Hormones Driving Labor and Birth



Do I need to learn how to give birth?

What hormones affect the process of labor and birth?

What is the role of oxytocin during labor and birth?

What is the role of endorphins during labor and birth?

What is the role of adrenaline during labor and birth?

What steps can I take to help ensure that these hormones work well?



Do I need to learn how to give birth?

You and your fetus/newborn have innate abilities to start labor, labor and give birth, breastfeed, and become deeply attached to one another. The ebbing and flowing of hormones drives these well organized, finely tuned processes. It is important that you and your caregivers understand how to work with — and avoid disrupting — this inborn knowledge and drive for birth, connection, and optimal nutrition. While you don’t need to be taught how to give birth, it is fascinating to learn about the amazing capabilities of women and newborns. For example, a newborn who was not exposed to pain medications and is placed skin-to-skin on his or her mother right after birth can crawl to her breast, self-attach, and begin nursing.

What hormones affect the process of labor and birth?

It can be especially helpful to know about three of the main hormones involved with reproduction: oxytocin, endorphin, and adrenaline. These hormones play a major role in regulating the process of labor and birth, and learning about them can help you understand what will happen during labor and birth. Childbearing women and their caregivers can take actions to support or disrupt their effects, so, understanding how they work and how they are affected is important for making informed decisions.

This page discusses how these hormones work around the time of birth, problems that can result from low levels of these hormones, and ways to help ensure that the hormones work well at this time.

What is the role of oxytocin during labor and birth?

Oxytocin is often known as the "hormone of love" because it is involved with lovemaking, fertility, contractions during labor and birth, and the release of milk in breastfeeding. It helps us feel good, and it triggers nurturing feelings and behaviors.

Receptor cells that allow your body to respond to oxytocin increase gradually in pregnancy and then sharply during labor. Oxytocin stimulates powerful contractions, which help to thin and open (dilate) the cervix, move the baby down and out of the birth canal, expel the placenta, and limit bleeding at the site of the placenta. During labor and birth, the pressure of the baby against the cervix, and then against tissues in the pelvic floor, stimulates oxytocin and contractions. So does a suckling newborn.

Low levels of oxytocin during labor and birth can cause problems by:
  • causing contractions to stop or slow, and lengthening labor
  • resulting in excessive bleeding at the placenta site after birth
  • leading providers to respond to these problems with interventions.

What is the role of endorphins during labor and birth?

In response to stress and pain, your body produces calming and pain-relieving hormones known as endorphins. The level of this natural opiate substance may rise toward the end of pregnancy. In unmedicated labors, it continues to rise steadily and steeply through the birth of the baby. (Most studies have found a sharp drop in endorphin levels with use of epidural or opioid pain medication.) High endorphin levels during labor and birth can produce an altered state of consciousness that can help you flow with the process, even if it is long and challenging. Despite the hard work of labor and birth, high endorphin levels can make you feel alert, attentive, and even euphoric after birth, as you begin to get to know and care for your baby. In this early, postpartum period, endorphins are believed to play a role in strengthening the mother-infant relationship. A drop in endorphin levels at this time may contribute to the "blues" that many women experience after birth.

Low levels of endorphins can cause problems in labor and birth by:
  • causing labor to be excessively painful and difficult to intolerate
  • leading providers to respond to this problem with interventions.

What is the role of adrenaline during labor and birth?

Adrenaline is the "fight or flight" hormone that humans produce to help ensure survival. Women who feel threatened during labor (for example by fear or severe pain) may produce high levels of adrenaline. Adrenaline can slow labor or stop it altogether. Earlier in human evolution, this disruption helped birthing women move to a place of greater safety.

Too much adrenaline can cause problems in labor and birth by:
  • causing distress to the unborn baby
  • causing contractions to stop, slow, or have an erratic pattern, and lengthening labor
  • creating a sense of panic and increasing pain in the mother
  • leading providers to respond to these problems with cesareans and other interventions.

What steps can I take to help ensure that these hormones work well?

You can promote your body's production of oxytocin during labor and birth by:
  • staying calm, comfortable, and confident
  • avoiding disturbances, such as unwelcome people or noise and uncomfortable procedures
  • staying upright and using gravity to apply your baby against your cervix and then, as the baby is born, against the tissues of your pelvic floor
  • engaging in nipple or clitoral stimulation activities before birth and giving your baby a chance to suckle shortly after birth
  • avoiding epidural analgesia.

You can enhance your body's production of endorphins during labor and birth by:
  • staying calm, comfortable, and confident
  • avoiding disturbances, such as unwelcome people or noise and uncomfortable procedures
  • delaying or avoiding epidural or opioids as a pain relief method.

You can keep adrenaline down during labor and birth by:
  • staying calm, comfortable, and relaxed
  • being informed and prepared
  • having trust and confidence in your body and your capabilities as a birthing woman
  • having trust and confidence in your caregivers and birth setting
  • being in a calm, peaceful, and private environment and avoiding conflict
  • being with people who can provide comfort measures, good information, positive words, and other support
  • avoiding intrusive, painful, disruptive procedures.

These lists clarify that many features of typical hospital childbirth settings can interfere with effective action of these basic hormones. It would be wise to consider seeking more favorable settings or taking special precautions in these settings to protect and support “physiologic” labor, birth, attachment, and breastfeeding drawing on your and your baby’s capabilities. Out-of-hospital birth settings and one-to-one continuous labor support, such as doula care, can help create conditions that enhance your body’s natural production of helpful hormones and keep disturbing hormones in check.



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Cascade of Intervention

Most recent page update: 4/11/2011


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