I chose to go to a hospital and to have an obstetrician deliver my babies because I was up in age and didn't want to take any chances.

Some folks recommend that the woman massage down below the birth area, to make the skin more supple and perhaps easier to stretch. I had to have an episiotomy (sp?), where the doc cuts down there to make more room for the baby to get out. Still, he barely squeezed through, since I am a small person. And he was only a bit over 5 pounds (born a month early).

I was able to get through with just a local where the doctor cut me. Otherwise, no drugs. It helped a lot when my husband rubbed my back. Some ladies might like something to press on in their hands. I also had some ice popsicles to eat while in labor. And I asked for an IV, since I tend to get weak after a long while without food.

My second child was a big guy--over 7 lbs at a month early, with a big head! So, not surprisingly, I had to have a c-section. But that was fine. It isn't anything to be ashamed about. It's generally done for the safety of the baby and/or mother.

Hope some of this stuff will be useful!