Leading hormones of birth

Assoc. Dr. Aslı Göker / Women's Health and Diseases Specialist, Birth Preparation Trainer

Three of the hormones secreted in our body at some moments without us noticing play the leading roles at birth. Which are these? Oxytocin, endorphins and adrenaline… Once you learn the power of these super hormones at birth, you will feel a noticeable decrease in your fear of birth.

• Women's bodies are perfectly equipped to give birth

Women have given birth since the world existed. Of course, some diseases such as diabetes increased and the risk of large babies emerged. Or the female body lost its flexibility from being in a sitting position all the time instead of being active. Nevertheless, just as the female body is perfect enough to form the baby, if it can feed and grow it, it has the power to give birth to it. When there is a medical problem, the necessary care is already provided, but in fact, these problems are not as high as thought.

The female body adapts itself to the baby throughout her pregnancy. Everything from the cardiovascular circulation to the functioning of the kidneys during pregnancy is adjusted to protect the health of the baby. The uterus is an organ for pregnancy and has no other function. And again, when the time comes, it gives birth. When the baby is ready, uterine contractions push the baby into the birth path. The baby also does not stop and actively participates in the birth. He struggles to be born with active and passive movements. The joints of the woman relax, the muscles give way to the baby, and in addition to the contractions of the uterus, the birth occurs with the feeling of straining.

All of this happens thanks to hormones that initiate, sustain, perform and eventually have protective functions in the body.

• Well, why can't today's women give birth?

Today's modern woman, unfortunately, may not be aware of her fertility. When the urban woman, who wants to control everything, thinks that she can also control the birth and tries to give birth by planning, the perfect mechanisms of nature can be interrupted.

However, I observe that expectant mothers who spend time outdoors and in nature listen to themselves, their body and their baby are much more comfortable. Women who listen to the needs of their bodies and take a lot of walks and rest, when the time comes, they can easily give birth with the feminine energy and fertility that they have inside. Or, if cesarean section is required, they can accept it and connect with their babies more easily.

Let's think of a woman who spent her time indoors like a shopping mall, worked until the last day, and sees birth as a terrible event that she needs to get through. On the other hand, I see that this woman can not give herself to the patience-demanding surrender of the birth and may have difficulty even accepting that it is for the health of the baby, for example, when an unplanned cesarean is required.

It is easier for expectant mothers who respond to the needs of both themselves and their baby to have a more comfortable pregnancy and to accept the changes when the baby is born and becomes a "mother".

• The cause of the fear of birth

Fear of birth; Unfortunately, it would not be wrong to say that the emphasis of the media and social media environment on the negative aspects of birth, which are culturally memorized, is a legacy. Of course, the woman will fear that something will happen to her or her baby, this is natural. However, the fear of the birth itself has reached such a level today that women are trying to get rid of this fear as soon as possible by cesarean section. However, with proper childbirth education, many of these fears can be overcome. A mother-to-be who finds a birthing team she trusts can surrender to the flow of labor. It should not be forgotten that obstetricians and other health professionals (midwives, nurses, etc.) are there to identify and prevent events that would put the life of the mother or baby at risk. In other words, if the mother makes an effort to focus on the birth rather than worrying about medical issues, it will make everyone's job easier.

The feeling of fear is strong enough to stop a progressive birth by increasing the hormone called adrenaline. Fear triggers tension, tension creates pain, and this becomes a vicious circle. Dr. Dick Read described this event years ago as the "Fear-Tension-Pain" triangle. These three factors prevent birth hormones from working in harmony. If this triangle is formed, the mother-to-be, doctor, midwife, nurse and doula can break this effect together and allow the birth to be set to its normal course. Allowing birth hormones to work is the key point here.

• The role of hormones

Many hormones are secreted at birth, but I will focus on three important hormones here: oxytocin, endorphin and adrenaline. Apart from being individually important, all three need to be in harmony with each other. In a birth in which everything progresses in its natural flow and suitable environmental conditions are provided, these hormones are secreted as needed and fulfill their duties for the mother and the baby.

OXYTOSIN

Another name for this hormone is "love hormone". It plays a role in sexual intercourse, birth and breastfeeding and even socialization. It is also secreted in men. Oxytocin is a hormone that contracts the uterus and is necessary for the separation of the placenta after birth. At the end of the birth, oxytocin is also used to stop the bleeding. The uterus is contractive and while breastfeeding, it provides milk flow by contracting the milk ducts.

The secretion of oxytocin hormone is affected by many factors. For example; In a crowded, noisy, lighted and cold delivery room, oxytocin secretion is impaired. The woman of the modern age mentioned above sometimes prevents this release by herself. Controlled behaviors such as staying in touch with the outside world with a mobile phone, following the progress of the birth by looking at the clock, searching for what stage I am now on the internet, and watching the news on television can cause the brain to work continuously, stop the oxytocin secretion and disrupt the progress of the birth. Fear and stress also negatively prevent the release of oxytocin. The pregnant woman feels safe, the privacy is at the highest level and the presence of only supporters beside her makes the pregnant woman calm and relaxed and allows her to release plenty of oxytocin. Active birth positions, freedom of movement, giving birth in a comfortable position and skin-to-skin contact of the mother with her baby after birth also keep oxytocin release at the optimum level.

ENDORPHINE

It is a natural pain reliever secreted by the body. It is at a high level in exercisers, it is secreted from the body in order to balance after stress or pain. Endorphins give people joy and happiness by putting them in a trance state. This hormone balances the feeling of pain caused by contractions at the time of birth and breaks the relationship of the mother with the outside world by moving to another dimension in the period between contractions. It is effective in establishing the bond between mother and baby after birth. It is the hormone of the parasympathetic system, it provides recovery and well-being.

Since endorphins are virtually the antidote to pain, it is secreted less in deliveries under epidural anesthesia or in deliveries with planned cesarean section. This can sometimes cause breastfeeding problems or melancholy. In these cases, it is compensatory to keep the mother and baby in contact with bare skin.

ADRENALIN

Adrenaline, the hormone of danger situations, is secreted to protect the body. Its classic definition is the "fight or flight" hormone. Adrenaline released in times of fear and stress, for example, allows you to jump without thinking to save your dog falling into water, or for you to run away from a burning house. Adrenaline secreted during the birth process stops the progress of labor and prevents oxytocin and endorphins. It reduces the blood flow to the uterus and causes severe pain. If the expectant mother does not feel safe at birth, she releases adrenaline. Therefore, we come to the same point again. If the expectant mother trusts herself, her baby and the delivery team, if she focuses on her delivery under appropriate conditions and surrenders to the flow, she will have a comfortable birth.

Adrenaline is needed when the baby is born. This hormone energizes the mother at birth, facilitates straining and passes on to the baby, accelerating the heart rate, making it easier to breathe and making her active. In this last stage, adrenaline is spontaneously secreted in sufficient quantities as needed by the body. And babies who look awakened at the end of a natural birth are babies who have taken oxytocin, endorphin and adrenaline hormones at the most appropriate doses.

To sum up, privacy should be provided in a quiet, dim and warm environment so that hormones can be secreted in harmony at birth. Questions that will cause the mother to "think" should not be asked, she should be allowed to return to herself. While these are happening, the feeling of support should be reinforced by giving the confidence that a team is always ready there for the health of the mother and baby.

• Postpartum effects of hormones

After birth, oxytocin continues to be secreted and the uterus continues to contract. Thus, the amount of postpartum hemorrhage is kept under control. While the prolactin hormone necessary for breastfeeding plays a role in the production of milk, oxytocin provides the contraction of the milk ducts and the flow of milk. These happen spontaneously in a non-invasive birth that proceeds normally. In planned cesarean sections, when the baby is removed from the place by surgery without giving the signal "I am ready for birth", no birth hormone is secreted in its natural flow. In case of medical necessity, we will of course have to do a planned cesarean section. For example; It is not possible to wait for the birth to begin in risky situations such as placenta previa that obstruct the birth path. Medical requirements should be set aside. However, in many cases it is possible to wait for the baby to give the "I'm ready" signal. Of course, the conditions of the hospital and operating room are also effective here. It will also be possible to benefit from the benefits of oxytocin, as it also allows oxytocin to be secreted by cesarean section (baby-friendly cesarean section) after the moment of spontaneous birth.

• Tips for a healthy birth

- Expectant mothers should primarily take care of their own physical and mental health.

- They should stay away from information pollution and seek answers to their questions about birth from reliable sources, doctors, midwives and nurses.

- If possible, they should attend reliable birth preparation trainings with their spouses and complete their preparations for pregnancy, birth, being a family, postnatal care, and birth psychology.

- Women are more likely to have a pleasant pregnancy and delivery if they trust their bodies and babies. For possible medical complications, the healthcare team will certainly do what is necessary.

- It is important for the expectant mother not to gain too much weight by paying attention to her nutrition, to move outdoors and to create an environment that will isolate herself from the outside world. This abstraction can be done by praying, by meditating or by listening to music… The important thing is to create a time of his own, where she can communicate with her baby and get away from the stress in the daily rush. Various examples of how this can be done are presented in the birth preparation trainings. In this sense, I also attach importance to these trainings. It is the woman who will give birth. Therefore, her biggest support will be "power from within".

- The goal is to deliver the healthiest way for mother and baby. For this purpose, the expectant mother should be able to demand suitable conditions for her, trust her doctor and fulfill her responsibilities.

"Our priority is always the health of mother and baby."

Everyone's birth is unique. Every mother and baby should have the right to live this special moment in the healthiest and most beautiful form. Today we talk as much as science knows, and of course there is more that we don't know, but we are definitely not robots. Our emotions are under the control of hormones and our priority is always the health of mother and baby. Regardless of the mode of birth, anyone who leaves the delivery room or operating room with a smiling face is the winner, and our greatest strength is love.