What? Have an unmedicated birth, but Why?

In the world of professional birth workers, we are expecting an uptick in bookings this fall for services like birth and postpartum DOULAS, childbirth classes, and breastfeeding consultations. Seriously, we all had to have something to do during this time at home, "wink-wink." I want to take some time to talk with you about the benefits of an unmedicated birth, planning for it, and how to support unmedicated labor and birth.

First, let me be clear on one critical point, as a birthing woman, you are in charge. You have the right to informed consent and informed refusal of all medical interventions. You have the right to change your mind about how you want to manage your labor and birth. You might want to review The Rights of Childbearing Women(1), established by the Childbirth Connection in response to severe and continuing problems with maternity care in the United States. At Mother Me, we respect your birth choices and work to provide our best regardless of how or where you decide to give birth.

Now that we are clear on that let's get to the issue at hand. What is unmedicated birth? What are the benefits of moving through your labor without medication? Is there a downside to having unmedicated labor and birth or a time when that may not be the best option? The unmedicated labor and birth that I am referring to here is free from medication to induce or augment labor, free from epidural use or the use of narcotic-like drugs to ease the sensations of labor.

It is widely accepted that labor begins when your baby's lungs secrete surfactant that contains proteins significant for breathing outside the womb. These secretions are picked up by the mother, and her body produces and increases hormones needed for normal labor and birth. These hormonal pathways of increased estrogen, prolactin, and oxytocin will bring-on labor. If undisturbed, oxytocin will advance labor, providing progressive pain relief along the way via the release of beta-endorphins. By allowing your labor to begin on its own, you can be confident that the hormonal pathways have prepared you and your baby for the journey of birth.

With that knowledge, let's dive deeper into what medical interventions might disrupt these hormonal pathways. We will begin with labor that has already started on its own. You were patient, allowing your baby and your body to guide how and when things began. Elevated prolactin levels are present at the onset of labor, and are vital to initiating production of mature milk for breastfeeding. Estrogen levels are at the highest point now and may trigger the flow of oxytocin, which brings about contractions. The rise of oxytocin then kicks off the body's natural pain-relieving mechanism in beta-endorphins. Epidural analgesia blocks uterine neuroreceptors for oxytocin and thus may slow the normal progression of labor. When labor slows, a synthetic version of oxytocin called Pitocin is often recommended. Pitocin is effective in increasing the timing and strength of labor contractions but has many potential side effects. Pitocin does not produce beneficial beta-endorphin.

In some cases, Pitocin may delay bonding and breastfeeding. Animal studies have raised concern that Pitocin may disrupt neuropathways in offspring via epigenetic effects. This medication, while often used during labor, comes with many other potential side effects and should be administered with caution.

At Mother Me, we are here to help you learn more about this and all your options in labor and birth.

(1) https://www.nationalpartnership.org/our-work/resources/health-care/maternity/the-rights-of-childbearing-women.pdf

(2) Buckley, S. (2014). The hormonal physiology of childbearing. New York, NY: Childbirth Connection.

(3) Anim-Somuah, M., Smyth, R. M. D., & Jones, L. (2011). Epidural versus non-epidural or no analgesia in labor. Cochrane Database of Systematic Reviews, (12), CD000331. http://dx.doi.org/10.1002/14651858. CD000331.pub3

(4) Goer, H., & Romano, A. (2012). Optimal care in childbirth: The case for a physiologic approach. Seattle, WA: Classic Day.

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