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Undisturbed Birth: Nature’s Blueprint for Safety, Ease, and

Pleasure Mother-Friendly Childbirth Symposium

Oct 14, 2015

Los Angeles

Family

Physician/GP

Diploma in

Obstetrics

Currently full-

time writer and

mother of four

homeborn

children ages

15 to 24

Live in

Brisbane,

Dr. Sarah J.

Buckley

Dr. Sarah J.

Buckley

Ecstatic Birth: Nature’s hormonal blueprint for labour

www.sarahbuckley.com

http://transform.childbirthconnection.org/reports/physiology

© 2015. National Partnership for Women & Families. All rights

reserved


Welcome! Midwives (students),

Physicians

doulas (students)

Childbirth educators

Nurses, L&D

Breastfeeding professionals,

Other health professionals

Hospital workers

Mothers, fathers

Agenda A birth story

Mammalian birth

The ecstatic hormones of undisturbed birth

Impacts of interventions

What makes birth safe?

Summary and suggestions

Q&A

A Birth Story

www.sarahbuckley.com Slide 8

First pregnancy, planned

homebirth

Father ‘Tom’ not involved

Living with a family

Healthy pregnancy

Goes into labour at term

Ruby’s Birth Story

‘Ruby’

www.sarahbuckley.com Slide 9


Moves to ‘birth nest’

Disturbed by children

Moves to smaller room

Disturbed again

Gives birth when house is

quiet, 3 am

Labour begins around 7pm while

in TV room with family

www.sarahbuckley.com Slide

10


Mammalian Birth

Mammalian Birth Evolution of placental mammal: 65 million years

Evolved for

Survival (safety)

Efficiency (ease)

Reward (pleasure)

= reproductive success

Basis of survival, individually and species

Used with permission http://locksparkfarm.wordpress.com/

Used with permission www.upali.ch

Slide used with permission, www.dolphintrainer.com

Mammalian Birth“ In all mammalian

species, the course

of delivery can be

influenced by

environmental

disturbances.

Anxiety and fright

inevitably lead to

prolongation of the

duration of labour…

For many animals,

the presence of an

Naaktgeboren 1989

Ch 1, Biology of Childbirth

In: Effective care in pregnancy and

childbirth Vol II

Imag

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ativ

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by

Kev

in G

oeb

el

Mammalian Birth

Avoid

environmental

disturbance

Avoid anxiety

and fright

Avoid presence

of observer

Feeling private

Feeling safe

Feeling unobserved

Core Requirements for Mammalian

Birth

Private

Safe

Unobserved

That the

labouring

female feels:

The Ecstatic

Hormones

of Undisturbed

Birth

The Ecstatic

HormonesDuring labour and

birth, Mother Nature

provides an ecstatic

hormonal cocktail to

enhance ease,

pleasure and safety

for mothers and

babies of all

Imag

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Oxytocin

Hormone of love

Beta-endorphins

Hormones of pleasure and

transcendence

Adrenaline/Noradrenaline

Hormones of excitement

Prolactin

Hormone of breastfeeding

and tender mothering

This ecstatic hormonal cocktail includes:

The Ecstatic

Hormones

Levels of these

hormones build during

labour, orchestrating

some of the actual

processes of labour and

birth as well as

enhancing ease, pleasure

and safety for mother

and baby.

The Ecstatic

Hormones

In the minutes

after birth, both

mother and baby are

suffused, in brain

and body, with this

ecstatic hormonal

cocktail of love,

pleasure, excitement

and tenderness.

The Ecstatic

Hormones

The postnatal peaks of these

ecstatic hormones and the

behaviours that they promote

provide long-term support for

mother and baby with breastfeeding

and attachment.

Imag

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The Ecstatic

Hormones

Triangle of Reproductive

Success

Imag

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ativ

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ns,

by

eden

pic

ture

s

Birth

The Ecstatic Hormones

Private

Safe

Unobserved

Hormonal release is enhanced

when the labouring mother

feels:

These are the basic

requirements for birth in all

mammalian species.


Oxytocin

Beta-endorphins

Epinephrine/norepinephrine

Adrenaline/Noradrenaline

Fight-or-flight

Catecholamine (CA) hormones

Prolactin

Imag

e re

pri

nte

d w

ith

per

mis

sio

n f

rom

ww

w.jo

you

sbir

th.in

fo


Middle brain

Old mammalian brain

Relational brain

Mostly produced in limbic system

Limbic system (instincts,

emotions) can compete with neo-

cortex (intellect, rational) for

dominance

OXYTOCIN

HPOC Chapter 3

Oxytocin

Means “fast birth”

Released from

limbic system into

brain and body

Physical and

psycho-emotional

effects during

Sexual

activity/orgasm

Pregnancy, labour

and birth

Breastfeeding

Hormone of love

Also released

during:

Pleasant social

interactions

Skin-to-skin,

eye-to-eye

Cuddle hormone,

ventral contact

Attachment,

maternal

behaviour

Imag

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ativ

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ns

by

Go

ldb

erg

Oxytocin

Reduces fear

(amygdala)

Increases trust,

sociability

Activates

parasympathetic,

reduces

sympathetic

nervous system

(SNS)

Calm and connection

Uvnas-Moberg, The Oxytocin Factor (03): Hormone of Closeness (09) ;

Biological Guide to Motherhood (15)

Image: Flickr Creative Commons by achichi

Oxytocin

Pain

relieving,

reward

Short half-

life

(oxytocinase)

Minimal

passage

through blood-

brain barrier

Pheromone

Other

properties:

Oxytocin

Oxytocin in

ReproductionCauses smooth muscle to

contract, e.g. in labour

Causes the ‘ejection

reflexes’

Sperm ejection - male orgasm

Sperm introjection - female

orgasm

Fetus ejection

Milk ejection

HPOC Ch 3.1.1

Q: Why did the chicken cluck

when she laid an egg?

A: Arginine vasotocin

Oxytocin

Oxytocin in Labour

Imag

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ileen

Su

lliva

n

Pulsatile

release

Rhythmic

contractions of

labour

Minimal plasma

oxytocin

increase until

second stage

Increased pulse

frequency HPOC Ch 3.1.3

Oxytocin Blood Levels in

Labour

0

1

2

3

4

5

6

7

pre labour Stage 1 Stage 2/3

OT over 30 minutes pulse frequency (no/30 mins) (after Fuchs 1991_

Oxytocin in Labour

Image: Flickr Creative Commons by goldberg

Increase in

oxytocin

receptor (OTR)

density with

onset of

labour in

women

Increases

uterine

sensitivity to

oxytocin for

efficient

labour and

Before

labour:

HPOC Ch 2

Oxytocin in Labour

1.8711

1140

3550

0

500

1000

1500

2000

2500

3000

3500

4000

non-pregnant 13-17 wks 37-41 wks early labour

fmo

l/m

gDN

A

Myometrial OTR Density in Pregnancy

and Labour

(From Fuchs 1984)

Oxytocin in Labour

Image: Flickr Creative Commons by goldberg

OTRs also

increased in

mammary glands,

brain in the

days and hours

before

physiologic

labor onset in

animals

(Meddle 07, Hayes 07)

Before

labour:

HPOC Ch 2, 3.1.2

Oxytocin in Labour

Maternal oxytocin crosses

placenta

(Tyzio 2006, 2014)

Crosses immature fetal blood-

brain barrier

Inhibits fetal brain activity

Reduces brain requirements

for oxygen and glucose

Neuroprotective

Autism: animal modelsHPOC Ch 3.1.3

Oxytocin

Imag

e:Ei

leen

Su

lliva

n

Stretching of

cervix/lower

vagina as baby

descends causes

oxytocin release

(Ferguson

reflex)

Second stage:

HPOC 3.1.3

Oxytocin

Maternal levels

elevated for 60

minutes after

birth

Elevations related

to newborn

prebreastfeeding

behaviour (Matthiesen

01)

Contracts uterus

Vasodilates chest

wall

Imag

e: W

ikim

edia

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mm

on

s

After birth:

HPOC 3.1.4

Oxytocin

Imag

e: W

ikim

edia

Co

mm

on

s

Levels increased

through mother-

baby

interactions

Skin-to-skin and

eye-to-eye

contact enhances

release

Breastfeeding:

mother and baby

receive a dose

of oxytocin

Postnatal:

Oxytocin

Imag

e u

sed

wit

h p

erm

issi

on

Releases

oxytocin in

labour

High levels at

birth

Peak at 30

minutes

Elevated for 4

days

Present in

breastmilk

Baby:

Oxytocin

Anti-stress

hormonal system

for the duration

of breastfeeding

and beyond (Srogren

00)

Calm and

connection

Postnatal:

Oxytocin research Osteoporosis,

obesity

Cancer, prostate

Cardiovascular

disease

Drug and alcohol

abuse

Depression,

anxiety, OCD,

autism, sexual

function

Prozac

HPOC 3.1.1

What Disturbs Oxytocin?

Common Maternity

Care Practices that

may Impact

Physiology

HPOC X.2

Maternity Care

Practices….• Maternity care provider and birth

environment (X.2.1)

• Prostaglandins for cervical ripening

and labor induction (X.2.2)

• Synthetic oxytocin for induction,

augmentation and postpartum care

(X.2.3)

• Opiate analgesic drugs (X.2.4)

• Epidural analgesia (X.2.5)

• Cesarean section (X.2.6)

• Early separation of healthy mothers

and newborns (X.2.7)

What Might Impact

Oxytocin?• Maternity care provider and birth

environment (3.2.1)


and labor induction (3.2.2)



(3.2.3)

• Opiate analgesic drugs (3.2.4)

• Epidural analgesia (3.2.5)

• Cesarean section (3.2.6)


and newborns (3.2.7)

HPOC 3.2

http://transform.childbirthconnection.org/reports/physiolo

gy

© 2015. National Partnership for Women & Families. All

rights reserved


Use of Synthetic Oxytocin

(SynOT)Pitocin, Syntocinon

• Chemically equivalent to

endogenous (natural) oxytocin

Use of Synthetic Oxytocin

(SynOT)• Acts very differently to

natural oxytocin

• Not pulsatile

• Higher levels (fewer receptors)

• Minimal passage through blood-

brain barrier

• Contractions,

stronger, longer

and closer together

• Can cause

hyperstimulation in

early labour

• Reduces fetal

blood/oxygen

• Requires monitoring

Acts very differently to natural oxytocin

Imag

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Synthetic Oxytocin

• Abnormal fetal heart

rate (FHR) patterns

(bradycardia,

arrhythmia)

• Permanent CNS or brain

damage

• Fetal death

• Low Apgar scores at 5

minutes

• Neonatal jaundice

• Neonatal retinal

from package insert for Pitocin 2005

http://dailymed.nlm.nih.gov/dailymed/drugI

nfo.cfm?id=4975)

Synthetic Oxytocin:

Side-effects

http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=4975

• Reduces number of

uterine oxytocin

receptors, increases

risk of bleeding after

birth (PPH)

• Cascade of interventions

More adverse

effects:

Synthetic Oxytocin:

Side-effects

NB: Does not give

“negative

feedback” to

oxytocin release

Synthetic Oxytocin:

Side-effects

Oxytocin is the drug most commonly

associated with preventable adverse

perinatal outcomes and was recently

added by the Institute for Safe

Medication Practices [US] to a small

list of medications “bearing a

heightened risk of harm, which may

require special safeguards to reduce

the risk of error.” Approximately half

of all paid obstetric litigation claims

Clark 2008 “Oxytocin: New perspectives on an old drug”

Synthetic Oxytocin:

Side-effects

• Effects on

breastfeeding?

• Passes to baby?

• Longer-term

effects?

More adverse

effects:

Synthetic Oxytocin:

Side-effects

HPOC 3.2.6

• Swedish epidural

study, 700

mothers and

babies after

normal birth

• Epidural vs non-

epidural matched

for age, parity,

gestational age

• Fewer exposed

babies suckled in

Wiklund 2009

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Synthetic OT :

Breastfeeding

Oxytocin levels with

breastfeeding Day 2

among 61 mother-babies

according to

interventions

Jonas et al 2009, Breastfeeding Medicine

“The higher the dose of

oxytocin infusion the women

received during labour, the

lower the women’s

endogenous oxytocin levels

were during a breast-

feeding episode during the

second day postpartum.”

Synthetic OT :

Breastfeeding

HPOC 3.2.6

BETA-ENDORPHINS

Beta-Endorphins

Natural opioids

(morphine, heroin,

pethidine, fentanyl)

Released with stress

and duress

Natural pain

killer/analgesics HPOC 4.1.1

Pleasure,

euphoria,

dependency

Pro-social

Reward

reproductive acts

Sex

Birth

Breastfeeding

Imag

e: W

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edia

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mm

on

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Beta-Endorphins

Beta-Endorphins in

Labour

Alter state of

consciousness

Transcend pain

Imag

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Cre

ativ

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by

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iam

Hormone of pleasure

and transcendence

In labour:

Beta-Endorphins in

LabourLevels gradually

increase

Equivalent to

endurance

athletic

performance

Very high levels

inhibit labour-

“ration labour”

In labour:

Beta-Endorphins in

LabourFacilitate

prolactin release

within limbic

system

Peak at birth,

subsides over

hours to days

Half-life:

Plasma 37 mins

Cerebrospinal fluid

>21 hours

Imag

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by

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ty.f

ish

er

BEs: Blood Levels in

Labour/Birth(from Hoffman 1984)

Beta-Endorphins:

Baby Secretes BE in

labour

Protects fetal

brain from

hypoxia (animal)

Levels peak at

birth, subside

over 2 hours

Present in

breastmilk

Baby:

(Zanardo 2001)

Significantly more beta-

endorphins in colostral milk

when mothers have normal

labour, birth (no epidural,

oxytocin) compared to pre-

labour cesarean (6pmol/l vs.

4.3)

Postpartum:

Helps baby with stress of

adapting to life outside the

womb

Beta-Endorphins:

Baby

Released as

mother

breastfeeds

Present in

breastmilk

Induces a

“pleasurable

Beta-Endorphins

Postpartum

What Disturbs

Beta-Endorphins?

What Disturbs Beta-

Endorphins?

• Synthetic oxytocin?

• Opiate drugs

• Epidural analgesia

• Cesarean surgery

Epidural Analgesia

“..epidural

analgesia is one

of the most

striking examples

of the

medicalisation of

normal birth,

transforming a

physiological

event into

WHO, 1995:

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Epidural Analgesia

Major effects on hormonal

physiology, during labour and

postnatally.

Epidurals: Beta-

Endorphins• Totally

abolishes pain

sensation

• Dramatic drop

in BEs

• Postnatally:

as low as 20%

of physiologic

levels

Imag

e: F

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Cre

ativ

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mo

ns,

by

arch

ibal

dju

de

HPOC 4.2.5

Epidurals: Oxytocin

• Epidurals reduce maternal oxytocin

levels

• Abolish sensory feedback

• Also, opiates inhibit oxytocin

release

• Numbing inhibits stretch receptor

feedback/Ferguson reflex

• Effects may persist after “wearing

off”

• Postnatally oxytocin reduced to

50% of normal levels

HPOC 3.2.5

Epidural: Effects on

Labour• Prolongs second

stage of labour

• Increases use of

synthetic oxytocin

• Increases

instrumental birth

• Increases CS for

fetal distress Anim-Somuah 2011, Cochrane SR

Imag

e: W

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edia

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mm

on

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Epidural: Maternal

Physiology• Drop in blood pressure (A-NA)

• Reduction in uterine blood

flow (Fratelli 11)

• Uterine hyperstimulation (A-

NA)

• Elevation in temperature

(Oxytocin/ autonomic NS)

All can affect the baby

• Reduced

oxytocin

• Reduced beta-

endorphin

• Reduced CAs

• Reduced

prolactin

Significant interference with

hormones of attachment, reward

Imag

e: F

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ativ

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by

jare

dan

dm

elan

ie

Epidurals: Maternal

Behaviour

Epidurals: Maternal

Behaviour

• 7/8 primiparous

sheep failed to

show interest

within 30 mins

of birth

• 8/27

multiparous

• 0/22 controls

• Substantially

reversed with

oxytocin into

Sheep:

Use

d w

ith

pe

rmis

sio

n h

ttp

://lo

ckspa

rkfa

rm.w

ord

pre

ss.c

om

/

• Spent less time

with their babies

in hospital

• Babies “less

adaptable, more

intense and more

bothersome” at 1

month

Human mothers after epidural:

Epidurals: Maternal

Behaviour

HPOC 3.2.5

• Reduced

oxytocin

• Reduced beta-

endorphins

• Reduced

prolactin

Significant interference with

hormones of breastfeeding

Epidurals: Breastfeeding

Imag

e: F

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Cre

ativ

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by

jon

ny.

hu

nte

r

HPOC 3.2.5

Catecholamines(CAs

)

HPOC Ch 5

Epinephrine/norepinephrine

Adrenaline/noradrenaline, CAs

Fight-or-flight

Released with anxiety, fright,

hunger, cold

Excitement, “tower of terror”Hormones of excitement

Catecholamines

In labour:

Levels gradually

increase

Very high levels:

Reduce uterine

contractions

Shift blood supply to

muscles, heart

Shift blood supply away

from uterus, baby

Prolong labour, fetal

distress

(Lederman 1985)

Catecholamines:

Mother

Catecholamines:

Mother

Private

Safe

Unobserved

CA levels

will rise when

the labouring

female does

not feel:

Imag

e: F

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by

win

nie

-t

Catecholamines:

Mother Mother’s CA

levels naturally

rise at

transition

Physiological

fear

Very high levels

paradoxically

uterotonic

Fetus ejection

reflex

Imag

e ©

Eile

en S

ulli

van

HPOC 5.1.3

CA levels in labour (Alehagan 2005)

Catecholamines:

Mother

Phase of Labour

0

100

200

300

400

500

600

700

800

900

Early Mid Late labour

CA levels as % of later-

pregnancy levels

noradrenaline

adrenaline

CAs benefit the baby in

labour:

Catecholamines:

BabyCA surge with head

compression

Shift blood to

essential organs

Brain

HeartHPOC 5.1.3

Catecholamines:

BabyCAs benefit the baby in

labour:Neuroprotective

Reduces cell death from

hypoxia

Stimulates anaerobic

glycolysis

Glucose metabolism at low

oxygen levels

Lagercrantz, H. and T. A. Slotkin (1986). "The "stress" of being born." Sci Am 254 (4): 100-7.

Catecholamines:

BabyIMPROVES BREATHING

INCREASES LUNG SURFACTANT

INCREASES LUNG-LIQUID

ABSORPTION

IMPROVES LUNG COMPLIANCE

DILATES BRONCHIOLES

PROTECTS HEART AND BRAIN

INCREASES BLOOD FLOW TO

VITAL ORGANS

MOBILIZES FUEL

BREAKS DOWN NORMAL FAT INTO

FATTY ACIDS

BREAKS DOWN GLYCOGEN (IN

LIVER) TO

GLUCOSE

STIMULATES NEW PRODUCTION OF

GLUCOSE

BY LIVER

FACILITATES BONDING

DILATES PUPILS

APPEARS TO INCREASE ALERTNESS

INITIATES THERMOREGULATION

BURNS BROWN FAT

Lagercrantz, H. and T. A. Slotkin (1986). "The "stress" of being born." Sci Am 254 (4): 100-7.

Pre-Labour

PreparationsIMPROVES BREATHING

INCREASES LUNG SURFACTANT

INCREASES LUNG-LIQUID

ABSORPTION

IMPROVES LUNG COMPLIANCE

DILATES BRONCHIOLES

PROTECTS HEART AND BRAIN

INCREASES BLOOD FLOW TO

VITAL ORGANS

MOBILIZES FUEL

BREAKS DOWN NORMAL FAT INTO

FATTY ACIDS

BREAKS DOWN GLYCOGEN (IN

LIVER) TO

GLUCOSE

STIMULATES NEW PRODUCTION OF

GLUCOSE

BY LIVER

FACILITATES BONDING

DILATES PUPILS

APPEARS TO INCREASE ALERTNESS

INITIATES THERMOREGULATION

BURNS BROWN FAT HPOC Ch 2, 5.1.2

Catecholamines

Postnatal:

NE: hormone of

bonding

Norepinephrine

enhances baby’s

olfactory senses

Levels drop

steeply for mother

and baby after

birth

CatecholaminesMother needs to

feel:

Private

Safe

Unobserved

Warm

On-going CA elevation

physiologically risks bleeding

Image: Flickr Creative Commons, by Chad Crowell

HPOC 5.1.4

What Disturbs

Catecholamines?

What Might Impact

CAs?• Maternity care provider and birth

environment (5.2.1)


and labor induction (5.2.2)



(5.2.3)

• Opiate analgesic drugs (5.2.4)

• Epidural analgesia (5.2.5)

• Cesarean section (5.2.6)


and newborns (5.2.7)

HPOC 5.2

Disturbance in

Labour

• Private

• Safe

• Unobserve

d

Conditions where

the mother does

not feel:

Disturbance in

Labour• Moving from familiar

to unfamiliar setting

• Presence of

strangers

• Change of carers

• Suggestion of risk to

self or baby

• Techniques of

monitoring

Examples:

Imag

e: F

lickr

Cre

ativ

e C

om

mo

ns

by

pre

mu

s

In labour:

• Levels gradually increase

• Very high levels:

• Reduce uterine contractions

• Shift blood supply to muscles, heart

• Shift blood supply away from uterus, baby

• Prolong labour, fetal distress(Lederman 1985)

Disturbance in Labour

Caesarean: Hormonal

Impact• Mother: less

or no

ecstatic

hormones

• Baby: lack of

hormonal

protection

and

preparation

• Pre-labour

Imag

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ikim

edia

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mm

on

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Caesarean: Maternal

Hormones• Depressed mood up

to 8 months

• Depressed self-

esteem

• Postnatal

depression?

• Reduced

breastfeeding

success

• Attachment?

Imag

e: F

lickr

Cre

ativ

e C

om

mo

ns

by

bre

ttn

eils

on

(Fisher 1997; Rowe-Murray 2001)

Less activation

of maternal

brain arousal

and reward

centres in

response to own

baby’s cry at

2-4w postpartum

Caesarean: Maternal

Hormones

(Swain 2008)

Imag

e: W

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edia

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mm

on

s

HPOC 3.2.6

Caesarean: Impact on

Baby

• Oxytocin

• Beta-

endorphin

• Adrenaline

• Noradrenalin

e

• Prolactin

Prelabour CS: newborn hormones:

50% of

physiologic?

60% of

physiologic?

10-30% of

physiologic

20 to 60% of

physiologic

70% of

(Lagercrantz

1986)

IMPROVES BREATHINGINCREASES LUNG SURFACTANTINCREASES LUNG-LIQUID ABSORPTIONIMPROVES LUNG COMPLIANCEDILATES BRONCHIOLES

PROTECTS HEART AND BRAININCREASES BLOOD FLOW TO VITAL ORGANS

MOBILIZES FUELBREAKS DOWN NORMAL FAT INTO FATTY ACIDSBREAKS DOWN GLYCOGEN (IN LIVER) TO

GLUCOSESTIMULATES NEW PRODUCTION OF GLUCOSE

BY LIVER

FACILITATES BONDINGDILATES PUPILSAPPEARS TO INCREASE ALERTNESS

INITIATES THERMOREGULATIONBURNS BROWN FAT

Fetal CA Surge in

Late Labour

Caesarean: improving

outcome• After 39 weeks

• In-labor planned

• Skin-to-skin

• Skin-to-skin

• Skin-to-skin

(Fisher 1997; Rowe-Murray 2001)

PROLACTIN

Prolactin

Prolactation

Important in

maternal attachment

Associated with

care-taking

Hormone of paternityHormone of tender mothering

Prolactin

Steep rise at end

of pregnancy

May stimulate

formation of

mammary receptors

Prolactin

receptor theory

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Prolactin

Levels drop in labour

Rise again at full

dilation

Oxytocin, BEs increase

prolactin release

Peaks at 1-2 hours

postpartum

Prolactin

0

50

100

150

200

250

300

350

400

7 6 5 4 3 2 1 BIRTH 1 2 6

Pro

lact

in le

vels

ng/

ml

Time before/after birth in hours

Figure X. Maternal prolactin levels in physiologic labor, birth, and postpartum

Source: Adapted from Stefos 2001

Stress reducing

Care-taking, monotony

Secreted into breastmilk

Optimal brain development

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Prolactin

What Makes Birth

Safe?

Hormonal Safety

Mechanisms

Oxytocin pre-labour preparations:

OTRs increased: uterus,

brain (A), breasts (A)

Oxytocin promotes ease and

efficiency Effective contractions in

labour

Effective pushing

Hormonal Safety

Mechanisms

Oxytocin protects the fetal

brain Switches off brain

activity (A)

Hormonal Safety

Mechanisms

Oxytocin protects the mother from

bleeding after the birth.

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Hormonal Safety

Mechanisms

Beta-endorphins imprint reward

and pleasure after birth

• Reward and motivate ongoing

maternal caretaking

behaviours

Hormonal Safety

Mechanisms

Beta-endorphins inhibit labour

with stress Inhibits oxytocin release

Hormonal Safety

Mechanisms

CAs: pre-labour preparations

CA receptors: fetal lungs, heart

Hormonal Safety

Mechanisms

Catecholamines inhibit labour

Hormonal Safety

Mechanisms

Hormonal Safety Mechanisms

Catecholamines protect and prepare

baby.

Prolactin pre-labour preparations

PRL: breasts, brain (A)

Hormonal Safety

Mechanisms

Prolactin prepares for lactation

OT, BEs in labor promote

release

Hormonal Safety

Mechanisms

Summary,

Suggestions

Private

Safe

Unobserved

Create and maintain a space

where the labouring mother

feels:

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Suggestions for an

Undisturbed Birth

Dim lighting

Few words, no

numbers

Cover the clock

Encouraging

instinctive

behaviour

“On another planet”

Image: Eileen Sullivan

Suggestions for an Undisturbed

BirthReduce mother’s neocortical

stimulation through:

Keep technology as simple as

possible: Astute but

subtle

observation

Physical

support, hands-

on

Encourage

Breath

Sound

Movement

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Suggestions for an Undisturbed

Birth

Spontaneous labour in a normal woman is an

event marked by a number of processes so

complicated and so perfectly attuned to each

other that any interference will only detract

from the optimal character.

The only thing required from the bystanders

is that they show respect for this awe-

inspiring process by complying with the first

rule of medicine –

Professor J. Kloosterman, 1982

nil nocere.

Suggestions: Undisturbed

Birth

undisturbed birth: nature’s - schedschd.ws/hosted_files/2015mfcisymposiumprotectingthemo/ef/mfci...

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