- 1. The laboring woman can respond to pain cues and work more effectively with her labor. For example, being aware of back pain in labor enables the woman to use positions which help the baby turn into a more optimal birth position.
- 2. Postpartum cortisol and ACTH levels are lower in women who do not receive epidural anesthesia in labor¹. Contractions cause stimulation of the vagina and cervix which triggers high levels of oxytocin release in the areas of the brain which are known to control maternal behavior. This vaginocervical stimulation was found to be ineffective in promoting maternal behaviors in sheep who had epidural anesthesia.²
3. During labor, your body responds to pain by releasing endorphins. Is labor painful for babies? No one knows for sure, but it can’t be terribly comfortable to have your head squeezed through a pelvis. Endorphins which are circulating in the mother’s bloodstream also reach the baby, and may provide some beneficial effect for the fetus. Mothers who have epidurals for delivery no longer release endorphins in response to painful stimuli.
4. Pain relief alone has not been found to increase maternal satisfaction with the birth experience. In fact, in one study, women who had epidural anesthesia reported a lower level of satsifaction with the birth experience than women who had natural childbirth, even though the epidural group also reported lower pain levels.³
1. Breastfeed Med. 2009 Dec;4(4):207-20. Handlin L, et. al. Effects of sucking and skin-to-skin contact on maternal ACTH and cortisol levels during the second day postpartum-influence of epidural analgesia and oxytocin in the perinatal period. Retrieved 12/06/2009 from http://www.ncbi.nlm.nih.gov/pubmed/19731998?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=19
2. Acta Paediatr Suppl. 1994 Jun;397:47-56. Keverne EB, Kendrick KM. Maternal behaviour in sheep and its neuroendocrine regulation. Retrieved 12/6/2009 from http://www.ncbi.nlm.nih.gov/pubmed/7981474?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=16
3. Regional Anesthesia and Pain Medicine: September/October 2001 – Volume 26 – Issue 5 – p 468-472. Kannan, Suresh M.D.; Jamison, Robert N. Ph.D.; Datta, Sanjay M.D. Maternal Satisfaction and Pain Control in Women Electing Natural Childbirth. Retrieved 12/06/2009 from http://journals.lww.com/rapm/Abstract/2001/09000/Maternal_Satisfaction_and_Pain_Control_in_Women.14.aspx
Could you please explain the significance of lover cortisol and ACTH levels pospartum.
Briefly, high cortisol and ACTH levels are thought to be associated with depression and stress. They may also be related to hypoglycemia. The benefits of lower cortisol and ACTH levels, then, would theoretically be a lower incidence of postpartum depression, lowered stress levels, and possibly better health.
Thank you for this – especially the references. It is obvious that epidural moms do not have the same ‘brain’ benefits of oxytocin that non-medicated women do (’labor land, inward focus, heightened response to meeting the baby, etc). This would make sense that synthetic oxytocin does not cross the blood brain barrier, whereas naturally, it is produced in the brain. Is this a correct conclusion?
I also wonder if this is because of the actual function of the epidural; does it actually block communication between the brain and the uterus? If there is a barrier (epidural) between the two, perhaps the uterus is trying to tell the brain to make/send more oxy, but the function of the epidural prevents the brain from receiving any of these messages. Or is it simply tied to the presence of pain (pain present? brain produces oxy. no pain? no oxy needed, none produced)?
Also, do you have any information on how administration of synthetic oxytocin affects how the mom produces it naturally? Would the body recognize that there is enough oxytocin (synthetic) and in response slow down it’s own natural production of it? I speaking in terms of no anesthesia, just oxy used in augmentation.
The best explanation I’ve read in one concise article is written by Sarah Buckley, MD. Entitled “Ecstatic Birth: Nature’s Hormonal Blueprint for Labor”. She gives an excellent explanation of all the hormones involved with natural labor, and how synthetic oxytocin is thought to interfere with this process. This is a fascinating area of research that is just beginning to be studied.