February 18, 2004

Endorphins - Nature's solution for labour pain

In all the comments about “painless labour” that have been flooding in to my Diary recently (see comments posted to any of the entries on “Hypnobirthing” for example), it has been notable that the role that natural endorphins play in easing the pain has not been mentioned. The “hypnobirthers” describe blissful states where they are “in tune” with what is happening but not feeling any pain. This state is being attributed to the birthing method when in fact, it is the body’s own endorphins that create this effect.

It is this ability of the body to produce its own pain killers that the Dutch women rely on (see my previous entry) and they discover this for themselves as labour progresses. Anyone in a relaxed state, where adrenalin is low, will produce endorphins in labour. In fact, endorphins can be found in a pregnant woman’s system from about 12 weeks of pregnancy, gradually increasing as the months go by until they are at quite high levels in the last weeks before the birth. Women notice their effects, even before the labour starts: they feel less energetic (after the last rush of getting everything ready); their sleep patterns may be disturbed by periods of wakefulness and possibly wild, even frightening dreams; they spend more time “navel gazing”, becoming more inwardly focussed and self aware; and most commonly, they are forgetful and vague, which can be very annoying.

When labour starts, the endorphins are already present and as the uterus begins to work harder, they are stimulated to even higher levels. It is easy to see these higher levels as labour advances: she withdraws (eyes closed, head down, no talking); is less physically active (snuggles down into a supported, upright position); needs to concentrate (inwardly focussed, trance like state) and feels more positive ( “I can do this, I am doing this”).

These effects are the direct biological effect of this hormone that all human produce, including pregnant women. Once endorphins are in her system, a woman has the capacity to ride with the contractions as they build, managing them as she needs to (shifting position, automatically adjusting to her own needs) and once the birth is over, experiencing the natural euphoria and sense of achievement (and forgetting the worst parts) that they produce.

When I wrote that women had the innate capacity to birth without needing to use external “birth methods” or “training”, I was referring to her ability to produce endorphins that would get her through this experience. When women are disturbed, frightened, fearful, physically restrained (e.g. on a bed) or mentally active (remembering her breathing, consciously relaxing), her endorphin production will be compromised by the automatic release of adrenalin, designed to protect her from harm, threat (real or perceived) and distraction. Research by Niles Newton as far back as the 60s clearly demonstrated these biological links. Michel Odent has written extensively about them in more recent times.

Some women need help to find a relaxed and conducive environment for birth, where they feel safe and protected and where no disturbance will inhibit the flow of oxytocin and endorphins. Midwifery care, home birth, immersion in warm water and protective support from caring others can help create such a place. Some women may need more help to overcome their fearfulness and I guess this is where “hypnobirthing” or some of the other structured techniques come in.

Whatever “method” that women choose to use, their success in achieving a natural birth, without drugs or interventions will be the result of good endorphin and oxytocin production within their own bodies. To attribute success to the application of a method, sells themselves short, and a failing to appreciate the way that Nature has provided for women’s needs in labour.

When I have presented workshops to midwives and educators in the USA, I have been surprised by the blank looks I have received when we talked about endorphin production. Perhaps several generations of managed births with drips, drugs, monitors etc has so restricted opportunities for the observation of natural births and the way the hormones naturally work during the process that women have forgotten about, and no longer trust, basic birth biology. This is certainly the message I am getting from the many comments posted to my Diary entries over the past week or so.

Midwives in most other countries know exactly what I am talking about because they see women exhibiting endorphin-driven behaviours as part of their daily work. I think I will stick with Nature, and leave the “birth preparation methods” to those who must rely on them, for whatever reason, to get them through labour. It seems a sad reflection on birth today, that many women will place their faith in a learned behaviour rather than their own instincts and innate abilities. It is all about having faith in Nature and a trust in women......

Posted by andrea at February 18, 2004 02:29 PM

Comments

What is it about women learning relaxation that disturbs you so? Is it that some women may need actual guidance to train thier bodies to relax? Or is it the word hypnosis that just rubs you the wrong way?

Once again if you were to read HypnoBirthing A Celebration of Life you would know that a discussion about the relaxation response and endorphin production is given there. This is also discussed in HypnoBirthing classes.

Yes of course it is our bodies own response to relaxation that kicks in the endorphin response. This is a key component in comfortable birth. Relaxation equals the ability to allow the body to do what is needed to give birth.HypnoBirthing helps women who might not otherwise know how to tap into this response.

As we grow and begin to understand more about birth in America then perhaps more women will trust thier own inherent birth instincts. For now HypnoBirthing is teaching women this very thing. How can that be a bad thing?

Posted by: Toshia Parker on February 19, 2004 01:40 AM

Comments

In reference to womens endorphins in a 'non-trained' situation, I birthed at home and experienced exactly what Andrea has referred to in this diary entry.
My midwife was very much 'hands off' and allowing me to dictate the pace, movement, position for my babies birth, and as a result I feel I was able to go with the building contractions and draw on my own inner strength, with no particular 'training' before the birth.

Posted by: rachel on February 20, 2004 12:53 PM

Comments

I love this site .. and wish there was more a message similar to that in this particular post, out in the community in general. Perhaps then I and others would feel less terrified of childbirth (not that it's looking likely that I'll ever experience it.)

Posted by: notes2004 on February 22, 2004 04:30 PM