What is an ecstatic birth?
A woman gives birth to her second baby in a rapid birth in the back of the car en route to the hospital. “That was,” she says, “absolutely ecstatic.” A fourth baby is born, unexpectedly breech, in the family spa-bath. The mother, who catches her own baby, describes the minutes after birth as “the purest bliss”. In a small clinic in France, a young mother gives birth to her footling-breech baby without drugs or intervention. A BBC cameraman asks her, half an hour later, how she felt as she pushed her baby out. She replies unhesitatingly to the camera, “It was like an orgasm.”
These true stories reflect an aspect of birth that is almost unknown in our culture; one that contradicts our cultural belief that giving birth is a traumatic experience. The ecstasy that these new mothers have experienced is not only possible, it is an intrinsic part of the birth process. Ecstatic birth has kept our species flourishing for more than two million years, bonding mothers and babies in love and pleasure, and rewarding new mothers for their crucial role in reproduction.
Ecstasy — an experience that takes us outside our usual state — is every woman’s genetic blueprint for birth. This blueprint includes the release of an ecstatic cocktail of hormones, the body’s chemical messengers, which are released from the middle part of the brain during labour, peaking at the moment of birth. These hormones include oxytocin, the hormone of love; beta-endorphin, hormone of pleasure and transcendence; adrenaline and noradrenaline, hormones of excitement and fight-or-flight; and prolactin, the hormone of tender mothering.
As well as inducing feelings of love, pleasure, transcendence, excitement and tenderness, this hormonal cocktail is also responsible for many of the actual processes of labour. Oxytocin, for example, is the hormone that causes a labouring woman’s uterus to contract, and adrenaline/noradrenaline, the fight-or-flight hormones, catalyse the final powerful contractions at the end of a natural labour. The orchestration of these hormones also provides important safeguards for mother and baby. For example, adrenaline/noradrenaline give the baby protection against the powerful contractions of late labour; and, after the birth, oxytocin acts to prevent maternal bleeding.
Oxytocin has been called the hormone of love because it’s released from our pituitary gland, deep inside our middle brain, during sexual activity, orgasm, birth and breastfeeding as well as when we are touching, hugging and sharing a meal. When our oxytocin levels are high, we feel loving and positive towards others. During a natural labour, a woman’s oxytocin levels gradually increase, reaching a peak around the time of birth. This oxytocin peak — the highest in her life — occurs because of the stretching of her lower vagina as her baby descends, and causes the strong contractions that will help birth her baby as efficiently as possible.
The baby also produces increasing amounts of oxytocin in labour, peaking at birth. In the minutes after birth, therefore, both mother and baby are saturated with oxytocin, the hormone of love. At this time, both partners will enjoy increased levels of oxytocin through skin-to-skin and eye-to-eye contact and by the baby’s first attempts at suckling. Oxytocin is an important hormone of bonding in mammals. Good oxytocin levels at this time will also assist the mother in delivering her baby’s placenta and protect her against bleeding by keeping her uterus well contracted. Oxytocin levels are elevated in the baby for at least four days after birth.
In breastfeeding, oxytocin causes the let-down (or milk ejection) reflex and is released in pulses as the baby suckles. During the months and years of lactation, oxytocin continues to keep the mother well nourished and relaxed. The anti-stress effects of oxytocin, which are also prominent in pregnancy, have been shown to persist for several months after weaning. The oxytocin system, designed to aid labour and produce love and bonding after birth, is a major casualty of medicalised birth.
Here in Australia, almost half of all labouring women are administered synthetic oxytocin (syntocinon) in labour to induce or speed up their labour. This can create significant problems for mother and baby. First, when a woman is given syntocinon by drip, oxytocin levels in her bloodstream can reach levels that are 130 to 570 times higher than she would naturally produce in labour. Her contractions will be longer, stronger and closer together than a labouring woman would naturally have, and all these factors can cause the baby to become distressed.
US birth activist Doris Haire says, “The situation is analogous to holding an infant under the surface of the water, allowing the infant to come to the surface to gasp for air, but not to breathe.” For these reasons, every woman with a syntocinon drip is under continuous monitoring to detect foetal distress. Foetal distress implies that the baby has insufficient oxygen and needs to be treated promptly (usually by caesarean) to avoid brain damage and death.
A second problem with syntocinon is it cannot, for physiological reasons, cross from the bloodstream back into the brain. This means it cannot act as the hormone of love because it cannot reach the middle brain. However, it can provide the hormonal system with what is called negative feedback — that is, oxytocin receptors in the labouring woman’s body detect her already high levels of oxytocin and signal the brain to reduce production.
We know that women who have had syntocinon infusions are at higher risk of bleeding after the birth because their own oxytocin production has been shut down. But we do not know the psychological effects of giving birth without the peak brain levels of oxytocin, the hormone of love, that nature prescribes for all mammalian species.
Natural birth pioneer Michel Odent has further suggested that many of our society’s problems — our current epidemics of drug addiction and teenage suicide, for example — may be traced back to this widespread and unprecedented interference with the oxytocin systems of Western mothers and babies at birth. Odent believes the functioning of the oxytocin system, which is still developing in the baby at the time of birth, reflects our ability to love ourselves and others. His theory, which is a powerful indictment of practices such as inducing and accelerating labour, is increasingly being supported by scientific research on oxytocin and other brain-hormone systems.
Beta-endorphin is a naturally occurring opiate; that is, it has properties in common with chemicals derived from the opium poppy such as heroin and morphine and is known to act in the same areas of the brain. Beta-endorphin, like oxytocin, is secreted from the pituitary gland in the middle brain, and high levels are present during sexual activity, pregnancy, birth and breastfeeding. Like the other opiates, beta-endorphin induces feelings of pleasure, euphoria and connectedness.
Beta-endorphin levels increase throughout a natural labour and levels peak at the moment of birth. Beta-endorphin helps the labouring woman to transcend pain and enter the altered state of consciousness that characterises a natural birth. After birth, high levels of beta-endorphin enhance bonding and mutual pleasure between mother and baby.
Beta-endorphin systems are also interfered with through medicalised birth, especially through the use of drugs for labour pain. As with oxytocin, the use of pain-relieving drugs can be seen as an artificial compensation for hormones that a labouring woman will naturally release if she feels safe and undisturbed. And, again, using drugs such as pethidine will lower a woman’s own production of beta-endorphin, reducing the help her body can give her with the stress of labour, and reducing her feelings of pleasure and transcendence at the moment of birth.
The long-term sequellae of such interference has been poorly researched, but what we do know is very concerning. A Swedish study, which looked at the birth records of 200 opiate addicts born in Stockholm from 1945 to 1966 and compared them with the birth records of their non-addicted siblings, found that when the mothers had received opiates, barbiturates and/or nitrous oxide gas during labour, especially in multiple doses, the offspring were more likely to become drug-addicted. For example, when a mother received three doses of opiates, her child was 4.7 times more likely to become addicted to opiate drugs in adulthood. This study was recently replicated with a US population, with very similar results.
Adrenalin and noradrenaline
The fight-or-flight hormones adrenaline and noradrenaline are part of a family of hormones called catecholamines (CAs) and are produced by the body in response to stresses such as hunger, fear and cold. As well as stimulating the sympathetic nervous system for fight or flight they also catalyse feelings of excitement, such as we might experience during extreme sports or riding the “tower of terror”.
During a natural labour, a woman’s catecholamine (CA) levels will gradually rise. However, if a labouring woman is fearful, cold, hungry or in excessive pain, she will release unnaturally high levels of CAs, which will reduce her oxytocin release. This will cause her contractions to slow and even stop, and will also cause blood to be diverted away from her uterus and baby to her large muscle groups in preparation for fight or flight. This CA response enhances safety for animals that give birth in the wild, who, when under threat, need a delay in labour and the muscular energy to flee to safety.
An instinctive CA response continues to operate in modern birthing environments. For example, when a labouring woman moves from her own familiar home environment to a hospital, her labour will often stall. The unfamiliarity of the hospital can trigger feelings of anxiety and she may sense at a primitive level that she (or her baby) is in danger. As well as slowing labour, the mother’s fight-or-flight response can reduce the blood supply to her uterus, putting her baby at risk of distress.
These hormones are, however, designed to benefit both mother and baby at the end of a natural labour. A woman may experience a sudden increase in her CA levels, especially noradrenaline, which will activate what has been called the foetal ejection reflex*. Under this hormonal influence, the mother experiences a sudden rush of energy; she will be upright and alert, with a dry mouth and shallow breathing and perhaps the urge to grasp something. She may express fear, anger or excitement, and the CA surge will, paradoxically, increase her release of oxytocin. With high levels of both oxytocin and CAs, she will experience several very strong contractions and she will birth her baby quickly and easily. Such a dramatic yet easy birth is uncommon in our culture because the foetal ejection reflex will operate only when a woman has been undisturbed in her labour.
For the baby, too, labour is an exciting and stressful event, and the baby’s CA levels rise as labour progresses. High CA levels in late labour provide an important safeguard for the baby by protecting against the effects of hypoxia (lack of oxygen) when the mother’s contractions are at their strongest. High CA levels help to divert blood to the baby’s most important organs and also make all the baby’s tissues more tolerant to low oxygen levels.
CA levels peak just before birth — the “catecholamine surge” — which also raises the baby’s blood sugar and fat levels so that his/her brain will have a good supply of fuel and be in peak condition at birth. High CA levels also clear fluid from the lungs, promote heat production, stimulate heart and breathing functions, and make the baby more alert and responsive at first contact with the mother. The CA hormone noradrenaline is also known to be an important “bonding” hormone in other mammals and almost certainly in human mothers as well.
Prolactin, the hormone of tender mothering, is also released in high quantities during labour and peaks at the moment of birth for both mother and baby. Prolactin is known to play an important role in reorganising the mother’s brain, hormones and behaviours in preparation for motherhood. According to Odent*, the presence of prolactin in the ecstatic hormonal cocktail ensures that a new mother’s feelings of love, pleasure, transcendence and excitement will be directed towards her baby.
After birth, prolactin is the main hormone of breastmilk synthesis. Prolactin is also present in breastmilk and is now thought to be important for optimal brain and neuroendocrine (or brain-hormone) development in the growing baby. This new finding provides scientific support for prolonged breastfeeding, as our human brains are not fully developed for at least two years.
Ecstatic birth will unfold most easily when labour and birth are the least undisturbed. An undisturbed experience does not, however, imply a lack of care or support but underlines the need for carers to be respectful of the basic needs of a labouring woman. A labouring woman needs to feel private, safe and undisturbed so she can enter the altered state of consciousness that will ensure a smooth and safe orchestration of her birth hormones. Ideal conditions for birth are similar to those of lovemaking or meditation, but any place can, with forethought (and a lot of cushions and fabric), be converted to a comfortable “birth nest”.
Ecstatic birth is also more likely when the chosen carer has an understanding of these basic needs and will respect the woman’s choices. One-on-one care with a chosen midwife is the ideal for a woman with a healthy pregnancy and baby, although this is currently available in Australia to only those with access to homebirth or birth-centre care.
The following suggestions recognise that the outcomes of birth are influenced by many factors and cannot be predicted or guaranteed. Ultimately, giving birth is a step into the deep mysteries, which will always take us outside our usual state
Optimising the ecstasy of birth
- Take responsibility for your health, healing and wholeness throughout the childbearing years. Specifically, pay attention to good nutrition (beginning pre-conception), good physical care, psychological and emotional exploration and support, developing self-trusting and instinctive attitudes and building a loving connection with your baby.
- Choose a model of care that enhances the chance of a natural and undisturbed birth (eg home birth, birth centre, one-on-one midwifery care).
- Arrange support according to individual needs; trust, a loving relationship and continuity of care with support people are important. Consider having an advocate at a hospital birth — eg private midwife or doula.
- Take the opportunity to create your own birth-nest, especially when birthing in a hospital or other unfamiliar place.
- Ensure an atmosphere where the labouring woman feels safe, unobserved and free to follow her own instincts.
- Reduce stimulation by keeping lighting and noises soft and reducing words to a minimum.
- Cover the clock and any other technical equipment.
- Avoid drugs unless absolutely necessary.
- Avoid procedures (including obvious observations) unless absolutely necessary.
- Avoid caesarean surgery unless absolutely necessary.
- Don’t separate mother and baby for any reason, including resuscitation, which can be done with the cord still attached.
- Breastfeed and enjoy it!
References to this article may be found on the extended version, posted on line at www.mothering.com/11-0-0/html/11-2-0/ecstatic-birth.shtml.
Sarah J Buckley is a GP, an internationally published writer on pregnancy birth and mothering and currently full-time mother to her four children, all born ecstatically at home. She lives in Brisbane. You can read more of Sarah’s writing at www.womenofspirit.asn.au/sarahjbuckley and you can contact her at email@example.com.