Ever heard a birth story where the woman goes into hospital after getting some really good contractions going at home — only to have them stop once they get through the hospital doors? What is often happening here is a very normal and important response by the woman’s body to her feelings of anxiety about her labour, and its all down to hormones. The good news is that you can increase your chances of avoiding this becoming part of your birth story by finding ways to increase your feelings of safety and security during labour.
You may have heard about oxytocin, as it is the major hormone responsible for creating contractions during labour. Did you know that in response to these contractions your body releases endorphins? These are your natural pain relievers, and they are very similar to opiates like pethidine. Endorphins are those powerful chemicals, which give you a high after a strenuous workout at the gym or after a really hot curry! In fact, your body will start to produce these endorphins well before labour, in preparation for the big event. As your labour intensifies, your endorphin levels rise in response, to get you and your baby through labour and birth.
But if you become scared or anxious during labour, your body may release another hormone into your system, which works against oxytocin and endorphin. This hormone is adrenaline, and its release is part of your body’s primitive survival behaviours, because its job is to slow down or stop your labour until the perceived danger has passed and you feel safe again, so protecting you and your baby.
This effect occurs because adrenaline reduces the levels of oxytocin in your body, slowing contractions. Adrenaline will also work upon your cervix to stop it from dilating and in some cases it will reverse the work you have already done and begin to close it.
A woman’s body might release adrenaline in response to anxiety about an increase in the level of pain she is experiencing, or the feeling that she has a lack of privacy, or perhaps in response to a worrying comment she has heard from a caregiver. But sometimes the source of the anxiety is less obvious because it is an emotional issue, such as the concern that the baby may have a disability or a fear of pushing the baby out. In these cases too, adrenaline can be released, slowing and sometimes stopping the labour.
So how can you avoid this becoming part of your labour? Well, one of the most important things you can do is to try to increase your potential for automatic relaxation in your chosen birthplace. If you are planning a homebirth, you will already be in your own environment. If you are planning to birth in a hospital this can mean doing a bit of preparation before labour begins, as you will want to try to create a ‘home from home’ in your hospital birthing room.
Firstly make sure that you visit your hospital birthing suite or labour ward during pregnancy, so that you are familiar with the place before you arrive there in active labour. Most hospitals run tours regularly. You will also be able to find out about the available facilities and meet more members of the hospital staff team.
Whilst you are there find out if:
You will have access to a bath/ birthing pool during labour?
There is a CD player in every room for any music you may bring from home?
You can have access to an electric oil burner for aromatherapy?
Every room has a small lamp or dimmer switch to create dim lighting?
Can you have access to a birth ball; bean bag; floor mats; extra pillows?
If you are a healthy woman with a normal pregnancy, it might be worth checking to see if your hospital has a birth centre attached to it. Births centres are usually run by midwives and their rooms are generally much more ‘homely’ than those in the main hospital birthing suite or labour ward.
Once you have done a ‘recky’ of the birthing suite, think about the kind of atmosphere you would like to give birth to your child in and how you might achieve this in the birthplace you have chosen.
Pack your hospital bag to increase your comfort and privacy!
Take your own bedding with you. Seeing and smelling your own linen can be very comforting. Pack your own shirts (or clothes) for labouring in. Take anything else with you which might remind you of your home for example photographs of family, scarves or sarongs to cover up unused hospital equipment, favourite ornaments etc.
Pack some CDs. Even if you do not listen to music regularly, music can help to create atmosphere whether that be peaceful or upbeat (both might be needed at some point during your labour) and can block out noises from the rest of the labour ward. Music has also been shown to relax the medical staff too. Make sure you take a good variety to avoid monotony.
Packing your favourite perfume to spray in the room can mask any unhomely hospital smells. Or if you find that aromatherapy helps to relax you, take some well chosen oils with you.
Once you have arrived at your birthplace:
Dim the lights – Close the curtains if it is daytime. If it is dark outside, turn off the main light and put on a small lamp or the bathroom light instead.
Set up a labour nest ON THE FLOOR on the opposite side of the bed from the door – Staying off the bed can be a good start if you wish to achieve an active labour. Placing yourself on the opposite side of the bed from the door, will minimise your disturbance from caregivers coming in and out of the room. In early labour, you may find it useful to simply lean over the bed during contractions. During active labour you could try kneeling on the floor and leaning over a beanbag and extra pillows during contractions and for relaxing in between them. Use matting and pillows to cushion your knees.
Check the temperature – Use fans or heaters to make sure that you are comfortable.
Your partner as ‘Guardian of the birthplace’ – This is one of the most important roles your birth partner can play whilst you labour. Seek your caregiver’s help in reducing disturbances to you whilst in labour, some suggestions include:
Ask that only essential personnel be present in the room. If you are labouring normally, you may only be attended by a midwife, but it is not necessary for her to be present all the time if you find this to be a distraction. Your caregiver might also ask if a student midwife can attend, this is your choice. In a hospital, you may be assessed by a doctor at 4 hourly intervals. Again your doctor might ask if medical students be allowed to attend, this is your choice. If you have a private doctor, they will expect to be there for the birth and possibly at other times during your labour. If the room is filling up with people even though all is going well, your partner can gently ask non-essential staff to leave.
Ask staff to knock and wait to be answered before entering the room.
Keep vaginal exams to a minimum. An observant caregiver should be able to assess your progress in labour just by noting your behaviour. If a vaginal exam becomes necessary, ask to have it performed in your current position if possible.
Escape to the toilet! If it is proving difficult to achieve a quiet and calm atmosphere in the room, and everything is going well, escaping to the toilet or bathroom can be effective. We are conditioned into giving people their privacy when they are in the toilet and the limited space will reduce the numbers of people in attendance. Using water during labour, either a shower or bath has also been shown to increase a woman’s sense of privacy during labour.
o Childbirth. New York: Bantum.