9.09.2008

Delivery Method Affects Brain Response to Baby's Cry

This article came to me quite timely after find it on Karen's blog:
Delivery Method Affects Brain Response to Baby’s Cry
When my own daughter was born by Caesarean section delivery, I was surprised how uninvolved I was in the process. My body was numb, and my view of the surgery was blocked by a sheet. When I finally heard a baby cry, it took a minute for me to realize that the sound belonged to my own baby.

Karen reports something similar...
I know that from my personal experience, I felt very detached in my mothering with my first child, who was born via c-section, when she would cry. With my second child, who was born via vbac, I couldn't tolerate hearing him cry. I would act immediately (well, most the time). I have chalked this up to the toll the difficult labor and recovery with the c-section, that it just took a lot out of me, emotionally and physically; whereas with my second, I felt victorious and energized, and I had energy to spend mothering my child.

I say this was timely, because I had just spoken with a wonderful woman who had an epidural with her two previous children and was now seeking a natural birth. Now I know that this particular article is talking directly about vaginal vs. cesarean births, but I would like to see vaginal unmedicated vs vaginal medicated vs cesarean as the conversation with this woman raised some interesting dialog.

One of her previous experiences, in particular, she had gotten the epidural, had her little girl, and then, after being given her baby, kept thinking 'how long until I can give her back'.

She felt bad that she was, for lack of a better explanation, not that interested in her babe at first site. As she said, it was like a dream. Only after her epidural wore off, and when her babe was brought to her a second time, did she really feel like she was meeting her little girl for the first time.

Sarah J Buckley, whom I have referenced before, has two great articles called Pain in Labor: Your hormones are your helpers and Ecstatic Birth.

In them, she talks about how a woman's body creates this marvelous cocktail of hormones that help her throughout labor, postpartum, and with newborn immediate bonding. When epidurals, synthetic induction hormones, or cesareans are performed/introduced to the laboring woman, these hormones production are stunted.

Oxytocin is the hormone that causes the uterus to contract during labor. Levels of oxytocin gradually increase throughout labor, and are highest around the time of birth, when it contributes to the euphoria and receptiveness to her baby that a mother usually feels after an unmedicated birth. This peak, which is triggered by sensations of stretching of the birth canal as the baby is born, does not occur when an epidural is in place. Administration of an epidural has been found to interfere with bonding between ewes and their newborn lambs.

Synthetic oxytocin is often given by drip- that is, directly into the bloodstream- when labor contractions are inefficient. Oxytocin given in this way does not enter the brain, and so does not contribute to the post-birth “high”, and in fact can lead to desensitization to the mothers own oxytocin production.

... Again we must ask: What are the psychological effects for mother and baby of laboring and birthing without peak levels of these hormones of pleasure and co-dependency?

Epidural pain relief has major effects on all of the above-mentioned hormones of labor. Epidurals inhibit beta-endorphin production,15 and therefore also inhibit the shift in consciousness that is part of a normal labor. This may be one reason why epidurals are so acceptable to hospital birth attendants, who are not prepared or trained to deal with the irrationality, directness, and physicality of a woman laboring on her own terms.

When an epidural is in place, the oxytocin peak that occurs at birth is also inhibited because the stretch receptors of a birthing woman’s lower vagina, which trigger this peak, are numbed. This effect probably persists even when the epidural has worn off and sensation has returned, because the nerve fibers involved are smaller than the sensory nerves and therefore more sensitive to drug effects.

... Another indication of the effects of epidurals on mother and baby comes from French researchers who gave epidurals to laboring sheep. The ewes failed to display their normal mothering behavior; this effect was especially marked for the ewes in their first lambing that were given epidurals early in labor. Seven out of eight of these mothers showed no interest in their offspring for at least 30 minutes.

There is good indication, from the article on cesarean vs vaginal bonding, as well as the articles by Dr. Buckley, that we are starting to make good strides to understanding the endocrine, psychological, mental, and emotional repercussions of our medicalization of childbearing women and processes.

Good information to, hopefully, cause us to pause and reconsider our birthing practices and what we optimally want out of our birthing time. Because, as I have said before, it is not 'just about the process' - the journey, the process, is for the health of the baby/mom (not just physically), and just happens to include the experience?

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