A plea for natural birth in Kuwait

How much are we aware of consequences of inductions of labours, unnecessary cesarian sections and frequent use of epidurals? I highly recommend every pregnant woman to read following article to be aware of risks of following procedures.

In modern societies most childbirths occur in hospitals with the assistance of the latest technologies. Protocols are being carried out and policies followed. But what about mothers and their wishes or decisions? What do we really know about  the consequences of such approaches to pregnancy and childbirth, the beginning of a journey of a new human being? Can we comprehend the effect it will have and what we will face in the future?

Currently, a lot of births are conducted as follows:

• Induction (forcing labor to start) by the administration of drugs (oxytocin and prostaglandins)

• Augmentation (speeding spontaneously occurring labor) by administrating drugs (oxytocin)

• Use of analgesics and epidural anesthesia (pain medications)

• Cesarean sections (surgical removal of baby) and even elective Cesarean section

• Deliveries in an unfamiliar environment (hospital)

Birth is a unique hormonal process activated by the body`s own production of oxytocin.  This serves the purpose of safe delivery of the baby, the onset of lactation (milk in the breast), and creating a bond between the mother and child. During the birth many cascading neuro-hormonal reactions (prostaglandins, prolactin, endorphines) take place which ensure progress and coping with labor.

Oxytocin is hormone which produced in brain. It stimulates:

• Peripheral action 
• uterine contractions 
• let down reflex of lactation

• Central effect 
• decreases fear 
• increases trust 
• encourages bonding  
• stimulates maternal behavior

Synthetic oxytocin, which is routinely administered during induction and augmentation of labor, does not cross the blood brain barrier like natural oxytocin.  Therefore it provides only peripheral actions which have effects on the uterus and breasts. It cannot affect the mother's feelings or behaviors, thus depriving her of natural releases of stress and anxiety. Also administrating synthetic oxytocin may interfere with the natural progress of birth.

Prostaglandins regulate contractions and are directly responsible for contraction of the uterus during labor. Synthetic prostaglandins, which are administered during induction of labor,  suppress prolactin secretion , the hormone responsible for milk production, and thus cause difficulties with breastfeeding.

Endorphines are produced in brain during pain and prolonged workouts like childbirth.  They resemble opiates and produce analgesia (natural relief from the pain). They also cross the placental barrier and help the baby coping with labor.  Administering medical analgetics and opiates during labor may disturbe the natural opioid system and decrese the production of natural endorphins, thus decreasing the natural supply to the baby.

 

Delivering by Cesarean section disturbs hormonal balance and processes that are meant to take place during childbirth.

Childbirth in an unfamiliar environment may produce anxiety and stress. During stressful situations the body releases adrenalin to cope with emergencies. Adrenalin acts as an antagonist to oxytocin, so a stressful birthing environment can slow the progress of birth and endanger its results.

Clearly, interventions and the use of medications during labor have immediate effects on the mother and baby in terms of the spontaneous progress of labor.  Interventions also create need for more interventions.  Notably, many interventions result in difficulties with breastfeeding.

Some scientists are examining the long-term effects of such labors, hypothesing about possible conseqences after interfering with the natural hormonal system.  They are studying the possible links between hormonal interference during labor and the baby's stress reactions, human bonding, anxiety disorders, depression, and even autism.

" 80% of the blood reaching the fetus via the umbilical vein goes directly to the inferior vena cava via the ductus venosus, bypassing the liver, and therefore immediately reaching the brain: it is all the more direct since the shunts (foramen ovale and ductus arteriosus) are not yet closed. . . . Furthermore, it appears that the permeability of the blood-brain barrier can increase in situations of oxidative stress—a situation that is common when drips of synthetic oxytocin are used during labor. We have, therefore, serious reasons to be concerned if we take into account the widely documented concept of “oxytocin-induced desensitization of the oxytocin receptors.” In other words, it is probable that, at a quasi-global level, we routinely interfere with the development of the oxytocin system of human beings at a critical phase for gene-environment interaction."  M. Odent



REFERENCES:


S Jordan1, S Emery2, A Watkins3, JD Evans4, M Storey5, G Morgan6: Associations of drugs routinely given in labour with breastfeeding at 48 hours: analysis of the Cardiff Births Survey
http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2009.02256.x/full


CG70:Induction of labour:NICE guidline
http://guidance.nice.org.uk/CG70/NICEGuidance/doc/English


Begley C. The effect of Ergometrine on breast feeding. Midwifery 1990;6:60–72.
http://www.ncbi.nlm.nih.gov/pubmed/2195299


Winberg J. Mother and newborn baby: mutual regulation of physiology and behavior – a selective review. Dev Psychobiol 2005;47:217–29.

http://onlinelibrary.wiley.com/doi/10.1002/dev.20094/abstract


Dunne C, Da Silva O, Schmidt G, Natale R.:Outcomes of elective labour induction and elective caesarean section in low-risk pregnancies between 37 and 41 weeks' gestation.

http://www.ncbi.nlm.nih.gov/pubmed/20085677


Alfirevic Z, Kelly AJ, Dowswell T.:Intravenous oxytocin alone for cervical ripening and induction of labour.
http://www.ncbi.nlm.nih.gov/pubmed/19821304

http://www.wombecology.com/physiological.html 

http://www.midwiferytoday.com/enews/enews1215.asp#main