Every pregnant woman needs to know that birth is intended to happen simply and easily and that six key birth practices make birth safer for mothers and babies. Every pregnant woman also needs to know that the standard maternity care is not evidence-based and, therefore, the health-care provider and place of birth will influence the care that she receives in powerful ways. Childbirth education can help women simplify pregnancy and birth and be a resource for understanding how decisions about maternity care influence the health and safety of mothers and babies.

Birth Is Intended to Happen Simply, Without Worry or Trouble

The physiologic process of birth is simply and carefully designed. Women’s bodies are designed to grow, birth, and nourish babies. In the last weeks of pregnancy, a series of physiologic changes occur, mostly, as evidence suggests, orchestrated by the baby. The cervix softens and may begin to dilate and efface. The uterine muscle becomes increasingly responsive to oxytocin. At first, oxytocin levels rise gradually and, when labor starts, more quickly. The pain associated with strong uterine contractions (the result of higher levels of oxytocin) sends a signal to the brain that stimulates the ongoing release of the large amounts of oxytocin required for strong, effective contractions. Coping with the increasingly strong contractions (by movement, relaxation, and other comfort measures) insures the continued release of oxytocin.

Pain plays an important role in helping labor progress by insuring that increasing amounts of oxytocin are released. When oxytocin levels are high (and the contractions are painful), beta-endorphins (“nature’s narcotic”) are released. Endorphins help women manage the pain of contractions by inducing an almost dream-like state and decreasing pain perception. In a very real sense, nature does not abandon women during labor.

Stress hormones, however, disrupt the process. Especially in early labor, stress and anxiety can stop labor; in active labor, stress can slow progress. Privacy and feeling safe and protected emotionally as well as physically help keep catecholamine levels low and labor progressing.

Women begin to have an instinctive urge to push as the baby moves down the birth canal. Following the urge, quite naturally, and changing positions in response to what the woman is feeling not only helps the baby descend and rotate but also protects the baby and the birth canal. When the baby is just ready to be born, if oxytocin and endorphin levels are high, a natural release of catecholamines gives women a surge of strength to push the baby out.

The baby is born with high levels of catecholamines and endorphins and is alert and calm. Placed skin-to-skin with his mother, the baby will find the breast and self attach. Even the small movements of the baby, when skin-to-skin with his mother, stimulate the release of maternal oxytocin. Oxytocin facilitates the separation and delivery of the placenta, decreasing the risk of maternal hemorrhage, and sets the stage for efficient milk let down and successful breastfeeding. Babies kept skin-to-skin stay warmer, are less likely to become hypoglycemic, cry less, have more stable heart rates, and breastfeed for a longer duration than babies who are separated from their mother.

Every pregnant women needs to know that labor and birth are simply and beautifully designed. In order to keep labor and birth as safe as possible, and to minimize the risk of complications, it is essential to respect the simple, natural, physiologic process of labor and birth and not interfere in any way, unless there is a clear medical indication. There is an optimal way to give birth, and this is it.

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