November 17, 2014

Undisturbed Birth

Several weeks ago, I attended an all day birth lecture with Australian doctor, Sarah Buckley. Dr Buckley, a trained medical professional, author of Gentle Birth, Gentle Mothering, mother of 4 and well respected birth advocate, presented a fascinating lecture called, “Undisturbed Birth: The Science and the Wisdom.” Throughout the lecture, I found myself frantically scribbling down notes, trying to capture all the inspiring information I could. While nothing she said was necessarily revolutionary, she made everything seem so obvious. I am mystified that her logical connections and science are not embraced by most of the medical birthing community.

Dr. Buckley spent the first several hours intricately discussing the individual hormones of labor and the role they play in creating the delicate balance for a functional birth. This basic chemistry forms the “hormonal blueprint of labor.” When this blueprint is disturbed, labor will not progress normally, and intervention is often needed.

Oxytocin

Oxytocin is made in the hypothalamus, deep in our brains, and stored in the posterior pituitary, the master gland, from where it is released in pulses. Oxytocin, also referred to as “hormone of love” is the hormone released during pregnancy, labor, orgasm and breastfeeding. It’s also responsible for triggering feelings of love and nurturing.

During labor, oxytocin plays a vital role. The oxytocin levels peak, and the secretion of this hormone helps regulate the rhythmic contractions of the uterus. It is the contractions of the uterus that help move the baby down, putting pressure on the cervix and allowing it to dilate. Without the strong presence of oxytocin, labor will halt and pitocin (artificial oxytocin) will need to be introduced.

Beta-Endorphins

Like oxytocin, beta-endorphin is secreted from the pituitary gland, and high levels are present during sex, pregnancy, birth, and breastfeeding. Beta-endorphin is also a stress hormone, released under conditions of duress and pain. During pain, it acts as an analgesic, and like other stress hormones, it suppresses the immune system. High levels of endorphins during labor and birth act a lot like morphine or a similar drug, allowing a woman in labor to enter an altered state of consciousness. This naturally occurring altered state will help her cope with the birth process, provided she is undisturbed.

Adrenaline

Adrenaline, also known as the “fight or flight” hormone, is secreted from the adrenal gland (above the kidney) in response to stresses such as fright, anxiety, hunger, cold, as well as excitement, and activate the sympathetic nervous system. For the majority of labor, we want to keep the sympathetic nervous system at bay since the presence of adrenaline diminishes the functionality of oxytocin. However, adrenaline does have it’s place in labor. At the final stages of labor, high levels of adrenaline activate the fetal ejection reflex. It makes the laboring mom very strong, alert and determined, ready for the final pushes to birth her child.

As I mentioned before, in order for labor to function properly, the birth hormones need to work in concert with one another. For that to happen, a woman needs to feel private, safe and unobserved. So what does that mean? For your body to be in the “rest and relax” state, and oxytocin to produce at it’s optimal ability, there can not be any threat, judgement or pressure presence. “Dutch biologist Naaktgeboren summarizes, “In all mammalian species, the course of delivery can be influenced by environmental…Anxiety and freight inevitability lead to prolongation of the duration of labor…For many animals, the mere presence of an observer acts as a stress-stimulus.”(1) As much as we may not want to admit it, we are animals. Many women find that when they are laboring at home, where they feel safe and comfortable with surroundings and birth attendants, labor can often progress nicely. But the same woman that presents a strong laboring pattern at home may find that her contractions have spaced out, or even stopped, upon entering the busy, noisy, bright hospital.

Since only about 1% of women birth at home, we need make a hospital experience more conducive for the birthing mother. Dr. Buckley presented these 3 ideas to help preserve the mother’s birthing space and proper hormonal balance and create an undisturbed birth.

Avoid environmental disturbances = Feel Private!
Avoid anxiety and fright= Feel Safe!
Avoid presence of observers = Feel Unobserved!

Tips for achieving the feeling of PRIVATE, SAFE AND UNOBSERVED!

-Make the hospital room as cozy as possible! Turn the lights off or down. Play music that mama likes. Hang pictures that are inspiring or comforting. Turn the sound down, or off, on the Fetal Monitors.

-Crowd control! Those who are not necessary to the birthing team should not be talking to the mother or in her space. If someone has to come, ask them to be quiet and discreet.

-Have a supportive, well planned birth team. International birth activist, Jeannine Parvati Baker says, “It’s going to be hard for the woman to give birth unless everyone in the birth room has confidence and faith in the birth.”

-Talk to your care provider about hospital timetables and protocols ahead of time. Many hospitals have set time limits on how long you can labor before intervention is introduced or how long you can push. See if there is wiggle room around this so the mother does not have anxiety about the pressure of the clock.

-Unrestricted movement- not feeling trapped! If possible, try to have intermittent monitoring which will allow for more freedom of movement. If the mother needs to be on full time fetal monitoring, get her off the bed and create space for her to move within the parameters of the fetal monitor’s wires.

I hope these concepts introduced by Dr. Sarah Buckley can help shape a beautiful birth experience for you. Happy birthing!

Sources
1. Essential Midwifery Practice: Intrapartum Care by Denis Walsh and Soo Downe
http://www.cdc.gov/nchs/data/databriefs/db84.pdf

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