Written by Shay Gabriel

Hormones. Sometimes they’re downright controlling, right? But did you know that you have the power to influence your hormones and to help them better serve you and baby in childbirth? Yes, we can impact the flow of hormones throughout labor, and in such a way that helps us labor more gently and with manageable pain. So let’s talk about which hormones we want to boost, which we want to minimize, and how!

Understanding labor hormones is one powerful step toward fostering a birth story you’ll love. Let’s start by referencing the fear-tension-pain cycle and how hormones are involved with this cycle…

Fear-Tension-Pain cycle mindful labor.png

Understanding the fear-tension-pain cycle can be a game changer for your labor! Becoming aware of how pain works within the mind and body allows us to more consciously influence our experiences.

Here's the gist of how this fear-tension-pain cycle works...this dance between psychology and physiology:

fear

Fear leads to an increase in adrenaline. We don't want adrenaline to run the show in labor, as adrenaline will trigger "fight/flight/freeze" and the body will want to wait until it feels safe again to allow labor to progress.

This is actually pretty genius, right? If you're being chased by a tiger (or perhaps more likely today: you're scrambling to send the kids off to school before work), adrenaline increases and your body knows to wait for a better time to get active labor going! In other words, when adrenaline increases, early labor contractions become less effective. So when we want labor to progress (e.g. the tiger has left the building), too much adrenaline is not helpful. Feeling unsafe can keep us in a state of stalled or ineffective labor.

Tension

Fear also causes tension. With tension, oxytocin & endorphins decrease, and that's not helpful either. We want oxytocin & endorphins to run the show in labor; they keep us feeling good and going with the flow.

Also with tension, blood flow to the uterus decreases. Again, not helpful. When blood flow to the uterus is restricted, it can't perform as efficiently.

This lack of oxytocin and endorphins and blood flow to the uterus all leads to...

Pain

Increased pain. And as the threshold for pain decreases, this can trigger a sense of fear. Thus, the cycle continues.

SO. How to break the cycle?

We want to minimize fear and optimize oxytocin, endorphins, oxygen, and blood flow. When we do so, we can "get out of our own way" and allow the body to labor as its equipped to labor.

Keep reading to learn more about the role key hormones play throughout labor. We'll offer insight into how to maximize the helpful hormones, keep adrenaline at bay, and flow with our bodies as best we can throughout labor.

labor hormones 101

oxytocin

First up: Oxytocin — that "love hormone" associated with sex, bonding, birth, and breastfeeding. Oxytocin is a "feel good" hormone that facilitates nurturing emotions and social behaviors.

It's important to note that Pitocin/artificial "oxytocin" (used to medically stimulate contractions) is not equal to oxytocin. However, it's not uncommon for medical care providers to say "oxytocin" when they actually mean Pitocin or "artificial oxytocin." Here, we share about the role of naturally occurring oxytocin in labor.

Oxytocin facilitates calm, provides natural pain management, stimulates efficient contractions, stimulates the fetal ejection reflex (the body involuntarily "pushing" baby when ready), facilitates breastfeeding, and more!

We can support oxytocin in labor by:

promoting calm, comfort, and confidence
feeling supported, brave, and empowered
laboring how you'd like
working with gravity and going with the flow of what feels best for your body

Things that hinder oxytocin include:

distractions and disturbances such as loud noise or people coming in and out
unwelcome people in the labor space
uncomfortable procedures
epidural
fear

Our birth doulas work to support you and to keep that oxytocin flowing!

Endorphins

We see from the fear-tension-pain cycle that fear and tension lead to a decrease in endorphin levels, which contributes to increased pain. In labor, we want to enhance the flow of endorphins, which are naturally occurring pain-relief hormones. In physiologic labor, endorphin levels continue to rise leading up to birth! Endorphins produce an altered state of consciousness, which we often refer to as "labor land." They promote endurance even if labor is long and challenging, facilitate a sense of euphoria after birth, and foster alertness and attentiveness in the postpartum phase.

We can support endorphins in labor by:

promoting a calm environment
being comfortable
feeling confident, informed, supported, brave, and empowered
delaying or denying pain medications such as epidural

Things that hinder the flow of endorphins include:

distractions and disturbances such as loud noise or people coming in and out of the labor space
unwelcome people in the labor space
epidural or opioid pain medication

Our birth doulas work to support you and your endorphins throughout labor, wherever and however you plan to give birth.

adrenaline

Chances are you’re familiar with adrenaline, and you might fall into thinking that adrenaline is what keeps us going in childbirth. On the contrary, adrenaline, aka the "fight or flight" hormone, facilitates survival — and it can actually slow or stop labor altogether. Adrenaline does play a helpful role when the body goes through transition and prepares for pushing, but until then, we want oxytocin and endorphins to lead the way. High levels of adrenaline can cause fetal distress, longer and less efficient labor, increased pain, and increased likelihood of intervention and cesarean birth.

We can minimize adrenaline in labor by:

promoting a calm environment
being comfortable
feeling confident, supported, informed, brave, and empowered
trusting a (trustworthy!) birth team
using comfort measures
avoiding conflict
reciting or listening to affirmations

Things that can boost adrenaline and work against labor progress include:

distractions and disturbances such as loud noises or people coming in and out of the room
unwelcome people in the labor space
feeling unsafe
fear
intimidation
lack of encouragement
intrusive procedures

Prolactin

And last in our coverage of key labor hormones — but certainly not least! — prolactin.

Prolactin is sometimes referred to as "the caregiving hormone." It influences the adjustment to life with newborn as well as the adjustment to life outside the womb for baby. Prolactin inspires bonding and attachment and helps reduce stress. It also plays a role in lactation preparation and breastmilk production.

We can support prolactin by:

laboring physiologically (without medication)
minimizing stress in labor and after birth
immediate and prolonged skin-to-skin
preserving “the golden hour” and keeping baby with mother during newborn examination
initiating breastfeeding early
breastfeeding on demand (i.e. nursing baby according to their round-the-clock cues)

Things that can hinder the flow of prolactin throughout labor and beyond birth include:

high levels of stress
medical interventions such as induction, epidural, Pitocin, and cesarean birth

bottom line / Takeaways

Notice several patterns (er, lots of repetition?) throughout this read? That’s GOOD NEWS for labor, friends! We can boil all of these hormone details down to the following bottom line:

In order to enhance the flow of hormones most conducive to gentle, manageable labor: Minimize stress, maximize comfort, and embrace physiology wherever possible — all for both birthing person and baby.

At its finest, physiology has a way of gently bringing our babies into the world. Surely there are times when medical intervention is necessary and even life-saving. And, while medical intervention is essential at times, in other times — namely in low risk pregnancies without complication — medical intervention can actually get in the way. (To learn more about this concept, look into the “cascade of interventions” aka “labor funnel.”)

It’s up to each and every birthing person to choose how and where (and alongside whom!) they want to labor. Laboring how you choose has a significant impact on your experience, however your birth story unfolds.

In the words of Dr. Shamsah Amersi,

"Mindfulness may not give you the birth experience you want, but it helps you fall in love with the birth experience you get."

It’s helpful to consider labor hormones when establishing your birth philosophy, birth team, and birth choices. And, it’s essential to know your options (and your birth rights) in order to be able to make informed choices, both before and throughout labor. Investing in doula support is an invaluable way to promote an experience that is informationally, physically, and emotionally supportive — both for you and any birth partners along for the journey.

Are you a Grand Rapids local interested in doula support? Meet the Sprout and Blossom Birth team, and contact us today!

Shay Gabriel is the content director at Sprout and Blossom whose love of parenthood and psychology has merged into a super-obsession of all things birthy and baby. She believes an informed experience lends to an empowered experience, no matter where you are along the journey.

Hello, Labor Hormones! How Can I Help You?