Hormones and Childbirth
As a midwife, most of my work is focussed on taking care of the basic needs of women during labor and birth, protecting their environment in order to promote the endogenous production of oxytocin and preserve a hormonal balance during childbirth.
Hormones trigger and are triggered by emotional states and are able to transform them into physical reactions (Young, 2009), catalyzing changes, adaptation and behaviours (Uvnäs-Moberg et al, 2005). Any neocortical brain stimulation in labour such as the use of rational language, bright light, pain, hunger, fearful memories, feelings of being observed or judged, or strangers attendance during this extremely intimate and sexual time in a woman’s reproductive life, can cause stress responses and the need for surveillance (Odent, 2009, Uvnäs-Moberg et al, 2005).
This fine tuned hormonal system so easily disrupted by perceived internal or external danger (Hastie and Fahy, 2009) should be acknowledged and cared for by midwives promoting normality as one of the main childbirth safety responsible.
This initiates the "Fear Cascade" (Foureur, 2008) by increasing cortisol and catecholamines blood levels. These oxytocin antagonist hormones, will cause weak uterine contractibility, longer labour (Foureur, 2008; Alehagen et al, 2005) and reduced uterine and placental blood supply leading to foetal hypoxia (oxygen deficiency in baby’s blood and tissues) (Talge et al, 2007; Glover and O’Connor, 2006; Van den Bergh et al, 2005). This fine tuned hormonal system so easily disrupted by perceived internal or external danger (Hastie and Fahy, 2009) should be, in my opinion, acknowledged and cared for by midwives promoting normality as one of the main childbirth safety responsible.
Anxiety in labour and childbirth conditions the mother and makes her more hyper-reactive to pain and bodily sensations that are misinterpreted as dangerous (Brodrick, 2014; Jokic-Begic et al, 2014; Curzik and Jokic-Begic, 2011; Spice et al, 2009; Lang et al, 2006), increasing fear and thus cortisol and catecolamines production (Brodrick, 2014).
Oxytocin plays a fundamental role not only in uterine contractibility, but also in the mother-baby bond and in infant care and breastfeeding (Buckley, 2009, Hastie and Fahy, 2009; Uvnäs-Moberg and Petersson, 2005). Recent studies suggest that oxytocin receptors increase toward the end of pregnancy to protect the baby's healthy development in the womb and to promote the physical and mental maternal well-being (Slattery and Neumann, 2008); playing an important role not only in childbirth physiology, but in its psychosocial and psychological mechanisms (Uvnäs-Moberg and Petersson, 2005).
Given its anatomical and physiological relation with the limbic areas of the brain, oxytocin has been found to be a mediator and controler of emotions, fear response and social behaviour such as love, mood, memory, rage, aggression and the correlation of passed experiences to present ones (Guzmán et al 2013; Kightley, 2007; McGaugh, 2004),. Oxytocin is involved in increasing pain threshold and lowering anxiety levels (Tracy et al, 2015; Rash et al, 2014; Uvnäs-Moberg et al, 2005; Windle et al, 2004; Bale et al, 2001) decreasing fear, and increasing trust, empathy and generosity (Bernaerts et al, 2016; De Creu, 2012; Lee et al, 2009; Heinrichs and Domes, 2008; Baumgartner et al, 2008; Kirsch et al, 2005; Huber et al, 2005; Kosfeld et al, 2005; Heinrichs et al, 2003). In this way, oxytocin enhances the human capability to understand others’ feelings (Bernaerts et al, 2016; De Creu, 2012; Lee et al, 2009; Zak et al, 2007), an essential component in the midwife-mother relationship.
All this behavioural effects created by the endogenous oxytocin, that is the one produced by the mother herself, are due to the fact that oxytocin can cross to the brain, which it does not take place with synthetic oxytocin used in medicalised births (Uvnäs-Moberg et al 2019).