Natural Childbirth III: Why Undisturbed Birth? | Chris Kresser
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Natural Childbirth III: Why Undisturbed Birth?

by Chris Kresser

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Nikolay Suslov/Hemera/Thinkstock

Spontaneous labor in a normal woman is an event marked by a number of processes so complicated and so perfectly attuned to each other that any interference will only detract from the optimal character. The only thing required from the bystanders is that they show respect for this awe-inspiring process by complying with the first rule of medicine – nil nocere [do no harm]
G.J. Kloosterman, The Universal Aspects of Childbirth

In the wild, mammals isolate themselves during labor.

A pregnant sheep, which is normally a herd dweller, will separate herself from the flock when birth becomes imminent. A rhesus monkey will move away from her group to the edge of the forest and choose a well-camoflauged hiding place in which to give birth. The rat, which is normally a nocturnal prowler, gives birth during the day to increase the chances that she’ll be unobserved. And the horse, which is normally a daytime grazer, gives birth during the night for the same reason.

Human beings are mammals

As often as we forget this, human beings are mammals. We share the same 175 million year evolutionary heritage of birth with other mammals. These similarities should be starting point when try understand the process of normal, undisturbed birth in our own species.

Like our mammalian relatives, human females are designed to give birth safely in the wild without supervision or medical intervention. It is as natural to us as eating, breathing, digestion, elimination and sleeping. It’s in our genes.

As physician and natural childbirth advocate Michel Odent reminds us:

When you consider birth as an involuntary process involving old, mammalian structures of the brain, you set aside the assumption that a woman must learn to give birth. It is implicit in the mammalian interpretation that one cannot actively help a woman to give birth. The goal is to avoid disturbing her unnecessarily. 1

Traditional humans also isolate themselves during labor

In a film about birth among the Eipos tribe of Papa New Guinea, ethologist Wulf Schniefenhovel documents mothers-to-be leaving their village and going into the bush just prior to giving birth.

Isolating oneself in this way has been the norm in traditional societies around the world, including the Kung San in Africa, the Turkomans in Central Asia and First Nations tribes in Canada.

In an eighteenth-century, firsthand account of birth practices in a tribe of Canadian Indians found in a Paris library, J-C B. explains1:

Women usually give birth by themselves and without any difficulty, and always away from their own homes in small huts which have been built in the forest for this purpose, 40 or 50 days beforehand. Sometimes they even give birth in their fields.

It’s worth noting that in these societies where women isolate themselves during labor, deliveries are often reported as being easy, almost to the point of seeming effortless to observers.

Why would this be? How does privacy and isolation contribute to easier and less complicated labor?

What kind of environment inhibits a female in labor?

To answer those questions, we can look at studies of mammalian birth carried out by Niles Newton in Chicago during the 1960s.

Newton studied birth in several mammals, but focused on mice in particular. She analyzed the factors that made deliveries longer, more difficult, and more dangerous.

She found that labor could be slowed or even stopped completely by:

  • Placing the laboring mother in an unfamiliar environment (a place where the sights and smells are not what she’s accustomed to).
  • Moving the mother from one place to another during birth.
  • Putting the mice in a transparent cage made of glass and observing them.

Does this sound familiar? Each of these things happens in a conventional hospital birth. The mother is moved during labor from her home, which is familiar, to a hospital, which is unfamiliar, and observed by a staff of people she has little connection to or experience with.

Although we are not mice, we do share similar needs as other mammals during labor. Anything that disturbs a laboring woman’s sense of safety and privacy will disrupt the birth process.

This definition unfortunately covers most of modern obstetrics, which has created an entire industry around the observation and monitoring of pregnant women. As Dr. Sarah Buckley observes 3:

Some of the techniques used are painful or uncomfortable, most involve some transgression of bodily or social boundaries, and almost all techniques are performed by people who are essentially strangers to the woman herself.

Underlying these procedures, Buckley says, is a fundamental distrust of women’s bodies and the natural processes of birth. This distrust has a powerful “nocebo” effect and becomes a self-fulfilling prophecy, where women are almost certain to need the interventions that the medical model provides and feel grateful for them no matter how traumatic the experience.

Because of this, many women in western culture have come to expect birth to be a medical emergency – rather than a natural, instinctual process – that requires medical management and intervention.

The hormonal orchestration of an undisturbed birth

The hormonal orchestration of birth is an exceedingly sophisticated and complex process that is still not well understood.

In fact, we still don’t know what causes the onset of birth. We know that estrogen, progesterone, cortisol and SP-A are all implicated, but we don’t know exactly how they work together. This is another reason why it’s so important to minimize interference in the natural birth process; we are more likely to cause problems with intervention than solve them.

A perfect example of this is fetal heart monitoring with ultrasound during labor. The pretense for this type of monitoring is that it will catch a potential problem and thus make the mother and baby safer.

However, studies show just the opposite is true. A large review published in Lancet in 1987 covering tens of thousands of births in Australia, Europe and the U.S. found that the only statistically significant effect of continuous fetal heart monitoring during labor was an increase in the rate of Caesarians and forceps deliveries.

The hormones involved in orchestrating mammalian birth are secreted by brain’s most primitive structure, the limbic system. The limbic system is not in our conscious control. For birth to happen optimally, we need to give this more primitive part of the brain precedence over the “rational brain” (the neocortex).

Anything that inhibits this shift of consciousness – including fetal heart monitoring, bright lighting, conversation, observation and expectations of “rational” behavior – will very likely interrupt the natural birth process.

Conversely, when we provide the right environment for a woman during labor – conditions in which she feels safe, private and unobserved – we facilitate the instinctual coordination of birth that is part of every woman’s genetic heritage.

Dr. Buckley observes4:

Undisturbed birth represents the smoothest hormonal orchestration of the birth process, and therefore the easiest transition possible; physiologically, hormonally, psychologically, and emotionally, from pregnancy and birth to new motherhood and lactation, for each woman. When a mother’s hormonal orchestration is undisturbed, her baby’s safety is also enhanced, not only during labor and delivery, but also in the critical postnatal transition from womb to world.

This, together with modern hygiene and the availability of advanced emergency medical techniques, give us a better chance of an easy and safe birth than any of our ancestors have had in the history of the human race.

In the next few articles in this series, we’ll be exploring the hormones involved in the birth process and how medical procedures such as epidurals and induction with synthetic oxytocin (pitocin) interfere with the exquisitely regulated (and still poorly understood) hormonal orchestration of undisturbed birth.

Note: I wrote this article on 7/16, and have scheduled it to be published on 7/22. If my wife Elanne has gone into labor and we’ve had our baby before then, it’s likely I won’t be able to respond to comments for a while.

Articles in this series:

  1. Odent M. Birth and breastfeeding: rediscovering the needs of women during pregnancy and childbirth. Clairview Books 2007.
  2. Odent M. Birth and breastfeeding: rediscovering the needs of women during pregnancy and childbirth. Clairview Books 2007.
  3. Buckley S. Gentle birth, gentle mothering: a doctor’s guide to natural childbirth and early parenting choices. Celestial Arts 2009. pp.96
  4. Buckley S. Gentle birth, gentle mothering: a doctor’s guide to natural childbirth and early parenting choices. Celestial Arts 2009. pp.97

80 Comments

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  1. Dear Chris, I will be having a home birth and couldn’t be more excited! I will be laboring in the tub since it really takes a lot of the pressure off, or at least it did for me. And I am thinking of possibly giving birth in the tub as well. My question is, will giving birth in the tub affect the baby’s microbiota/microbiome/good bacteria? I know baby’s are born covered in goopy stuff (you like my scientific term? 😉 that is good for their body to absorb naturally rather than being washed way, however, I know that they also swallow the mother’s microbiota as they are being born so perhaps being born in water, while it may wash away some of the good stuff it may not be that big of a deal? I have not found a lot of research on this topic but I am curious what your thoughts are on this matter. I hope to hear back soon as I don’t have much time left to make a decision :). Thank you in advance!!

  2. Chris – I am dismayed to see that several of the research studies you cite about birth are from the 80’s – some over 30 years old! Now…some aspects of birth haven’t changed much in the last 30 years….but so many have! The rise of natural childbirth practices, the dramatic changes in the way epidural medicine is administered and used, practices around episiotomy, etc….I’m really surprised that you are citing some very old data in some cases (especially around the incidence of C-section with regard to epidural…that one was from the 80’s, when 3X the amount of medication was typically used!). As a reader and follower, over and over again you’ve convinced me with the use of solid data and research. This is a disappointment!

  3. where I live we have no choice but to give birth in hospital, where most women are treated very inhumanely. Before I gave birth everything in me was screaming not to go to the hospital although they were very nice to me. Then on the day everything started great but as soon as we got there they strapped on fetal monitoring and I was whisked away for a c-section. A year later I’m still struggling with PTSD, panic attacks, bonding issues. The physical recovery was a piece of cake compared to the mental recovery.
    It can’t be overstated how important it is that a woman gets the birth that she wants, that she feels empowered and respected.

  4. Chris,
    Do you have any opinion about cord blood banking? My wife is due in February and I’m trying to weigh the cost against the potential benefit of saving the cord blood.

  5. I absolutely love this series. My 4 month old son was born naturally at home…. which was so not the plan. I had a midwife, a normal low risk pregnancy, and I wanted a natural, drug free birth… but… I wanted to give birth at the hospital ….”just in case”.

    My labour was fast. VERY fast for a first time mom. About 1.5 hours… there was NO time to get to the hospital,

    I pushed my baby out at home, on my bed (covered in every single towel I owned). No drugs. No interventions. This was the best, most life changing moment of my life.

    I felt every contraction. I felt my baby move down my birth canal. I felt the ring of fire of his crowning head. I felt him come out of my body. And then, I felt the euphoric effects of the hormonal cocktail my body released.

    Seriously, this experience changed me and it SADDENS the heck out of me that more women do not get to experience this. I strongly believe that the ONLY reason I got to experience this is because I had a fast labour. Had I been at the hospital at the time and someone offered me an epidural, I would have grabbed it out of their hand and shoved it in my back myself. Which could have slowed my labour, which could have lead to the cascade of interventions…..

    I would really like to see the system change to make achieving a natural labour at home possible for more women. Of course this is not possible for all women, but many more than there are currently…

    • Hi.. I’m.really encouraged reading ur birth story .. However I’m worried if I have any tears in the perinium . they say first time moms are at high risk for tears

      • First time mom’s are far more at risk for tearing in hospital with interventions. My first labor was too fast for the unavailable doctor. They talked me into ‘a little something’ for the pain, then loaded me up with something that stopped my labor. Then when the doctor arrived they cranked it up again with too much pitocin. The contractions were too strong, left no time for natural stretching, and I tore like mad.

        Chances are, had they left me alone, it would have been fine, just not by that doctor’s schedule. It was awful and definitely interfered with our nursing and bonding, as baby was too stoned to nurse for the first day or so.

  6. I love your articles and reading about other people’s positive birth experiences. I’m due in 3 months and I feel so discouraged. I’ve been telling myself that I’ll do it naturally and that we’ve been doing this for so much longer drug-free than with drugs and that we’re all strong enough to do it. I moved from Canada a few months ago where I had an awesome doctor that supported whatever I wanted to do, to a latin american country where the doctor flat out told me, Well yeah you could do it that way but I wouldn’t if I were you because you don’t know what you’re in for and the pain is going to be overwhelming…then how are you going to feel in your water? I don’t recommend it to women who have never had children. I didn’t know how to respond to that (politely). Now he has my SO all worried that I’m lining myself up to suffer for no reason. Needless to say, I’m looking for a different doctor but I have to admit that what makes me the most nervous is being dragged to a hospital here when the time comes and completely blocking up emotionally. I’ll work on preparing myself mentally in the next few months. Wish me luck.

    • I figured I’d write a follow-up to my comment 🙂
      I found an obgyn who fully supported my wishes for a water birth and she referred me to a doula she trusts. My doula also gives prenatal classes and so I got to know her a bit before the birth through those. My son’s birth was amazing. I labored at home all day getting last-minute things done, taking walks, baking, I even went to eat a salad at a restaurant. I breathed through my contractions like I learned in my classes and waited until it was clear I was in transition. I had contractions at home for 24 hours before heading to the clinic. When I got there the birthing pool was ready and I tried to keep walking around and keep myself busy but the pain was just way too strong. I was already 8 cm dilated when I made it there. I went in the pool and my doula and husband were there to guide and encourage me through the last phase of labor. My son was born at 3 am and I only needed two stitches afterwards. Reading positive stories and really psychologically preparing myself were key to getting through labor. Thank you again for the information you provide us on your website!

  7. Thank you for such an empowering article and all the birth stories. My second child is due in 5 weeks and I am frankly terrified after an awful hospital birth experience with my first child. It started well but ended as far from a natural delivery as you could get in an operating theatre being dragged down the table as they yanked my daughter out with forceps. I was shaking so badly from the epidural that I as unable to hold my daughter for about an hour, she was so badly bruised that she still had small lumps several years afterwards and I had a fractured tailbone and a huge hematoma. It has taken me 6 years to work up the courage to have another baby. After reading your articles lots of things have begun to fall into place and this has really helped me start to make sense of everything that happened to my daughter and I. In the last couple of weeks I have have started considering a home birth as I am low risk right now and we are only 15 minutes from the hospital if needed anyway. I want to keep my options open but the more I read the more a home birth seems like a much more positive option.

    I am also interested in the whole cord clamping issue that JB mentions above.

    Thanks again 🙂

  8. Chris, I have read many of your articles about pregnancy, babies etc. They are very informative and I recomend that all of my friends read them. Howvever, my wife is pregnant and I have been wondering how you feel about cord clamping, delaying, and cutting.

    What are your thoughts on the subject?

    Thanks,

  9. I’ve found this article and comments to be very interesting. I especially find the comments women made about making lots of noise during labor being empowering and natural. My husband and I took a class about Hypnobirthing before our first child and after a very difficult birth I felt that although we had learned useful information, that because there was intervention and I had yelled lots that I had somehow failed and was weak. I was ashamed of that. Now I’m thinking of other examples where that noise is empowering – like the yelling during martial arts or the roaring of an animal as they attack. These are indications of control and power.
    My second birth experience was so much better. I labored at homem for several hours (taking some Advil for the back labor discomfort) until it was almost time to push and then was very straightforward with staff when arriving at the nearby hospital. I didn’t change into hospital clothes and only layed down briefly so my dilation could be checked (in between contractions.) I labored in a position that was comfortable for me (forearms slightly elevated and legs wide facing the bed.) I blocked out the sounds and sights of the delivery room and the delivery was so quick that my doctor almost missed it. After delivery my daughter was covered in a blanket and handed up directly while the umbilical cord pumped out. My husband took her for a few minutes while I was tended too. Breastfeeding happened right away. It was practically perfect.
    This was the same hospital.
    Hospital birth doesn’t have to be traumatic, but I agree that there are many factors that tend to make it so. Being proud of our strength as women and sharing positive birth experiences wherever they have occurred I think is important – especially sharing without judging if friends, relatives, etc. choose a more medical method or hospital birth or a birth at home.
    Thanks for the thought of enjoying the birth. It can be great.

  10. Before I gave birth to my first child I told myself “birth is going to be awesome”. And I beleived it. And guess what…it was! We had planned a hospital birth but almost didn’t make it. Labor started at night, I sat in my living room by myself and told myself that I wasn’t in labor, then took a shower…then started pushing! So I learned that no one needs to tell a woman how to give birth. The birth was 5 hours start-finish, and probably would have been faster if we hadn’t been trying to make it to the hospital. My second birth was 2.5 hours, at home in my bathtub.
    I think it’s sad that people assume that if you had a fast uncomplicated birth that you are a superwoman and it’s not possible for them. It usually is possible! But you have to talk yourself out of everything that society has ever told you about birth. I told a friend of mine due 6 months after me that it would be great…but she didn’t really believe me and trusted her doctor way too much. Her water broke early, she was induced a few hours later, labor FTP, then c-section because “her pelvis was too small”. Yeah right. Many of her parenting plans like breastfeeding went downhill from there. It’s just sad that women are so marginalized that they can’t even trust themselves to give birth and feed their babies.

  11. My son was born thirty minutes after getting to the hospital on a sultry August night near midnight. I was only in any pain for 45 minutes before he was born. I spent the entire twenty minutes up in labor and delivery arguing with the L&D nurse, the L&D CNA and finally, the OB who informed me I hadn’t been pushing thirty seconds before he came rocketing out of my body like a champagne cork sailing out of the bottle. I wanted to get off the table and strangle her. I had no interventions until after he was born and the stupid OB yanked his two vessel cord and broke it, necessitating that the placenta be manually retrieved. After it was all over, I couldn’t help but think that I wish I’d had him on the grass in the dark, warm parking lot. I was great and felt like I could have left and gone home an hour after he was born.

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