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Natural Birth: It’s not just about the drugs.

birthSuzanneNO_RED--300X200PHOTOGThe pursuit of a natural birth is not just about minimizing medical interventions and their attendant risks. It’s not about being super-woman enough to endure the powerful sensations. Every moment of the natural labor and birth process has a purpose leading to optimization of the emotional and physical health of mother and baby.

When not interfered with, natural labor helps to protect the fetal brain, prepare the lungs, establish healthy flora, and build the infant’s immune system. When uninterrupted, hormonal interplays provide imprinting and attachment between mother and baby, help to establish milk production and nursing behaviors, protect mother’s mood for days to come, and initiate instinctual parenting behaviors.

Flora and the Newborn

Vaginal birth provides the passing infant with important exposure to mother’s flora. This initial seeding appears to have long-term impact on the eventual array of bacteria the child maintains in his microbiome. The newborn’s next flora exposures are from the air and people around him, mother’s nipples and colostrum, and mother’s kisses. Somewhat different floral signatures can be found in infants based upon the environment they are born into (i.e., every environment has its own spectrum of bacteria and will provide a different array of flora to a newborn).

Infants born in large urban hospitals tend to harbor flora that is less favorable than that derived in smaller centers. A less desirable character to their flora is found to persist for a long time. Whereas hospitals tend to harbor a high portion of potentially infection-causing bacteria, a child home birthed to a healthy family tends to become inoculated with a healthier spectrum of flora.

Establishment of Flora after Cesarean Section

Greater diversity of intestinal bacterial species is linked to greater health.  Studies find infant flora in the first days after a cesarean birth to be much less diverse than that of vaginally delivered babies. When born via scheduled cesarean, the infant does not experience any labor. These infants are found to have the least diverse flora, suggesting that mother passes some flora to baby during labor. Irregularities in the flora of infants born by cesarean are still measurable 6 months after birth.

In addition to greater risks for asthma and allergies, scientific reviews have found children born by C-section to suffer more diabetes, more hospitalizations for intestinal infections, and more celiac disease. All of these are related to the character of a child’s gut flora. If baby is able to obtain some of mother’s colostrum very quickly after birth, and repeatedly after birth, it should reduce some of these undesirable risk factors. Some facilities are practicing the spreading of flora from mother’s vagina over the bodies of newborns right after surgical delivery (although oral intake is the strongest benefit).

Flora and the First Latch

Formula-fed infants develop a more adult-like spectrum of challenging flora—including E. coli, Bacteroides, Staphylococcus, and Clostridium—and will carry far fewer of the highly protective bifidobacteria. Exclusively breastfed infants will harbor many health-promoting lactobacilli and yield around 90% bifidobacteria by a week after birth. These differences in the microbiome are largely responsible for the greater number and severity of infections found in babies who receive any formula. The optimal establishment of the newborn’s flora depends upon a latch at the breast as soon as possible after birth, and frequently thereafter.

The Anti-Flora

Obstetricians are aware that when a bacterium known as group B strep (GBS) is colonizing a mother’s vagina during pregnancy, her baby is more likely to develop an early infection with this bacterium after birth. Mothers are often given flora-disrupting antibiotic drugs during labor when GBS is found. A 2014 scientific review of studies finds the evidence supporting this practice to be weak. Even if early GBS infections in infants are being reduced by antibiotic practices, there has been an emergence of other types of early infections from bacteria that are not affected by the kinds of antibiotics used, including a surge of drug-resistant E. coli infections affecting delicate preemies. Most importantly, the scientific review found that the use of precautionary antibiotics did not reduce the number of infant deaths—neither from GBS infection nor from all causes—and the number of later, serious infections is increased by the use of antibiotics during labor. Several natural options exist for promoting floral health and neutralizing GBS in the mother before birth.

Hormones Doing Their Job

Much hormonal interplay occurs during labor, serving all kinds of valuable purposes for mother and baby.

Endorphins, the body’s own opiate-like agents, increase in mother steadily throughout natural labor, reducing pain and providing some calm. Their presence after birth helps mom to feel excited and happy, and to focus on her baby. These are also passed to the fetus through the placenta, helping to give some calm and pain protection, and helping to protect the fetal brain from the effects of reduced oxygen.

After natural birth, the newborn releases her own surges of endorphins, leading to healthy control of her respiration. The infant ingests more of these endorphins with her first tastes at mother’s breast. The effects help to reinforce baby’s breastfeeding. If labor is not experienced, due to scheduled C-section, the infant does not receive these elevated endorphins. The lack of this priming during labor apparently prevents the newborn from creating surges of these factors after birth. This lack has been linked to reduced respiratory functioning.

If mother is given Pitocin to speed labor, the increase of the pain reducing endorphins is blocked. Maternal stress during labor can be caused by Pitocin delivery. In hospitals, stress is often caused simply by lack of adequate emotional support. The resultant stress hormones slow the progression of labor, increase the perception of pain, and may impair the fetus’s blood supply. All of these potentially lead to medical interventions that further interrupt the natural processes. Stress hormones can also inhibit milk production.

Prolactin hormone (“pro-lactation”) peaks during natural labor, priming mother’s brain and breast receptors for the establishment of milk production and helping to establish parenting behaviors in mom. When birth occurs surgically without labor, the loss of this prolactin surge is one likely factor in the breastfeeding difficulties known to be associated with cesarean section births.

Awesome Oxytocin

Oxytocin is well known as the feel-good, bonding hormone that acts throughout our lives in response to togetherness and especially to skin-to-skin contact. It’s also known to be a key factor in the birth process.

Oxytocin naturally surges in mother’s body during labor, providing the contractions needed to expel the baby. Oxytocin is also passed on to the fetal brain. As mother’s body feels the vaginal passage of the child, further oxytocin surges are stimulated. Much higher levels now occur and accumulate in mother’s brain. The infant can continue to receive oxytocin from mom as the cord continues to pass blood to baby after birth. Exceptionally high brain oxytocin in mother and baby just after natural birth provides for a powerful imprinting between mother and newborn as they smell each other and gaze into each other’s eyes.

Further encouraged by skin-to-skin contact, oxytocin remains exceptionally high for an hour or more after birth. It provides mother and baby with feelings of trust, calm, comfort, and wellbeing, while also causing a little impairment in memory so they forget some of the discomfort experienced. When not impeded, this hormonal high also sets the stage for successful initiation of breastfeeding. The first nursing attempts then lead to continued oxytocin releases for both. Importantly, when occurring shortly after birth, this serves to help contract the uterus, preventing excessive bleeding in mom.

This entire oxytocin experience acts in mother’s brain to initiate affectionate maternal behaviors, helping first attempts at nursing to feel quite natural and teaching mom to want nothing more than to hold her baby and respond to his cries. While brain changes occur during pregnancy and in response to later physical contact, especially nursing, this exceptionally high post-birth window created by natural labor leads to some valuable reorganizing of receptors in mother’s oxytocin and stress responding portions of her brain.

High oxytocin in the female brain has also been shown to promote preference for whatever male is present during its surges, (one good reason for dad to hang around after the birth).

Interrupting Oxytocin’s Benefits 

Pitocin is an imitation oxytocin used to induce or enhance labor. Whereas oxytocin is created in the brain, this synthetic agent injected into mother’s bloodstream does not cross the blood-brain-barrier. Hence, artificially induced mothers miss out on the majority of oxytocin’s bonding, calming, mood elevating, and amnesic benefits. So does baby.

As mentioned, mother’s oxytocin crosses the placenta into the fetal brain during labor, silencing the brain so the child is less stressed by the birth process. In addition, baby’s brain is made to be less vulnerable to damage from periods of reduced oxygen or blood sugar.

If mother has received Pitocin, then any natural regulation of appropriate levels of oxytocin releases in the infant would be absent, and the baby would not receive brain-protecting oxytocin from mother. Further, it is known that excess uterine stimulation typically seen with Pitocin use creates dangerous episodes of oxygen depletion in the now unprotected fetal brain.

Although Pitocin does, indeed, create uterine contractions, women receiving this synthetic hormone have a heightened risk of uterine hemorrhage after birth. It appears that the excessive, prolonged, and inappropriately timed levels of this synthetic oxytocin lead to desensitization of uterine receptors. Hence the uterus does not shrink appropriately even in response to further Pitocin doses after birth.

If anesthesia is used during labor, feedback systems for oxytocin release are interrupted. This can prolong labor and may lead to administration of Pitocin. If mother is unable to feel the vaginal passage of her infant as a result of anesthesia, there is no heightened oxytocin release in response to the passage. The mother misses the rest of her opportunity for the beneficial brain effects of oxytocin. Her mood is not enhanced, her maternal behaviors are not naturally switched on, and eager brain receptors are not encouraged to expand.

When a baby is born highly drugged, he is less able to partake from the oxytocin-provided benefits of calming, bonding, and drive to breastfeed.

In cesarean delivery without labor, mother experiences no oxytocin surges and passes none on to the fetus. There are none of the extraordinary oxytocin experiences for mother or baby. Maternal protection of the fetal brain does not occur. Mood elevation, stimulation of breastfeeding behavior, and an initial imprinting do not occur. If some labor is experienced before C-section, a portion of the oxytocin experience occurs.

Preventing mothers from these potent oxytocin surges in their brains can lead to increased risks of postpartum depression and poor bonding. It has been found that the oxytocin levels secreted during nursing remain low for at least two days following a C-section, with a notable increase in mother’s anxiety level and decrease in her breastfeeding success.

Other Natural Infant Protections

Mother’s body supplies very important sugar to baby’s brain during labor. This provision is often impaired, however, when mothers are restricted from food intake during the birth process.

Baby receives certain antibodies from mother during the last term weeks in the womb but the majority of this transfer occurs during labor. Without labor, the infant receives few antibodies. The lack of antibody transfer may be one factor in the reality that infants born via low-risk elective cesareans have a tripled death rate in the first month of life, versus vaginal births. The lower success in breastfeeding after cesarean is another large factor.

The hormonal changes of natural labor help to quickly clear fluids from the fetal lungs through a process of absorbing fluids out of the lungs, along with some mechanical clearing from the contractions themselves. When labor is artificially induced, infants suffer from breathing distress more than twice as often as with spontaneous labor. In cesarean section without labor, an infant is 4 times as likely to suffer respiratory distress. This impact on the lungs is evidently long lasting, as babies born via C-section are shown to suffer from allergies twice as often as those delivered vaginally. They suffer more asthma as well.

In the minutes after birth, the un-cut cord continues to provide oxygenated blood to the infant, to assure against any gap in oxygenation. It pumps extra blood into the newborn to assure the right amount of iron is provided for storage, to prevent later anemia.

If not covered up, baby’s head exudes a yummy aroma for mom to breath in with drunken delight as she holds and nurses her baby, helping mom to fall in love with her baby and to want to protect it with all her might.

The Road to Natural Health

Labor and birth seldom go exactly as we’ve planned. Although the road will likely be easier when optimal measures are followed in the beginning, many years of childhood still remain and many options exist for reducing and healing any negative consequences resultant from any unavoidable straying from your plans. Frequent skin-to-skin contact, nursing, and responsive attention help to optimize the benefits that bonding hormones have to offer. Additionally, current research is finding ways that parents may optimize their children’s health through the gut via diet, probiotic supplements, and other measures.

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For science journal references and further information, see Linda Palmer’s latest book: “Baby Poop, What Your Pediatrician May Not Tell You …about Colic, Reflux, Constipation, Green Stools, Food Allergies, and Your Child’s Immune Health.

Additional reference:

Sakala C, Romano AM, Buckley SJ. Hormonal Physiology of Childbearing, an Essential Framework for Maternal-Newborn Nursing. J Obstet Gynecol Neonatal Nurs. 2016 Mar-Apr; 45 (2): 264-75.

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