07 Sep Why effective labor support is like good foreplay
You have likely heard that one of the predominant hormones involved in the birth process is Oxytocin. (If not, now you have.)
Oxytocin is the hormone that causes contractions of the uterus, which is what opens the cervix and helps get the baby out. In fact, synthetic Oxytocin (also called Pitocin) is what doctors and midwives use to help induce or speed up labor. It’s the star of the hormonal show during labor. High five, Oxytocin!
But Oxytocin is no novice to your bloodstream. You have been secreting and experiencing Oxytocin your entire life. It’s often called the “Cuddle hormone” or “Bonding hormone” and is triggered by specific events.
Your brain creates Oxytocin:
1) During Breastfeeding
2) When you see a baby or baby animal
3) When you share a meal with someone, especially if you cooked it. Oxytocin facilitates blood flow to the digestive process.
4) During a hot make-out session or a looooong hug (at least 20 seconds).
5) When you eat dark chocolate. (mmmmm)
6) In HUGE amounts during an orgasm (for women and men).
This is good news, guys! If we are already creating Oxytocin, and in predictable ways, it means we can tap into those factors through labor. It means you can change your labor by changing your environment. And do you notice what a lot of those moments have in common? Uh huh. They’re times when you feel good, when you feel loved and safe.
So really, Oxytocin flourishes when you’re in the mood for some sweet sweet lovin’.
The implications of this are so great. It means that to really get through labor and to make labor more efficient, you bring in the romance. When women make their Birth Plans and ask for things like darkness, privacy and freedom, it’s not because they selfishly want a “nice experience”. Although having a beautiful day as your first day as a parent is a fine idea (as long as we aren’t TOO attached to the idea), it’s rarely that simplistic.
Women request these things because they’ve learned that setting up the environment can help the process. While I am 164% grateful that we live in this modern age with amazing options (hello, epidurals!), I also know we are still mammals. We are still often at the mercy of our biology for this process.
SO, what can you do to get the Oxytocin flowing? While this is a personal question, it’s also universal in some ways. Just think about what gets most people in the mood. Like the following:
The lighting of an atmosphere changes the entire mood. Think of your favorite romantic restaurant. There are probably low lights, indirect sources of light and maybe even a lot of darkness! Some restaurants even place candles at every table. And every cliche romance scene on TV includes candles. The fluctuating, low light causes the brain to respond with Melatonin, which partners to create Oxytocin. This is also why 80% of labors begin in the evening hours, when the lights are low, hormones are high and you’re safe in your cave.
To try now: One evening when you are particularly achy and stressed, draw a warm bath with 2-3 candles lit around you. First, have only the overhead lights on. After 10 minutes, have someone flip off the overhead lights and sit in just the candle-light. Feel the changes in your mood and your physical body. This is your brain creating hormones that help you relax and get ready to sleep! Nice job, brain.
To bring to labor: Candles aren’t cool, not when there are oxygen tanks around. BUT most hospital rooms have several light switches to help adjust the lighting options. Ask your nurse when you arrive what the options are. You can also bring either a strand of twinkle lights or some LED tea-lights to scatter around an otherwise darkened room. This trick works with an epidural or without! The body is still in labor while the mother has relief.
If the staff needs to see better for procedures or charting, they will turn on overhead lights for safety. My experience has been that they are also sensitive to your environment and want to help you feel comfortable so will often flip them back off if possible.
What disrupts it: Bright overhead lights, although this is not universal for every woman. It also depends on how far into labor you are and how much Oxytocin is in the system. The more there is, the less sensitive your labor may be to changes in light. (anecdata)
While there are exceptions, most people need some privacy to get that good lovin’ energy going. This is where you can see some variation among women, too. Some women really, really, really need to know that you’re both alone. Some think it’s hot that you have house guests in the next room while you get busy. This sensitivity to privacy also translates to using the toilet. Some women can only go in their own home, while others’ bodies aren’t as sensitive and can use the porta-potties at a packed Radiohead concert.
In pregnancy: Think about your body’s comfort around these events. Are you someone who needs familiarity, your own home, lots of privacy to relax enough to have a good BM? Does it affect you? This can help spur conversations now about who you want to invite to your labor: maybe you don’t want your mother in the room after all? Or maybe every important person in your life can be there! Put in some bleachers! You can also ask your doctor or midwife if they have students or residents who will be a part of your care and what your options are for privacy.
During labor: In early labor, many women cope and rest alone. They allow their partner (and other support people) to rest while they are still able to work solo. This is especially effective if done in darkness so that the brain gets multiple signals of safety: darkness and privacy. Then the mother and her partner can work together when she is ready for support, establishing their own private dance of distraction or physical coping. The hormones are ramping up, which helps protect the process from disruption.
Once things are more intense, she may invite her doula or other support person over. Depending on her plans for pain medication, she may want to head to the hospital once it’s clearly active labor. Some providers will also suggest she stay home as long as possible so that the hormones are thick and steady. Again, this extends the time of privacy at home.
Once at the hospital or birth center, the laboring woman can request a minimum of extra staff. If she has spoken ahead of time with her doctor, she will know the possibilities for this. Spending time laboring in the shower or bathroom enforces a bit of privacy just because there’s not room for many bodies.
What disrupts it: Lots of people. A crowd. Many strangers, especially those who will assess your cervix with their hands. If the idea of a lot of staff makes you nervous, talk candidly with your doctor or midwife about it. There are several approaches to this, and I do see some doctors or midwives/hospitals limit the amount of staff each patient sees. It’s not handled only way (at least not in the U.S. I can’t speak for other countries.).
Hey, babe. I brought your favorite robe. I even warmed it up for you.
When Oxytocin takes over the body, the blood concentrates in the core. This is a reason many women’s arms and legs feels weak and unsupportive as labor progresses. They begin to lean forward on people, the kitchen counter, the hospital bed, etc. The blood needs to rush to the core to provide support for the hard-working uterus!
To try now: Think about what you’ll bring with you to your labor. Some women like to bring their own robe and fuzzy socks from home. When touring the place of birth, you can also ask if you have control of the temperature in the room. Some hospitals have thermostats in every room.
In labor: Bring your favorite warming, comfort items with you into labor. Your robe, your slippers or fuzzy socks. Partners can ask about adjusting the temperature in the room if the mother is too cold. If you do not have pain medication, you can ask about a warm shower or bath to keep warm.
Exception! The body begins to make its own warmth as labor progresses. If a mother does not have pain medication, she is probably moving a lot and heating her own body. These women often feel hot and overheated when labor is advanced. If a mother has an epidural, her body may also warm up. There is a phenomenon called an “Epidural Fever” in which the body heats up because it doesn’t regulate its temperature as efficiently.
One big, fat sign of progress in labor is that the laboring woman changes her speech pattern. This is such a huge, almost predictable sign, that I watch for it in my clients to help determine where they are in the process. I like to speak with them on the phone in early labor when they are often talkative, excited and speaking more like their day-to-day selves. Then as things pick up and their contractions (Oxytocin!) increase, I again want to talk on the phone. She will speak slower, like she’s high or sleepy. She will be less verbose and need to stop talking completely to get through a contraction. Now we’re talking!
This happens because of the changes in the brain when Oxytocin takes over. The Neocortex, the frontal lobe, begins to shut down as labor progresses. The primal brain, the Limbic system, is firing like crazy. Guess where speech lives? Yep, the frontal lobe. So when she’s speaking in grunts and hand-waves, the changes in the brain are apparent.
To try now: Think about what happens when your brain is high on sex? When you’re 30 minutes deep into being turned on and feeling good, how are you communicating? I’m going to guess with a lot of body language and maybe some dirty talk (keep reading for more on that one). Talk with your partner and support people about this typical occurrence so that they know how best to communicate with you. If they could use some pointers, I have an entire post about “How to Talk to a Woman in Labor” just for them.
In labor: As the mother becomes increasingly non-verbal, she usually likes quiet and focus (from others, too) as she copes with contractions. Supporters can help by holding their own conversations until her contraction has ended. When asking her questions, try to frame them in yes or no for ease of communication. Also, if you want to try a new coping technique or massage, you can try telling her ahead of time: “I’m going to try *blank* during this contraction. Just say no if you don’t like it.” This tip is SO HELPFUL in clarifying the communication between the laboring mother and her supporters.
What distracts: Lots of questions, which is sometimes just necessary in a hospital setting. Once the partner has heard the answers to the questions, he/she can help by answering them when they come up again (they usually do).
Loss of Inhibition
Remember that question about how you communicate during the Horizontal Mambo? And the dirty talk? You might turn hot pink in the face to say such naughty things during a normal conversation, you sexy minx. But that Oxytocin, boy, it sure helps with feeling FREE. We see this in labor, too. I see some women rip their gowns off because they’re hot, to hell with the strangers in the room. Some have no problem using the toilet with a guest or two in the bathroom. Some drop F-bombs every five minutes, though she’s never said one before in her life.
While many women are nervous for certain bodily, ahem, experiences during labor (pooping on the table, anyone?), the glorious news is that Oxytocin can help them not to care in the moment. I make no promises, but it’s common.
To prepare now: Tune into how you already get uninhibited when you’re feeling good and sexy. Take stock of how your persona, communication and boldness change under the influence of Oxytocin. Maybe even try to do it a little more between now and labor-day. Speak frankly with your partner and supporters about this natural loss of inhibition that occurs. Make sure they can handle it and that you have an agreement of safety and privacy. Like, whatever happens in labor STAYS in labor.
In labor: The loss of inhibition often comes later in labor. In fact, early labor can have some self-consciousness in it. Labor is still shy early on. So a woman can again choose that privacy and darkness to keep her feeling safe until the hormones take over. If she does have people around, she may like the television on so that she isn’t the focus of attention.
What disrupts it: Too many people, too soon. Sometimes for safety reasons or for an induction, the couple is at the hospital early. In this case, she can ask her nurse for a minimum of disruptions if possible. Again, spending time laboring in the bathroom or shower can help her find her rhythm. (Bonus because we’re already conditioned to be less inhibited in the bathroom.)
Use of Water
“I drew you a bath, pregnant goddess. Oh, am I in your way?”
This one is a little convoluted. Lots of women are attracted to water during labor because it is pain-relieving. While it’s not known that Oxytocin itself is what draws women to use showers or tubs in labor, there is evidence that being IN water helps beta-endorphin levels increase . So using water for pain-coping and relaxing can help get you a foreplay mindset.
There is a fascinating book about this interplay, “Blue Mind: The Surprising Science That Shows How Being Near, In, On, or Under Water Can Make You Happier, Healthier, More Connected, and Better at What You Do” by Wallace J. Nichols. He talks about the neuroscience of our exposure to water and how it affects our physiology. Great for you relaxation nerds out there.
To do now: Find out what options are available for hydrotherapy in your chosen birth location. Almost every hospital has showers available for patients’ use, some with removable shower-heads so that someone can direct the stream onto the mother’s belly or lower back for relief. If there are immersion tubs available, find out if your doctor or midwife allows their patients to use them (not everyone does). If so, under what circumstances would you not be able to use the tub? (BMI, hypertension, risk factors during labor, etc)
In labor: Run things by your doctor, nurse or midwife if you plan to use water for pain-relief in labor. Not only will they be able to approve the safety of your particular circumstance, but the stage of your labor may dictate whether they recommend a tub or a shower. But ask! Immersion in water, especially, has been shown to reduce pain during labor.
Oxytocin thrives when we are in close proximity with people we trust and love. There is research that reveals that hugging for at least 20 seconds releases Oxytocin from the brain. While that’s awesome for some heavy petting in the back of your parent’s Volvo, some suggest that it’s way too long for a friendly hug.
Receiving warm contact from your partner raises Oxytocin levels and lowers blood pressure. All good things for the perception of birth (and for progress).
To try now: Talk with your partner about what sort of touch you like, what gets you in the mood. But also learn about what’s more typical physical touch during labor. There is a difference for many couples: because the woman is going through pain, she may be distracted or overwhelmed by certain physical touch.
In labor: Stay close to each other. If the laboring woman has an epidural, bring a chair up close and give her a foot massage. If she doesn’t have one, let her lean into you. Touch her with reassurance between contractions. While she goes through vaginal exams or IV placements, hold her (other hand) and give her something good to feel.
Our mammalian nature comes out in full force on this one. It’s not a conscious or logical choice to respond to the unfamiliar smells of a new environment in labor. The brain is trying to assess if the new place is a safe place to have a baby. Once it gets settled in, especially if the first couple hours are reassuring, then it finds its labor rhythm again and labor can progress.
To do now: If birthing in a hospital, take a tour (or two!). Get accustomed to the smells and sounds of the place where you will have your baby. Think also about ways you can bring your own familiar smells into the labor room with you: that robe we talked about up in “Warmth” or a pillow from home.
In labor: Nothing smells more familiar than a partner. If it works for her favorite coping position, the mother can lean into and breathe in her partner’s smell through contractions or between. Grabbing her own robe and own pillow from home also keeps her surrounded by familiar smells. Bringing her favorite lotion, with which her brain is familiar, is nice too!
Actual Physical stimulation
Sexual or sensual stimulation abso-fucking-lutely gets the hormones going for birth. Some women are ALL about using any tools necessary to get their bodies coursing with Oxytocin. Some women find this distasteful and no-thank-you-very-much. This is YOUR birth. You get to decide how raunchy or conservative you go about it.
But I can’t talk about foreplay without actually talking about foreplay. The loving, sex-infused touch will get those hormones going. This means: kissing, nipple stimulation, sensual touch and clitoral stimulation. These things don’t have to be overt, and they can still be kept private. It’s really powerful stuff. I was once at a birth where the mother was pushing for a long time. She spent a few minutes alone with her husband and her favorite toy. Her contractions picked up, came back stronger and she had her baby shortly after!
To try now: Hopefully you’ve had several years of playtime under your belt. But talking openly about it with your partner can help normalize the idea now. Talk about what you would be comfortable with and if any of this is more than you’re interested in.
In labor: Some couples are fine kissing during labor. Some doctors/midwives will suggest nipple stimulation to get contractions picked up. This may be by way of breast pump or self-stimulation or stimulation from your partner. Or you could get straight kinky. Partners, you can always touch her lovingly and with warmth. Focus on conveying love with your touch. Even just a reassuring hand builds oxytocin. Finally, the “big guns” would be clitoral stimulation. This can be with a hand or your favorite toy (I LOVE this one. In general. Ahem.).
Ooooh, nothing feels better than someone saying a nice thing to you at a hard time. It keeps you going, keeps you focused and can change the story in your own head. These words can be private, personal things. But even just encouragement and supportive words work. You can get a heavy dose of encouragement from a doula, but of course any person involved in the birth has this capability. If you would like some ideas of what exactly is helpful to say, I have an article “How to Talk to a Woman in Labor” just for you.
To try now: Read that article and get access to the Cheat-Sheet for partners for how to support a woman in labor. Talk now about the sorts of things that you would like to hear. For instance, some women really like to be reminded that this whole thing will end and not go on forever. Some like to be reminded of the baby. Some want to be told they’re doing a good job.
In labor: Partners can be bold to say sweet things to their lady. This is especially true after any disappointing vaginal exams (maybe she’s not as dilated as she’d like to be), hard choices or through tough moments. Encourage her effort and endurance, her wisdom and patience. Tell her she’s beautiful. Tell her how amazing she is. Actually, this is just good life advice. Go do it now.
Free of distraction
I don’t know about you, but many people find it challenging to get into the mood when they have a long list of stuff they have to get done. Even worse if there’s a time constraint! When the mind is thinking about logistics, dealing with older children, or knowing that there’s a clock ticking, that frontal lobe is activated. So the biological process may take a pause while other things are handled.
I see this effect quite a bit with my second-time clients. Once the older kid is safely tucked into bed and my client’s “mother brain” is allowed to relax, her labor usually picks up. It is also commonly true after arrival at the hospital – when the intake questions are asked, the IV is placed and the couple is left to labor, the brain can let the body do it’s thang.
To do now: Plan for the little logistical things that need to happen. What’s the plan for notifying your place of employment? Go ahead and draft that Out of Office email now. What about any animals that will need to be boarded or watched? If you have older children, do you have reliable options for last minute childcare (especially in the middle of the night!)? Have you packed the bag? Do you have all necessary phone numbers stored in both of your phones? (The doc’s office, your doula if applicable, etc)
In labor: Unless you are trying to rest through early labor, spend some time arranging for all of these logistics. Once labor picks up, it becomes increasingly challenging to get even minute tasks accomplished. Partners can also be mindful of taking care of as many logistics as possible so that the mother can just labor. Tap into your inner mind-reader, partners. Of course it won’t be perfect, but every little thing that you take off of her plate allows her brain to relax a little more.
Bringing it all together
Truly, these are just some ideas, some things to keep in mind as you tour your birth locale and again during the birth process. They can help you with questions for your doctor or midwife and spur some good conversation with your birth team. But please don’t fall into the canyon of thinking it has to go down perfectly. In fact, it’s best to acknowledge now that birth is a messy, unpredictable event. Just do what you can with what you have and where you are. The rest is an adventure!
If you’re totally geeking out about the power of this hormone, you can learn more about Oxytocin! I love “The Oxytocin Factor” by Kerstin Uvnas Moberg and “The Scientification of Love” by Michel Odent. Both are brilliant books about this fascinating hormone and how to get more of it in your life.
*Please know that these ideas are given as suggestions for labor progress and the mother’s experience of the birth, not for safety. Safety always trumps labor progress, so of course the environment will change when there’s any question of mom or baby’s health. It’s actually a way that you’ll know if the matter is serious: the entire energy and amount of people in the room changes, the lights come on, there’s lots of talking and rushing, time limits, etc. All Adrenaline. This is when you pay attention and forget the atmosphere, but do what your baby needs. As always, remember I’m not a medical professional.