood pressure. My fast labours also make it a non-option for me, as it can't be placed until a woman is dilated 4cm, and when I reach that stage, I'm in transition and soon to give birth. But even if those things weren't true, I wouldn't want the epidural. In the majority of cases, it confines the woman to bed, instead of allowing freedom of movement. I know for me being confined to bed isn't ideal. It also necessitates an IV and continuous monitoring, further limiting mobility. While few studies have compared those who receive epidural a with those who go natural, there are indications that the epidural may negatively impact early breastfeeding, which means it also affects overall breastfeeding success. Breastfeeding is extremely important to me, so I don't want to jeopardize that. It also increases chances of instrumental delivery.
Ok, so the epidural is out, but what about opioids that are either injected or placed in an IV? For one, it can lead to a similar problem with early breastfeeding, since it can make the newborn tired at birth. I know from experience that such drugs are highly effective with surgical pain, but the pain of labour is not at all like surgical pain, not even during the raw, primal pain of transition. But I also know from experience that receiving those drugs in labour didn't lead to decreased pain. An outside observer wouldn't realise that, though, as it gives the appearance of decreased pain and of being calmer; in reality, I was simply unable to respond to the pain, while still acutely feeling everything. My friends who had opioids in labour have reported the same feeling. It's anecdotal, I know, but it's enough for me to decline such drugs in labour again.
Then there are things like gas and air (sadly not widely available in the US). I personally didn't like it in labour, as it made me feel nauseated (I take pain over nausea), which is a common side effect. I say "sadly" in regards to its being unavailable, though, because any effects are short-lived and it doesn't adversely affect the baby, to my knowledge. I did like having it for getting stitched up after birthing Kieran, though. Thankfully I've not required stitches after the others.
My main reasons for going natural? The ability to move as I wish and the absolute euphoria after birth. The birth isn't a haze, but is something I experience completely, not just feeling the pain but the endorphins. Baby and I are both alert after, so the baby can breastfeed immediately before we both sleep. It's an amazing thing. I will say, though, that it doesn't just happen. But how to accomplish it is another post.