If I ask you which part of your body is the most important part for childbirth what would you say? Your uterus? Maybe your vagina? Those are pretty standard responses, but what if I asked you to think outside the box. What about your hormones. Would you think of them?
What if I told you that your uterus and your vagina are merely passengers, and your hormones are what drives birth?
They didn’t mention THAT in the hospital antenatal classes did they!
There’s a reason for that. Our culture ascribes to the “birth as a physical event” belief system. Which ties in nicely with the “birth as a medical event” belief too. And it’s true that birth is a physical event, but it is controlled by hormones. What birth is not, is a medical event. Birth is a normal physiological act for all animals, including humans.
So the average woman on the street thinks it’s her uterus that does all the birthy things, but have you ever noticed how hospitals induce labour? They use the synthetic version of the hormone oxytocin. The pharmaceutical version of oxytocin is called syntocinon, or pitocin and most of us have heard of that somewhere along the way.
Oxytocin plays many roles in birth. It controls uterine contractions which dilate the cervix, it helps the woman feel calm, it helps control bleeding (once again by controlling uterine contractions) and it helps promote powerful bonding after the baby has been born. Oxytocin is the hormone of love, it’s what gives you that warm fuzzy feeling of contentment after you have an orgasm.
Oxytocin is just one of the hormones that’s at play in birth though. There is also beta-endorphin, which helps with pain management, or as some people like to say “it helps women to ride the birthing waves”. However you like to say it, beta-endorphin plays a crucial supporting role in labour and birth. Beta-endorphin is the natural equivalent of pethidine.
There’s also adrenalin, which is the hormone of fight or flight. Adrenalin is where we get into trouble in modern birth. When adrenalin is released by a labouring mother, it stops the release of oxytocin. This was a primal safety feature of birth, it allowed labour to stop so the mother could escape danger.
Have you ever been in a time machine? Well you’re about to! Fasten your seatbelts, set the dial for 15,000BC
This is what you see: A woman is labouring along nicely. She’s in a warm, dark cave. But OH NO!!! a saber tooth cat is creeping in, looking for some prehistoric fast food. A quick burst of adrenalin stops the woman’s contractions. She clubs the cat over the head (boy is she awesome under pressure!?) and it staggers away. Not too long after that her adrenalin settles down, the oxytocin comes back, and a new caveling person is born.
See how useful that adrenalin is? Adrenalin is also the hormone that wakes women up from their labour-land state when the time comes to push, so as we can see, it plays a really important role.
“How does adrenalin cause problems for modern women?” I hear you ask. Let’s come back to the present day now. No helmets necessary for this trip.
In order for a woman’s uterus to contract and for labour to progress safely, there are certain conditions we need. Think about how an animal might give birth, and how her owners, or a vet, might attend the birth. The main goal of a pet owner or a vet witnessing birth is to avoid disturbing the mother. Cat owners go to great lengths to make an expectant mother cat feel safe and private. We have known for aeons, that disturbing a labouring mother cat can be fatal to the mother or kittens.
Providing a mother cat with a warm, dark, private environment, enables her kitty-cat brain to release all the right hormones. Disrupting her, disrupts the hormones. It’s a giant no-no.
Now take a moment to remind yourself that humans are mammals, just like our pet cats. Remember your journey back in time?
Give some thought to the ways we treat modern day labouring women.
They are rushed and bustled out of their warm, private homes, into cold nights and fast moving vehicles. They’re taken to unfamiliar surroundings with bright fluorescent lighting. Lots of people talk to them and touch them all over their bodies. People stick sharp things in them. They are given uncomfortable, undignified hospital gowns to wear, gowns that leave you feeling exposed and vulnerable. It’s the complete and absolute opposite of what we do for cats. It’s the complete opposite of what our prehistoric sisters sought for themselves.
Why do we treat women like this? Because we believe it is the only safe way for women to give birth.
Why do we believe that that? Because we believe that birth is a physical event.
Birth may well be an event that occurs to our physical bodies, but the driving force of birth, the force that controls it all, is our hormones. Women often talk about how their labour slowed or stopped completely once they arrived in hospital. Well, now you know why don’t you!
The hormones that control birth require certain conditions. They’re often referred to as being shy, because they are only released if everything is just right.
What are those conditions?
- Warm / or comfortable temperature
- Darkened / or private
- Quiet / without constant interruptions
To our brains, which are identical the brains we had 17,000 years ago, the hospital is like a saber tooth cat. It’s unpredictable and it disturbs us. Even though we might believe it to be safest, our brains read things differently. Lights, bustle, strangers sharp things? The modern day version of a saber tooth cat. Hormones don’t like hospitals anymore than they liked saber tooth cats.
So what happens to a woman who arrives in hospital and her labour stops? Does the hospital say “Here’s a beanbag and a warm drink. Get comfy, things will pick up soon” or do they start a drip of synthetic hormones to kick things into gear. In the vast and overwhelming majority of cases it’s the latter.
“What could be wrong with that?” you might ask. “It’s just a synthetic version of oxytocin, and you keep telling us how important the hormones are!?”
Actually there are a huge number of things wrong with the synthetic version of oxytocin. To give you some idea of just how different they are you might like to imagine the similarities between hot pink, liquid strawberry flavouring, and a fresh, ripe, juicy strawberry. Basically there’s no comparison.
Oxytocin, the real deal, effectively dilates the cervix, and in harmony with the other hormones, works to jolly the mother along. Syntocinon, or pitocin, creates far stronger contractions, and yet they are less efficient at dilating the cervix.
Synthetic oxytocin – pitocin / syntocinon – also blocks the other hormones from being produced. Yes, that’s right. It creates really intense, but inefficient contractions, and blocks the release of the hormones that keep you comfortable during labour.
Syntocinon creates such powerful contractions that the woman feels unable to manage the intensity. “To hell with this natural birth plan, GET ME A *swearwordswearword* EPIDURAL NOW!” she bellows. And who can blame her!
Remember she has no natural hormonal support. The epidural causes the contractions to slow. The doctor orders the nurse to increase the syntocinon. This increases the intensity of the uterine contractions to such a degree that the placenta is compressed, and baby’s oxygen supply is cut short. Soon the baby is distressed, and an emergency caesarean is called.
This process is well known as The Cascade of Interventions. It doesn’t always end in a caesarean. Sometimes it ends with an exhausted mother and an assisted delivery, otherwise known as a forceps or ventouse birth.
But just because the baby has emerged, doesn’t mean the danger is over. After many hours of exposure to the synthetic hormones, the uterus may be unable to clamp down and expel the placenta, and this results in a PPH, or Post Partum Haemorrhage.
How do hospitals manage a PPH? With a quick shot of syntocinon.
Without the release of the natural oxytocin bonding with a new baby is not as natural. Women frequently discuss feelings of guilt, in birth trauma groups, because they didn’t experience the rush of love they expected upon meeting their baby. But it isn’t that the woman is inadequate, or that she doesn’t love her baby, it’s that the “rush of love” is actually a “rush of hormones”.
What is greater, the risk of induction, or the risk of remaining pregnant?
Here’s some questions to ask your provider if they recommend an induction or augmentation. It’s a really good idea to google everything twice before discussing it, so that you’re fully clued in.
- What are the risks of inducing / augmenting my labour?
- What are the benefits?
- Are there any alternatives? For example, medication, rest, dietary changes etc.
- Some sources suggest that risk of stillbirth increases slightly when a woman goes past 42 weeks gestation. How does that risk compare to the risk of stillbirth from complications that arise during induction? SEE HERE FOR MORE INFORMATION
Hospitals are so well set up for birth as a physical event, that almost everything they do, directly inhibits or interrupts the hormones we need for birth. Of course some women give birth in hospital without any trouble, but a huge number of women are having their labours augmented after natural onset, because they have slowed or stalled. Lots of women are also being induced, so their labours never have any of the natural hormones that keep birth safe, manageable, and promote bonding.
There is a time and a place for the use of synthetic hormones. A few medical conditions make induction a good option. However what we need to remember is that induction has risks. We need to balance those risks against the risks of not inducing or augmenting rather than reaching straight for the synthetic hormones. The importance of natural hormones in birth cannot be overstated. The safest way for a woman to give birth is in surroundings that support the natural release of the hormones, and supported by people who understand how the hormones work.