Hormones and the Waiting Game: Letting Labor Begin on its Own, Weighing Benefits v Risks of Induction

Part 2 of 7, a series written by our team of Lamaze Childbirth Educators. Part 1 can be read here.
 


If you’ve been pregnant before, or had friends or family who have been pregnant, then you have likely either heard or been asked, “Is the baby here yet” or “Did you have the baby yet”? Strangers who feel they possess the ability to gauge exactly how pregnant you are simply by glancing at your belly, and say something along the lines of, "Oh, you must be about to pop”!  Or our personal favorite, "you're STILL pregnant!?"
 

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Healthy Birth Practice #1: Let Labor Begin on its Own


Once a "due date" is assigned, people start to view that date like the finish line. You finish the marathon of pregnancy, and hit 39 - 40 weeks and you're done. The turkey timer has popped up, and everyone you know (and some you don’t) wait with pregnant anticipation for you to announce you are headed to the hospital, or for you to share a picture of your new little bundle the second he/she is born. However, the due date comes and goes. Still no baby. You just ran a marathon and crossed the finish line, you shouldn't have to run around the block a few more times before you get your medal, right? You’ve got impatient family members, people wanting to make plans to visit, your favorite midwife or doctor is only on call certain days, not to mention you are feeling so ready to be done. If you’ve paid your dues, and grew and carried that sweet baby for at least 39 weeks; what is so wrong with inducing labor or giving it a little push to help make schedules fit, or so you can have your favorite provider for delivery, etc. 

Every day of the last weeks of pregnancy is vital to your body's (and your baby's) preparation for birth. Should you choose for labor to be induced, it becomes a medical event and proceeds quite differently from spontaneous labor.


In pregnancy, labor will start only when all the players—your baby, your uterus, your hormones, and your placenta—are ready. There are hormones that play a part in labor (oxytocin, endorphins, catecholamines, and prolactin) are important. Here's why:


Oxytocin causes labor contractions and helps create feelings of love, calmness, and connection to others.

There is a natural occurring oxytocin surge in the mother’s body that precedes spontaneous labor. This is thought to have a neuroprotective effect on the baby, reducing oxygen requirements of the fetal brain. Also worth noting, when higher levels of the synthetic version of oxytocin was used (pitocin), it produced the opposite effect on the fetal brain in animal studies. In english: The surge in the naturally occurring oxytocin in your body before spontaneous labor, can actually help protect your baby’s brain during parts of labor when oxygen is not as readily available. 
 

Endorphins help relieve stress and pain around the time of birth.

Oxytocin and oxytocin receptors increase in the final days before spontaneous labor. Endorphin levels and endorphin receptors also gradually increase as well. Women who exercise regularly have higher levels of endorphins when they go into labor and report less labor pain than women who do not exercise regularly. Letting labor begin on its own and exercising regularly throughout pregnancy will allow women to begin labor with optimal levels of endorphins.
 

Catecholamines help you and your baby feel alert and ready for birth, and they help protect your baby’s heart and brain during strong labor contractions.

Catecholamines are vital to readying the baby’s lungs for air breathing after birth, and fetal catecholamines increase a few days before spontaneous labor. Knowing that due dates are rarely exact (and even if they are, some babies need more time), inducing at 40 weeks can still lead to issues if the baby is not ready.
 

Prolactin is called the “mothering hormone.” It has many roles including helping your breasts make milk.

However, its not just for breastfeeding! There are studies that show that like its cohorts oxytocin, endorphins, and catecholamines, prolactin levels increase throughout pregnancy, increasing shortly before the onset of spontaneous labor. It is also thought that prolactin in late-gestation plays a part in helping fetal lungs to mature as well as helping with temperature regulation of the baby after birth.


Each of these hormones are important is helping your labor progress as smoothly as safely as possible. Each one is an important piece and plays an important role in the entire birth process. Your body has its own instructions and these hormones respond to each instruction, helping you to reach you goal. If you interrupt that process through a non-medically necessary intervention or try and get your body to start the process through induction or “natural induction”, it may throw your body, baby, and birth, off a bit.

There are clear medical reasons for induction of labor, and an appropriate induction can save the life of the baby, the mother or even both! While an induction of labor has a higher percent of cesarean rate associated with it, having clear dialogue with care providers about benefits v. risks, and the right path for YOU is key. So while a cesarean is not definitive with an induction, ask yourself if the potential benefit truly outweighs the risks. 

In pregnancy, labor will start only when all the players—your baby, your uterus, your hormones, and your placenta—are ready.

Just as little humans grow at different rates, some babies never get the memo that they are supposed to be ready to come out on the day a provider or ultrasound estimated. However, when they are ready, your body knows, and will begin the process of evicting its tiny tenant in the most beneficial way possible. With the cascade of hormones - one signaling another in perfect harmony, your body helps itself and your baby to birth in the safest way possible.

 

  Attribution: Lamaze International

Attribution: Lamaze International



The Institute of Medicine says it takes on average 17 YEARS after new research is published for medical professionals to change the way they practice. Don't get stuck with outdated practices for your baby's birthday! With our private prenatal lesson or "intensive" ONE DAY childbirth class, you'll learn how to get evidence based care to optimize your birth outcome. In both Atlanta and Tampa, we teach an "intensive" preparation for childbirth with our "ONE DAY" group class. You can reserve 2 seats here.

If you cannot attend an in-person birthing class with us, we suggest you schedule a private prenatal lesson. Registration for either the Intensive class or a private, in-home lesson includes access to our online Learning Center where you may watch videos, read further research and download sample birth plans. Both these class options are an excellent opportunity for you and your birth partner to gain current evidence based birth practices that can help you have the safest birth for you and your baby. Sign up today.


This post is part 2 of a 7 part series written by our team of Lamaze Childbirth Educators. Part 1 can be read here. Stay tuned for upcoming posts in our series, How To Alleviate Fears and Manage Labor Pain.