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I began sorting through my overstuffed bookshelf to simply fill up a giveaway bag for Housing Works. About halfway through the books, I came across a forgotten gift – Enjoy your labor: A new approach to pain relief for childbirth, by Dr. Gilbert Grant, Director of Obstetric Anesthesia at New York University Medical Center. Dr. Grant gave me this signed copy of his book while I was acting as somebody’s doula during her final stages of pushing. Appropriate timing and interaction? I think not. Anyway, before adding it to my rather large giveaway pile, I decided to look through Dr. Grant’s gift.
First of all, as an obstetric anesthesiologist, he is biased towards pain medications. Grant asserts that natural birthing is “misogynistic” in practice. In a Times Online article, he compares giving birth without pain relief to undergoing an appendectomy without pain relief. This attitude doesn’t sit right with me. Dr. Grant argues the body is ill-equipped to birth babies, when in fact our body’s hormones are designed to birth offspring. The human body possesses an amazing hormonal blueprint that can allow it to manage the pain of childbirth without pain medication should you choose.
The Role of Hormones
Let’s examine the role hormones play in helping people through labor. The three main hormones involved in the delivery process are oxytocin, endorphins, and adrenaline.
Oxytocin
Oxytocin is made deep within the brain in the hypothalamus and stored in the posterior pituitary – the master gland – where it is released in pulses.
Also known as “the hormone of love,” oxytocin is released during pregnancy, labor, orgasms, and breastfeeding; It triggers feelings of affection and nurturing.
During labor, oxytocin levels are at their peak, and its secretion assists in regulating the uterus’s rhythmic contractions. Contractions of the uterus help push the baby further down, putting pressure on the cervix which allows it to dilate. After the baby is born, oxytocin levels continue to surge, helping birth the placenta. The baby may be brought to the breast to start to nurse which will help continue the flow of oxytocin and may protect the birthing parent against postpartum hemorrhage.
Endorphins (Beta – Endorphins)
Like oxytocin, beta-endorphins are secreted from the pituitary gland, and high levels are present during sex, pregnancy, birth, and breastfeeding. Beta-endorphins are a stress hormone released under conditions of duress and pain to improve mood. They act as analgesics and—like other stress hormones—suppress the immune system. High levels of endorphins during labor and birth act a lot like morphine, helping people cope with the birth process provided they are undisturbed.
Many years ago, I attended the birth of my friend Liz’s second son, Owen. She chose to do an unmedicated birth at the now closed, St. Luke’s / Roosevelt Birthing Center. This provided a quiet atmosphere with little disturbance. Towards the end of labor, Liz lay in bed, silent between contractions. Her eyes were soft and somewhat glazed over, words scarce. Reflecting later, here is how she described her birth experience:
“I got in the tub, and immediately my back pain went away. The warmth of the water slowed the contractions a bit too, and I was able to relax. After a while, though, I started to feel like a raisin, and the bed looked so inviting, so I got out of the tub and laid down. I was actually able to doze a bit between my contractions. A little before 7pm my doctor checked me and said I was about 9.5 centimeters. She asked if I wanted her to break my water and I decided to wait a bit. I don’t know why. I wasn’t thinking specifics. I was in such a bizarre zone of pain and power and determination and anticipation,that I just said no. From that point on I was on a level that I can only compare to a psychedelic drug experience *I feel funny using that analogy, and I apologize if it’s not appropriate, but I have been searching for a way to describe how I felt, and that is truly the only thing that compares.*”
Liz’s testimony speaks to the brilliant hormonal design of the body, which produced the endorphins needed to move her away from pain, let go of the rational mind, and follow instinctual desires. Unfortunately, most studies have found a sharp drop in endorphin levels with the use of epidural or opioid pain medication.
Adrenaline
Adrenaline, the “fight or flight” hormone, is secreted from the adrenal glands, located above the kidneys. It’s produced in response to fright, anxiety, hunger, cold, and excitement. I often explain the “fight or flight” hormonal reaction by highlighting how it helps wild animals give birth safely. When an animal feels threatened, adrenaline is produced, slowing down the secretion of oxytocin and allowing the animal to stop contracting, regather, and find a safe, quiet place to give birth. Now consider a human giving birth. It’s not surprising that labor often progresses nicely when an expecting parent is at home, feeling secure and comfortable with their surroundings and birth attendants. However, the person who presents a solid laboring pattern at home may, upon entering the bustling hospital, suddenly find their contractions have spaced out or even stopped; this is because of the release of adrenaline.
Adrenaline is not all bad when it comes to birth. At the final stages of labor, high adrenaline levels activate the fetal ejection reflex. This makes the laboring person very strong, alert, and determined, ready for the final push to birth their child..
How to manage adrenaline
So, if you’re planning to give birth in a hospital, what can you do to optimize the experience and setting?
Here are some ideas that may help reduce stress hormones and allow the oxytocin to flow.
- Bring music that will help you relax.
- Try to keep interruptions to a minimum.
- Invite only those you want in the room to join you.
- Turn the lights down.
After taking a closer look at the three main hormones involved in the labor and the delivery process, it seems absurd to compare unmedicated childbirth to a surgical procedure; it is nothing like an appendectomy without anesthesia. It’s an individual choice to take pain relief for birth, but not a medical necessity. If you choose to forgo medication, your body will kick in with its special cocktail of protection, as Liz called it a “psychedelic experience.”
At the Prenatal Yoga Center, we hold both in-person and online classes for expectant and postpartum folks. To view our list of classes for Prenatal and Postnatal Yoga click the button below.
FAQs
When is oxytocin released?
Also called the hormone of love, oxytocin is released during pregnancy, labor, orgasms, pleasurable moments such as connecting with someone you love, petting a beloved pet and breastfeeding.
What do beta-endorphins improve?
Beta-endorphins are a stress hormone, released under conditions of duress and pain to improve mood.
Where does Adrenaline come from?
Adrenaline, also known as the “fight or flight” hormone, is secreted from the adrenal glands located above the kidneys.
Sources
https://my.clevelandclinic.org/health/body/23040-endorphins
https://my.clevelandclinic.org/health/body/23038-adrenaline
https://my.clevelandclinic.org/health/articles/22618-oxytocin
