Hormones and environment – what helps and hinders labour?
When the long-awaited day finally comes around and you give birth to a tiny, brand new human being you will be at your most powerful (hell yeah!), but also vulnerable. As a woman in labour your senses will be heightened and how you are feeling and your immediate environment have a huge impact on your labour.
To help things go super smoothly, you need to feel safe, secure, warm and – most importantly – undisturbed. Ideally you won’t be ‘watched over’, or unduly interrupted or questioned. As birth is pretty primal, you want the rational, logical, thinking part of your brain well and truly out of the picture so you can get into your own zone.
Even small things can tip you out of this undisturbed state and into feeling anxious, and your immediate environment can play a big part. Giving birth is the most intimate and personal thing you will ever do – along with having sex with your significant other – and of course the two are intrinsically linked. You need to create a similar environment for birth as you would when getting intimate with your partner. Usually for most this would be an environment with low lighting, not having people wandering in and out, not having someone asking us how we are progressing and ‘can we hurry up a bit’, not having someone make suggestions on how we should be ‘doing it’ and not being told what position we should be in. Can you imagine?! Nothing would be more likely to shut your body down, clamp it up and cause everything to stall.
Birth is the same; interruptions, (usually) giving birth in a public building, bright lights, being poked and prodded by a relative stranger and being told to ‘hurry up or we’ll need to intervene’ are all a huge hindrance. Without going into great detail about birthing hormones, I do want to explain them briefly how they are affected by environment.
Oxytocin is the powerhouse hormone of labour. It starts your surges and shapes the length and strength of them, keeping labour going. It is also known as the ‘hormone of love’, because it is released when couples make love, and when people feel relaxed, happy, safe and secure. It comes out in abundance when it is dark and it will be one of your best friends during labour. Coupled with high levels of endorphins, oxytocin makes labour feel more comfortable.
The fight-or-flight hormones, adrenaline and noradrenaline, are produced by the body in response to stresses such as hunger, fear and cold. When these hormones kick in, our sympathetic nervous system gets ready to ‘freeze, fight or flight’.
It is normal for there to be adrenalin during the transition part of labour (towards the end of the first stage) and when the uterus is nudging the baby out. However, if a woman has high levels of adrenalin during her labour it can inhibit her contractions, slowing or even stopping labour. Blood flow to the uterus and placenta is reduced, which not only affects labour, but can also affect the baby.
‘Fight or flight’ is a great tool for wild animals giving birth, as this reflex inhibits labour and sends blood to the major muscle groups, so the birthing mother can most likely choose to flee from a threat. We are lucky enough not to need this when we give birth, but bright lights, feeling as if we are being observed, frequent interruptions and feeling fearful can tip a woman into this state. As a result, surges are less efficient and more painful and labour may stall or even stop completely.
Beta-endorphin
These are naturally occurring opiates which are our very own powerful painkillers with similar properties to morphine and pethidine. During labour they will help reduce pain and help the woman feel calm and ‘zoned out’. Interruptions and chatter take you out of this zone, so keep this to a minimum to allow yourself to get into a rhythm. This is where your birth partner can really help.
What will help you feel safe, secure and uninhibited?
- Lights out / lights low. This is the big one. Melatonin is a hormone that helps us sleep and its production peaks when it is dark. Melatonin helps with the release of oxytocin so keeping things dimly lit will help with this process. If you are planning a homebirth you will have more control over lighting, but you can still achieve this on the labour ward. Most labour wards have dimmer switches. You can bring in portable blackout blinds, battery-operated candles or fairy lights for gorgeous soft light, or bring in an eye mask or even sunglasses to shut out the outside world. The room is yours to make your own.
- Touch (if wanted!) – hugs, kissing, cuddling, stroking/massage – these produce oodles of oxytocin and the release of endorphins. A long hug from your partner or birth partner will make you feel safe; his or her familiar scent will settle and calm you.
- Movement – try rocking, swaying, using a birth ball, using the lowered bed as a prop to lean on, wriggling, on all-fours, sitting on the toilet: follow your body’s lead. Movement helps the baby get into a good position and makes things feel more manageable for the mother.
- This is not saying you cannot interact with or talk to anyone, but keeping interruptions to a minimum, and avoiding complex questions that take you out of your zone, is key. Birth can of course be noisy, and making sounds can be releasing. But make sure the environment you are in lends itself to letting you release, relax and go into yourself. Mammals take themselves to a dark, quiet place to give birth – think of a cat having kittens – and we need to do the same. Each interrupted surge is one that is less efficient. Make each incredible, amazing and powerful surge count.
- Smell is one of the most powerful. The familiar smell of home, whether on a blanket, pillow or pyjamas, or through the scent of a candle transferred on to fabric – can increase comfort levels. Sounds – play a familiar relaxation MP3 that you have been listening to (particularly relevant for those who have prepared using Hypnobirthing), or bring in ear plugs to block out the outside world.
- Birth partners. Your input is so important! Ensure the birth plan is read (we all know birth plans need to be flexible, but they are your hopes and wishes and it is important that they are read). Ensure your partner has access to food and drink. Control the environment; keep questions at bay and protect your partner’s space. If you’re unsure what to do, just think ‘Am I/is this helping to make her feel safe, secure and private?’
When a woman has an undisturbed birth, her hormones can flow perfectly, enhancing the safety of her and her baby. Interference with this hormonal flow can make birth more difficult and painful.
To conclude – of course, there is a lot we cannot control during birth. However, there is also a lot we can do to help ensure that it unfolds as comfortably and easily as possible.
To find out more about paving your way to a smooth labour and birth book onto a friendly and relaxed Hypnobumps’ course!
Feel free to share this blog and I’d love to hear what helped your labour!
Further reading
Lothian, Judith A. ‘Do Not Disturb: The importance of privacy in labour’ Journal of Perinatal Education, 2014. http://www.ncbi.nlm.nih.gov. (Accessed August 2016)
Buckley, Sarah ‘Undisturbed Birth’, AIMS Journal, Vol 23, No.4, 2011. www.aims.org.uk/Journal/Vol23No4/undisturbedBirth.htm
Barbeau, Beth ‘Safer Birth in a Barn’, Midwifery Today, 2007. www.midwiferytoday.com (Accessed August 2016)
Buckley, Sarah ‘Pain in Labour: Your hormones are your helpers’, 2005 www.sarahbuckley.com/pain-in-labour-your-hormones-are-your-helpers-2 (accessed September 2016)