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Labor and Birth

Oxytocin

 

What is Oxytocin?

Oxytocin is an amazing little hormone.

Even if you don’t know what oxytocin is, you probably notice its effects each day. Oxytocin is sometimes referred to as the “love hormone” and it has a unique role in many of life’s important events. Oxytocin is released by activities such as cuddling, nursing, massage, and lovemaking. Even hair brushing and chocolate can encourage oxytocin release. However, the largest release of this hormone is usually at the moment of birth.

The emotional and physical importance of Oxytocin-

The impact of oxytocin is twofold. First- it has an incredible emotional impact. As you probably guessed, it is often present when we do things that have a special ability to bind us to others. Oxytocin release during nipple stimulation (such as while nursing a baby) serves to bond us powerfully to our children. The incredible oxytocin “high” that is experienced at the time of birth causes a fierce attachment to our child and an overwhelming desire to love and protect them. The emotional impact of oxytocin is powerful in romantic relationships as well as the parent/child dynamic.

Second – it has an important physical component. The surge of oxytocin causes contraction of the uterus both during labor and after the birth. This is not only beneficial, but can actually be lifesaving, as it prevents excessive blood loss.

Oxytocin and your labor-

Imagine the typical charts of labor that you may have seen. Labor is often depicted as coming in waves or hills. Each contraction lasts for around a minute and is followed by a longer break. As time goes on, the contractions get longer and the breaks get shorter.

But what causes these rushes of contractions? What stimulates them? The answer is fairly simple- oxytocin. Produced in your brain, oxytocin is rhythmically pulsed throughout the body. This is, in part, why contractions come in waves with a break between them. (Note that a labor stimulated or sped by an IV drip of Pitocin may not follow this pattern. Pitocin is what artificial oxytocin, often delivered via an IV, is called.)

It is important to understand what can stimulate oxytocin during labor (relaxation, massage, nipple stimulation), because you can use this knowledge to speed or encourage good, strong labor, if necessary. The same things that make you open to oxytocin reception and production (feeling loved, safe, and secure) can help encourage healthy labor.

Think of the uterus at the time of birth. This large, powerful, and muscular organ has been stretched to capacity to hold a full term baby. Suddenly, as the baby delivers, it is empty and must quickly shrink down to a much smaller size. Let’s not forget that the uterus, during pregnancy, has a large organ (the placenta) attached to it on the inside. Shortly after the birth of the baby, the placenta detaches and delivers. The spot of placental attachment within the uterus leaves, what really is, a large wound. This place (the spot where the placenta was attached) is where we see blood loss from at the time of birth.

Now, if you have a large, stretched out organ with a large wound within it, how do we reduce the size of that wound and thus reduce subsequent blood loss? The answer is simple- we must quickly shrink the organ (the uterus) and thus the wound (the place where the placenta was attached). Oxytocin serves this special purpose. The contractions it causes (remember how strong they are at the time of birth?) help to quickly shrink the uterus and limit blood loss.

As a new mom often notices, the days after birth are not without contractions. Every time a new mom nurses her baby, these post-baby contractions (often called “after-pains”) may be felt. While they may be uncomfortable, after-pains serve an important purpose – they help the uterus continue to shrink down so that mom’s blood loss is minimized.

You can see that oxytocin is important to our day to day life but particularly vital during childbearing and the years after. Oxytocin emotionally helps us feel bonded and attached to our children. It also serves to protect the life of mom by helping minimize her blood loss postpartum.  There is a lot to love about the “love hormone.”

4 Simple Ways to Prepare for Natural Birth

Congratulations on your pregnancy!  Many women desire a natural birth but preparing for one can seem overwhelming.  Here are some wonderful tips for preparing yourself for the best natural birth possible.  There is so much you can do to ready yourself and your family for birth.  With these four simple things: education, nutrition, birth place, and birth team, you will be more able to make your goal a reality.  

#1-Education-  Probably the most important step in preparing for natural birth is to educate yourself as much as possible.  Just as with breastfeeding, the more you know about the benefits of natural birth for you and your baby, the more motivated you will be to follow through and prepare accordingly.

Of course there is a plethora of information out there on birth.  How do you trudge through it and find the diamonds among the coal?  First, a comprehensive childbirth education program is a must.  Look for one that is longer rather than shorter.  A weekend “crash course” cannot possibly give you all the information that you need to navigate policies, stay low risk and prepare properly for the birth you want. 

Look for natural childbirth classes that cover staying low risk, nutrition and exercise, relaxation techniques, choosing a care provider and birth place, the stages of labor, preparing your partner, common policies and procedures, breastfeeding and newborn care, and possible complications and how to avoid them. 

Not only will a good birth class help prepare you, it should prepare your partner as well.  In all honesty, your partner’s preparation is tantamount.  If they are frightened or simply unaware of normality, it will inevitably impact the birth negatively. 

In addition to preparing your partner, your natural birth instructor will be able to guide you to find the best books, websites, even care providers and doulas in your area.  Think of a childbirth instructor as somebody on the “inside.”  They have been there and done that and now they can help you accomplish the same thing.  (Our instructors are well trained women who have had natural births, themselves.  You can see a list of their requirements here.)

#2-Nutrition-  As you will quickly learn, preparing your body for a natural birth is just as important as preparing your mind.  Your body will go through some drastic changes as it grows first a placenta, then a baby, adds fluid, almost doubles its blood volume and prepares for future breastfeeding. 

Eating properly means not just avoiding refined foods such as sugars, white flours, packaged foods and chemical sweeteners, it also means adding the right foods into your diet.  Daily nutrition should include several servings of greens (broccoli, spinach, kale, asparagus, etc), citrus foods (oranges, tomatoes, kiwis, bell peppers), vegetables and fruits (celery, cucumbers, bananas and apples), whole grains (spelt, quinoa, oatmeal), eggs, complete protein sources (meats or other combined proteins such as beans and rice) and dairy (milk, Greek yogurt, keifer). 

Women are amazed at how much better they feel when eating properly during pregnancy. Many common pregnancy ailments disappear. Great nutrition and adequate protein can even help eliminate morning sickness.  Your childbirth instructor can provide you with a complete system to chart your nutritional intake and make corrections, if needed.  You can also find many phone apps with which you can keep track of your daily nutrition throughout pregnancy. 

Great nutrition will help your body and your baby be ready for a natural birth.  Many care providers believe that common ailments that surface at the end of pregnancy and often lead to induction or C-section can actually be avoided with optimal nutrition.

#3-Choose Your Birth Place Carefully-   One of the most important choices, as you prepare for a natural birth, is your choice of birth place.  Many factors play into this decision from insurance coverage to proximity.  Women often have three main choices available to them when it comes to birth place:  hospital, birth center or home.  The birth place that works best for you and your family will be influenced by many things, from cost to your own health to where you feel most emotionally comfortable. 

Wherever you choose to birth, be sure that the policies are not so prohibitive that they make natural birth nearly impossible.  Some important policies to look for are:

  • Women are encouraged to eat and drink in early labor.
  • Vaginal exams are kept to a minimum.
  • Women are encouraged to move about in labor.
  • IV’s are only given when necessary.
  • Breastfeeding is supported.
  • They have a low C-section rate. 

In a birth center, you may want a hospital nearby in case of transfer and an environment in which you feel comfortable and supported.  If choosing a home birth (as with any other birth place), you will want to carefully choose your midwife. Look specifically for someone with experience, skills or certification that you feel comfortable with. 

While it may be tempting to choose a birth place simply because it is close, doing things because they seem “easy” is an often regretted decision for birthing women.  A nearby hospital with a sky high induction and C-section rate will greatly increase your chances for the same.  In the case of an unwanted and/or unneeded cesarean section, a shorter drive for a birth place can yield a much longer recovery.  Choose your birth place carefully. 

#4-Choose Your Team Well-  You won’t win the Super Bowl with a football team made up of expert karaoke singers and you won’t get a natural birth with a team of care providers who specialize in surgical birth.  Choosing your birth team carefully is one of the best ways to ensure you get a natural birth.  Sometimes, even when a mother is knowledgeable and physically prepared, things can fall apart for her in labor if her team doesn’t support her decisions. 

So how do you find this pro-natural birth team of supporters?  Asking your childbirth instructor is a great way to start.  As a woman experienced in birth and engaged in the local birth community, she should have a list of resources to provide you with. 

There are many people who will make up your birth team. All of these people will influence your birth experience.

A great doula (a woman trained to support a birthing mother) can be a fabulous resource for both the laboring woman and her partner.  She can provide emotional and physical support, an experts view on supportive care providers, and may act as a sounding board for advice. 

Another good person to have on your team is a Webster Certified chiropractor.  Chiropractic care during pregnancy (and even birth) can help ensure the pelvis is well aligned so that it can move for a faster and more comfortable birthing experience with a better positioned baby.  This alone can help avoid many problems that prevent natural birth. 

Probably most important of all is your choice of care provider.  Your doctor or midwife will make decisions when you can’t and will be there for the final moments of birth.  It is vitally important that this person be both trustworthy and skilled.  If you are a low risk woman, you may want to consider midwifery care.  Midwives often work in hospitals (thought many can be found working in a home birth or birth center environment) and their approach to birth tends to be more supportive of  natural choices. 

You CAN Have an Amazing Birth!  Choosing a natural birth is a wonderful decision. With the right choices and preparation, we believe that most women can achieve this goal.  (Check out our stats from our students!)  Proper education, excellent nutrition, and careful choice of your birth team and your birth place are all things that can make your choice of a natural birth more attainable.  When all is said and done, sometimes things don’t go exactly as planned.  But, when we have done our best and chosen a care provider that we trust, we can rest assured that we did everything possible to accomplish our goal.

What Does Labor Feel Like?

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What does labor feel like?  This is a question that almost every soon-to-be mother asks.  It fills us with trepidation, excitement, and even fear.  So what DOES labor feel like?

The answer is a little different to everybody because, of course, labor is as individual as the women who experience it.  To begin deepening our understanding of labor, let’s talk about the basic stages of labor as defined by medical professionals, generally, and then describe common ways women describe the “feel” of each part of labor.

Labor can be broken down into these parts:

Pre-labor, Early labor (first stage), Active labor, Transition, Pushing (second stage), and Delivery of the placenta (third stage).

Pre-labor-

Pre-labor is often called “braxton-hicks” and can begin early on in pregnancy, sometimes as early as 20 weeks.  Women often begin feeling braxton-hicks earlier in their pregnancy the more babies they have.    Named for the man who first described them, an English doctor named John Braxton Hicks, they have been talked about for hundreds of years.

Some people like to think of pre-labor contractions as a practice for labor.  While they are usually spotty, irregular, painless, and don’t cause dilation of the cervix, pre-labor contractions may serve to “warm up” the uterus and help prepare the baby and body for labor.

For most women, braxton-hicks feel (usually) painless, cannot be regularly timed like serious labor contractions, and may stop and start.  These pre-labor contractions can be brought on by excessive activity, lack of food or water, and even stress.  Unlike true labor contractions, pre-labor contractions are often felt in “spots” rather than over the entire uterus.  The sensation is different for each woman and can feel like simple baby movement or even gas.

Early labor-

Early labor is aptly named and just defines the part of labor that is early, or the beginning.  Unlike pre-labor contractions, early labor contractions are regular, will not stop with eating, drinking water, or rest.  Early labor contractions will be regular but not close together.  If timed, they usually last less than a minute and are not intense, though they are noticeable.  Early labor contractions can feel like tightening or rhythmic menstrual cramping.

Often women are excited to experience these regular and consistent early labor contractions because it means that they are really “in labor” and will be meeting their baby soon.  With longer breaks between them (often 5 to 20 minutes apart or more), early labor contractions are not typically overwhelming but are a signal to the woman and her partner to start preparing for the work that comes ahead as labor progresses.

The beginning of labor signifies what is medically known as “first stage labor”.

Active labor-

As these contractions become more regular, stronger, longer and closer together, a woman will enter what is known as active labor.  The majority of labor is, most often, experienced here.  Dilation is happening as the cervix opens and shortens and the baby may start to move down.

What does active labor feel like?  This part of labor feels more serious and like the “work” that labor is named for.  At times, there are feelings of pressure as the baby turns and moves downwards putting more pressure on the cervix.  Women will feel these active labor contractions closer together, often about five minutes apart and lasting about a minute or so long.

Contractions are stronger, longer, and closer together.  They may feel like rhythmic cramping, intense pain in the low back, or even warm shooting sensations down the legs.  Some women feel contractions over their whole stomach area, while others feel them very low, where the cervix is opening.  The work of the uterus in labor is to pull that cervix back, so that the baby can come down and out.

Still, there are breaks between the contractions and a chance to catch your breath, relax, eat, and enjoy the journey of labor.  This certainly is hard work and, to some, may feel a little overwhelming.  Active labor requires support, a wonderful birthing environment and knowledge of what is going on so that the sensations and intensity of contractions do not take a woman by surprise.

Transition-

Transition is the part of labor that people often fear.  This intense part of labor happens right before the pushing phase and can be a time of rapid dilation.  Not all women will notice an overwhelming transitional phase of labor, but those who do certainly don’t forget it.

Transition is often the shortest part of labor, typically lasting between 15 to 30 minutes. It can feel overwhelming and what many would call “painful”.  This time of hard work will yield a reward, though!  When transition is over, pushing begins and the baby will soon arrive.

What does transition feel like?  Physically and emotionally intense to some, contractions can come right on top of one another, even double peaking.  Transition can be accompanied by vomiting, shaking and strong sensations of pressure as the baby moves into position to be born.

Often gone are the breaks between contractions.  Transition contractions leave little time in between for chatting and laughter.  Mom will be serious and focused. She will need reassurance and support.  Emotionally, she may want to give up, so this is the time when she needs the most strength and respect from those around her.  This physical and emotional sensation of surrender is vital to the birth experience and helps the mom let go of her body and open up so that the baby can descend and the cervix can open.

While sometimes feared, transition labor is usually brief and is so rewarding because when it is over baby will be here soon.

Pushing (second stage labor)-

The urge to push is often an exciting change of pace.  Pushing, like any other part of labor, can feel different for different people.

For some, pushing is painless and exciting.  The feelings of pressure can be overwhelming and impossible to fight.  Many women describe the initial pushing sensations as the “need to poop”.  The baby is big and is pressing down on the same parts of the body and triggering the same reflexes as a bowel movement would.  The urge to “go” or “poop” is a good thing and helps direct the body to effectively push.  When mom has triumphantly passed through transition labor without any medication, she will be aware and able to feel and work with her body through this important and physically active part of labor.

Pushing can be intense but can also be enjoyable.  Every woman experiences pushing in labor differently.  Pushing contractions often space out with five or so minutes between them, giving mom a longer break to recover.  She may, once again, be excited and able chat and talk with those around her.    Upright positions will speed and encourage this process.

Part of the second stage or pushing part of labor is crowning.  Some women notice a sensation called a “ring of fire” during crowning.  This feeling is usually very short and is caused by the tissues of the vagina stretching tightly over the head of the baby.  The “burn” that some women notice can be temporarily painful but is an important thing to feel.  This “ring of fire” helps mom back off of pushing during the time of crowning.  This pause gives the tissues time to gently stretch over the baby’s head, helping her vaginal tissues not tear.  Another benefit of an unmedicated birth is that mom can feel this burning sensation and listen to her body accordingly, helping prevent excessive vaginal tearing.

The delivery of the placenta (third stage of labor)-

The last stage of labor is the delivery of the placenta.  Many women barely notice this part of labor.

Breastfeeding can help the uterus contract after the delivery of the baby and cause “after-pains” or mild contractions that help the uterus clamp down and help the placenta deliver.  Often care providers will just tell a woman to “cough” as they gently tug on the cord AFTER the placenta has detached.  The placenta is soft and usually comes out easily, with little or no pain.  Once the placenta detaches and is sitting in the uterus it can feel heavy and delivering it will feel like a relief.

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When it comes down to it, each labor and each woman is unique.  We all experience labor in our own way and would describe it differently.  Think of the labor of each baby as a unique journey and gift to help bring it into the world rather than something to be avoided.  Certainly the sensations and even pain of labor serve a purpose, as they tell us what to do and when to do it.  The feelings of labor are not useless, rather they teach us how to move and more efficiently birth our baby.

 

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