Sphincter Law- Part 1

doula at work
In birth work, obstetricians use the Law of Three Ps:

• Passenger (baby)
• The Passage (the pelvic structure and vagina)
• And the Powers (strength of uterine contractions)

From these Ina Gaskin believes stems the misunderstood capacity of a woman’s body from both the pregnant woman and the doctors who work with them. From the misunderstood capacities are the causative factors leading to all the interventions and procedures that now create problems in birthing, such as: Cesarean sections, Forceps use, vacuum extractors, etc.

The blame is placed upon women, for what obstetricians see as “dysfunctional birth”. Women have birthed for eons without a hitch; doctors perceive having a baby as “a problem of physics rather than a millions-of-years-old physiological process (168)”.

The Basics of Sphincter Law

• They function best when the atmosphere is private, and familiar.
• They do not open “at will” and do not respond to commands such as “Push!”
• When in the process of opening (relaxing) they will suddenly close down if a person is upset, frightened, humiliated, or self-conscious. This is the reason why in most traditional cultures women assist women in birth.
• If the mouth and jaw are relaxed, there is a direct correlation to the ability of the sphincters opening in the cervical and vaginal area (or the anus, for that matter).

What are the Sphincters?

These are a grouping of muscles that surround the rectum, bladder, the cervix and vagina. Each has a function for the body. These muscles remain contracted to keep the openings of certain organs held shut until something needs to pass through.

How do they work?

They work in conjunction with the brain. The brain has two sections that directly influence the functions of the Sphincters. These sections are the neocortex and the brain stem (or “primal” brain).

The brain stem is the portion that is directly connected to hormonal functions, and more instinctual. The hormones it releases (related to birth) are oxytocin (the main ingredient in the drug Pitocin, used to induce labor), endorphins, and prolactin.

Whereas the neocortex stimulation works to inhibit the brain stem from hormone release. It is “stimulated” during labor by asking too many questions of a woman in labor, bright light, and failure to protect her privacy during birth.

The sphincters work with the brain stem (and its many hormonal excretions) by a relaxation response. They respond to emotions. A good example of this relaxation response is what happens when toilet functions are interrupted. Everything gets held in, and it takes a while to relax again, right?

~more on the “Sphincters” next week!

Pain in Childbirth – Part 2

father in delivery room

What contributes to PAIN in labor?

Fatigue

Muscles that are stretched, hurt. The muscles of the uterus work faster, the blood and oxygen flow is lessened. When there is tension, the uterus works even harder and fatigue sets in. The tension of the surrounding muscles has created a “brick wall”. So, relax.

Tension

The stretching of the lower uterine portion and the intense contractions of the upper uterine muscle are what is thought to be the source of the pain felt. But these muscles actually have very few pain receptors. You would not feel the pain unless the muscles were forced to work in an unnatural manner. If tense and fearful the nerve endings of the muscles and tissues around the uterus send messages to the pain receptors. There is a direct correlation of tension to pain.

Tired muscles

The biochemistry of the muscle is imbalance when tired. It creates tension that sends out more electrical activity. The physiological changes will lower the point at which the muscle will hurt.

The outlet is too small, or baby too big

These actually do not need to be an issue. Usually the position of the baby or laboring mother, are the causative factor of pain. The pain messages are signaling that something isn’t right. What will help is a change of position of the mother.

Get out of the horizontal position, to a vertical one, and things will change. The baby is assisted (most of the time) to re-position him/or herself in the womb to facilitate birth without as much pain. As stated in a different hand-out, just doing this type of change in position opens the outlet by 20%.

Fear

Information is out there on all the things that “can go wrong”. We are not taught that birthing is a natural process; we women are pummeled with media and other females telling horror stories about birth.

There is a shroud over the whole process of birth, making it seem to be a great mystery. What is needed is correct information.

Your uterus is a magnificent muscle which is affected by the neuro-hormonal pathway that connects the brain, the circulatory system and the uterus. Fear causes an alteration of the pathway creating a reduction of blood and oxygen to the brain. This results in the tightening of the cervical opening of the womb.

Fear unbalances the hormones of the body. Being fearful causes the release of labor inhibiting hormones. These are the stress hormones of the adrenal glands that when in stress, we release hormones that are the fight-or-flight mechanisms. Animals also have them, and the hormones are released to stop labor allowing them to find a safe place for birthing. These then block the labor enhancing hormones . This lengthens the labor and increases the pain felt.

A well-informed, correct education about birthing will assist you. Make sure your labor supporters also have been educated so that their fear is not surrounding you when you are in labor.

Occasionally, the sensation of pain will continue, even after all the relaxation techniques are implemented. This may be due to a tightened psoas muscle or mal-aligned hip. Both can cause tension in the body, and / or problems with the baby being delivered easily. These two issues can be checked, and remedied.

The Natural Pain relieving Narcotic: Endorphins

“Circulating throughout the body are natural hormones that relax you when stressed and relieve pain when you hurt (138)”

What is sad is that most women do not know about these hormones, or that they can activate them when needed. In the 1970s studies were being done for drug addiction and the presence of these hormones in the receptor sites of the brain (for morphine-like substances). What was found was that the nerve cells that are attached to receptor sites, had chemical pain relievers that acted to dull the sensation of pain in the cells. Here is how they can work for you:

As you probably know, Endorphins are raised during exercise and well, labor is strenuous exercise!

  • When the abdomen contracts in labor, the Endorphin level is raised.
    o This is especially true in the second stage of labor.
    o They are the highest after labor, and two weeks beyond.
    Endorphins are highest during vaginal birth, not so much when labor was started but delivery was cesarean.
  • Endorphins are higher in newborns that had signs of fetal distress during their delivery.
    o Baby also receives Endorphins during birth.
  • The release of Endorphins also will stimulate the production of prolactin, the hormone that relaxes and creates the “mothering” sensation.
    o Prolactin regulates milk production, which boosts the interaction with baby and mother.
    o These hormones are what researchers think are the cause of the “birth high”.
  • Mothers who had surgical birth have lowered hormone levels, which would account for the delay in milk supply after cesarean birth.
  • Endorphin production is directly tied to a person’s emotional state.
    o So if stress and anxiety are not resolved the body increases the stress hormones, Catecholamines, which counteract the relaxation produced by Endorphins.
    o Like commercial narcotics, Endorphins may behave differently woman to woman, which is why some women may feel more pain than others.
  • Injectable narcotics give you a bit of blast of pain relief, whereas Endorphins give you a steady dose throughout labor.

Women in labor are very aware of the natural hormone effects and describe the experience as a “natural high”.