Pregnancy and labour are supposed to be natural and normal events. They provide a woman with a unique opportunity to learn about her body and soul. A woman experiences changes in all aspects of her life as the pregnancy progresses, and thus can experience transformation into an intuitive, relaxed and receptive mother. She is given a chance to find out how powerful and competent she is by facilitating bringing a new life to this world.
" Whoever and however you intend to give birth, your experience will impact your emotions, your mind, your body, and your spirit for the rest of your life" Ina May Gaskin
The transition from pregnancy to labor is a sequence of events, that often begins gradually.
The physiological transition from being a pregnant woman to becoming a mother means an enormous change for each woman, both physically and psychologically. Every system in the body is affected and the experience represents a major transition in a woman's life.
During the last few weeks of pregnancy, a number of physical and psychological changes may occur, including:
· Mood swings
· Surges of energy
· Lightening : baby usually " drops down" into the pelvis 2-3 weeks before the onset of labour, breathing becomes easier and heart and stomach function more easily.
· Engagement of the baby’s head: pelvic floor becomes more relaxed and softened allowing the baby's head to descend further into the pelvis increasing pressure on the perineum floor.
· Walking becomes more difficult
· More frequent trips to the bathroom!
· Braxton-Hicks contractions, warming-up contractions which may be just your uterus practicing, or might be helping to reposition your baby or help your cervix move into position for birth.
· Cervix of the uterus becomes soft, effaces (thins), and dilates (opens). Mom will lose the protective fluid at the end of the cervix called the “mucous plug”, creating slightly pinkish cervical fluid.
· Feelings of great intensity, from exited anticipation to fearful expectancy.
What is happening during labour?
Labour is the process of giving birth, from the onset of true labour pains until the completion of delivery.
Labour is usually divided into 3 stages.
1. In the first stage, the cervix dilates (opens) and the baby descends into the pelvis.
Before labour : Baby is engaged ( positioned in a bony pelvis and head is pressing against cervix) and cervix is still closed by the mucous plug
Active labor, or the onset of regular contractions: Contractions dilate cervix and push the baby into the birth canal.
During labour cervix dilates (opens) and effaces (thins) to enable baby to pass through birth canal
During labour: as the head of the baby descents into the birth canal, the head needs to mold in order to fit the diameters of bony pelvis.
2. In the second stage, mom’s usually feel the urge to push as the baby descends all the way to the pelvic floor.
3. In third stage baby is delivered and placenta is expelled.
According to WHO's recommendations85%- 95% of pregnant women should be able to give birth spontaneously- without the assistance of obstetric tools or interventions.
Our bodies are designed to give birth: While the process of birth is quite complex, when we allow our bodies to work the way are were designed to, it’s a simple and beautiful process. Three primary hormones assist in this process:
OXYTOCIN
Oxytocin is a hormone produced in the brain which gradually increases during pregnancy.
Oxytocin is called the “love hormone”; it helps us to feel peaceful, affectionate, and empathetic, and helps us move into the right side (non-rational) of our brain. Oxytocin is one of the primary hormones that triggers a mother’s instinct to nurture, protect, and bond with her baby. Humans produce the most oxytocin during love making and childbirth. They must feel safe and enjoy privacy to produce the optimum levels of oxytocin.
During labour, Oxytocin stimulates powerful contractions which help thin and open the cervix, move the baby down and out of the birth canal, expel the placenta and limit the bleeding. It also helps women to be calm and relaxed during labor.
After delivery, oxytocin stimulates the let down reflex ( milk ejection reflex) and is released as babies nurse.
Laboring moms naturally produce the needed amount of oxytocin to help labor progress when they feel safe and secure.
Here are some ways to naturally help promote the production of oxytocin:
· Stay calm and relaxed
· Seek positive experiences ( laugh, hug, talk to your friends or loved ones, watch a funny film)
· Delay epidurals and avoid the use of synthetic oxytocin (Syntocin or Pitocin)
· Nipple stimulation (for example, with a breast pump)
ENDORPHINES
Endorphines are hormones produced in the brain in response to positive stress or pain. They are calming and pain relieving hormones, sometimes referred to as natural opiates (pain killers). An example of this is when runners describe their feelings at the end of a race as feeling “elated” or experiencing the “runners high.” The amount of endorphins in a naturally laboring mother is significantly higher than a marathon runner, that is why you will hear some mothers describe their birth experience as “ecstatic.”
In unmedicated labours, endorphins continue to gradually rise through the labour and can cause an altered state of consciousness that can help woman to flow with the process, even if it is long and challenging. Despite the hard work, high endorphine levels make laboring woman feel alert, attentive and euphoric.
In medicated labours (such as induced labours) , endorphine levels are lower because the natural signal sent to the brain to continue to increase the release of endorphins in response to increasing levels of oxytocin is shut off. This can cause labors which use Syntocin or Pitocin to be excessively painful and create a need for interventions.
How to keep endorphins level high:
- Staying calm, comfortable and confident
- Avoiding disturbances (avoid unwelcome people, unnecessary interventions)
- Delaying epidurals, avoid synthetic oxytocin.
ADRENALINE
Adrenaline is a hormone known as the “fight of flight" hormone that our bodies produce to ensure survival and to deal with stress. Certain amounts of adrenaline are needed during the labour in order to deal with the physical demands of labour, but excess amounts can be harmful. Women who feel threatened may produce high levels of adrenalin which can slow or stop labour.
Excessive levels of adrenaline can:
- Decrease blood flow to uterus and placenta slowing contractions and lengthening labour and causing distress to the baby
- Create a sense of panic in the mother
- May create the need for interventions
You can keep adrenaline levels low by:
- Staying calm, relaxed and comfortable
- Trusting in your body and it's capabilities
- Staying in a private and safe environment
- Avoiding conflicts and disruptive procedures
How does labour start?
The onset of labour is a process, not an event, therefore it is very difficult to pinpoint exactly when the painless (or sometimes painful) contractions of pre-labour develop into progressive rhythmic contractions of established labour.
The exact trigger of labour is still unknown. It is believed that when a baby is ready it releases hormones into the mother’s blood to initiate the labour.
What factors affect successfully progressing labour?
The mind and body are connected and they affect each other. This is called the Mind-body connection.
Emotional disturbances are shown to affect the physiological state of woman . Fear, anxiety, stress, anger, fright and suppressed emotions can hold up a labour .
Negative feelings heighten the perception of pain and can help elevate the stress hormone
" adrenaline " which may slow or stop contractions. They also reach the baby who can suffer from neonatal distress as well.
Negative emotions also cause tension in muscles , thus making the softening, the thinning and the opening of the cervix difficult.
The simple progress of birth: Maintain a safe and private environment
All labor progression is dependant on the release of the hormone oxytocin but can be inhibited by any interference in a laboring mother’s environment.
For birth to proceed optimally ,the limbic system, which the more primitive part of brain ( the part that controls instincts, memory and emotions ) needs to take precedence over our neocortex ( the rational part of the brain). This shift of consciousness, which some call " going to another planet" or " tapping deeply into one self " is aided by the release of birthing hormones and is inhibited by disturbances such us bright lighting, loud conversation, expectations of rationality and use of rational language (like when the nurses ask you questions about early labor etc.) Most women at this point are unable to- and should not be expected to- answer rational questions near the end of labor. Her support system should step in to answer for her, or lean close to whisper questions in a quiet voice in between contractions.
" If we hope to create a non violent word
where respect and kindness replace fear and hatred ,
we must begin with how we treat each other at the beginning of life,
for it is where our deepest patterns are set,
from these roots grow fear and alienation or love and trust. "
~Suzane Arms
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