Vaginal home birth: always unmedicated?
You can not have an epidural at home. An epidural requires an anesthesiologist or nurse anesthetist to administer and monitor. with an epidural you are also at risk for a number of complications which may require immediate medical attention.
Systemic pain medications usually can not be done at home. Many pain medication given during labor require consistent monitoring and may cause side effects in the baby. Systemic medications are given via IV or injection. Some midwives will give some forms of systemic pain medications, it depends on the midwife, the equipment they have and state laws. Usually midwives don't give pain medication.
If you are planning a home birth it is key to be prepared for the pain and know natural coping techniques. Make sure that you understand all the benefits and risks of a home birth. Consider hiring a doula to attend your birth as well and provide you with personalized one on one support.