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Thoughts of a Cornish doula

Hormones of birth

15/9/2017

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​Hormones have got a pretty bad rep. They get blamed for mood swings and pregnancy symptoms and a lot of people assume they just negatively affect women. However, they are pretty amazing and are responsible for a lot of positive things that happen in our body throughout our lives, nothing more important than their role in birth though. Here we are going to take a look at the four main hormones involved in birth, Oxytocin, Endorphin's, Adrenaline and Prolactin. You may have heard of some of these, you may have heard of all of them or none of them. They each have their part to play and during an undisturbed birth they will facilitate the dilation of the cervix and the birth of the baby through foetal ejection reflex, they will help relieve pain and allow you to cope with contractions, they will kick start milk production and facilitate bonding with your baby.
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By educating yourselves prior to birth you learn how to encourage and allow the flow of these hormones which in turn will allow your body to birth your baby. You can use this knowledge to create a positive and protected birthing environment wherever you decide to give birth, your birth partners can also use it in their job as gatekeeper and to find the best ways to keep you comfortable and focused.
 
Ok so first we look at Oxytocin- The love hormone, it is present during pregnancy, birth, sex and any times we feel happy, safe and loved. When the baby’s head connects with the cervix and initiates labour, Oxytocin is released, it causes the uterus to contract and plays a part in the foetus ejection, placenta ejection and milk ejection. It facilitates bonding and helps to mediate anxiety and fear. The oxytocin levels surge at the point of birth triggered by the baby’s head pushing on the pelvic floor, this is responsible for that “rush of love” a lot of mothers reports feeling soon after their baby is born.
So what happens if the oxytocin flow is interrupted? Contractions start to slow down. Remember we are mammals and although we forget it sometimes our bodies are still programmed to respond like every other mammal. Mammals like to birth in private. Warm, safe and undisturbed. If this environment is interrupted by bright lights, conversation or fear then our limbic system interprets that as a threat and shuts down birth. Oxytocin levels go down and adrenaline levels go up to prepare our body for fight or flight. Now our rational brain knows that the doctor/midwife/nurse who turns on the light and starts a conversation is not trying to eat us but our limbic system does not and during birth the limbic system is in charge. Creating and protecting your birth environment really helps to preserve the flow of oxytocin as does touching and kissing and cuddling.
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Next up, endorphins- Beta-endorphins create feelings of pleasure and are natural pain killers. Endorphins are there to help you rise above the pain and continue to be alert and even euphoric. In very long labours, high levels of endorphins can slow contractions down to allow you to have a break and get some rest, this is completely normal. Endorphins also play a role in kick starting milk production with the release of prolactin and maturing the baby’s lungs ready for birth. It has been shown that epidurals and opioid pain relief causes a sharp drop in endorphins. These are nature’s pain relief and if left alone your body will produce enough to allow you to cope with the contractions. Endorphins also cross into breast milk which in turn encourages bonding by making baby feel pleasure during breastfeeding.


Adrenaline- So now we are getting to the second stage of labour, during the first stage both latent and active we have wanted to suppress the production of adrenaline but now we are at the serious part of birthing your baby you need it. During the first stage adrenaline pushes against oxytocin and can make labour slow, more painful and cause foetal distress. When birth is undisturbed adrenaline is low until birth is imminent when there will be a rush of adrenaline which activates the foetal ejection reflex which is when the body experiences a few strong and uncontrollable contractions which quickly birth your baby without any conscious pushing as well as giving you a sudden burst of energy to cope with the birth your baby. One thing to note is that if this happens you may feel shaky and cold immediately after birth as the levels in your body drop rapidly. Get your birth partner to make sure you have blankets on hand to ensure you and baby are kept warm to prevent another rush of adrenalin as you will now need to build oxytocin again to birth the placenta.

Finally we will look at Prolactin- This is the main hormone responsible for milk production and breastfeeding. Prolactin is what causes your breasts to prepare during pregnancy but it is limited due to hormones produced by the placenta, once the placenta is released a rush of prolactin is triggered and peaks in the first couple of hours after birth. As well as milk production it is also responsible for feelings of submission and surrender which help facilitate the bonding and patience to serve your baby’s needs.
Preserving the “Golden hour” straight after birth is pivotal in facilitating the important bonding and establishing breastfeeding, Prolactin and Oxytocin peak in that first hour and any disturbance may inhibit the very important roles that they have in this process.
 
So now we have looked at what is happening hormonally during your labour and birth, what can you do to protect these hormones and allow them to do their job? I have mentioned undisturbed birth a few times already but it really is central to this. Allowing your body and your baby the space and time to do their job without interference from the outside world is the most effective way to achieve the euphoric birth. Whether you decide to birth in hospital or at home you can create a safe and welcoming environment for yourself. Your birth partner can be the gatekeeper at the door, explaining to anyone who must come in that they need to preserve your space and respect your need for quiet and calm. Create a nest for yourself, comfy pillows, blankets and beanbags. Think about smells you like. Think about food and drink that are nourishing and nurturing. Below are a few links that I think explaining undisturbed birth and birthing environment well:

http://www.aims.org.uk/Journal/Vol23No4/undisturbedBirth.htm
http://sarahockwell-smith.com/2012/11/04/how-to-create-a-birthfriendly-calm-birth-environment-wherever-you-are/
 

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    ​Nicki Burnett

    A Cornish Doula opening her mind and heart about birth, doulaing, feminism, activism and life in Cornwall.

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