Hormones in Labour and Birth
“Undisturbed birth…..is the balance and involvement of an exquisitely complex and finely tuned orchestra of hormones” (Buckley, 2004a)
As you go into labour you begin to release hormones, all necessary and all there for very specific reasons. Your body can respond to these hormones more effectively in certain situations and environments, it can also create more of some to override the others depending on your emotional and mental state. So lets have a look at what hormones we need, why and how we can maximise them to create a positive birth experience.
Oxytocin
Oxytocin, also known as the love hormone is produced when we are happy, safe and feel loved. It is released when we orgasm, when we are in labour and when we are feeding our babies, it is associated with the 3 B’s - Birth, bonding and breastfeeding.
When we’re pregnant the receptors that respond to oxytocin increase in preparation for labour and birth. When our baby’s head pushes on the cervix it sends a message to our brain and oxytocin is released to help stimulate contractions, if you are continuously disturbed during labour e.g. to check your blood pressure or monitor the baby’s heart rate, or you feel unsafe your oxytocin levels will drop. This can lead to your labour slowing down, which in turn can result in interventions being used to help you progress. However there are ways to naturally increase the flow of oxytocin, such as avoiding some pain relief medication like epidural, active labour positions (staying upright using a birth ball, walking,squatting etc, this will allow gravity to help bring your baby down and press on your cervix), nipple stimulation, for example hand expressing during early labour and creating a safe dimly lit ‘nest’ like space to help make you feel safe and protected.
Oxytocin is also associated with the ‘positive feedback loop’
Endorphins
Endorphins are known as the body's natural painkiller they are released when we are stressed and/or in pain to calm us and relieve the pain we’re in, but they can be impeded by the use of medical pain relief such as epidural or other opiates. Endorphins are a powerful tool while we are in labour and giving birth, our endorphin levels rise during pregnancy and in labour and can create a euphoric feeling if they are not interrupted. Endorphins can make us feel alert, attentive and happy after birth, strengthening the birther-baby bond.
If our endorphin levels drop our pain can increase dramatically, causing us to feel like we can no longer cope. If this happens interventions are more likely to take place.
Prolactin
Prolactin plays a big role in reproduction and creating milk, it helps adapt a person’s physiology ready for pregnancy and feeding, it is called the ‘caregiving’ hormone, due to its place in promoting bonding between the birthing person and baby post birth. Prolactin reduces during the early stages of labour, then peaks dramatically towards the end, stimulating the release of Oxytocin, triggering more intense contractions. Medical interventions during labour and birth may impact the release of Prolactin, which can cause problems when trying to initiate breast/chestfeeding and hamper the birther\baby bond. We can try and maintain our prolactin levels by having a spontaneous, undisturbed birth and keeping the birthing person and their baby close immediately after birth and in the initial postnatal period.
Adrenaline
Adrenaline triggers our fight or flight response, it sends our body and brain into survival mode and is released when we are anxious, fearful or in pain. Adrenaline is a powerful hormone in labour and can help or hinder the process hugely. Adrenaline is important during the end of the 2nd stage of labour, we have a spike when we go through transition which gives us a boost of energy to be able to cope with the pushing stage. The surge of Adrenaline also increases the release of Prostaglandins and Cortisol which in turn increases the use amount of Oxytocin, and so the cycle continues to help us birth our baby. The normal elevation of Adrenaline also helps baby adjust to the outside world immediately after birth by increasing the blood flow to their heart and brain, helping to regulate their temperature and breathing, it also makes them more alert which aids in establishing feeding.
If we release too much Adrenaline during labour however, it can have a negative impact by increasing pain, making us feel overwhelmed and stalling or even stopping contractions, and cause the baby to become distressed. This can all lead to interventions including cesarean birth.
Conclusion
As we can see, the hormones we need to be able to bring our baby’s into the world are complicated and intricate, they are intrinsically linked and if one is not allowed to work its magic the others are affected as well. Although sometimes necessary, medical interventions can have a detrimental impact on how our body responds to these hormones and how well we are able to birth our babies. Letting our natural instincts take over and promoting an optimal birthing environment can help our hormones flow unhindered and help us form bonds as a family unit with greater ease and less stress.
August 2020
References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4720867/
