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Monday, April 18, 2011

The Sexuality of Birth: Baby In, Baby Out

No this blog post isn't meant to be crazy or controversial. I know that talking about "sexuality" and "birth" seems outrageous to some, or it may seem like a moot point and even too risque to talk about in the same sentence. But as Ina May points out, we like to forget that women give birth with the same anatomical parts that are engaged in the sexual act that got the baby in there in the first place. It's a fact of life people! And Ina May is just so wise, so matter-of-fact about it, that one wonders why we are embarrassed to acknowledge the normal, created physiology of our bodies.
Part of the reason we as women are so fearful to birth is that we have lost confidence in the normalcy of the birth process. That our bodies are MADE to do this.(I love this pic from the move "The Business of Being Born", that shows the very moment of a normal, uninterrupted, unmedicated, joyful birth)

I've been touting Ina May's new book because I feel like it's SO important for women, men, and care-providers to know and understand the very real and practical function of how a woman's body is made to respond to the birth process. And, how much we as practitioners can GET IN THE WAY of a woman having her baby.
We really can and do get in the way.
I love that Ina May is so practical. It would behoove us all to learn (and remember) these things.
There is much talk of "orgasm" during labor, and instead of it being sensationalized and something to "aim" for (like women need the pressure of not only giving birth, but having an orgasm as well! Obviously that's not the goal!) Here are some particularly pertinent excerpts from her book. Everyone should knows these things!!:

"There is plenty of evidence that the process of different hormones secreted by women's bodies during labor explains the phenomena described above (that when a woman feels frightened or threatened her labor can and will stop, or even reverse. Get the book if you want to read about the falsity of "failure to progress" and "uterine dysfunction" ;).

Adrenaline is the hormone that is active when a labor reverses itself or stops. Most people have some familiarity with the effects of adrenaline--it makes us stronger and faster, and it is the "fight or flight" hormone that is activated when we perceive danger. When adrenaline (catechalomine) levels are high in a laboring woman's body, her pelvic muscles will be tense, and she will experience much more pain than she would if someone were able to assuage her fears.

Most people know that oxytocin is a drug that is often given in synthetic form to women in hospitals to make labor stronger, or is given after birth to prevent or stop excessive bleeding. However, they are less likely to know that women's own bodies are capable of excreting oxytocin and that this endogenous oxytocin not only causes uterine contractions (and thus keeps labor moving along and prevents excessive bleeding after birth) but that it's associated with feelings of love, trust, gratitude, and curiosity. While synthetic oxytocin can be effective in stopping hemorrhage by causing the uterus to to contract, it does not induce feelings of love, trust gratitude, and curiosity in the way that the mother's own oxytocin does. In addition, synthetic oxytocin when used for strengthening labor causes more painful contractions that often lack the painless rest periods of unmedicated labor.
When adrenaline levels are high, oxytocin levels are low, and vice-versa. (these changes, by the way, can take place almost instantly). The women who reported feeling their cervices open when words of love and encouragement were spoken were responding to levels of oxytocin in their bloodstream.

Dr. Kerstin Unvas Moberg and her team in Sweden carried out some of the most useful research of the late 20th century in the area of maternal-infant behavior (see: Kerstin Unvas Moberg, The Oxytocin Factor: Tapping the Hormone of Calm, Love, and Healing (Cambridge, MA: Da Capo Press, 2003). Their work effectively demonstrated that people's oxytocin levels rise significantly when they share a pleasant, delicious, and unhurried meal together, and when they are in the process of falling in love. But the highest levels of oxytocin of all occur in mothers and their babies during the first hour just following birth (emphasis mine). This is the time of bonding, when mother and baby are programmed by nature to adore each other and share moments that neither will ever forget." (Note from me: what are things that we do in our treatment of the third stage of labor that interrupt this time that are actually causing more harm?)
"Such moments should only be interrupted for medical procedures when a true emergency occurs; interruptions should not be routine. Interestingly, when such important moments are allowed to unfold without interruption, the risk of postpartum problems in mothers and babies is reduced. babies breathe better and their heart rhythms are more regular when they have skin-to-skin contact with their mothers' chest. Mothers are less likely to hemorrhage in these circumstances as well.
Beta-endorphins are a third kind of hormone relevant to labor and birth. Beta-endorphins are nature's opiates, and they have powerful pain-numbing effects. When we expend alot of physical effort, beta-endorphin levels rise correspondingly. They also rise when we are warm enough and, most importantly, when we are feeling secure. Being in love and feeling sexually aroused are also associated with high levels of endorphins.
I am well aware of how skeptical people will be about the strength of beta-endorphins. Sports physicians, however, are well aware of the threat of reinjury when an athlete is playing well--the pain of reinjury might not be felt because of the beta-endorphin rise caused by strenuous and successful play. People who have had to free themselves from traps in ways that involve the need for self-injury often report that they could bear the pain--another example of the potential strength of endogenous beta-endorphins.
It is important to remember that fear and negative emotions inhibit a rise in beta-endorphins. This is one reason why whining does not alleviate labor pain, whereas moaning may. There is an important distinction between these two kind of vocalization. Moaning is a sound that may indicate pain, but may also indicate pleasure, and is consistent with relaxation (while opening the throat, relaxing face muscles); whining indicates complaint and self-pity, is high pitched, and doesn't happen during pleasurable experiences.

Beta-endorphins, combined with oxytocin, explain why some women--strange as it may seem to anyone who hasn't seen or experienced it--experience orgasm during labor or birth. Orgasm, of course, is an experience we almost exclusively associate with making love--so much so that some women become offended and upset even thinking about the possibility of having such an experience while giving birth. I think this kind of reaction has much to do with the fact that the medical model of birth has successfully wiped from most people's minds the obvious fact that women give birth with their sexual organ. Further confusion results because women in our culture are not taught that their vaginal tissues have the ability to swell in a way that is every bit as impressive (and surprising, viewed for the first time!) as the change in the flaccid penis when it becomes erect.
Every man knows that erection happens because of blood that is trapped in the penis. The penis enlarges far more than it could it if were forcibly and hurriedly stretched to it's maximum. The trouble is that women don't have such an obvious way of knowing that vaginas do fancy tricks too and that blood can suffuse the vaginal tissues in a similar way in order to easily allow the passage of a full-term baby without tearing. High levels of both endogenous oxytocin and beta-endorphins are necessary for such swelling. Obviously, such hormonal levels are not possible when women are in great pain, feel threatened, pressured, or being subjected to constant interruptions---just as men don't get erections when they are terrified or being threatened with sharp instruments.

Too many women have been exposed to the myth that when a baby passes through the vagina, that organ will be permanently stretched and ruined. It is true that vaginas can be badly injured when babies are pulled through with vacuum extractors or forceps, just as they can be injured by rape. However, when vaginas are treated well and not subjected to routine episiotomy or forced pushing, they swell impressively, since these tissues have the ability to hold large amounts of blood when the mother's labor has produced the ecstatic hormones of oxytocin and beta-endorphins.
(note from me: this is why the atmosphere of a laboring woman's space in which she is birthing is of the utmost importance. It's not just about lighting candles and playing soft music...it directly affect the physiology of her body and labor. People and strangers rushing in and out, yelling at her to push, etc....could you have a bowel-movement if someone were in your face yelling at you to push and holding your legs apart? I didn't think so ).
Under these circumstances, vaginas function marvelously in birth, and when they become small again, they are no more ruined than is a penis when it softens and shrinks following an erection."

From Birth Matters, by Ina May Gaskin


poshyarngirl said...

Awesome book! great post.Love Ina May. ;p

Anonymous said...

Hi Beth. I went to your old blog and I saw those adorable booties you made. I have some friends who will have a baby soon. Can you give me the pattern? Thanks.

-Brielle Autery

Youthful One said...

I'm convinced. I need to read the book before delivery. ;-)

Brielle said...

Oops! I mean the booties from your "A different kind of midwife, and the David Mayfield parade" post.