This is a reprint of an article published in the December 2011 edition of
Midwifery Today.
Adrenaline in Labour
by Rayner Garner
It had always puzzled me why labour in birth is so painful and distressing for so many mothers. Then
in 1980, when my eldest daughter was born in Hawaii, it all became clear.
What actually happens
in labour? Well, most labouring mothers who enter a hospital in active labour go into a fight or flight reaction: adrenaline
floods the system and the cervix is prevented from opening further, as the brain sends the message to fight or flee from a
perceived predator. Most doulas, physicians and other medical staff are not predators in disguise; they are there to help.
Yet, the mother’s unconscious is not privy to rational thought. Her response is a primitive reaction to a sense of imminent
disaster, often accompanied by screaming and writhing in totally agony.
When the cervix cannot
fully open, the baby is eventually squeezed between two muscles, one which is triggered to help the neonate down the birth
canal, and the other which is commanded by the adrenaline coursing through in the mother’s system to close the cervix
as a way of protecting her and her baby against the perceived threat. It is no wonder that pain in labour can be so overwhelming
that all thoughts of the birth plan fly out of the window and the poor mother begs for an epidural!
It hasn’t always been this way. My wife, and I decided to have a home-birth with a midwife in attendance, and though
her parents were a little upset about it, we had an unexpected ally in her grandmother. She was one of the many immigrants
brought over to Hawaii from Japan to work in the sugar cane and pineapple plantations.
She’d
had three children, two who were born in the plantation, and one in hospital. She gave birth in the plantation by herself
and after it was over, she’d strapped her baby to her body and trudge home. The next day she’d be back at work
with her newborn strapped to her back; she couldn’t afford to lose a day’s pay. There was nothing
unusual about what she did; it was the custom at that time amongst plantation workers.
She had her third child in hospital. By then a new law had come into
existence in Hawaii, and home-birth was discouraged without a medical professional present. Treatment was free. She told us
that the experience was quite awful. She felt rushed and degraded, mainly because she was poor and the staff was unsympathetic.
That birth was quite painful, too, quite unlike her first two births, which apart from a moment or two at the end, didn’t
hurt at all.
My wife was a Hula dancer in her youth. Hula dancers dip
and sway in a position most Westerners would find impossible or very painful. (In ancient times the Hula was considered to
be an excellent preparation for sex and childbirth.) When my wife’s waters broke she slipped quite naturally into the
squatting position, going into labour in the ideal position for giving birth, as gravity is allowed to take its essential
role in helping the neonate down the birth canal.
I grabbed the waterproof
sheet that had come with the home-birthing kit and slipped it under my wife. She then looked at me and told me to get the
midwife. I responded with, “Why? You are going to have the baby in a minute, and we can save ourselves a lot of money.”
I realised as soon as I said it that this was not the best thing to have said.
My wife’s expression totally changed to one of great hostility. She hissed, “Get the midwife!” At that
moment, I realised that in my wife’s unconscious I had become, albeit unwittingly, a typical predator.
“Oh, sorry, of course dear,” I responded. I rang the midwife, who, fortunately, was not far away. However,
as soon as she arrived, my wife got up, went in to the bedroom and lay down on the bed. I thought it was quote strange. Apart
from one examination early on in her pregnancy, she had decided to limit any interference with the normal process of birthing.
As long as there was no pathology present she had concluded that Nature knew far better than anyone else what was needed.
I asked the midwife to wait a moment and went to my wife. I realized that she had
gone into fight or flight. The baby was not going to come just yet after all. So I asked the midwife to wait with some friends
who had just arrived, and she agreed. I got the impression that this was quite usual.
I knew
intuitively that unless the adrenaline coursing in my wife’s system was not discharged, we were in for a long and painful
wait. So, for some reason, I said something to her which got her quite mad. She
lunged at me with a furious cry and
started hitting me with both fists. I managed to get a large pillow in between us, and she started hitting it furiously.
She seemed to forget about her labour and determined to do as much damage to the cushion as she
could. She shrieked and raved, and used language I don’t know she even knew! A few times she slackened off, but sensing
she wasn’t finished, I’d get down on the floor and start to beat the cushion too. I also made grunting noises
from deep down in my gut, which seemed to trigger a corresponding reaction in her.
After about twenty minutes of this, she suddenly got up, resumed her crouching position, gave a little grunt,
and my daughter’s head crowned. My daughter’s eyes were open and looking at me, very peaceful and calm.I lost
myself looking into her eyes. I was starting to feel a great surge of love overcome me when my wife broke in with, “I
want a photo of this!”
I had never seen a woman in such peace and calm before while in labour.
I asked her, “Aren’t you in pain? No, it is just a sensation o stretching muscles,” she
responded. The midwife asked her permission to check that the cord was not wrapped around our daughter’s
neck. The act of using her finger to check this did not cause any further reaction and I realised that the discharge of adrenaline
was complete. We sent a friend out to get her camera from her car, and I took a photo. (Of course, it never came out as we
couldn't use flash and the light was too dim.)
Then my wife gave a little wiggle and our
daughter was born without any cries or other signs of distress. We placed our daughter on her breast and they both looked
at each other in total bliss. We didn’t cut the cord immediately, but left it until it stopped pulsing.
We also left the vernix, which covered her body. Many mothers have an instinctive desire to lick the vernix off as soon
as the infant is born. This seems natural, as the vernix is full of nutrients and in early times would have supplied the mother
with some initial nourishment until she had the energy to forage for food, or until close relatives could bring food. The
act of licking increases the bonding between mother and infant, and also stimulates the nerve endings that cover the infant’s
body. Most animals do this act of familial piety instinctively, and caring for newborns in this way reaps many benefits, such
as the immediate release of oxytocin, the hormone of love.
Looking at my wife and daughter’s
expressions towards one another filled my heart with love and a great desire to be part of such wonderful feelings. And, if
I am totally honest, I was also filled with envy that they could be host to these indescribable feelings.
If my wife had followed the instincts of earlier mothers and chosen
a private, dark and quiet place, like a cave or a hut reserved for labour, where she would undisturbed by people unfamiliar
to her, the fight or flight mechanism would not have been triggered. Such an environment is not always possible, and this
is when the fight or flight reaction is activated. Yet, she had followed the defensive mechanism of labour, which is designed
to help a woman and her infant stay safe, by discharging the adrenaline using strenuous exercise to mimic fighting off an
illusory predator.
Apart from the sensations of stretching muscles, she had not experienced the pain and distress
common to labour. A really human birth. I have seen a number of videos showing pregnant women dancing just before giving birth,
and this would be a great way for a woman to discharge adrenaline when labour is halted because of the fear and flight or
fight response. So much more harmonious than fighting the pillows!
Rayner Garner
was a plastic surgery
and burn technician from 1948−1951.
He later trained as a physiotherapist,specializing in the causes of chronic pain without
any organic foundation,
and studied with Dr.
Ida Rolf.
He
lives in London.
