Before I talk about the benefits of natural childbirth I want to make a disclaimer that I am in no way judging women who choose to take a different route and prefer having medication during delivery. As women we deserve to have ultimate control over our bodies and make decisions on how we give birth. Yet women also need to be given information regarding all choices of interventions, understanding that nothing is without risk. In addition, I am grateful that we have access to medications and interventions that can absolutely be life-saving. Labor and birth are mysteries that do not always go as planned, and sometimes an epidural and medical augmentation are extremely helpful in facilitating a vaginal birth and a Cesarean may be live saving. My hope is to let women in this country know that natural childbirth is not crazy, despite the crazy looks you may get, and that there are many benefits.
I remember when I told people I was planning to have a natural childbirth with my second child. I got a lot of funny looks and comments. You know the ones like, “Why would you do that” or my favorite “Well you don’t get a medal for not getting an epidural”. Unfortunately, this is the general mentality in the U.S. regarding natural childbirth. But it is not about getting a medal. There are many benefits! I realized this after the birth of my first child, which was an induction that lead to cesarean. I was induced before my body was ready, laid flat on my back with an epidural for 15 hours, which lead to a mal-positioned baby resulting in the need for a Cesarean. I went on to have two VBACs where I was not induced, was upright and active, and had great deliveries.
So what are all of the benefits?
Shorter Labors
As I just mentioned from my own experience, when mom is upright and actively working through her labor, labor tends to be shorter. There are several cardinal movements of birth where the baby has to actively rotate and descend through the pelvis during labor and birth. Being upright and able to change positions frequently during labor facilitates this process and helps prevent the baby from getting stuck in a bad position. Getting an epidural or other pain medications limits mobility, and may slow labor contractions.
Faster Recovery Time
Women who have natural birth usually feel great a short while after delivering their babies. They are able to be upright shortly after labor if they desire, and they can walk around or take a shower. After natural childbirth mothers usually experience a euphoria caused by the release of endorphins in the body during labor. As I will discuss below, tests have shown that a woman’s body will not release nearly as many endorphins if a pain medication is utilized.
Empowering Experience
While there is no medal given for giving birth naturally, it is an empowering and life-changing experience. Similar to running a marathon or any other physically and emotionally draining process, women feel a strong sense of achievement and confidence that helps them through motherhood.
Alert Experience
When narcotics are not used during labor, women are very alert and fully conscious of the experience. This allows them to be fully present when their babies arrive, and be connected to their bodies in a profound way.
Experiencing the Hormonal Cocktail of Birth
To understand the benefits of natural childbirth, we need to understand the complex hormonal changes that take place during labor and birth which involves the following hormones: estrogen, progesterone, oxytocin, beta-endorphins, prolactin and catecholamines. Estrogen and progesterone play a crucial role in the initiation of labor to prepare the uterus for contractions in labor. Oxytocin is associated with the contractions of labor, and has also been referred to as the hormone of love because of its involvement with sexual activity, orgasm, birth and breastfeeding. Oxytocin is released as labor begins, and increases in amounts as labor progresses. After birth, when the infant stimulates the mother’s breast, high levels of oxytocin are produced to contract the uterus and prevent postpartum hemorrhage. Oxytocin also facilitates the “milk ejection reflex” which allows for successful breastfeeding. And finally, oxytocin promotes a strong bond between mother and baby as the hormone of love flows in high amounts. Beta-endorphin is a naturally occurring opiate that helps mothers deal with the pain of childbirth. High amounts are produced in labor, allowing the mother to enter into a trance-like state going deep into herself, or ‘laborland’. Prolactin is released by the pituitary during pregnancy and lactation, which prepares the woman’s breasts for lactation. The combination of prolactin and oxytocin contribute to the elevated mood and calm feeling mothers experience during breastfeeding. Catecholamines are the “fight or flight” hormones which peak right before transition (the hardest part of labor). These high levels stimulate uterine contractions, contributing to the “Fetus Ejection Reflex” which occurs as baby is born.
So what happens when we add interventions like an epidural, narcotics, or synthetic oxytocin (Pitocin) to the hormonal cocktail of labor? Unfortunately, all of these medications have a significant impact on the production of these hormones in labor. Whenever an epidural is given and all pain is removed this inhibits beta-endorphin production, which is the hormone that helps moms reach the altered shift in consciousness in dealing with the intensity of labor. Following this, naturally occurring oxytocin levels drop, which can cause labor contractions to slow down. Without high levels of oxytocin and beta-endorphins, a surge in catecholamines does not occur as the birth becomes imminent.
Synthetic oxytocin (Pitocin) can also interfere with the delicate orchestration of hormones during birth. The effect of synthetic oxytocin is not the same as that of natural oxytocin produced by a laboring woman. When Pitocin is given, it does not cross the blood/brain barrier unlike naturally occurring oxytocin. As a result, the pituitary is not stimulated to release beta-endorphins. Without the pain-relieving help of abundant beta-endorphins, women who are induced with Pitocin are more likely to require epidurals. The uterine contractions produced by synthetic oxytocin are longer, more forceful and much closer together than a woman’s natural contractions since IV Pitocin is delivered continuously and natural oxytocin is delivered in spurts as the body needs it. This can cause significant stress to the baby, because there’s not enough time to recover from the reduced blood flow that happens when the placenta is compressed with each contraction. The net effect of this is to deprive the baby of necessary supplies of blood and oxygen, which can in turn lead to abnormal fetal heart rate patterns and fetal distress.
A Swedish study showed there is nearly 3 times greater risk of asphyxia (oxygen deprivation) for babies born after augmentation with Pitocin. And a study in Nepal showed that induced babies were 5 times more likely to have signs of brain damage at birth.
Pitocin can also cause complications for birthing women. Evidence suggests that women who receive Pitocin have increased risk of postpartum hemorrhage, which is likely due to the prolonged exposure to synthetic oxytocin. Continuously administering Pitocin through an IV makes the oxytocin receptors in her uterus insensitive to oxytocin and her own postpartum oxytocin release ineffective in preventing hemorrhage after birth.
As you can see, the introduction of interventions like epidurals and Pitocin disrupts the hormonal orchestration of labor, which results in women giving birth with relatively low levels of naturally occurring oxytocin, endorphins, and catecholamines. These are powerful hormones of love and ecstasy which produce euphoric feelings in a mother who has just given birth and facilitates bonding between mother and baby.
Epidurals May Lead to Other Interventions
Once an epidural is added, a mother will be connected to several wires or lines prohibiting mobility including the following: epidural line in her back, IV line in one arm, blood pressure cuff on the other arm, pulse oximeter on finger, two belts around her waist for continuous monitoring of contractions and the baby, a catheter for urine, and sometimes fetal monitor attached to the infant's scalp.
Epidurals have been shown to have the following effects on labor, laboring mothers, and the baby:
Other Risks Associated with Pitocin
The U.S. Pitocin package insert includes the following warning of issues that it can cause:
I Want to Plan a Natural Childbirth, So What Now?
If a mother decides that she would like to experience a natural childbirth, a mother can plan a natural childbirth at home, birth center, or hospital. Choosing the right care team can make a big difference. Ask around to find the right care team. Doulas are a great resource and can tell you about different options in your area. You can also ask on natural childbirth or other natural support groups or Facebook groups. However, as mentioned before, birth is a mystery, and flexibility is needed when things do not go as planned and interventions are needed. Don’t beat yourself up if your birth doesn’t go as plan. Do take time to grieve and get support.
I Want a Natural Childbirth but I’m Scared of the Pain!
A great resource for overcoming fear in childbirth is the classic Childbirth without Fear by Dick-Read. Our bodies are designed to give birth facilitated by a magical cocktail of hormones to help us through the process. Plan ahead for your natural childbirth experience by educating yourself on the process. Ways to prepare:
By Shannon Greika, Certified Professional Midwife
References
Buckley, S. (2015). Hormonal Physiology of Childbearing: Evidence and Implications for Women, Babies,
and Maternity Care. Childbirth Connection Programs, National Partnership for Women & Families.
Buckley, S. (2009). Gentle birth, gentle mothering: a doctor’s guide to natural childbirth and early
parenting choices. Celestial Arts.
Dick-Read, G., Snaith, L., & Coxon, A. (1968). Childbirth without fear: The principles and practice of
natural childbirth. London: Heinemann
Lothian, J. (2005). The Birth of a Breastfeeding Baby and Mother. J Perinat Educ. 2005 Winter; 14(1):
42–45. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595228/
Milsom, L., Ladfors, L., Thiringer, K., Niklasson, A., Odeback, A., & Thornberg, E. (2002). Influence of
maternal, obstetric and fetal risk factors on the prevalence of birth asphyxia at term in a Swedish urban population. Acta Obstet Gynecol Scand. 2002 Oct;81(10):909-17. http://www.ncbi.nlm.nih.gov/pubmed/12366480
Matthew, E., Manandhar, N., Manandhar, D., & Costello, A. (2000). Risk factors for neonatal
encephalopathy in Kathmandu, Nepal, a developing country: unmatched case-control study. BMJ. 2000 May 6; 320(7244): 1229–1236. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC27363/
Odent M. The scientification of love. Free Association Books 1999.
http://americanpregnancy.org/labor-and-birth/epidural/
http://naturallysavvy.com/nest/the-benefits-of-natural-childbirth
I remember when I told people I was planning to have a natural childbirth with my second child. I got a lot of funny looks and comments. You know the ones like, “Why would you do that” or my favorite “Well you don’t get a medal for not getting an epidural”. Unfortunately, this is the general mentality in the U.S. regarding natural childbirth. But it is not about getting a medal. There are many benefits! I realized this after the birth of my first child, which was an induction that lead to cesarean. I was induced before my body was ready, laid flat on my back with an epidural for 15 hours, which lead to a mal-positioned baby resulting in the need for a Cesarean. I went on to have two VBACs where I was not induced, was upright and active, and had great deliveries.
So what are all of the benefits?
Shorter Labors
As I just mentioned from my own experience, when mom is upright and actively working through her labor, labor tends to be shorter. There are several cardinal movements of birth where the baby has to actively rotate and descend through the pelvis during labor and birth. Being upright and able to change positions frequently during labor facilitates this process and helps prevent the baby from getting stuck in a bad position. Getting an epidural or other pain medications limits mobility, and may slow labor contractions.
Faster Recovery Time
Women who have natural birth usually feel great a short while after delivering their babies. They are able to be upright shortly after labor if they desire, and they can walk around or take a shower. After natural childbirth mothers usually experience a euphoria caused by the release of endorphins in the body during labor. As I will discuss below, tests have shown that a woman’s body will not release nearly as many endorphins if a pain medication is utilized.
Empowering Experience
While there is no medal given for giving birth naturally, it is an empowering and life-changing experience. Similar to running a marathon or any other physically and emotionally draining process, women feel a strong sense of achievement and confidence that helps them through motherhood.
Alert Experience
When narcotics are not used during labor, women are very alert and fully conscious of the experience. This allows them to be fully present when their babies arrive, and be connected to their bodies in a profound way.
Experiencing the Hormonal Cocktail of Birth
To understand the benefits of natural childbirth, we need to understand the complex hormonal changes that take place during labor and birth which involves the following hormones: estrogen, progesterone, oxytocin, beta-endorphins, prolactin and catecholamines. Estrogen and progesterone play a crucial role in the initiation of labor to prepare the uterus for contractions in labor. Oxytocin is associated with the contractions of labor, and has also been referred to as the hormone of love because of its involvement with sexual activity, orgasm, birth and breastfeeding. Oxytocin is released as labor begins, and increases in amounts as labor progresses. After birth, when the infant stimulates the mother’s breast, high levels of oxytocin are produced to contract the uterus and prevent postpartum hemorrhage. Oxytocin also facilitates the “milk ejection reflex” which allows for successful breastfeeding. And finally, oxytocin promotes a strong bond between mother and baby as the hormone of love flows in high amounts. Beta-endorphin is a naturally occurring opiate that helps mothers deal with the pain of childbirth. High amounts are produced in labor, allowing the mother to enter into a trance-like state going deep into herself, or ‘laborland’. Prolactin is released by the pituitary during pregnancy and lactation, which prepares the woman’s breasts for lactation. The combination of prolactin and oxytocin contribute to the elevated mood and calm feeling mothers experience during breastfeeding. Catecholamines are the “fight or flight” hormones which peak right before transition (the hardest part of labor). These high levels stimulate uterine contractions, contributing to the “Fetus Ejection Reflex” which occurs as baby is born.
So what happens when we add interventions like an epidural, narcotics, or synthetic oxytocin (Pitocin) to the hormonal cocktail of labor? Unfortunately, all of these medications have a significant impact on the production of these hormones in labor. Whenever an epidural is given and all pain is removed this inhibits beta-endorphin production, which is the hormone that helps moms reach the altered shift in consciousness in dealing with the intensity of labor. Following this, naturally occurring oxytocin levels drop, which can cause labor contractions to slow down. Without high levels of oxytocin and beta-endorphins, a surge in catecholamines does not occur as the birth becomes imminent.
Synthetic oxytocin (Pitocin) can also interfere with the delicate orchestration of hormones during birth. The effect of synthetic oxytocin is not the same as that of natural oxytocin produced by a laboring woman. When Pitocin is given, it does not cross the blood/brain barrier unlike naturally occurring oxytocin. As a result, the pituitary is not stimulated to release beta-endorphins. Without the pain-relieving help of abundant beta-endorphins, women who are induced with Pitocin are more likely to require epidurals. The uterine contractions produced by synthetic oxytocin are longer, more forceful and much closer together than a woman’s natural contractions since IV Pitocin is delivered continuously and natural oxytocin is delivered in spurts as the body needs it. This can cause significant stress to the baby, because there’s not enough time to recover from the reduced blood flow that happens when the placenta is compressed with each contraction. The net effect of this is to deprive the baby of necessary supplies of blood and oxygen, which can in turn lead to abnormal fetal heart rate patterns and fetal distress.
A Swedish study showed there is nearly 3 times greater risk of asphyxia (oxygen deprivation) for babies born after augmentation with Pitocin. And a study in Nepal showed that induced babies were 5 times more likely to have signs of brain damage at birth.
Pitocin can also cause complications for birthing women. Evidence suggests that women who receive Pitocin have increased risk of postpartum hemorrhage, which is likely due to the prolonged exposure to synthetic oxytocin. Continuously administering Pitocin through an IV makes the oxytocin receptors in her uterus insensitive to oxytocin and her own postpartum oxytocin release ineffective in preventing hemorrhage after birth.
As you can see, the introduction of interventions like epidurals and Pitocin disrupts the hormonal orchestration of labor, which results in women giving birth with relatively low levels of naturally occurring oxytocin, endorphins, and catecholamines. These are powerful hormones of love and ecstasy which produce euphoric feelings in a mother who has just given birth and facilitates bonding between mother and baby.
Epidurals May Lead to Other Interventions
Once an epidural is added, a mother will be connected to several wires or lines prohibiting mobility including the following: epidural line in her back, IV line in one arm, blood pressure cuff on the other arm, pulse oximeter on finger, two belts around her waist for continuous monitoring of contractions and the baby, a catheter for urine, and sometimes fetal monitor attached to the infant's scalp.
Epidurals have been shown to have the following effects on labor, laboring mothers, and the baby:
- May cause sudden drop in blood pressure.
- May experience a severe headache caused by leakage of spinal fluid (1% of women experience this side effect). A procedure called a “blood patch”, which is an injection of your blood into the epidural space, can be performed to relieve the headache.
- Epidurals require continuous monitoring for changes in fetal heart rate.
- Other side effects include shivering, ringing of the ears, backache, soreness where the needle is inserted, nausea, or difficulty urinating.
- May make pushing more difficult and additional medications or interventions may be needed such as forceps, vacuum, or Cesarean.
- Is triple the occurrence of induction with Pitocin.
- Increases the risk of cesarean section by 2.5 times.
- Numbness for a few hours after the birth in the lower half of your body.
- In rare instances, permanent nerve damage may result in the area where the catheter was inserted.
- Epidural medication does reach the baby. Most studies suggest that some babies will have trouble “latching on”, causing breastfeeding difficulties. Other studies suggest that a baby might experience respiratory depression, fetal mal-positioning, and an increase in fetal heart rate variability, thus increasing the need for forceps, vacuum, cesarean deliveries and episiotomies.
- May lengthen labor.
- Increase the chance of fever, which increases the likelihood antibiotics will be prescribed.
- Triples the risk of severe perineal tear. Since the mother is numb, she may push harder than needed, whereas a mother without an epidural is in-tune with pushing, listening to her body.
- Quadruples the chance that a baby will be persistently posterior (face up) in the final stages of labor, which in turn decreases the chances of spontaneous vaginal birth.
- Increase the chance of complications from instrumental delivery. When women with an epidural had a forceps delivery, the amount of force used by the clinician was almost double that used when an epidural was not in place. Instrumental deliveries can increase the short-term risks of bruising, facial injuries, displacement of skull bones and blood clots in the scalp for babies, and of episiotomy and tears to the vagina and perineum in mothers.
- Increase the risk of pelvic floor problems (urinary, anal and sexual disorders) in mothers after birth.
Other Risks Associated with Pitocin
The U.S. Pitocin package insert includes the following warning of issues that it can cause:
- fetal heart abnormalities (slow heartbeat, PVCs and arrhythmias)
- low APGAR scores
- neonatal jaundice
- neonatal retinal hemorrhage
- permanent central nervous system or brain damage
- fetal death
- Tumultuous labor and tetanic contractions, which may cause:
- premature separation of the placenta
- rupture of the uterus
- laceration of the cervix
- postbirth hemorrhage.
- Fetal hazards include: fetal asphyxia and neonatal hypoxia from too frequent and prolonged uterine contractions, physical injury and prematurity if the due date is not accurate.
I Want to Plan a Natural Childbirth, So What Now?
If a mother decides that she would like to experience a natural childbirth, a mother can plan a natural childbirth at home, birth center, or hospital. Choosing the right care team can make a big difference. Ask around to find the right care team. Doulas are a great resource and can tell you about different options in your area. You can also ask on natural childbirth or other natural support groups or Facebook groups. However, as mentioned before, birth is a mystery, and flexibility is needed when things do not go as planned and interventions are needed. Don’t beat yourself up if your birth doesn’t go as plan. Do take time to grieve and get support.
I Want a Natural Childbirth but I’m Scared of the Pain!
A great resource for overcoming fear in childbirth is the classic Childbirth without Fear by Dick-Read. Our bodies are designed to give birth facilitated by a magical cocktail of hormones to help us through the process. Plan ahead for your natural childbirth experience by educating yourself on the process. Ways to prepare:
- Childbirth Education Classes – there are several different kinds of childbirth educations classes you can take. Look into different ones and see what is a good fit for you and your partner. Some great ones include:
- The Bradley Method
- Hypnobabies
- International Childbirth Education Association Instructors
- Birth from Within
- Hire a doula – Fabulous resource to help you and your partner through the process.
- Read books! Some of my favorites include:
- The Birth Partner
- Ina May’s Guide to Childbirth
- Active Birth
- Natural Birth the Bradley Way
- The Birth Book by Sears
- Childbirth without Fear
- Trust your body.
- Listen to positive affirmations.
- Eat well – Nutrition plays an important role in keeping mothers low risk to avoid certain interventions.
- RELAX! Birth is easier when we don’t fight it, but go with it. Practice relaxation techniques.
By Shannon Greika, Certified Professional Midwife
References
Buckley, S. (2015). Hormonal Physiology of Childbearing: Evidence and Implications for Women, Babies,
and Maternity Care. Childbirth Connection Programs, National Partnership for Women & Families.
Buckley, S. (2009). Gentle birth, gentle mothering: a doctor’s guide to natural childbirth and early
parenting choices. Celestial Arts.
Dick-Read, G., Snaith, L., & Coxon, A. (1968). Childbirth without fear: The principles and practice of
natural childbirth. London: Heinemann
Lothian, J. (2005). The Birth of a Breastfeeding Baby and Mother. J Perinat Educ. 2005 Winter; 14(1):
42–45. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595228/
Milsom, L., Ladfors, L., Thiringer, K., Niklasson, A., Odeback, A., & Thornberg, E. (2002). Influence of
maternal, obstetric and fetal risk factors on the prevalence of birth asphyxia at term in a Swedish urban population. Acta Obstet Gynecol Scand. 2002 Oct;81(10):909-17. http://www.ncbi.nlm.nih.gov/pubmed/12366480
Matthew, E., Manandhar, N., Manandhar, D., & Costello, A. (2000). Risk factors for neonatal
encephalopathy in Kathmandu, Nepal, a developing country: unmatched case-control study. BMJ. 2000 May 6; 320(7244): 1229–1236. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC27363/
Odent M. The scientification of love. Free Association Books 1999.
http://americanpregnancy.org/labor-and-birth/epidural/
http://naturallysavvy.com/nest/the-benefits-of-natural-childbirth
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