Oxytocin - the key to physiological labour, nursing, & biological nurturing


Luka Zigic, CBC CBE

Most of us know and understand the hormone oxytocin as the "love hormone" or the "feel good hormone", many of us know that this hormone is released when we feel happy and safe. Most of us, however, don't fully comprehend this incredible hormone's involved in physiological birth and lactation. Further more, oxytocin plays massive and integral part in tapping into your natural, inborn instinct to parent. Natural vaginal birth, skin to skin contact between mother and baby, and breastfeeding are a sequence of events that are vital in terms of promoting the natural release of oxytocin. This is the way that human mothers biologically adapt to motherhood.

According to the book Oxytocin: The Biological Guide to Motherhood, humans, much like other mammals, are born with the instinctual ability and knowledge to care for their offspring. However - humans are a highly intelligent species that has developed immensely in terms of cognitive, social, and communicative abilities, these skills and this intelligence happen to have an adverse affect on our intuition. Simply put - our intelligence as a species negatively impacts the inborn competence that we possess, as mammals, to birth, breastfeed, and care for our babies. Isn’t that super interesting? We are so developed and intelligent as a species that this actually restricts us from tapping into our mammalian abilities. We all have the capability to know what our own baby needs, and you can promote this instinctual ability by allowing oxytocin to be released naturally, during labour, delivery, golden hour, & throughout the fourth trimester. 

Let's chat about some ways we can help oxytocin flow to maximize our labour, birth and lactation experience.

Very important gradual psychological and physiological adaptations occur during labour and vaginal birth that depend on a mothers own natural oxytocin to be released into circulation. Oxytocin helps contract the uterus while also relaxing the cervix to allow the baby to pass through, much like it contracts our milk making cells, and relaxes the ducts to allow milk to flow more freely. When we understand how massively labour and lactation are impacted by the release of oxytocin, we can begin to try to take control of our surroundings and mold them to bring forth as much peace and serenity around us. Labour can be a really exciting time, it may even trigger some anxiety surrounding the unknown and meeting our little one. We know that scientifically what happens when we are anxious, nervous, or scared is that our body goes into fight or flight. When this is happening, cortisol & adrenaline (our stress hormones) starts to take control and oxytocin has a hard time doing the work she needs to do to progress labour or release milk. The best thing we can do during the start and progression of labour and while we are learning to nurse is to prevent the release of cortisol and adrenaline as much as we can, and really go ahead and lean into the things that make us feel good. Making sure we are doing lots of research, filling our brain with lots of knowledge as we prepare, and surrounding ourselves with positive birth/breastfeeding stories & experienced leading up to welcoming baby home is essential for preparing for a peaceful birth. Taking birth classes and even hiring a birth doula or lactation consultant if it's in the budget could be just the ticket to assist you in feeling confident and prepared for labour, birth, and breastfeeding. 

Many of us are afraid and worried of the unknown, naturally. The way we combat this is by ensuring we are well researched with evidence and science based information, that we understand what is & isn't normal, and have a good grasp of how our body works during this time! When we are armed with information that prepares us for birth & lactation this way, we head into the experience with confidence and understanding that birth & lactation are not only natural, normal, and not scary... but that our body truly knows what to do here, we are designed for this. When we finally understand this, it gives us the power to not be afraid. When we enter the experience unafraid and prepared, we are unstoppable! We break the fear/tension/pain cycle, we take control of our experience, and we can now focus on relaxing, letting oxytocin flow, confident that our body is doing the work.

Labour and Oxytocin

Once labour begins, you and your partner should begin to monitor contractions, while you try to relax and minimize stress levels. Stay at home as long as possible; as birth is one of the only positive times we really go to the hospital, for many of us, even just being in the sterile hospital environment can trigger stress and slow down labour. Being wherever you feel most calm and comfortable is important. If that place is the hospital, then do that! You may find that a birth doula or birth attendant may be helpful in helping you navigating labouring at home as long as you are able and also show you pain coping strategies to do at home with either them or your partner. Upon determining that it’s time to move labour to the hospital, you can continue to increase oxytocin production by maintaining a peaceful ambiance, have your partner take care if paperwork at check in while you focus on your breath and keeping relaxed, listen to some music on your headphones. Having only essential and supportive people with you during your labour and birth will help keep the vibes in check. Dim the lights in your room once you have settled in, allow yourself to laugh and have fun, let your partner soothe you by offering comfort measures, gentle touch, and kiss. Move your body; dance, sway, walk, & cuddle. Avoid unnecessary medical intervention or drugs if you can, as they can inhibit the flow of good labour hormones and the release of oxytocin during and following labour. The goal is to allow your body to feel and work through each contraction wave, allowing your hormones to catch up and relieve pain with bursts of endorphins. As your labour progresses, you will feel your baby move slowly down the birth canal, as with each rush of oxytocin your uterus contracts, and your body knows it's time to push. Contrary to Hollywood portrayal, your body doesn't actually need to be told when to push. When it's time, the reflex and urge to push is so powerful, that it's happening whether we want it to or not. We actually really want to avoid accepting guided pushing from the hospital staff as it is possible this could result in some complications. Something worth noting though is that if you are accepting pain alleviation through medical intervention and you can't feel your contractions, you may require guided pushing.

A note about c-sections and oxytocin - Of course, in some cases, a c section is a necessary and life saving procedure. We are so lucky to live in a time where mothers and babies are able to receive this care when they need it. That is undoubtable. However, its important to understand that it is increasingly becoming the choice medical intervention in about 30% of births in Canada (1 in 3 women have a c section here, where as only about 10% of all births should be ending in C section according to the WHO). The consequence of c section vs vaginal birth is that less oxytocin is released into the body. The amount that is released depends on how long the mother is having contractions prior to the surgery. In the case of elective c section no oxytocin is released as there aren’t any contractions taking place. 

The Golden Hour

The Golden Hour is defined as the first hour following birth, it is considered the most integral factor in success of a mother's breastfeeding journey, bonding with her infant, and reducing stress for both baby and mom through skin to skin and oxytocin release. You and your babe have just gone through one heck of an experience; you’re both tired and need a moment to soak each other in. There tends to be this rush around getting the baby cleaned up, weighed, measured etc. This is all great and necessary, but it can wait. First and foremost - we are taking full advantage of skin to skin time during golden hour with your little one, if you can take two hours that’s even better. Most birthing hospitals these days have adopted golden hour as standard procedure and won't give you a hard time about this. Just know it's something that you are absolutely entitled to. Once you've had your first latch and nursing session with your baby, dad can accompany baby to be seen by the nurses to do all the weigh ins and check ups. Once this is done, dad can have his turn doing skin to skin with baby! Following birth and during the golden hour we can increase release of oxytocin by doing as much skin to skin with your little as possible. Avoid too many visitors in the hospital if you can, as well as when you are home for the first while, it can tend to be a little overwhelming. I do encourage you, though, to accept help from your immediate support system around the house with things like cooking, cleaning, laundry so you can focus on connecting with your little, healing up, & breastfeeding around the clock. The fourth trimester is all about skin to skin snuggles, relaxing, healing, connecting (with your partner and baby as a new family unit) and loads of eye contact. All of these things will have positive immediate and long term affects on your baby. Some of the benefits of oxytocin release in the golden hour and fourth trimester are temperature regulation for your baby, temperature synchronization with mom and baby via skin to skin, less crying, triggers baby to seek out breast instinctually, 

Breastfeeding and the giving of warmth

When a baby suckles at the mothers breast, nerves are stimulated in the nipple, they send signals to the brain and oxytocin flow is triggered. Oxytocin begins to flow with this signalling, and triggers milk ejection (let down) as well as a phenomenon called “the giving of warmth". As mentioned earlier, Oxytocin squeezes our milk making cells (alveoli) causing them to contract and push out milk into the ducts and out our our nipple pores. While contracting the milk cells, oxytocin is also relaxing the ducts to allow for milk to pass more freely through.

The giving of warmth is the phenomenon that causes an increase in skin temperature on in our breast/chest area to help regulate baby’s temperature during skin to skin. Similarly to milk ejection, oxytocin dilates blood vessels to allow blood to easily pass more easily/quickly through them. This rush of blood through the dilated blood vessels increases blood pressure in the chest which un turn increases the temperature of your chest area, allowing your babe to get nice and toasty warm on your chest as you do skin to skin.

Now that we have discussed how oxytocin can be naturally released, let’s go over the way it can be inhibited.

We know that unfamiliar and scary situations and places can trigger stress and adrenaline hormones, which have a negative affect on releasing oxytocin. Another way oxytocin release is inhibited is through unnecessary medical intervention and administering of pain medications. In Canada, when it comes to pain intervention in the hospital most commonly we are offered laughing gas (nitrous oxide), morphine, fentanyl, and the Epidural. Narcotics such as morphine and fentanyl have a short life (last about 15 minutes) and do not fully remove sensations of pain, they need to be frequently re-administered to maintain the feeling of cutting the edge off. These narcotics do enter babies bloodstream and can cause them to be sleepy, delay breastfeeding initiation which can impact the success of breastfeeding, and impact release of oxytocin for mother and baby amongst other things. It is important to understand and use these tools appropriately, and not in excess to prevent further intervention. Epidurals have the highest likelihood to relieve pain completely, but even this method is not sure fire, and largely depends on the skill of the person administering it as it is injected right into the spine. Some are completely relieved of pain, some are only relieved on half of their body, some not at all. Epidurals are responsible for inhibiting oxytocin flow during labour which can result in a longer labour. Nitrous oxide is one of the pain alleviation offered that does not pass through to the baby and doesn’t affect oxytocin release during or after labour. 

Pitocin (synthetic oxytocin) may be administered because labour is slow to progress and either the mother or the doctor want to speed things up. Another reason it may be administered is because one perhaps an epidural was used (which slows labour down and now doc wants to pick it back up synthetically). The use of Pitocin is related to delaying release of your natural oxytocin once the Pitocin wears off. Another thing to note is that when pitocin and other medications to relieve pain are administered, uterine contraction become very painful and difficult to deal with once they wear off due to the delayed or inhibited release of natural oxytocin/endorphins. When we think about it like this its easy to see how many moms get trapped in a cycle of needing constant intervention once one intervention has been administered. Once we mess with the natural flow of birth and our hormones, our body gets confused and has a hard time getting birth moving. Usually a cascade of intervention follows the first intervention because of this.

Birth is designed to work so that you could do it on your own, in a forrest, without help. We are so lucky to have modern medicine and sterile places to birth our babies, in particular for those who are high risk. But remember...

You knew how to conceive your baby without being told how to, your body knew how to build it from a tiny cell, and trust me,

you will know how to birth that baby when it's time!

When we let nature take its course with labour and birth, breastfeeding and listening to our intuition comes much more easily.

Trust the process, trust yourself.

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