Why Natural Birth: How Labor Hormones Benefit Both Mother & Child
Before, during, and after labor, Mom and Baby's hormones perform an intricate dance that carries them through the extraordinary performance of birth. This hormonal cascade naturally eases pain, quickens the labor process, and prepares the infant for life outside the womb. Routine interventions disrupt this rhythm leading to undesirable outcomes and a high c-section rate. In this post I'm going to demonstrate how oxytocin, beta-endorphins, and catecholamines work to support both mother and child, and briefly touch on the dangers of "harmless" hospital protocols.
Oxytocin
48-72 hours before labor, Mom releases an abundance of oxytocin. This hormone brings numerous benefits to her and her baby.
BENEFIT 1. LESS PAIN! As oxytocin increases, it stimulates the production of endorphins, the “feel good” hormone that lessens pain. Endorphins also improve mood and lower stress, helping to create a positive birth experience. Isn’t that genius? Right when the body ramps up contractions, it also provides a way to lower discomfort!
BENEFIT 2. BETTER BONDING. I think it goes without saying that the “bonding hormone” is extremely important in the development of attachment. Before labor, both Mom and Baby upregulate their oxytocin receptors, meaning that they are now better able to experience the effects of oxytocin, and their capacity for bonding is enhanced. Immediately after birth, this primal bond kicks in, and Mom and Baby are instinctively drawn towards one another. This relationship entails more than just cute baby cuddles; studies show that well-attached infants demonstrate better brain development, memories, learning, and less depression later in life. Your body knows that attentive care is what’s best for your child, so it pulls out all the stops to make it a delightful experience!
BENEFIT 3. BETTER BREASTFEEDING. The sooner breastfeeding starts, the more successful it will be. In addition to bonding, the post-birth oxytocin surge also stimulates milk production. When skin-to-skin with your newborn, your body says "time to eat!" and produces the nutrient-dense milk specifically designed for your baby. Time and time again we hear unfortunate stories of mothers who were medicated, or missed those first few hours with their little ones. Their milk production was delayed, Baby had to drink formula, and the golden learning opportunity was missed. For reasons described below, most moms do not stick with breastfeeding longer than three months. The oxytocin produced before, during, and after labor is a powerful ally in overcoming any obstacles to breastfeeding.
Beta-Endorphins
Beta-endorphins (or just "endorphins") are stimulated by Mom's production of oxytocin. This powerful hormone eases labor and helps to preserve the physical and mental health of the infant.
BENEFIT 1. "LABOR LAND". Endorphins provide Mom with a "natural anesthetic." You may have heard of the dream-like state she enters in the latter half of labor. "Labor Land", as we call it, is characterized by an altered state of consciousness that helps her manage stress and lower pain. Keep in mind that this is a primal state of deep focus and Mom may start "sleep talking", or saying things that don't add up. For example, when I entered Labor Land I repeatedly whispered to my husband "I'm sorry babe, I said that I could do it." This, of course, was an excellent sign, and our daughter was born within the hour!
BENEFIT 2. REDUCED FETAL HYPOXIA. Fetal hypoxia occurs when Baby is deprived of adequate oxygen. This can lead to learning and mental disorders, motor dysfunction, and sexual debilitation in males. But not to worry, beta-endorphins save the day! Contractions restrict oxygen from your little one, but beta-endorphins cross the placenta to safeguard the fetal brain against the negative effects of oxygen deprivation. Remember, your body wants to protect this baby, and nowhere is this more clear than in its production of such a powerful lifeline.
BENEFIT 3. BETTER LONG-TERM MENTAL HEALTH FOR BABY. Just a few laboring hours can improve your newborn's lifelong mental health! After birth, beta-endorphins prime Mom and Baby's reward centers to take pleasure in one another's company. Now that's sweet and all, but this mechanism has lifelong benefits. Preliminary studies show that staying close and indulging in this pleasurable experience may positively affect Little One's pain sensitivity and addictive tendencies later in life.
Catecholamines
You might have heard that catecholamines can stall or even stop labor, and that's true! But timed appropriately, this collection of hormones can actually assist Mom in pushing, protect Baby's heart and brain, and prepare the fetal lungs for air.
BENEFIT 1. THE FETAL EJECTION RESPONSE. As touched on above, catecholamines can hinder labor progress. If Mom is nervous or startled during labor, then her brilliant body says "better shut things down until my baby is safe." Her body then releases catecholamines to stop labor. (And in case you were wondering, this is why relaxation is so important!) Assuming, however, that the first stage was normal and calm, the body says "get to work!" when it's time to push. At this point catecholamines help labor by facilitating the Fetal Ejection Response, or "FER". This reflex directs the body to push with no conscious effort from Mom (a little like the vomiting reflex, but less nasty). Women often complain of perineal tears, long pushing times, or worse - the FER is the body's way of protecting you from these unwanted complications, and well-timed catecholamines help make it happen!
BENEFIT 2. PROTECTION FOR BABY AND PREPARATION FOR BREATHING. A few days before labor, Baby will upregulate his epinephrine-norepinephrine (two hormones within the "catecholamines" group) receptors, making him more receptive to these hormones. Why is this important? When Mom is nearing the second stage of labor, she has a huge uptick in catecholamines. Because Baby is now so sensitive to these hormones, the catecholamines can then be used to preserve blood flow to the heart and brain, protecting them from fetal hypoxia. Catecholamines also prepare the baby for air-breathing by clearing his lungs of fluid. And lastly, they promote alertness for the initiation of breastfeeding. This hormonal grouping is responsible for a lot!
"Harmless" Interventions
Isn't this amazing?! Your body knows exactly what to do for the safekeeping of you and your little one. So what's the issue? "Harmless" interventions such as the induction, epidural, and Pitocin deprive Mom and Baby of these life-changing benefits.
Let's start with induction. Right around 40 weeks, most OBs start tapping their impatient feet. Threats of a stillbirth are effectively used to pressure women into inductions that they neither want nor need. But what about all the hormonal goodies the body provides just before labor? Gone. Every. Single. One.
Baby misses the catecholamine boost designed to protect her from hypoxia. She will gasp for air with each contraction and, if her heart rate falters, will require a cesarean delivery. In fact, the second most cited reason for operating is the non-reassuring fetal heart rate that comes with oxygen deprivation. Furthermore, 66% of c-sections start with the induction of an otherwise healthy pregnancy.
But the downsides don't stop with Baby. Mom will not enjoy the analgesic (pain-reducing) benefits brought about by oxytocin. Furthermore, Pitocin contractions are notoriously intense, and can even contract the uterus so hard that it bursts. Fortunately uterine rupture is rare and most Moms opt for an epidural before that point. This popular pain med, however, does more harm than good. Epidural analgesia hinders the production of beta-endorphins, depriving both mother and child of numerous advantages. Mom flies right over "Labor Land" and Baby is deprived of yet another buffer against fetal hypoxia. In fact, 34% of fetal heart rates falter within 30 minutes of epidural administration, putting these babies at great risk for numerous disorders. While some heart rates climb back up, over 30% continue to fluctuate, necessitating an emergency c-section as mentioned above. Furthermore, without the in-labor endorphin surge, the mother-baby bond is watered down, putting the newborn's long term mental health at a disadvantage.
With so many drawbacks, it's reasonable to ask why healthcare professionals would continuously push these drugs on low-risk patients. Unfortunately the 21st century hospital system follows the fear-based model which, above all, seeks to prevent lawsuits. One bad experience leads to a trial which leads to detrimental policies like mandatory inductions. And while most interventions are not life-threatening, they do deprive families of the life-changing benefits of an undisturbed physiological birth. My own sister, a nurse in the Houston area, complains that "all these protocols stop me from actually caring for people." It's tragic that well-meaning men and women should enter the healthcare field only to have their altruistic goals thwarted by red tape. While I don't pretend to have a solution to this greater problem, I do have a suggestion for parents: trust your body, trust your baby, and trust your primal wisdom to guide you and your little one through the miracle of birth.
SOURCES
"Executive summary of hormonal physiology of childbearing: Evidence and implications for women, babies, and maternity care." Journal of Perinatal Education. 24(3), 145-153. (Buckley. 2015.)
"Midwife-led continuity models versus other models of care for childbearing women." Cochrane Library. (Sandall, Soltani, Gates, Shennan, Devane. 2016).
https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-25528#:~:text=Abnormal%20fetal%20heart%20rate%20tracing%20or%20suspected%20fetal%20distress%20with,6%2C7%2C8%5D
http://www.journaldmims.com/article.asp?issn=0974-3901;year=2020;volume=15;issue=3;spage=382;epage=386;aulast=Shekhawat
