Oxytocin: for the love of birth
Oxytocin: “A hormone released by the pituitary gland that causes increased contraction of the uterus during labour and stimulates the ejection of milk into the ducts of the breasts.” Oxford English Dictionary
That’s the biochemistry…but why is it important in birth? And do we actually have any control over it?
Oxytocin is a wonder hormone - it makes us feel happy, fall in love, bond with our friends, brings our baby into the world through contraction of the uterus, triggers prolactin (the hormone that produces milk). This little chemical is released via neurotransmitters in the brain when we so much as touch someone we like, eat food that we really enjoy, kiss our loved ones or hug each other. Admittedly these hormone releases are in small doses. As oxytocin levels increase, so do endorphins, which act as our body’s natural pain killers. Oxytocin is at it’s highest quantity during and after orgasm, childbirth and breastfeeding. Quite simply it is the love hormone - the one that keeps us connected to the people we love.
But oxytocin in vulnerable. The mere whiff of adrenaline (our stress hormone) can start affecting the power of oxytocin. This is when our ‘Fight or Flight’ instincts kick in. So finding the balance is vital; raising and maintaining oxytocin levels in childbirth will allow labour to progress smoothly. But at the same time stress hormones must be kept at bay or, if at all possible, completely avoided.
Birth is primal. Michel Odent expertly writes about the need for the birthing brain to be unstimulated in order for our hormones to function in the way they should. As labour begins finding a calm, dark and quiet space allows nature to take it’s course. For many women their safe and comfortable space is at home; the place where they have total control over the external environment.
Make a Nest
Creating a a space that allows your body to work with it’s primal instincts will assist the flow of oxytocin once your labour begins. Give this as much priority as you would a nursery. Choose a room or space in your home and from around 36 weeks start making it a place you want to be. Somewhere you feel safe and relaxed. Apply these four principles, but make it personal:
Comfortable - warmth, cushions, bean bags, birth ball, fluffy blankets
Low lighting - candles, fairy lights
Calm - gentle music, comforting scents, hypnobirthing tracks
Your Space - privacy, photos, important items that give you inner strength
This nest will allow your neurotransmitters to keep firing more oxytocin into your blood stream. Add into the mix a birth partner who gently places their hands on your shoulders, slowly massages your back, calmly sits with you and breathes through contractions at your pace, makes you smile, kisses you and feeds you that energy releasing chocolate you’ve been saving for this special occasion. Now the oxytocin levels are increasing and your contractions are becoming more powerful.
Your midwife arrives. She doesn’t need to ask you any questions because she knows you well, and so your primal birthing brain is not disturbed. Your oxytocin continues to flow at high levels as your baby is born. Oxytocin then works its magic as the peak levels at birth help you fall in love with your baby (and your partner all over again). Oxytocin powers on, contracting your uterus again for the birth of your placenta and then triggers the let-down reflex* so you can feed your baby.
What are the key ingredients? A safe environment, a calm birth partner and a midwife you know and trust.
We have touched on adrenaline, the stress hormone. As soon as your body starts releasing adrenaline it has an adverse affect on oxytocin. If your oxytocin levels are lower than adrenaline, your labour will slow down or stop because of the instinctive fight or flight response. So here are some useful tips to keep those adrenaline levels low:
A calm birth partner
Both adrenaline and oxytocin directly rub-off on the people around you. So your birth partner needs to radiate oxytocin to help you release even more.
Partners report that being prepared for the birth, attending antenatal classes, having everything organised at home, having back up plans, sorting childcare (if you choose to) are examples of how they have kept calm. Birthing at home gives partners the freedom to move around the house, channel their energy into jobs such as filling the pool, making a brew for the midwife, reading a book, having a nap, getting some air. If birthing in a Midwife Unit or a Hospital knowing the route, having change for the car park, having everything in the car, having a back up plan if at work.
Avoid stimulating your ‘thinking brain’
The neocortex is the part of the brain responsible for our sensory functions - sight, hearing, conscious thought, language. For oxytocin to release to its full effect, the neocortex needs to be resting. So avoid bright lights, TVs, phones, electronic devices, noise, even excessive talking. Stay in your nest for as long as you can. Switch between your nest and the bathroom (another place we associate with privacy and calm). Have a bath or shower and allow the warm water to soothe you.
Get those oxytocin levels as high as you can - the higher the oxytocin, the harder it will be for adrenaline to have an affect. So before you call your midwife to your home (especially if you do not know who it will be) or make your way to the car for the inevitable journey, do everything that can release oxytocin. Allow your contractions to build. Do not let adrenaline take control.
Since 1993 midwifery leaders have been fighting for women to have the same midwife throughout their entire journey (DH, 1993). Even today the Better Births report has highlighted that women want continuity of carer and the NHS have clear targets to achieve this (NHS England, 2016). In the context of oxytocin production in labour, having a midwife you know and trust allows your birthing instincts to thrive, minimises the need for excessive talking (because she knows your choices) and allows the midwife to also encourage oxytocin release through loving touch. In absence of continuity, being prepared and having confidence in your body and your choices will give you the strength you need to let the oxytocin flow.
I talk a lot about the power of oxytocin and how to harness it to help you birth your baby in my Birth Works courses. But the best advice I can give you is to seek out support from your local homebirth group, attend antenatal classes to enhance your knowledge (for knowledge is power), get involved with the positive birth movement. These small steps will help you and your partner understand, appreciate and experience the wonder of oxytocin. If continuity of carer is important to you, I offer this in my midwife-mother partnership.
*The let-down reflex is when the muscle cells and milk producing cells in the breast tissue contract to release milk. Oxytocin is the hormone that makes this happen. Aren’t our bodies incredible?!
NHS England, 2016. Better Births: Improving outcomes of maternity services in England. https://www.england.nhs.uk/wp-content/uploads/2016/02/national-maternity-review-report.pdf
Department of Health, 1993. Changing Childbirth: Report of the Expert Maternity Group.