“Birth hormones matter: Take precaution before intervention” could be the bumper sticker summary of Dr. Sarah J. Buckley’s new, in-depth report, Hormonal Physiology of Childbearing: Evidence and Implications for Women, Babies, and Maternity Care. In her book, Dr. Buckley reviews the important role of birth hormones in helping expecting women prepare for birth, initiate labor, bond with their babies, and begin breastfeeding.
The report also covers common practices that may create stress for the mother and interfere with natural hormonal processes during labor and birth, such as lack of privacy, loud noise, bright lights, and unnecessary or too frequent interventions, assessments, and monitoring. The full report and a consumer-friendly booklet are available through Childbirth Connection under Hormonal Physiology of Childbearing. These materials are a must-read for healthcare practitioners, childbirth educators, and pregnant women alike to get a firm understanding on the power of birth hormones.
Midwifery encourages the work of birth hormones
Buckley’s report came out on the heels of the release of the British National Health Service’s new evidence-based guidelines which promote, among other recommendations, midwifery care and the option of out of hospital birth for low-risk pregnancies. When one looks at the effects of stress on the release of beneficial hormones during labor, birth, and postpartum, the argument in favor of midwifery care and the birth center option becomes even clearer.
Midwife means “with women”. A midwife is with her patient as much as possible during labor and birth. Midwives engage in physiologic birth practices, or care that is supportive of the woman’s physical and emotional needs, involving little to no medical intervention unless truly necessary. In other words, midwifery care supports the processes of birth hormones that help promote healthy outcomes and bonding.
This minimalist approach makes sense. In the U.S., perinatal outcomes have not improved despite increasing cesarean and induction rates over recent years. It’s time to realize that “less is more” when it comes to intervention and care of low risk pregnancies. When a situation warrants medical attention, midwives are trained to recognize and manage certain complications to ensure the health and welfare of mother and baby. If a patient becomes higher risk, midwives work with ob-gyns for collaboration, co-management, or referral of patient care as necessary.
The Birth Center Option
According to Britain’s new NHS report, all low risk pregnant women should be offered the option of the birth center. Birth Centers are an excellent alternative to the hospital. If only more of them existed! Located alongside a hospital or “freestanding” with a nearby hospital providing back-up, birth centers offer a perfect, safe environment for birth. The typical birth room is a quiet, dimly lit, comfortable space with a big queen size bed and a tub for water labor or birth.
Electronic fetal monitors are unnecessary as only women with low-risk pregnancies birth at the center. Instead of continuous monitoring, a handheld doptone is used to intermittently and unobtrusively listen and record the baby’s heartbeat while allowing the laboring woman more freedom of movement. A midwife and nurse facilitate the labor and birth with the woman’s birth partner. If a situation occurs in which transfer to the hospital is necessary, protocols are in place for efficient transport.
Full disclosure: I am a nurse-midwife who has practiced in a birth center environment and given birth to my two children in a birth center with midwives. I realize I’m biased but I truly believe there is nothing like midwife-led care and out of hospital birth for low risk pregnancies. For me, the simple act of entering a hospital creates stress. Like many others, I associate hospitals with sickness and disease. The birth center and the midwives had the complete opposite effect on me. I felt relaxed, warm, and safe within their care and in an environment fully conducive to “letting go” and allowing my birth hormones to take over. You and your baby deserve a positive experience too, no matter where or with whom you birth your baby. The important point to remember is this: know your options, check them all out, and then make an informed choice that is right for YOU.