Neurophysiology of the Childbearing Year: Maternal and Infant Responses

Considering the importance of the changes taking place in the brain during the childbearing year in both mother and baby, it would make sense that we would thoroughly understand the implications of the disruption of those natural processes and further, that we would avoid such disruption if at all possible.

Obviously, if there is a medical need for a life-saving intervention, disruption is unavoidable. In such cases, there are ways to lessen the severity of problems arising from such a disturbance. However, here I wish to address nature’s plan for a smooth transition, and the routine (thus avoidable) ways in which such a plan is often thwarted.

With 93% of women reporting routine interruption of labor through electronic fetal monitoring that keeps them strapped to the bed, (Lothian, 2003) and 34% of women undergoing surgical birth (ibid.) despite the World Health Organization’s admonitions that cesarean rates should not exceed 12-15%, (Wagner, 2006) we really need to explore the ramifications of such routine use of technology.

In 1983, Dr. Thomas Verny founded the Association for Prenatal & Perinatal Psychology and Health (APPPAH) to examine the possible repercussions of such meddling. Verny, author of The Secret Life of the Unborn Child, suspected that babies were conscious beings even before birth. It had long been assumed that babies were born ‘empty vessels’ so to speak; they didn’t think or even feel pain. David Chamberlain, a Boston psychologist and co-founder of the APPPAH explains in Babies don’t Feel Pain: A Century of Denial in Medicine that this determination may have come about because the early experiments (sticking babies with pins) were done on babies whose mothers had been anesthetized during birth. Because the babies were also anesthetized, having received the same dose of medication as their mother, it stands to reason that the babies would not react to painful stimuli. However, the researchers instead concluded that babies don’t feel pain, reinforcing the pervading belief that what happens to them during birth is simply not important.

However, Chamberlain and Verny weren’t buying it. Nor were Dr. Michael Odent, Joseph Chilton Pearce, Dr. Fredrick Wirth or others.

In The Biology of Transcendence: A Blueprint of the Human Spirit, Joseph Chilton Pearce explains that human fetal brain growth follows the pattern of other mammalian species:

“If a pregnant animal is subjected to a hostile, competitive, anxiety-producing environment, she will give birth to an infant with an enlarged hindbrain, and enlarged body and musculature, and a reduced forebrain. The opposite is equally true: If the mother is in a secure, harmonious, stress-free, nurturing environment during gestation, she will produce an infant with an enlarged forebrain, reduced hindbrain, and smaller body.” (Pearce, 2002. Pp. 115)

If babies have perceptions, and their brains are being shaped before birth (Wirth, 2001) through the experiences of the mother, some thinking people began to wonder how the birth process might affect brain growth. Again using what was known about other mammalian parturition, some postulated that if interruption of the natural processes of birth and natural infant feeding had detrimental consequences in other species, perhaps it did in human babies. And if that was so, then perhaps human mammalian mothers also suffered in some way. Nearly a century after routine medical interventions were introduced into birth, researchers finally started to wonder if we were creating problems for mothers as well as babies and if so, how?
For instance, beginning with the onset of labor, we know that 41% of women participating in the 2006 Listening to Mothers Survey began their labors medically induced. (Declercq, Skala, Corry, & Applebaum, 2006.) Eighty percent of those inductions were chemically induced with Pitocin, an artificial form of oxytocin. (ibid.)

There are many possible ramifications of the introduction of pitocin. The artificial substance does attach to chemical receptors in the uterus, therefore it does cause uterine contractions. However, it does not cross the blood-brain barrier, so it does not act exactly like naturally produced oxytocin, nor does it pair with other neurotransmitters to change behavior like naturally occurring oxytocin does. It seems it may also ‘take up’ receptor sites for endorphins, thus not only creating pain, but blocking the body’s own response to lessen pain.

To see how this impacts the physical process of birth first, it might be helpful to explain that current obstetrical practice encourages ‘active management’ of the third stage of birth. ‘Third stage’ is the final part of birth wherein the placenta is birthed. ‘Active management’ includes administration of pitocin, early cord clamping, and cord traction to ‘guide’ the placenta out. The rationale behind active management is that it reduces bleeding, which is the primary concern of third stage. Of course it would be if the hypothalamus was no longer making oxytocin because the brain wasn’t getting the message to produce. Thus at least 41% of women are being ‘managed’ in such a way as to interrupt the bonding process-oxytocin has been called the ‘love hormone’, and when paired with prolactin facilitates motherly love (Fisher, n.d.)-denying the baby about 100 ml of blood that he or she needs to perfuse his or her vital organs, not because third stage is dangerous, but because first stage (labor) has been meddled with. If we keep in mind that if pitocin is administered not only during inductions, but augmentation of labor (to make labor go faster), that number of mother-baby pairs impacted would be far higher.

Karen Strange, Certified Professional Midwife and Neonatal Resuscitation instructor explained during a HypnoBirthing® Conclave presentation this author personally attended (October, 2008) that undisturbed, the immediate period following birth is when the baby’s brain gets the message to ‘fire and wire’. It is the surge of oxytocin, along with beta-endorphin release and prolactin that help the mother and baby to fall deeply and immediately in love. Prolactin optimizes brain growth and according to Dr. Sara Buckley is important in neuroendocrine development in the growing baby, (Buckley, 2005) which she feels maybe be why breastfed babies have higher IQs and is reason to breastfeed as long as the baby’s brain continues rapid development; usually 2 or 3 years. Alarmingly, she also shares Dr. Michel Odent’s observations that:

“…the functioning of the oxytocin system, which is still developing in the baby at the time of birth, reflects our ability to love ourselves and others. Odent has suggested that many of our society’s problems-our current epidemics of drug addiction and teenage suicide, for example-may be traced back to the widespread and unprecedented interference with the oxytocin system of mothers and babies at birth.” (Buckley, 2005. Pp. 17)

While the possible implications of the disruption of the natural process is staggering from the perspective of the child, mothers suffer as well. Buckley discusses this in Gentle Birth, Gentle Mothering as manifesting in a number of different ways, such as increased incidences of postpartum depression. Mary Kroeger, in Impact of Breastfeeding: Protecting the Mother and Baby Continuum notes that most breastfeeding difficulties originate with routine birthing interventions. She devotes each chapter to common interventions and explains exactly how it disrupts the breastfeeding experience. Considering what we now know about the many ways in which breastfeeding encourages brain growth, separate and apart from the 100 or more ingredients found in mother’s milk that are not found in formula, (Williams & Stehlin, n.d.) anything that causes problems in breastfeeding should be avoided.

Neurological damage isn’t the only issue with alterations in natural birth and breastfeeding patterns. Nature has fine tuned the transition from womb to world so delicately that even our immune systems develop and function sub-optimally if the process is disturbed. (Penders, Thijs, Vink, Stelma, Snijders & Kummeling, et al., 2006). But even if our brains are the only thing effected by the casual disregard for natural birth and breastfeeding so prevalent today, isn’t that enough? If maternal and infant behavior is predicated on a hormonal cocktail entitlement that few receive, which the research suggests it is, (Russel, 2007) shouldn’t we be basing maternity care practices on said research? Shouldn’t there be some requirement to show that any non-medically indicated interventions are safe and effective? Because according to A Guide to Effective Care in Pregnancy and Birth, available in its entirety for free at ChilbirthConnection.com, much of what is done to women and babies routinely has not only been shown to be ineffective, but is dangerous as well. This conclusion is supported by the fact that infant and maternal outcomes have worsened, not improved as most might think, as routine use of technology has increased. (Wagner, 2006)

What we know is just the tip of the iceberg. Shouldn’t we be trying to understand if attachment disorders in children, postpartum depression in mothers, child neglect, abuse and abandonment, or learning disorders might stem from the needless interruption of the birthing process? Wouldn’t it be less expensive and easier to minimize the number of mothers and babies suffering by not messing with the hard-wiring taking place at the time of birth instead of trying to fix what’s broken later? Shouldn’t we at least be willing to consider that nature has a plan that usually works, and intervene only when it doesn’t?

Perhaps with the 30 years of research regarding the symbiotic relationship between mother and baby in the childbearing year we have thus far, we should implement protocols that protect that delicate balance and bring the ecstasy back to birth.
Fortunately, there is hope on the horizon. While evidence-based maternity care is still just an ideal we strive towards, there are people working diligently to inform parents of the weight of their pregnancy and birthing decisions. Debbie Takikawa produced What Babies Want, a documentary that features many of the experts mentioned here. Debra Pascali-Bonaro and Kris Liem just released Orgasmic Birth: The Best Kept Secret, a phenomenal DVD, while Elena Tonetti-Vladimirova lectures world-wide on the concepts laid out in her educational DVD Birth As We Know It. All of these works take the scientific evidence and distill it into language that speaks to the hearts of parents. These are hopeful reminders that we can get back what has been lost, and heal what has been harmed…if we only choose to listen.

Resources

APPPAH, (2009). Association of Prenatal & Perinatal Psychology and Health website, retrieved Oct 1, 2008 from http://www.birthpsychology.com/

Buckley, S. (2005). Gentle Birth, Gentle Mothering. One Moon Press. Australia.

Chamberlain. D., (2005). Babies don’t feel pain: A century of denial in medicine. Retrieved October 6, 2008 from http://www.terrylarimore.com/BabiesAndPain.html

Declercq, E.R., Skala, C., Corry, M.P., Applebaum, S., (2006). Listening to
mothers II: Report of the first national U.S. survey of women’s childbearing experiences. Maternity Center Association, New York. Retrieved October 11, 200 from
http://www.childbirthconnection.org/article.asp?ck=10397

Fisher, D., (n.d.) Falling in love: The chemistry of the first breastfeed. Retrieved October 4,2008 from www.breast-feeding-information.com/the-chemistry-of-the-first-
breastfeed.php

Kroeger, M., (2004). Impact of Birthing practices on breastfeeding: Protecting the mother baby continuum. Jones and Bartlett, Massachusetts.

Lothian J., (2003). Listening to mothers—The first national U.S. survey of women's childbearing experiences. Journal of Perinatal Education, 12(1).

Pearce, J., (2002). The Biology of Transcendence: A Blueprint of the Human Spirit. Park Street Press. Rochester, Vermont.

Penders, J., Thijs, C., Vink, C., Stelma, F. F., Snijders, B., & Kummeling, I., et al. (2006). Factors influencing the composition of the intestinal microbiota in early infancy. Pediatrics, 118(2), 511–521.

Russell, J., (2007). The maternal Brain. British Society for Neuroendocrinology. Retrieved October 12, 2008 from http://www.neuroendo.org.uk/content/view/23/11/

Verny, T., (1981). The secret life of the unborn child. Summit Books, New York.
Wagner, M., (2006). Born in the USA: How a broken maternity system bust be fixed to put women and children first. University of California Press, Berkeley.

Williams, R., Stehlin, I., (n.d.) Breast Milk or Formula: Making the Right Choice for Your Baby. Retrieved October 10, 2008 from http://www.fda.gov/fdac/reprints/breastfed.html

Wirth, F., (2001). Prenatal Parenting. Regan Books/Harper Collins. New York.