PHOTO CREDIT: RED PRODUCTIONS LTD 2015
'It’s not because 'I'm too posh to push' – it's about what I think my body is capable of. I'm not good with pain - I faint when I stub my toe.'
These are the words of “Call the Midwife” star, Helene George, who plays the loveable Trixie in the popular television series. When she had her baby in September last year, she made the choice of giving birth via an elective caesarean. She is not the only women who believes her body is not capable of managing the sensations that childbirth brings and what she has been quoted as saying, is not far off what I hear most women say when they discuss giving birth. What it does tell me, is that she appears to lack the knowledge of birth physiology and I wish I had been able to tell her more about this before she had her baby.
I wrote a whole book on this subject because I wanted my daughters to have something available for them to read about pregnancy and motherhood that would be facts and not myths about what happens to your body when you give birth. I strongly believe that you cannot compare childbirth and the sensations that go with it to any other pain in this world. Why is that? Because when you give birth, if you are in the right environment and well supported, your body is physiologically different!
It seems that not many people are aware of the fact that giving birth is a physiological process. A physiological process is something that happens in your body without you needing to think about it. Most of these processes are to do with survival, for example, how the nutrition in the food we eat is extracted and the waste disposed of, coughing and sneezing, breathing and sleeping, as well as ovulation and childbirth. All these processes are facilitated by hormones released from our old and primitive brain and there is little need to involve our intelligent brain, or the neo-cortex as it’s also known as.
The key is actually to shut down the intelligent brain so that the primitive brain can take over and do its thing. We’ve all been there! Perhaps we’re off on holiday and the evening before, we’re lying in bed, trying to go to sleep. We keep telling ourselves, in our neo-cortex, “I must go to sleep or I will be so tired” and the more we’re doing this, the more impossible it seems to go to sleep. It’s actually better to think, “It doesn’t matter if I don’t sleep, I can just lay here and rest and that will be just as good”. By giving up trying to control a physiological event and shutting the neo-cortex down, the hormones required for sleep will be able to be released from the pituitary gland and in roughly 20 minutes, you will be fast asleep.
Childbirth works in exactly the same way! The hormones required are oxytocin and endorphins and these can only be released if the woman is in a relaxed, warm and safe environment. These two hormones are involved when the baby is made – and the same environment is needed when it’s time for the baby to enter this world. Oxytocin is Greek and means ‘quick birth’ and the more of this ‘love’ hormone that you release, the quicker you will meet your baby. Endorphins are your body’s natural morphine and these two hormones work together during childbirth. Oxytocin makes the muscles in the uterus work which in turn, helps open the cervix, the neck of the womb, so that the baby can come out. At the same time, endorphins are released to help with the side-effects of the intense work of the womb’s muscle and therefore making it manageable for the woman.
It’s quite simple – make sure the woman is warm, feeling well supported and safe, that the lights are dimmed and that there aren’t too many people around and those that are, keep quiet. This will support and enable that primitive part of the woman’s brain to easily and freely release these hormones.
However, what often happens is that before labour has even started, many women are petrified and even phobic about the thought of the pain and discomfort that they keep hearing being associated with childbirth. Statements such as: “You wouldn’t have a tooth out without pain relief would you, so why even contemplate having a baby naturally?” are frequently heard and peddled around to insinuate that this is a very good comparison of two very different events.
I have two answers for this; firstly, we are not meant to have teeth pulled out! It’s not a natural thing to happen. Secondly, your body’s physiology will be very different when you’re sitting in a dentist’s chair as you will be completely in your intelligent brain, most likely a bit fearful so there will be adrenaline in your blood stream. This might trigger the ‘flight or fight’ reflex, which means you may even need to be put under a general anaesthetic to have your tooth out.
Unfortunately, this release of adrenaline often happens to women during childbirth. They start feeling fearful and scared because they have not learnt about birth physiology, they don’t know that when we say childbirth is a natural event, we actually mean something that happens without you even needing to think about it. Just like eating, sleeping, sneezing and coughing.
We are mammals and all mammals have been equipped with this natural process. But to survive in the wild, mammals that are in labour and feel threatened by a predator have also been conditioned to stop labour so that they can run off somewhere safe and then continue the labour and birth process.
A woman’s body works in exactly the same way but we no longer face those predators from the past, instead these have been replaced by high-tech hospital environments that a healthy pregnant woman, who is having a healthy and non-complicated pregnancy usually end up in. It automatically triggers the ‘flight or fight’ reflex and by doing so, the release of adrenaline inhibits the hormones of oxytocin and endorphins, which means labour slows down and becomes more painful. As the natural morphine in the woman’s body disappears, labour becomes unmanageable and often she will need pharmaceutical pain management for the pain. Perhaps labour even completely stops so she will need the artificial version of oxytocin to bring labour back on track. Basically, the whole natural and physiological process has been taken over by an artificial process all because of the adrenaline overload caused by not being in an environment that supports a physiological birth to unfold.
You might have heard the statement “failure to progress” and often women feel that their bodies have failed during childbirth. There is only one thing that causes these ‘failures’ and that is the failure of providing an environment where the woman’s body was able to release the hormones required for a physiological birth to happen.
Just like you can’t think yourself to sleep, you cannot think yourself into childbirth. It is not academic – it is primal and mammalian.
I am 100% sure that if all women understood how their bodies work and if they were well supported before, during and after childbirth – the number of women requesting caesareans would sharply drop.
I believe it is every woman’s right to choose where and how she would like to give birth, whether that is with or without pain medication, or a planned caesarean birth – however I’m not convinced all women are making those choices with all the knowledge about physiological childbirth.
Kicki Hansard is a member of Doula UK, however any opinions expressed on this blog are personal views and not necessarily the view of Doula UK.