Giving birth in ecstasy: This is our birth right and our body’s intent.
Mother Nature, in her wisdom, prescribes birthing hormones that take us
outside (ec) our usual state (stasis), so that we can be transformed on
every level as we enter motherhood.
This exquisite hormonal orchestration unfolds optimally when birth is
undisturbed, enhancing safety for both mother and baby. Science is also
increasingly discovering what we realise as mothers - that our way of
birth affects us life-long, both mother and baby, and that an ecstatic
birth, a birth that takes us beyond our Self, is the gift of a
Four major hormonal systems are active during labor and birth. These
involve oxytocin, the hormone of love; endorphins, hormones of pleasure
and transcendence; epinephrine and norepinephrine, hormones of excitement;
and prolactin, the mothering hormone. These systems are common to all
mammals and originate in our mammalian or middle brain, also known as the
limbic system. For birth to proceed optimally, this part of the brain must
take precedence over the neocortex, or rational brain. This shift can be
helped by an atmosphere of quiet and privacy, with, for example, dim
lighting and little conversation, and no expectation of rationality from
the laboring woman. Under such conditions a woman intuitively will choose
the movements, sounds, breathing, and positions that will birth her baby
most easily. This is her genetic and hormonal blueprint.
All of these systems are adversely affected by current birth practices.
Hospital environments and routines are not conducive to the shift in
consciousness that giving birth naturally requires. A woman’s hormonal
physiology is further disturbed by practices such as induction, the use of
pain killers and epidurals, caesarean surgery, and separation of mother
and baby after birth.
Hormones in Birth
Perhaps the best-known birth hormone is oxytocin, the hormone of love,
which is secreted during sexual activity, male and female orgasm, birth,
and breastfeeding. Oxytocin engenders feelings of love and altruism; as
Michel Odent says, “Whatever the facet of Love we consider, oxytocin is
Oxytocin is made in the hypothalamus, deep in our brains, and stored in
the posterior pituitary the ”master gland”, from where it is released in
pulses. It is a crucial hormone in reproduction and mediates what have
been called the ejection reflexes: the sperm ejection reflex with male
orgasm (and the corresponding sperm introjection reflex with female
orgasm); the fetal ejection reflex at birth (a phrase coined by Odent for
the powerful contractions at the end of an undisturbed labor, which birth
the baby quickly and easily)(2); and, postpartum, the placental ejection
reflex and the milk ejection or let-down reflex in breastfeeding.
As well as reaching peak levels in each of these situations, oxytocin
is secreted in large amounts in pregnancy, when it acts to enhance
nutrient absorption, reduce stress, and conserve energy by making us more
sleepy.(3) Oxytocin also causes the rhythmic uterine contractions of
labor, and levels peak at birth through stimulation of stretch receptors
in a woman’s lower vagina as the baby descends.(4) The high levels
continue after birth, culminating with the birth of the placenta, and then
The baby also has been producing oxytocin during labor, perhaps even
initiating labor;(6) so, in the minutes after birth, both mother and baby
are bathed in an ecstatic cocktail of hormones. At this time ongoing
oxytocin production is enhanced by skin-to-skin and eye-to-eye contact and
by the baby’s first suckling. Good levels of oxytocin will also protect
against postpartum haemorrhage by ensuring good uterine
In breastfeeding, oxytocin mediates the let-down reflex and is released
in pulses as the baby suckles. During the months and years of lactation,
oxytocin continues to act to keep the mother relaxed and well nourished.
One researcher calls it “a very efficient anti-stress situation which
prevents a lot of disease later on.” In her study, mothers who breastfed
for more than seven weeks were calmer, when their babies were six months
old, than mothers who did not breastfeed.(8)
Outside its role in reproduction, oxytocin is secreted in other
situations of love and altruism, for example, sharing a meal. (9)
Researchers have implicated malfunctions of the oxytocin system in
conditions such as schizophrenia(10), autism (11), cardiovascular
disease(12) and drug dependency (13), and have suggested that oxytocin may
mediate the antidepressant effect of drugs such as
As a naturally occurring opiate, beta-endorphin has properties similar
to meperidine (pethidine, demorol), morphine, and heroin, and has been
shown to work on the same receptors of the brain. Like oxytocin,
beta-endorphin is secreted from the pituitary gland, and high levels are
present during sex, pregnancy, birth, and breastfeeding. Beta-endorphin is
also a stress hormone, released under conditions of duress and pain, when
it acts as an analgesic and, like other stress hormones, suppresses the
immune system. This effect may be important in preventing a pregnant
mother’s immune system from acting against her baby, whose genetic
material is foreign to hers.
Like the addictive opiates, beta-endorphin induces feelings of
pleasure, euphoria, and dependency or, with a partner, mutual dependency.
Beta-endorphin levels are high in pregnancy and increase throughout
labor,(15) when levels of beta-endorphin and corticotrophin (another
stress hormone) reach those found in male endurance athletes during
maximal exercise on a treadmill.(16) Such high levels help the laboring
woman to transmute pain and enter the altered state of consciousness that
characterizes an undisturbed birth.
Beta-endorphin has complex and incompletely understood relationships
with other hormonal systems.(17) In labor, high levels will inhibit
oxytocin release. It makes sense that when pain or stress levels are very
high, contractions will slow, thus “rationing labour according to both
physiological and psychological stress.”(18) Beta-endorphin also
facilitates the release of prolactin during labor,(19) which prepares the
mother’s breasts for lactation and also aids in the final stages of lung
maturation for the baby.(20) Beta-endorphin is also important in
breastfeeding. Levels peak in the mother at 20 minutes,(21) and
beta-endorphin is also present in breast milk, (22) inducing a pleasurable
mutual dependency for both mother and baby in their ongoing
The hormones epinephrine and norepinephrine (adrenaline and
noradrenaline) are also known as the fight-or-flight hormones, or,
collectively, as catecholamines (CAs). They are secreted from the adrenal
gland, above the kidney, in response to stresses such as fright, anxiety,
hunger or cold, as well as excitement, when they activate the sympathetic
nervous system for fight or flight.
In the first stage of labor, high CA levels inhibit oxytocin
production, therefore slowing or inhibiting labor. CAs also act to reduce
blood flow to the uterus and placenta, and therefore to the baby. This
makes sense for mammals birthing in the wild, where the presence of danger
would activate this fight or flight response, inhibiting labor and
diverting blood to the major muscle groups so that the mother can flee to
safety. In humans, high levels of CAs have been associated with longer
labor and adverse fetal heart rate patterns (an indication of stress to
After an undisturbed labor, however, when the moment of birth is
imminent, these hormones act in a different way. There is a sudden
increase in CA levels, especially noradrenaline, which activates the fetal
ejection reflex. The mother experiences a sudden rush of energy; she will
be upright and alert, with a dry mouth and shallow breathing and perhaps
the urge to grasp something. She may express fear, anger, or excitement,
and the CA rush will cause several very strong contractions, which will
birth the baby quickly and easily.
Some birth attendants have made good use of this reflex when a woman is
having difficulties in the second stage of labor. For example, one
anthropologist working with an indigenous Canadian tribe recorded that
when a woman was having difficulty in birth, the young people of the
village would gather together to help. They would suddenly and
unexpectedly shout out close to her, with the shock triggering her fetal
ejection reflex and a quick birth (24).
After the birth, the mother’s CA levels drop steeply, and she may feel
shaky or cold as a consequence. A warm atmosphere is important, as if the
mother is not helped to warm up, the ongoing cold stress will keep her CA
levels high, inhibiting her natural oxytocin release and therefore
increasing her risk of postpartum hemorrhage.(25)
Noradrenaline, as part of the ecstatic cocktail, is also implicated in
instinctive mothering behavior. Mice bred to be deficient in noradrenaline
will not care for their young after birth unless noradrenaline is injected
back into their system(26).
For the baby also, birth is an exciting and stressful event, reflected
in high CA levels(27). These assist the baby during birth by protecting
against the effects of hypoxia (lack of oxygen) and subsequent acidosis.
High CA levels at birth ensure that the baby is wide-eyed and alert at
first contact with the mother. The baby’s CA levels also drop rapidly
after an undisturbed birth, being soothed by contact with the
Known as the mothering hormone, prolactin is the major hormone of
breast milk synthesis and breastfeeding. Traditionally it has been thought
to produce aggressively protective behavior (the “mother tiger” effect) in
lactating females.(28) Levels of prolactin increase in pregnancy, although
milk production is inhibited hormonally until the placenta is delivered.
Levels further increase in labor and peak at birth.
Prolactin is also a hormone of submission or surrender--in primate
troops, the dominant male has the lowest prolactin level--and produces
some degree of anxiety. In the breastfeeding relationship these effects
activate the mother’s vigilance and help her to put her baby’s needs
first.(29) The baby also produces prolactin in pregnancy, and high levels
are found in amniotic fluid, possibly of uterine or placental origin.(30)
The function of prolactin in the baby is unknown.
Undisturbed birth is exceedingly rare in our culture, even in birth
centers and home births. Two factors that disturb birth in all mammals are
firstly being in an unfamiliar place and secondly the presence of an
observer. Feelings of safety and privacy thus seem to be fundamental. Yet
the entire system of Western obstetrics is devoted to observing pregnant
and birthing women, by both people and machines; when birth isn’t going
smoothly, obstetricians respond with yet more intense observation. It is
indeed amazing that any woman can give birth under such conditions.
Some writers have observed that, for a woman, having a baby has a lot
of parallels with making a baby: same hormones, same parts of the body,
same sounds, and the same needs for feelings of safety and privacy. How
would it be to attempt to make love in the conditions under which we
expect women to give birth?
Impact of Drugs and Procedures
Induction and Augmentation
In Australia, approximately 20 percent of women have induced labor, and
another 20 percent have an augmentation--stimulation or speeding up of
labor--with synthetic oxytocin (syntocinon, pitocin) (31). In the U.S.,
these rates are 19.8 percent and 17.9 percent,(32) adding up in both
countries to around 40 percent of birthing women being administered
synthetic oxytocin by IV during labor.
Synthetic oxytocin administered in labor does not act like the body’s
own oxytocin. First, syntocinon-induced contractions are different from
natural contractions, and these differences can cause a reduced blood flow
to the baby. For example, waves can occur almost on top of each other when
too high a dose of synthetic oxytocin is given, and it also causes the
resting tone of the uterus to increase (33).
Second, oxytocin, synthetic or not, cannot cross from the body to the
brain through the blood-brain barrier. This means that syntocinon,
introduced into the body by injection or drip, does not act as the hormone
of love. However, it does provide the hormonal system with negative
feedback—that is, oxytocin receptors in the laboring woman’s body detect
high levels of oxytocin and signal the brain to reduce production. We know
that women with syntocinon infusions are at higher risk of bleeding after
the birth, because their own oxytocin production has been shut down. But
we do not know the psychological effects of giving birth without the peak
levels of oxytocin that nature prescribes for all mammalian species.
As for the baby, ”Many experts believe that through participating in
this initiation of his own birth, the fetus may be training himself to
secrete his own love hormone.”(34). Michel Odent speaks passionately about
our society’s deficits in our capacity to love self and others, and he
traces these problems back to the time around birth, particularly to
interference with the oxytocin system.
The most commonly used drug in Australian labor wards today is
pethidine (meperidine, demorol). In one state, 34 percent of laboring
women in 1998 were given this drug.(35) In the U.S., several opiate-like
drugs have been traditionally used in labor, including meperidine
nalbuphine (Nubain), butorphanol (Stadol), alphaprodine (Nisentil),
hydromorophone (Dilaudid), and fentanyl citrate (Sublimaze). The use of
simple opiates in the labor room has declined in recent years, with many
women now opting for epidurals, which may also contain these drugs (see
below).(36) As with oxytocin, use of opiate drugs will reduce a woman’s
own hormone production,(37) which may be helpful if levels are excessive
and inhibiting labor. The use of pethidine, however, has been shown to
slow labor, more so with higher doses(38).
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? Some researchers believe that endorphins are
the reward we get for performing reproductive functions such as mating and
birthing; that is, the endorphin fix keeps us having sex and having
babies(39). It is interesting to note that most countries that have
adopted Western obstetrics, which prizes drugs and interventions in birth
above pleasure and empowerment, have experienced steeply declining birth
rates in recent years.
Of greater concern is a study that looked at the birth records of 200
opiate addicts born in Stockholm from 1945 to 1966 and compared them with
the birth records of their non-addicted siblings. When the mothers had
received opiates, barbiturates, and/or nitrous oxide gas during labor,
especially in multiple doses, the offspring were more likely to become
drug addicted. For example, when a mother received three doses of opiates,
her child was 4.7 times more likely to become addicted to opiate drugs in
This study was recently replicated with a U.S. population, with very
similar results (41). The authors of the first study suggest an imprinting
mechanism, but I wonder whether it may be a matter of ecstasy--if we don’t
get it at birth, as we expect, we look for it later in life through drugs.
Perhaps this also explains the popularity (and the name) of the drug
Animal studies suggest a further possibility. It seems that drugs
administered chronically in late pregnancy can cause effects in brain
structure and function (eg chemical and hormonal imbalance) in offspring
which may not be obvious until young adulthood(42–45). Whether such
effects apply to human babies who are exposed for shorter periods around
the time of birth is not known; but one researcher warns, “During this
prenatal period of neuronal [brain cell] multiplication, migration and
interconnection, the brain is most vulnerable to irreversible
Epidural drugs are administered over several hours via a tube into the
space around the spinal cord. Such drugs include local anaesthetics (all
cocaine derivatives, eg. bupivicaine/marcaine), more recently combined
with low-dose opiates. Spinal pain relief involves a single dose of the
same drugs injected through the coverings of the spinal cord, and is
usually short-acting unless given as a combined spinal-epidural (CSE).
Epidural pain relief has major effects on all of the above-mentioned
hormones of labor. Epidurals inhibit beta-endorphin production (47) 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, practically or professionally, 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 (48).
A woman giving birth with an epidural will therefore miss out on the
fetal ejection reflex, with its strong final contractions designed to
birth her baby quickly and safely. She must then use her own effort, often
against gravity, to compensate. This explains the increased length of the
second stage of labor and the extra need for forceps when an epidural is
used (49). Use of epidurals also inhibits catecholamine release (50),
which may be advantageous in the first stage of labor; close to the time
of birth, however, a reduction in CA levels will, as with oxytocin,
inhibit the fetal ejection reflex and prolong the second stage.
Another hormone also appears to be adversely affected by epidurals.
Prostaglandin F2 alpha helps to make a laboring woman’s uterus
contractible, and levels increase when women labor without epidurals. In
one study, women with epidurals actually experienced a decrease in PGF2
alpha, and average labor times were increased from 4.7 to 7.8
Drugs administered by epidural enter the mother’s bloodstream
immediately and go straight to the baby at equal, and sometimes
effectively greater, levels (52, 53). Some drugs will be preferentially
taken up into the baby’s brain (54), and almost all will take longer to be
eliminated from the baby’s immature system after the cord is cut. For
example, the ‘half life ‘of bupivacaine- the time it takes to reduce blood
level by 50%- is 2.7 hours in the adult, but around 8 hours in a newborn
Another indication of the effects of epidurals on mother and baby comes
from French researchers who gave epidurals to laboring sheep (56). 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.
Some studies indicate that this disturbance may apply to humans also.
Mothers given epidurals in one study spent less time with their babies in
hospital, in inverse proportion to the dose of drugs they received and the
length of the second stage of labor (57). In another study, mothers who
had epidurals described their babies as more difficult to care for one
month later (58). Such subtle shifts in relationship and reciprocity may
reflect hormonal dysfunctions and/or drug toxicity and/or the
less-than-optimal circumstances that often accompany epidural births--long
labors, forceps, and cesareans.
Incredibly, there have been no good studies of the effects of epidurals
on breastfeeding (59), although there is evidence that babies born after
epidural have a diminished suckling reflexes and capacity
Caesarean section involves major abdominal surgery and increases the
risk of maternal death by about four times (62), as well as possibly
affecting mother and baby’s health in subsequent pregnancies (63).
Cesarean rates are currently 21.1 percent in Australia (64) and 22.9
percent--the highest level on record--in the U.S. (65). Obviously there is
a shorter or absent labor with cesarean birth, and the peaks of oxytocin,
endorphins, catecholamines, and prolactin are absent. Furthermore, mothers
and babies are usually separated for some hours after birth, so the first
breastfeed is usually delayed. Both will also be affected to some extent
by the drugs used in the procedure (epidural, spinal, or general
anaesthetic) and for post-operative pain relief.
The consequences of such radical departures from our hormonal blueprint
are suggested in the work of Australian researchers who interviewed 242
women in late pregnancy and again after birth. The 50 percent of women who
had given spontaneous vaginal birth were the most likely to experience a
marked improvement in mood and an elevation of self-esteem after delivery.
In comparison, the 17 percent who had caesarean surgery were more likely
to experience a decline in mood and self-esteem. The remaining women had
forceps or vacuum assistance, and their mood and self-esteem were, on
average, unaltered (66).
Another study looked at the breastfeeding hormones prolactin and
oxytocin on day two, comparing women who had given birth vaginally with
women who had undergone emergency cesarean surgery. In the cesarean group,
prolactin levels did not rise as expected with breastfeeding, and the
oxytocin pulses were reduced or absent. In this study, first suckling had
been at 240 minutes average for cesarean babies, and 75 minutes average
for babies vaginally born. Duration of breastfeeding was not significantly
different for the mothers, and the authors conclude that “other
factors…can compensate for deficient hormonal release.”(67).
Other research has shown that early and frequent suckling positively
influences milk production and the duration of breastfeeding (68,69). The
authors of the hormonal study above add, “These data indicate that early
breastfeeding and physical closeness may be associated not only with more
interaction between mother and child, but also with endocrine [hormonal]
changes in the mother.” (70)
These studies not only indicate important links between birth and
breastfeeding, but also show how an optimal birth experience can influence
the long-term health of mother and baby. For example, successful
breastfeeding confers advantages such as reduced risk of breast cancer and
osteoporosis for the mother and reduced risk of diabetes and obesity
long-term for the child. And enhanced self-esteem after a natural birth- a
life-long effect, in my experience -is a solid base from which to begin
The connections between events at birth and long-term health certainly
deserve more study. (See Michel Odent’s Primal Health Database
www.birthworks.org/primalhealth for a summary of current research.) But we
cannot afford to wait for years for researchers to ”prove” the benefits of
an undisturbed birth. Perhaps the best we can do is trust our instincts
and vote with our birthing bodies, choosing models of care that increase
our chances of undisturbed- and ecstatic- birthing.
Even in non-interventionist settings, it is uncommon for the baby to
remain in the mother’s arms for the first one to two hours. And yet
nature’s blueprint for this time includes a specific and genetically
encoded activation of the brain and nervous system for both mother and
baby. For example, when the newborn baby is in skin-to-skin contact, at
the mother’s left breast (which is where new mothers in all cultures
instinctively cradle their babies) and in contact with her heart rhythm,
“a cascade of supportive confirmative information activates every sense,
instinct and intelligence needed for the radical change of environment …
Thus intelligent learning begins at birth.” (71).
For the mother also, “A major block of dormant intelligences is
activated…the mother then knows exactly what to do and can communicate
with her baby on an intuitive level.” (72) This awakening of maternal
capabilities is well known among animal researchers, who link it to the
action of pregnancy and birth hormones on the brain of newly delivered
mothers (73). Such intuitive capacities are sorely needed in our human
culture, where we rely so heavily on outside advice from books and
'experts' to tell us how to care for our babies.
According to Pearce, when these activations do not occur within about
45 minutes of birth, “…cut off from his mother’s nurturing and with none
of the encoded expectancies met, the newborn’s adrenals continue to
release steroids in the face of maximum fear and abandonment. The infant
screams for a short time and then silence falls.”
The damage caused by separation, Pearce writes, is “massive and past
the point of repair.” Like Odent, he believes that our current birth
practices are psychologically crippling to babies, mothers, and society as
a whole, and the evidence in his book Evolution’s End: Reclaiming the
Potential of Our Intelligence is compelling.
Optimizing the Ecstasy
The following suggestions will help a woman to use her hormonal
blueprint and so optimize the experience and safety for herself and her
baby. Remember that birth is “orgasmic in its essence” (75), so that
conditions for birth are ideally as close as possible to conditions for
- Take responsibility for your health, healing, and wholeness
throughout the child-bearing years
- Choose a model of care that enhances the chance of a natural and
undisturbed birth (eg home birth, birth center, one-on-one midwifery
- Arrange support according to individual needs; trust, a loving
relationship, and continuity of care with support people are important.
- Consider having an advocate at a hospital birth- eg private midwife
- Ensure an atmosphere where the labouring woman feels safe,
unobserved, and free to follow her own instincts
- Reduce neocortical stimulation by- keeping lighting and noises soft
and reducing words to a minimum.
- Cover the clock and any other technical equipment.
- Avoid drugs unless absolutely necessary.
- Avoid procedures (including obvious observations) unless absolutely
- Avoid caesarean surgery unless absolutely necessary.
- Don’t separate mother and baby for any reason, including
resuscitation, which can be done with the cord still attached.
- Breastfeed and enjoy it!
One way to ensure minimum interference in the third stage is to
practice Lotus Birth, or non-severance of the cord. This is only
compatible with a physiological third stage, and also keeps mother and
baby together and secluded in the hours and days after birth. It is the
subject of a new book and, having had three Lotus-born babies myself, I
highly recommend both the practice and the book (74).
Giving birth is an act of love, and each birth is unique to the mother
and her baby. Yet we also share the same womanly physiology and the same
exquisite orchestration of our birthing hormones. Our capacity for ecstasy
in birth is also both unique and universal, a necessary blessing that is
hard-wired into our bodies, yet that requires, especially in these times,
that we each trust, honor, and protect the act of giving birth according
to our own instincts and needs.
Dutch professor of obstetrics G. Kloosterman offers a succinct summary,
which would be well placed on the door of every birth room:
Spontaneous labour in a normal woman is an event marked by
a number of processes so complicated and so perfectly attuned to each
other that any interference will only detract from the optimal
The only thing required from the bystanders is that they
show respect for this awe-inspiring process by complying with the first
rule of medicine--nil nocere [Do no harm]. (76)
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34. See note 2
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Sarah Buckley (42) trained as a GP (family MD) and GP-obstetrician in
New Zealand. Giving birth to her children Emma (11), Zoe (8), Jacob (6)
and Maia Rose (1),all born ecstatically at home, has fuelled her passion
for birth and motherhood, and she is currently fully occupied with
mothering, writing and lecturing.
She lives in Brisbane Australia with her children and her partner
For Details about Sarah's brilliant new book see http://www.sarahjbuckley.com/* *