In 1975, in her book “Spiritual Midwifery” Ina May Gaskin first wrote about a labour which went backwards. That birth story was possibly only one example in her women-centred practice which led to her proposing ”Sphincter Law” as a means to explain why some labours do not fit the accepted ’3 progressive stages’ definition of labour. In that instance the woman’s labour, as measured by vaginal examinations, reversed after she heard comments, and became fearful that her labour was progressing unusually fast. As I suggested in a previous blog, trying to determine how much the cervical muscle or sphincter has dilated is one common way labour is disturbed. This is because the understanding that labour can go backwards or stall depending on what is happening to, around or for the woman is rarely appreciated by most maternity carers and institutions.
Current knowledge about the interplay of labour hormones and the factors which aid or hinder their flow, particularly that of oxytocin, reveals that a woman’s labour can start and stop for hours, or days as well as reverse. Applying this knowledge to maternity practice and antenatal preparation would see labours labelled as “Failure to Progress” relegated to the history books, as women will have carers who promote and protect their oxytocin flow to optimise smooth and quick labour progress. Such care will also aid the simultaneous flow of other hormones, such as morphine-like endorphin which enables a woman’s body to cope with the amazing changes necessary to give birth, a process which should be outside of conscious control.
Oxytocin is a substance secreted by the pituitary gland of our deep, ancient midbrain; the same area where other basic, involuntary acts such as breathing and heart beat arise. Just as thoughts and fears can interfere with breathing, for example we can hyperventilate or breathe poorly when frightened, so thoughts and any stimulation of our conscious brain interferes with the production of oxytocin. Equally when our thoughts and fears are quiet oxytocin flows, therefore maternity carers need to resolve, not heighten any fears and concerns of pregnant women to enable them to start and progress in labour. Women and their babies would be better served by proactive care approaches like practical dietary information and support in pregnancy rather than fear laden maternity language and regimes such as “Gestational Diabetes” testing. Almost any thoughts, particularly in first time mothers, can hinder the flow of oxytocin, because thoughts activate conscious brain activity which needs to be quiet for the shy hormone, that is oxytocin to emerge or lead!
External factors can make our hearts and breathing race, so too the flow of oxytocin is changed by things such as light which stimulates our visual perceptions to make us aware and alert, however when the light is low the darkness hormone; Melatonin also enhances the oxytocin flow. Hence many women naturally begin and progress in labour during the night. An effective flow of oxytocin is ensured when external factors such as noise, light and cold are reduced. Language is one form of communication which stimulates brain activity to hear, process and decide to respond or not, which can over-ride the hormonal directives from the primitive, mammalian parts of our brains.
Every culture, since men began to domesticate animals has made birth a social event, with the cast of expert strangers, family and friends of the last few decades possibly being the greatest. It is not coincidental that the labour of first babies in particular, is now something that takes up to half a day or more, before the need to exhort the woman to push hard to get the baby out or have it extracted. Yet oxytocin is Greek for “fast birth”, so named by the English physicist who first isolated this substance in 1905, as a pregnant cat who was given a dose then had a rapid birth. Thus fast or ‘Precipitate Labour’ which is driven by the woman’s hormones need not be ‘dangerous’ for women nor their babies as obstetric oriented or informed carers warn. However fear can negatively impact perceptions and panic poorly informed participants when they only know or learn about birth as something dire and risky. Yet an understanding of the hormones and their work shows birth as an involuntary act, one of three hormone driven processes aimed at healthy survival and perpetuation of our species. But the hormonal blueprint of labour requires that women ‘nest’ or labour in privacy so they are compelled to respond instinctively to their bodies needs, like other mammals.
When labour and birth is protected as an involuntary act, many problems such as ‘abnormal’ positions like breech resolve, twins can birth vaginally. Or several issues can be fixed in the one labour for example a first, posterior-positioned baby born ‘right way round’, after 4 hour labour in the daytime, because the mother had a shawl over her head for much of the time. Instinctive labour climaxes with an irresistible “Fetus Ejection Reflex” birth of the baby, with mother and baby bathed in hormones that will then birth the placenta, reduce bleeding and grow their positive, mutual relationships. Michel Odent in his latest book “Childbirth and the future of Homo Sapiens” has suggested that “the art of midwifery should become the art of creating the conditions for a fetus ejection reflex”.