The Power of Ecstatic Birth with Dr. Sarah Buckley

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I am thrilled to have Dr. Sarah Buckley on today's show to share her wisdom about how your hormones create an ecstatic blueprint for birth and mothering. She also discusses how honoring the process of birth creates safety for you and your baby. Don't miss this episode!

Topics We Discuss in This Podcast:

• How Sarah's first baby helped her realize there was something missing from her medical training about birth – and from popular expectations about baby care
• Why understanding hormones is just as important as understanding the “stages of labor”
• Your body is programmed for a smoother, quicker birthing than you realize – here's why (and how)
• What exactly is “undisturbed birth” and why is it so important?
• Does “undisturbed” birth mean “unassisted” birth? Here's why it doesn't for many women.
• A rule of thumb that will help you choose the right support team for your birthing time
• How to use the “sabertooth tiger” effect to your advantage during labor
• Sarah's recommendations for preparing for natural birth and working with your contractions
• Why mothers are meant to enjoy their newborns and feel pleasure while breastfeeding
• It's not selfish – it's science! How an ecstatic birth experience makes labor safer for you – and your baby
• Sarah explains exactly why you don't want to let your little one out of your sight!
• What your baby really wants when s/he checks out of Hotel deWomb <3

Right-click here to download the MP3

Things Mentioned on This Week's Podcast

• SarahBuckley.com – Dr. Sarah Buckley's website
• Ecstatic Birth: Nature's Hormonal Blueprint for Labor – Sarah's free guide for mothers
• Undisturbed Birth DVD – Get Sarah's lectures on DVD
• Sarah's answers to your questions about epidurals
• Hormonal Physiology of Childbearing – Sarah's detailed paper on hormones and birth. There are lots of resources here to share with your care providers as well as resources for you to download and share with other mamas
• Gentle Natural Birth – Sarah's resources for birth professionals
• Will the Real Oxytocin Please Stand – my article on how your own oxytocin creates a smoother, safer birth

Full Transcript of Dr. Buckley's Interview

Click here to download a PDF copy of the interview

Hi, this is Kristen from NaturalBirthAndBabyCare.com, and I am thrilled to be here with Dr. Sarah J. Buckley.  She is a New Zealand trained GP and family physician, with qualifications in GP obstetrics and family planning.  She's also the mama of four home-born children, and currently combines full-time motherhood with her work as a writer on pregnancy, birth and parenting.  She's also a PHD candidate at the University of Queensland.  I'm thrilled to have her here.

Welcome Sarah.

Sarah: Thank very much, it's a pleasure to be here.

Kristen:  I'm so excited, I've got questions, I could probably keep you for hours, but I'm going to try and stick to the questions that we talked through.  What I really wanted to focus on was one of your passions, which is the hormones of birth, because I feel passionately that women need to know about it.

Sarah: It's a beautiful body of work, and I think what's so nice about the hormones of labor and birth is it really underlines how superbly designed our bodies are.  Because there's so much kind of information and perspectives out there that birth is kind of like an accident waiting to happen, and our bodies are intrinsically flawed.  But, when you start to look at the hormones and all the different ways in which they support mothers and babies you really realize how superbly designed we are.

Kristen:  I just love that!  I really do.  I think it's so important for women to realize that we're not, in fact, broken.  Or like you said, an accident waiting to happen.  But that we and our babies are something that is meant to work.

How did you become interested in the hormones of birth?  And did you realize just how important they were when you first started your research?

Sarah:  Well, there's a few different things.  I guess I have got to go back to when I was ten and they went round the classroom and asked you what you wanted to be when you grew up, and I actually said an author.  I wanted to write.  So it's always been a passion of mine.

But, of course, I did medicine.  Which is a fantastic foundation because I had these experiences in my training where I attend women giving birth in different situations.  And then I had my own babies.  And then I had all the medical training around it.  And there we such a big gap between what I experienced myself, and what I'd learned about birth.  So I was really interested in what was that gap.  How come birth for me was such a profoundly positive experience, and I know for many other women, and that's not what I got taught about it.

I was very influenced by Michel Odent, who was talking about the hormones.  I think I first heard him talk in 1993 or something like that.  He's been a great mentor to me.

So it was really a way of, it's a great intersection between the physical experience of giving birth and not just my experience, but other women's experience.  And then the scientific, medical science of it as well.  And it really bridges those things beautifully.

When you look at the hormones it tells us what a profound, subjective experience childbirth is, and why it has to be like that.  Why it's designed to be like that.  It's just designed to powerfully reward, not just women, but in fact females of any mammalian species.  Because that's what actually helps the species survive.  That's what activates the reward and pleasure centers so that then that mother will be rewarded and motivated to give the care to her young.  Whether it's a mouse, and elephant, or a woman.  We all have the same neurobiology to a large extent.  As a consequence of the same hormonal physiology.

Kristen:  That's very interesting, I think it is interesting to see.  We keep goats here on our little hobby farm.  One of our goats, she really is very crabby in her personality, but she dotes on her babies.  It's interesting to see how it transcends even personality and influences that mothering behavior.

Sarah:  Well, that's exactly it!  This is much too important to leave to personality, right?  It's about the continuation of the species, so that's true for us as well.

That's another thing that influenced me, Kristen.  I was mothered in a kind of typical 60's way, I was born in hospital, and got separated from my mother, I didn't get breastfed.  And just those typical things that happened really, so I didn't have that imprinting you might say, from my own experience.  And of course, I didn't see other women giving birth.  Probably never saw anyone breastfed.  So I didn't have any conscience memory of those things.

But when I gave birth myself, everything just kind of kicked in.  And what I thought I was going to do with my baby, like put her in a little basket in the next room was completely opposite to what I did.  I knew I had that subjective experience.  Something happened in my brain over those hours of labor and birth that shifted me such that I didn't want my baby more than a meter away from me.  And when you look at it from a kind of evolutionary perspective, of course, you don't.  Because if you're not in touch with your baby, if your baby is not in touch with you, then that's incredibly dangerous.  That's what's hardwired into our bodies through these millions of years of evolution, of giving birth in the wild.

That's another part of the puzzle.  Part of the perspective that I bring.  I studied anthropology and it's a really great way to look at childbirth.  Like how are we designed?  What is it that hardwired into our bodies.  And it kind of all makes sense because it's all about survival of the species for all mammals.  It's all about commonalities that we have as mammals.  As Michel Odent says, we don't need to humanize birth, we need to mammalianize it.

Kristen:  I find that so valuable.  Often when I talk to women I think it's very easily relate-able.  Because most of us have had this experience in our childhood of a beloved dog, or a beloved cat going off into a quiet dark corner to give birth to her babies.  And I tell them that you're not so much different.  You need the same thing.

Sarah:  Exactly.  Exactly.  And that's exactly what I say, Kristen, I say the core requirements for birth among all mammals is that the laboring female feels private, safe, and unobserved.  Because, in the wild, that sense of being observed is a red flag.  If something is observing you, it might not be friendly, or rather unlikely to be friendly.

So women in labor, and again, the hormones explain this really well, are in this kind of exceptional situation, where your kind of, it's physiologic or natural labor and birth, your kind of in this dreamy state.  You're also very switched on because you need to be switched on.  Because just like a rustle in the leaves, or a strange smell, or just that sense that you're being observed, could be fatal for you and your baby.  You can't kind of defend yourself very easily in labor.

You might have noticed this, you can't kind of run away, or fight very easily.  So there's all these things that are built into the systems of labor and birth so that we are very sensitive, and we are very alert in labor, even at the same time we're kind of in labor land, or on another planet as some people say.  Apparently one of the Native American tribes, they say that the laboring mother goes out to the stars to collect the soul of her baby and bring it back.

Kristen:  I really like that thought.  That's a nice thought.

You've mentioned your own little one's birth, and how very different it was from what your medical background and your teaching about birth were.  Can you talk a little bit about how your births influenced you?  How they really pointed out that there was something really missing in your education, so to speak?

Sarah:  Well definitely the first one Kristen, because as I said I had all this medical training.  And I'd also had the big advantage really of being present when two of my friends had given birth at home.  So I kind of had this other perspective on it as well.  I had also noticed in my training that the women that gave birth most easily were the ones that gave birth at night when there were not as many people around.  When I wasn't there.  I didn't know these women, I just had to catch the babies, and check off a box, which was not a very good setup.

So, I noticed that the more private, and kind of safe, kind of secluded, the more intimate the atmosphere you could say, the better the results.  So with my first baby, this is hilarious. I planned to have like twelve people there.  I had a doctor, two midwives, I had my sister coming from New Zealand.  I had like three supporters, and myself, and my husband.  There was going to be this whole crew.  And I remember my sister in law said to me, she's a homebirth midwife, and she said every extra person adds an extra hour to the labor.  That's a good rule of thumb.  And I thought, oh dear, that's not going very well.

So that's a good thing that I did at that point, when we had a meeting beforehand because she was a planned homebirth.  So we had a meeting before, and at that meeting, I said “Look, whoever, I'm inviting you to the birth, but I might not call you.  It just depends on how I feel.”  I think that was the most intelligent thing I did in the whole planning.  Because then I had space to not have to have this whole mob of people.  And to really go with what worked for me.  And I think that's a really important point.  You don't know how you're going to feel in labor.  It might be different one labor to another.  So to have a setup that is flexible.

What is going to be private, safe, and unobserved for you in that particular situation?  And it might be different, certainly will be different to other women, some women might be having their best friend, or their mother there might be the thing that makes them feel safe.  And for some women, having their best friend or their mother there might be the thing that makes them feel stressed.  It's going to take them out of labor, right?  So it's very individual.  I guess I learned that from my first daughter, Emma's birth, that being private, safe, and unobserved was the best thing to get my labor hormones flowing.  I had a very kind of unexpectedly short labor, just five hours, with my first baby.

That taught me that in a very embodied way.  The lesson, learning that something changed in my brain.  I knew that something had changed through those processes of labor and birth that made me a mother in a completely different way.  I've got to tell you, this is nearly twenty-seven years ago now, so there wasn't even a word for attachment parenting.  There was kind of standard parenting, and then there these other strange things that people did, like sleep with their babies.  And that's just what I did.  There was no way that my baby was going to be in another room.  That went against every maternal instinct that I had at that time.

It was a very obvious thing that had happened to me.  I was going from one situation into a completely different situation in my brain.  Something had happened there.  So that kind of fascinated me really.  How did that happen?  Which led me to be more interested in hormones.  And then all of my births, there were great reasons for all of them to be at home.  I was much more private and safe.  Things flowed.  Things that would have been tricky or complicated in some situations, were quite straightforward at home.  And I had all the support that I needed.  All of those things.

Then, of course, I'm sure this is your experience too when you have other children, it's so beautiful to have your other children present and really sort of soak up that intimacy, that magic of birth, and have it there in your own home.  It kind of permeates the whole house, and everybody is kind of in this love state.  Because giving birth it's a huge release of oxytocin, the hormone of love.  That hormone actually acts as a pheromone.  It's transmitted between individuals.  Through this organ in the nose, it's one of our nasal organs.

So that time after birth, that hour after birth, it's basically a love fest.  Everybody falls in love with everybody.  It's designed to be like that.  Baby and mother fall in love with each other.  The mother falls in love with the midwife.  The partner falls in love with the mother.  I mean everyone.  It's palpable in there.

And in fact, I'll tell you a story.  When I do workshops.  When I talk about that.  Like two times, midwives have come up to me and said, I've got a letdown.  I've got a physical letdown of my milk in that atmosphere the hour after birth from the pheromonal oxytocin.  So it's very powerful.  These things, it's not just a good feeling, it's actually a powerful biological event that happens in that hour after birth.  That's designed to bond everybody.  I think in terms of human history, it's probably designed to bond close members of the social group so that they'll look after the baby as well.

And the other thing to say about that is when you look at it through this lens, it completely throws out that idea that women are doing this just to have a good experience.  Because labor and birth are designed to be a good experience.  They're designed to have pheromonal oxytocin.  They're designed to activate our pleasure and reward centers so that we fall in love with our babies.  And that's actually critical for species survival that we're rewarded and motivated to give this dedicated care that every mammalian baby needs.

As I said, a mouse, a dog, an elephant, they don't go to prenatal classes to learn how to look after their babies.  It all happens through the processes o labor and birth.  Because of the immense activation of the pleasure and reward centers.  And they look after their babies because it feels rewarding because it feels pleasurable.  It feels more rewarding than cocaine actually at that time through various research.  So, yeah, that's the thing.  It is designed, my sort of flagship article it's called, Ecstatic Birth: Natures Hormonal Blueprint of Labor [ http://www.mothering.com/articles/ecstatic-birth/ ].

It's exactly what's meant to happen.  That was very much reinforced through my own experiences as well.  Every one of them.  It's kind of addictive, the more babies you have, the more ecstatic it becomes in some ways.  Because those parts of your brain have been worked at again and again.  And the pathways just flow, and it can be immensely pleasurable.  It's the hormones of orgasm.  It's designed to be like that.

Kristen:  Yes, I've been accused a few times of being addicted to having babies.  So maybe there's something to those accusations.

Sarah: Well, it's species survival.  Mother nature wants us to have lots of babies, right?  And wants us to breastfeed them.  Making babies, having babies, breastfeeding, it's all the same hormones.  It's all those reward and pleasure hormones.  I say it's a bit like mother nature patting us on the back, you're doing a good job, do more of it.

Kristen:  Yeah, I think that's really beautiful.  I love hearing this acknowledged.  I love when I read an article that acknowledges this.  And especially about the pleasure.  I think that we all realize that making the baby, or hopefully, making the baby is pleasurable.  I think that many of us are starting to realize that birth can be pleasurable.  But maybe through the pain, it doesn't feel pleasurable, but I think that the real place where we get taboo, Sarah, is with breastfeeding.  I just feel like a lot of women are ashamed to say that I find this to be pleasurable because then they feel like society will frown on them for doing something that is perhaps wrong.  But breastfeeding is actually meant to be very pleasurable, for both mother and baby.

Sarah:  Well, that's right.  And I think also that we've got to look at breastfeeding through cultural context.  Because that's not true in many cultures.  Women would not have a problem enjoying breastfeeding.  I think that's a particular western, and I've got to say a particularly American concept.  We don't have that in Australia so much, no one in Australia is going to get her baby taken from them for saying it's a pleasurable thing.  It is a cultural context.  Some cultures encourage to feed the baby long term, for years.

So that is a cultural context.

But just going back to the biology of it, yes definitely, when we give birth we release oxytocin, hormone of love, hormone of pleasure, calm and connection, relaxation and growth.  Stimulates reward and pleasure centers.  Endorphins, that activate the reward and pleasure centers powerfully.  We release prolactin, which is a calming, soothing, relaxing hormone as well.  We release adrenaline, noradrenaline, which is also called epinephrine, norepinephrine, that makes us excited.  So we have the ecstatic hormonal cocktail at the moment of birth.  Particularly that hour after birth.

I'm not saying that the contractions of labor, or the rushes, or expansions, however, you call them, I'm not saying that those have to be pleasurable.  I mean it's such a unique experience with that, I will never say that birth is designed to be painless.  I don't believe that.  But birth is designed to give us the hormonal support that we can transcend the stress and pain of labor.  And that's the endorphins that put us into this altered state that we talked about.  It's designed to give us that actual pain relief which is endorphins and oxytocin.  It's designed to, as soon as the baby is born, that we're flooded with this neurochemistry of ecstasy, of euphoria, of reward and pleasure.  So that, I say it's like the best first date ever.  You're meeting your partner, this partner, this biological partner that's essential for species survival in this atmosphere of total euphoria.  Total ecstasy.

And then that becomes associated with the baby.  And then every time you see the baby, you think of the baby, it's a moment of pleasure for you.  So that you'll want to be with the baby.  You'll want to have your baby next to you.  You won't want your baby in the next room because, from a biological, evolutionary perspective, the baby wouldn't survive if you put the baby somewhere else to sleep.  The baby wouldn't be there in the morning.  So it's hardwired into us, it's hardwired into our babies.

And our babies also get this pleasure stimulation of the pleasure centers through labor and birth.  So we have this beginning of a great love affair, as Michel Odent calls it, and it's essential.  It's essential for survival.  It's been essential for these millions of years of mammalian evolution, and it's still hardwired into us as well.

Kristen:  That's lovely, lovely.  Sarah, in your book, Gentle Birth, Gentle Mothering, you say that it's an undisturbed birth that helps to bring in mother nature's blueprint for safety, ease, and ecstasy.  As you mentioned your flagship article on Ecstatic Birth.  Could you talk about what is an undisturbed birth?  Like your women in the middle of the night who gave birth before you had a chance to get there.  Can a mom have a care provider there and still have this undisturbed birth?  Still get these great hormonal benefits and this blueprint?

Sarah: Oh, yes definitely.  I'm not saying we should go into a cave and give birth.  That's not what I'm saying at all.

In fact, when I do this talk, I actually go through all the ways that different animals give birth.  And many, some animals are solitary birthers.  Like cats tend to be solitary birthers.  But some animals, like elephants, actually have that tribe around them.   Which is again, important in the wild.  To have that protection and support from any predators.  And apparently elephants in the wild, they form this circle, and they sway in time with the laboring mother.  And they sooth her with their trunks.

It's really what makes you feel safe and private, and unobserved.  That's the key question.  And how can you set up a situation like that for your birth?

It's totally possible in a hospital setting, but, it's difficult in a hospital setting.  The doors open, and people are coming in and out through the door, that you don't know without knocking.  I say the ideal situation to have a baby is the same situation where you could make a baby.

So it's really about how you do that.  How do you set that up?  There's a part of my workshops when we do an activity and we sit down in groups and talk about how can we undisturb birth.  And many of the midwives that come to my talks, my workshops, work in hospital settings.  So, things like putting a “Knock First” sign on the door.  Or like bringing your own familiar things into the hospital with you, so that your smells are there.  Like your pillow to bury your face into.  So you can cut out some of that external stimulation.

Staying at home as long as possible, that's a really good one.  Because, what actually happens, and I call it the snowball of labor, so just going back into labor, labor is not a homeostatic event.  It's not an even where everything is designed to stay the same.  Like our bodies usually do, right.  So labor is an accelerating, a snowballing effect where things start off small and get bigger and bigger.  And that happens through a whole lot of positive feedback loops that happen in labor.  I've actually just talked about these in my blog, on my website.  About Epidurals in Labour [ http://sarahbuckley.com/blog/httpsarahbuckley-comblogepiduralrisks-faqpt1 ]. There's a little picture there of the positive feedback loops of labor, that makes the hormone activity get bigger and bigger and bigger, so that in the end, like a snowball, it's virtually unstoppable.

So at the beginning of labor, if you move to hospital at the beginning of labor, particularly first time when these things haven't happened in your body before, they're kind of new, even biologically new, it's quite easy to get distracted, for those stress hormones to come into slow down and even stop your labor.  You're not feeling private, safe, and unobserved.

But then, what happens as this snowball gets bigger and bigger, and all these positive feedback systems in labor accelerate the processes.  In other words, you could say you're in active labor.  As you get towards the end of labor, the snowball is so big it's virtually unstoppable.  In fact stress at the end of labor has a different effect.  I call this the saber-toothed tiger effect because it's kind of designed for us to give birth in the wild safely and easily.  So in the beginning of labor, the female is in labor, or your great, great, great five hundredth great grandmother's in labor, and a saber-toothed tiger turns up at the beginning of labor, it makes much more sense to slow down or stop labor and give her the space to fight or flight, right?

But if the saber-toothed tiger turns up at the end of labor, when this snowball has really built up, and labor is virtually unstoppable at that point, it makes much more sense for the stress hormones to trigger a fast and easy labor, she scoops up her baby and then runs away, right.  That's the biology of it.  That's in fact what happens.

So, stress, or moving to hospital, or something stressful happening at the end of labor is more likely to promote the processes of labor.  Whereas stress at the beginning of labor is more likely to inhibit the processes of labor if that makes sense to you?  So it's really a long story as to why staying home as long as possible, and then going to hospital at the last minute is a really good way to have an undisturbed birth, if you like, and to make the most of your laboring hormones, and the snowball of labor.

There are multiple studies that show that.  The more advanced a woman is in labor, the fewer interventions, the less likely she is to have a cesarean, etc.

Of course, you need to figure out what's going to help you to feel private and safe and unobserved if you do that at home.  And you may want to have your own doula, a midwife that can come home with you, a supportive birth companion.  You may want to be able to ring up the hospital and just check in with someone.  You need to feel safe in whatever situation.  And that is such a subjective experience, so that's the thing to think about.  What is going to help me to feel private, safe, and unobserved?

That's an undisturbed birth.  That's how you can set up a birth where your hormones are going to flow, and you're really going to get the most of these ecstatic hormones.  We've talked all about the pleasure and reward of birth, but it's actually, these hormones also promote safety for you and your baby.  We talked about the stress hormones.  Kind of environmental context, promoting safety.  But some of these hormones help to, help the baby in labor to deal with the stresses of labor for themselves.  Because the baby, labor is stressful for the baby too, the baby's subject to these intermittent contractions.  Which every contraction squeezes not just the baby, but squeezes the placenta.  So squeezing the baby cuts off the baby's blood supply to some extent.

But just like we're superbly designed, babies are superbly designed as well.

So what happens to the baby in this hormonal physiology is the baby gets this rush of adrenaline, noradrenaline late in labor that makes sure the baby's heart and brain are well supplied with oxygen.  Helps the baby's brain cells to be resistant to low oxygen levels.  Gets the baby ready for the transition to life outside the womb.  Clears out the lung fluid.  Opens up the airways.  Increases the lung lubricant/disinfectant.  It gets the baby's fuels.  Optimizes the baby's glucose, not just at the time, but builds up the baby's glucose fuels for that gap until the mother's milk comes in.  It gets the baby ready for the neurologic transition, as we might call it, because…

If I can talk a bit more about it.

I said that the baby in the womb is a bit like Hotel D'Womb.  Hotel of the womb.  The nutrients are delivered to the baby 24/7 room service.  The wastes are taken away.  The baby is warm and rocked and everything.

Suddenly the baby is going to come out and have to do all of those things for themselves.

And some of those things can happen slowly, like the nutrition.  It will take the baby a while to get their own metabolic fuels going, but the breathing has to happen straight away.  That's a number one thing.  This hormonal physiology that happens for the baby.  The catecholamine (CA) as it's called, as she prepares the baby for life outside the womb.  To make a successful and safe transition, particularly in terms of breathing.

There's a lot about this in my report, I haven't mentioned that hormonal physiology of childbearing, if you Google that you'll find it. [ http://www.nationalpartnership.org/research-library/maternal-health/hormonal-physiology-of-childbearing.pdf ]

It's also in the ecstatic birth article, which you'll find on my website, sarahbuckley.com, in the subscribe section.

But basically when you understand how the catecholamine surge works and benefits babies.  Then you also understand what the problems are for babies who are born by a cesarean, and particular prelabor cesarean, where there's none, not just the catecholamine surge doesn't happen, but all the preparation that underlies all of these hormones, that underlies the catecholamine surge too, doesn't happen for the baby.  The baby born by prelabor cesarean is at a double disadvantage.

They're not quite ready to be born, otherwise they would have triggered labor, and secondly, they haven't experienced labor, so they're more likely to have breathing difficulties, we know that for sure.  They're more likely to end up needing high levels of care for breathing difficulties.  Most babies do get over that, but that's a really big effect.  It's a big morbidity as we say because the baby is going to be separated from the mother just at that time when the baby is ready to initiate breastfeeding.  That's not possible.

The baby can also have hypoglycemia, low blood sugar because it hasn't had that catecholamine surge to stimulate the baby's metabolic fuels.  The baby is not alert because it hasn't had the catecholamine surge to promote blood supply to the brain.  The baby can also have difficulty keeping themselves warm, because they haven't had that initiation of the baby's own thermoregulation, making their own heat, which they do through the burning of brown fat.  So understanding the catecholamine surge tells you all the problems that prelabor cesarean babies can, and actually do have as well.

Kristen:  I find that so fascinating.  It really goes back to what you already said.  I think it's a huge problem that women, they're, I meet women who are actually belittled for choosing natural childbirth.  It's implied that she's being selfish, and she's putting her baby at risk because she's putting her “experience” before her baby's safety.  But, what you're saying is that by her having this experience, she's actually creating safety for herself and her for her baby.

Sarah: Yeah, she's making the most of her hormonal blueprint, which is not just about ecstasy and pleasure, it's about safety as well.  You can think back to all these, as far as we know, sixty million years of mammalian evolution.  The whole purpose of this reproductive evolution is safety.  It's designed to be safe.  The whole system is designed as safer ease.  It's designed to promote ease in labor.  Just going back to the predator stuff that we talked about.  The saber-toothed tiger effect.  The shorter the mother's labor, this is all mammalian species we're talking about here, the less exposure she has to predators.

Birth is actually designed to be as efficient and easy as possible.  It's designed for pleasure, as we've talked about.  It's designed to stimulate the mother's pleasure and reward centers so that she'll go on and give that dedicated care that every mammalian mother needs to give to her newborn.  Every mammalian baby can't look after themselves when they come out.  They need finishing off with breastmilk.

So safety, ease, pleasure and also safety. So the whole thing is designed to support the baby through that transition that we talked about.  To add safety factors that help the baby to deal with that hypoxia, those low oxygen levels.  That helps the mother to deal with the stress and pain of labor.  To give her the best transition.

We haven't talked about the prelabor preparations that happen as well.  This is an important aspect of safety.  The baby's catecholamine surge, that happens on top of all these days and weeks of increasing sensitivity.  What we say, receptor up-regulation for the baby.  So when the catecholamine surge comes in labor the baby's system is maximally sensitive to it, and it will be very efficient for the baby.  And the same thing is true of the mother.  The mother has all these prelabor physiological preparations.  That means when these hormones come in and labor the mother is maximally sensitive.

For example, we know from actual measurements in real life women that the number of oxytocin receptors in her uterus increases in the lead up to labor.  So at that onset of labor, her uterus is maximally sensitive.  So the oxytocin she releases during labor will make her uterine contractions very efficient.  And the corollary to that, of course, is if she's induced in labor, then by definition, she doesn't have that peak number.  It only happens in that physiologic onset of labor is the time that all these systems, term labor I'm talking about, all these systems are maximally efficient and effective.

One analogy I use when I give my talks.  I show a picture of William and Kate getting married, and I say from mother nature's perspective more preparations are needed for the birth of a baby than for the royal wedding.

So induction of labor or prelabor cesarean is a bit like William and Kate turning up at Westminster Cathedral a week, two weeks, or even a month before the wedding and expecting everything to be the same, and it's not going to be the same because all the preparations haven't happened.

Again, what can happen after prelabor cesarean.  The mother can have difficulties with breastfeeding because these preparations in her breasts haven't happened.  The increase in receptors to the breastfeeding hormones, oxytocin, and prolactin, we haven't, we know this from animal studies, we haven't actually measured receptor numbers in real, live women's breasts.  So if anyone wants to have that done on them they can put their hand up.  I don't recommend it actually.

We know from animal studies, and of course, this happens in humans because we need the same things.  We need a successful transition from Hotel D'Womb to breast nutrition.  That's really important for the survival of the offspring.

So all these prelabor preparations have to happen as well.

Again, for the mother, as for the baby, there's a prelabor cesarean, the mother misses out doubly.  She misses out on hormones of labor and birth, and she misses out on the prelabor preparations as well.

Kristen:  Yeah, it's just so … it just fascinates me that complexity and also the beauty of it.  I also think it's so validating for mothers to hear that this is a good thing.  And again, that their bodies do know what to do.

Shifting gears maybe a little bit now, because the number one question that I get about birth, once a mom has decided that “I'm going to have a natural birth, and I'm going to do what it takes.  I'm going to not listen to the people who tell me that I'm being selfish.“

But the number one question that I still get from women is “How do I handle the pain of labor?”  And number two is usually “What do I do if labor stops, or it stalls, or it's not going fast enough for care providers?”  And I actually feel like you spoke to that when you said that it's designed to be efficient.

How would you speak to a mom who's concerned?  “I want to have a natural birth.  I want to make sure that I honor this hormonal blueprint, but, I'm really worried that it's going to hurt, and I'm going to end up screaming instead of being ecstatic?”

Sarah:  Well, it's the agony and the ecstasy.  It's actually the same hormones.  When we're under stress and pain we release endorphins, which are also euphoric hormones.  You kind of can't separate them to some extent.  Some women do have painless births.  That's totally a possibility.  For most women, there are intense sensations.  I don't think there's any way around that, personally.  I wouldn't, as I said, I wouldn't tell a woman to expect a painless birth.  If it happens, it's a blessing.  But, you know, it's likely to be intense.  You've got this big baby coming through your body, so that's the reality of it.  How can we set ourselves up, everything that I've said tells us how our bodies set us up.

So our body set's us up with prelabor physiologic preparations.  So we get this increased number of receptors in our body, and our brain, and our breasts.  So that when this intensity of labor comes in we have some natural pain release through oxytocin, through endorphins.  When we are in an undisturbed situation so that we can follow our instincts.  We can go with them and see what it is that we need and it's a difficult question to answer, because it really, like the circumstances, it really is going to be different for every woman and every labor.

With my first birth, for example, I had done a lot of yoga.  I used a stopwatch, and I figured out, oh, these contractions last 30 seconds, or 40 seconds, or a bit longer, no with the birth. I would have a break in between. So I actually timed them, and ah, wow if I just breathe, and breathe, and breath and get over this, I'm going to have a break.  That's what really helped me with that first one.

I did different things.  Breath, sound, and movement are always good tools.  What do we do when we're challenged in other situations.  What kind of support do we need, and how can we have the freedom to follow our own instincts.  I think those are the kind of questions to ask.  And also having faith in our bodies, that millions of women all over the world are doing this at this very minute, and that millions of women have done it in the past.  We can tune into the sisterhood as well and really trust our bodies.

And look, sometimes, we do have this pain relief available, and sometimes that is a good thing.  I'm not totally against interventions.  Every intervention has its place.  But we've got to consider what is the gap?  Every intervention produces a hormonal gap.  So we want to give it our best shot, we want to set ourselves up a situation where it's as undisturbed as possible.  We want to be free to use our breath, to make a sound, to move as we need to, all of those things that we do in any kind of challenging situation.  We want to have the people there that are going to help us to relax and support us.  We don't want to have the people who are going to make us stressed.  That's really important.  And we want to have the freedom to tell people to come or go.  That's really important too.  When you're in labor, you're the queen.

As Ina May says, if a woman in labor doesn't look a goddess, someone isn't treating her right.

So we're the center.  Women-centered care.  We're the center of the circle.  We need to have the ability, the power, to decide what happens in that space, for ourselves, for our companions.

So all of those things are going to put us in the situation where we can respond to whatever we need in that moment.  And I can't tell you what it's going to be in that moment, but anything that you can do to help you to relax in between contractions is going to be helpful.  Which is where mindfulness, yoga, those kind of things are helpful too, because for most women, there's an intense contraction, and then there's this space in between, which is usually longer than the intense contraction.  So how can you deal with that intensity?  What tools do you have to do that?  And then how can you make the most of that space between the contractions as well.

Those are questions to ask yourself really.  How can you do that?

I know that there's some childbirth education where they actually mimic some stressful or painful thing.  Yoga is good for this because you often put yourself into like a bit of a stretch.  Like pinching, or putting your hand in cold water, and how are you going to deal with that?  What are you going to do?  How can you relax into that?

Many women describe that the pain, it seems like a pain at the start, it's a bit like I described hormonally, that when you go deeply into it without resisting it that it can actually slip into pleasure.  I'm not saying that's going to happen for everyone all the time, it's kind of like an advanced meditation technique.  How do you be with the pain, and be with the pain, and be with the pain, until you're not resisting it anymore, and it can slip into pleasure?

But, it certainly happens after the birth, and for some women, it does happen during labor as well.

Everything I've said up to this point, having a physiologic labor and birth, going into labor under your own steam, so that you've got that full complement of receptors, of readiness for labor and birth, for support, hormonal support as well, all of those things will help.  And one more thing I wanted to mention, which is, a little bit of how do we get labor going if it stalls, I mean, again, going back to those core requirements, private, safe and unobserved.  How can I feel, or how can I help this woman to feel, private, safe and unobserved in this situation.

I also mentioned previously that the hormones of having a baby are the same hormones of making a baby.  So we've got exactly the same hormones, and the same patterns actually, we've got oxytocin, we've got endorphins, we've got adrenaline, noradrenaline.  We've actually got prolactin as well.  So it's all of the same hormonal orchestration for making a baby.  So that gives us another whole set of tools.  So actually the hormones of sexual arousal, of sexual activity, can help us.  Can promote oxytocin.  Can get labor going again if it stalls.

I mean, the first thing to say is “What's in the environment?”  Is there a reason, is there a good reason why this labor is stalled?  Is there something in the environment that needs to change?

Many women have found that sexual activity in labor to actually promote contractions.  Which is actually the biology of it.  So self-pleasuring, pleasure with a partner, you've probably seen this on Orgasmic Birth, that's a beautiful way to kind of open up that possibility.

My friend Deborah, she recommends that women actually take a vibrator with them in labor.  One thing, it can give you that boost of oxytocin.  But secondly, just putting it on the bed, right, can clear the room out.  So if you want to feel private, just put your vibrator on the bed.  And she says, if that doesn't work, turn it on.

Anyhow, I'm not saying you need to do that, but there's a whole toolkit.  We can think creatively about it.  And have a whole toolkit of possibilities for ourselves to create, basically, private, safe and unobserved situation.  Then, if we do need, or we do want to, and labor needs to go faster, and one of the problems with that actually is, how fast should labor go?  It's not a mathematical event, right?  And natural phenomenon don't tend to follow mathematical formulae.  Not every child walks at 12 months.  It's an average.

But if you say every child has to walk at 12 months then you set yourself up for a lot of problems.

It's the same thing, not every woman is going to dilate at the same speed.  So to expect us to follow this kind of mathematical graph is not biological.  It's not biology.  It doesn't happen like that.

If you can set yourself up a situation where there's not that kind of expectation it's kind of ideal as well.

Again, having your own midwife, your own doula, being in a low technology setting, like a birth center, or at home.  You're much more likely to have flexibility around that.

You've got to do what's right for you, and I don't think it's anyone's job to tell anyone else what's right for them.  You need information, and to think about these things, so you can set up the situation that's going to work for you, and your family that's unique.  One-off.

Kristen:  So many good thoughts there, and I think, as you're speaking, I'm thinking, and reflecting and listening to you, I hear things like you mentioned Ina Mae, and she talks about a few of those things in Spiritual Midwifery, with all of this hippy language.  She gets to all of that too.  Just smooch on your man, and that sort of thing, and I think it really does do something for women.  I also, one of the things, I don't remember if she said it, or if it was in one of the birth stories, but I think it may have been one of the moms in one of the birth stories.  But one of the mothers said I wanted to get heavy.  And when you were talking about kind of going the contraction, or the rush, or whatever you want to call it.  You almost transcend the pain.  And this was the experience I think that I've had with my last few babies especially.  It's very intense, I would define it as intense, but when I get to that place where, and by this time, this many babies, it feels familiar.  That familiar feeling that this is really happening.  And that this baby is really coming through me right now.  And just going into it, there's something freeing.  The intensity is still there, for me, one of the things is I always feel desperately thirsty.  But I think there's a physiologic reason too.

I no longer frame it in the thought of pain, but more in the “I want this to happen”, “I want my baby to come.”  And it's just, it's really interesting to me to think about the hormones, and then, obviously my births are anecdotal evidence, but it's so interesting, my own births are inspiring and intriguing to me.  And just looking at this, and just thinking, how can I help other women through this experience.

Sarah:  We could say, from the hormonal perspective, that when we resist the intensity of labor, we're kind of creating some stress, which the stress hormones are then going to counteract the hormones of labor and birth.  So the idea is to not resist the intensity of labor, for all that's a big undertaking, right?  I'm sure you've also had this experience, we could also take it on, these are actually profound spiritual practices.  I think that our own bodies as females take us into intense, challenging, but ultimately transcendent possibilities of mothering, and birth.

And then that carries on into motherhood.  I mean, all these hormones of breastfeeding we're talking about are also ecstatic hormones.  It's designed to be pleasurable, rewarding, and kind of transcendent, really.  My last baby, I really took on breastfeeding like a meditative practice, and I wouldn't do anything.  Not every time, sometimes I would be nursing at the keyboard, but sometimes I would just sit there and breath, and feel all these hormones, my connection with my baby, and it was totally euphoric.  It was a beautiful interlude.  We get these interludes in our day.  These hormones of labor, and breastfeeding, which are the hormones of labor and birth, are just dying to keep rewarding us and keep connecting us to our baby.

I remember going to a, it was actually a like a birth activist meeting.  And I had my, I think he was like two, and I was breastfeeding him.  I remember I was taking the minutes, right, so I was sitting there and I was taking the minutes, and it was all going well, and then I would breastfeed my baby or my toddler, and I could feel my brain turning really soft, like turning into mush, I could actually feel these hormones coming into my brain.  I got kind of less sharp.  More soft, but you can go with it, it's a very beautiful feeling.  We end up in these situations, unfortunately, in our modern culture where we're kind of pulled both ways.  It's difficult to go into these hormonal states.  We're doing things that require our brain to be sharp, like operating heavy machinery, and driving cars, for example.  At the same time we're looking after babies, and doing jobs, and it's not easy to be in both of those brain states.  Of being very switched on and alert, but also allowing that softness, and that pleasure, and that connection that our breastfeeding hormones are taking us into.

Kristen:  Yeah.  It is an interesting place that we live in the modern world.  But I think that talking about it helps us to respect that, and it helps us to think that softer place that you're talking about, and I have an experience similar to what you're talking about.  I was sitting in a bookstore with a friend and we had been talking and I had my baby, and I was nursing him, and I just kind of … and she said I could see the prolactin rush happening because you just start to get that drowsy, content feeling, and then all that stuff just doesn't matter as much.

I think that it's good for us as women to know, and to be validated that part, that aspect of ourselves, and our being is of great value to our children, and like you've been saying, to our entire species.  Because sometimes that is not as valued today.  Or it's implied that it's some sort of weakness or defect.

Sarah:  The other thing that I think about that Kristen, is that when you're breastfeeding, you're in a different state.  You're in a different hormonal state.  When you've got young children, for a start, but the breastfeeding adds a whole other level of hormonal biology on top of that.  So you're in a different mental state, your brain is functioning differently, you could say, to people who aren't in that situation.  I remember feeling sometimes like I was on another planet really, it was hard to connect to people in this ordinary state.  At times, when I was breastfeeding, especially the more I was breastfeeding when my babies were little.  Again, that's perfectly normal and natural, that's how we're meant to be.  What's missing in our culture is a community of other people who are in that state that you can kind of hang out with.

My advice if you're in that, and feeling kind of a bit, feeling a juxtaposition of that with the way the culture operates, which is insane really like we're all going at this incredibly fast pace.  Breastfeeding slows us down and makes us soft and receptive.  So if you can find yourself a community in some way where that's okay and you can just enjoy that, I think that's really advantageous.  La Leche League, we have breastfeeding association over here.  Parenting groups, like attachment parenting groups.  Somewhere that you can really feel normal in that exceptional state that you're in.  Which is all designed to make sure that your baby survives.  To have you attached to your baby.  To have you physically connected to your baby.  To increase your vigilance over your baby.  To breastfeed your baby.  It's all one hormonal system.  It's all about your baby surviving.

Kristen: Yeah, it's a beautiful thing too.  It is.

All right Sarah, do you have any closing thoughts that you would like to share with our listeners?

Sarah: I think the most important thing is, however, you can get yourself into a situation of trusting your body, and trusting your baby, and a bit like I was saying with breastfeeding, it's finding your tribe.  Finding your culture where that's normal so that you're protecting yourself to some extent against some of the negativity out there around birth.  The negativity around breastfeeding, and kind of attachment parenting being close to your baby.  Because it is biological.  What your doing is biological imperative for our species.  Somehow we've kind of forgotten that.  You're in the stream of evolution doing that with your baby, with your birth, with your baby.  Find other people that are in that stream as well.  Find yourself a culture where you trust your body, trust your baby, trust your child, and you trust life really.

Kristen:  Yeah, that's lovely.  Good trusts to have.

Where can a listener go to get more from your, or more about you Sarah?

Sarah:  You go to my website, which is SarahBuckley.com.  There's some blogs, some articles, you can also see links to my books, there are links to my report Hormonal Physiology if you want all the science, it's quite scientifically intense, but that's available as a free download if you search Hormonal Physiology and my name you'll find that.  I have another website, gentlenaturalbirth.com which has some membership for professionals, and at the moment I'm working on some webinars.  Check out my website SarahBuckley.com and see if I've got it up yet, I'm going to put the ecstatic birth webinar up there.  So that's something with a lot more information about what I'm talking about.  And I also have DVD's with this information as well.

Kristen: That's great.  You mentioned a few things, I tried to make some notes as we talked, but I was soaking in as much, so you mentioned a few articles so I will try to get all of those up on the show notes so listeners can head over to the show notes and find links to everything that we have mentioned.
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