Episode 185 - Guide to a Great Birth
[0:00] Welcome to the Great Birth Rebellion podcast. I'm your host, Dr. Melanie Jackson. I'm a clinical and research midwife with my PhD, and each episode, I cast a critical eye over current maternity care practice by grappling with research and historical knowledge to help you get the best out of your pregnancy, birth, and postpartum journey. Hello, and welcome to today's episode of the Great Birth Rebellion podcast. This podcast is all about helping you curate a circumstance that would help you increase your chances of having a great birth. And that is exactly what this episode is about today. I have done an episode like this about Guide to a Great Birth before, but this is a revamped, refreshed, built-out version of that.
[0:55] And I want to talk about the hormonal cascade of labour and birth, why it sets us up for bliss and joy, and how to tap into that. Some strategies on how you can tap into the possibility of bliss, joy at your birth, but also what is a great birth, how you can get one for yourself. There are some specific things that you can do that will increase your chances of having a great birth. And that's what today's episode is all about. But before we kick off into that, I just have something to share. In order to keep this podcast free to you, the listener, I'd like to thank my sponsor for today's episode, Poppy Child from Pop That Mama. She is about to do something epic.
[1:38] Poppy is hosting a pain management in labour masterclass live in New York City, and she's live streaming it to the world. This session will be all about how to cope with the intensity of labour and how to work with the sensations instead of fighting them. You'll learn real tools that you can use in birth, and it's a must-watch with your birth partner, so you're both prepared for what labour actually feels like and how to write it. Even better, it's totally free, and it's happening on the 19th of January, so you can click the link in the show notes of this podcast to sign up for the live stream. A replay is also available if you can't be there at the time, but you have to be on the list to get it. So spots for the live stream are limited. Save your place now. So go through to the link in the show notes to save your spot.
[2:31] Okay, now let's get into it. The first thing you need to understand is that birth will always transform you. There is not a scenario, there's not a birth scenario in which you are not transformed as a woman and as a parent or as a person.
[2:49] The fact is, is that you'll either be transformed for the better or for the worse. And that is exactly what this podcast is about. Helping you have a positive transformation as a result of your pregnancy, birth and postpartum experience. So the first thing you need to know is there's no way you can come out of your birth the same person. You are transformed for better or worse. Now, of course, your life is changing because you're also getting a baby. But that's not what we're talking about today. There's more that happens when you have a baby than just getting a baby. So today I'm going to tell you about that transformation, the science, the anatomy of birth, and the ways that it fundamentally changes us as women for the better or worse. And I want to talk about how you can make it so that birth changes you for the better, so that you can start your parenting journey not having to recover from birth because it's had a destructive effect on you. Birth can actually propel you ahead into your parenting journey with joy and health. You can actually be more equipped if you have a great birth. And today I'm not talking about your baby during this talk.
[4:03] Today, I'm going to be talking to you about you. And because most maternity care providers will focus on the outcomes for the baby, but today I'm going to focus on the outcomes for you. And I want to talk to you about how you can manufacture and curate a birth that is not only great for your baby, of course, we want great outcomes for your baby, but also great and safe for you. So when we talk about what a great and safe birth is, let's start there.
[4:31] What is a great and what is a safe birth firstly of course it goes without saying that if you come out of your birth physically well and you and your baby are well and alive that's great that's one of the necessities of a safe and great birth it almost goes without saying and it is not unreasonable to expect, especially in the developed world, that you will come out of your birth alive, you and your baby. However, just being alive and physically well often doesn't result in a great birth. What women will sometimes tell you is that yes, they are alive, their baby's alive, everybody is physically well, but their birth was not great and they did not feel safe. A lot of women will report feeling scared and that they had to endure the birth process.
[5:33] So yes, a great birth is one where you are not only kept physically safe, but also emotionally, spiritually, culturally, psychologically safe.
[5:47] And socially safe. If you are alive at the end of your birth, that is supposed to be the bare minimum expected standard. You should expect from your birth experience that you and your baby will come out alive. That's the bare minimum. And anyone who tells you that an alive mum and baby is all that matters doesn't understand the importance of emotional, psychological, spiritual, cultural safety, social safety that needs to be achieved in the birth process in order for women to feel truly safe and in order for them to describe their birth as great.
[6:28] So firstly, a great birth is a safe birth, but being physically safe is not the only element of safety. It's the one that's prioritized in a lot of maternity care services. But in order to have a great birth, You need to feel safe and protected physically, emotionally, socially, culturally, spiritually, mentally safe. There's a lot of elements of safety that need to be met in order for you to describe your birth as great. And if you feel safe across the full spectrum of safety, not just physical safety, and your care provider has respected your decisions during the birth process, then you are in line to describe your birth as great. But how do we do this? How do you set yourself up for a great birth where you felt safe and where you were cared for? That's what we're going to be uncovering today. But first, eight years ago, I stood up out of a birth pool that was in my bedroom with my newly born second child in my arms. Her placenta was still attached and inside my uterus. And I heaved myself up out of the pool with my husband helping me on one side, one of my midwives helping me on the other, and the other midwife drying me down as I got out of the pool.
[7:47] And I just said, oh my gosh, that was so good. I can't wait to do it again. Literally, my first thought after getting out of the pool, after pushing my baby out was, I would like to do that again.
[8:05] And I didn't have any medication, any intervention. It was a home birth. It was quite fast. I sent a text message to my sister at 8 p.m. Saying, I think I might be going into labour. and by 10.30 p.m. I had my baby in my arms. So fairly quick birth.
[8:23] But what happened to me during the birth of my second child was something that I speak about often, but it's also quite unbelievable. If you've been listening to the podcast for a while, you will know my birth story.
[8:36] But I speak about it very positively, not because the end result was my beautiful baby. Of course, That's the fun thing. But we are wired to experience joy and feel bliss during birth. And we get that high, that blissful high after birth that makes us feel like we want to do it again and think, wow, that was amazing. I want to do it again. And I'll explain to you why we get that. But before stepping out of the birth pool and immediately wanting to do it again, we.
[9:08] What happened for me was that my body took over. This is while I was in labour. My body took over and my uterus was pushing my baby out. Almost, it felt like no additional pressure for me. I didn't have to add much. And I could feel my baby moving down into my pelvis. And then I could feel the stretch that happens to your vulva when the head is emerging, that full stretch. And you will have heard me speak about it before, what you can say to yourself when you feel that full stretch. It's just a stretch. But we are designed to stretch, to get big, so that a baby can come out of us. I wasn't frightened of that feeling. And I remembered feeling that feeling with my first birth and thinking, yeah, it's not that bad. Some people describe it as the ring of fire, but I'm not sure that that's the right language to make women look forward to that moment. And in fact the pushing and stretching phase of labour and birth for me was the most satisfying.
[10:07] The most blissful part of the labour and birth so if I can offer you that for a language change if you want to replace the wording of the ring of fire with it's just a stretch and my body is designed to get big then yeah it's a stretch but it's not that bad it's just a stretch so at that full stretch, when the biggest part of the baby is coming out the head, what we would often describe as crowning. I did think not that bad, but also something came out of me that nobody was really expecting. I wasn't even expecting it. A big hysterical laugh as my baby was emerging. And I'll explain to you why that happened.
[10:56] Why at that moment of full stretch did I feel like laughing? And it was actually so hysterical and unusual that one midwife whispered to the other, what is she doing? And I remember just saying, I'm so happy. I just can't explain how happy I was. And, you know, there's this very famous midwife. Her name's Ina Mae Gaskin. If you've been in the birth world for a second, you may have read one of her books. And she explains what our vulvas and vaginas are capable of at this point of full stretch. She explains that we never think, oh my gosh, can a penis get big without being damaged? And is that normal? And should we be frightened of a penis getting big? I mean, part of the process of reproduction is that a penis gets big. Men are told, yeah, that's fine. You can do it actually. It feels pretty good. There's no fear of that. There's no warnings around all the things that could go wrong in the male erection. Yet when we speak about women's bodies and what's going to happen to them as their vulva gets big and stretches for the purpose of reproduction...
[12:07] We tell women that it's painful, that they could tear, that they might bleed, that perhaps their vulva and perineum is incompetent and needs to be cut. And in fact, episiotomy rates here in Australia are over 25%. All of the language given to this pushing out of your baby phase and the stretching of your vulva is frightening and terrifying. But I want to tell you, actually, it could be one of the greatest parts of your birth. And I'll explain why. I'll explain the scientific reason why that moment in birth, we are actually hormonally and physically wired to have the ability to enjoy this part of labour. But this is not what women are told. Women are told it will hurt. You should be scared. It feels like your vulva is on fire.
[13:01] But I'll tell you what is actually happening in this moment. You know me. From a scientific viewpoint, I'm a PhD. I've got a PhD in the area of midwifery. So if I academically think about this moment and understand the value of it, then there is a very scientific reason why a woman would hysterically laugh while giving birth. And what I'm going to explain is that we are wired to feel bliss and joy while doing it because labour and birth are predominantly governed by hormones and hormones are what starts labour, they are what keeps labour going and you would never give birth vaginally, your body would never be able to do it without the soup of hormones that we get. And the predominant hormone of labour is oxytocin. So in labour and birth is where a woman will experience the highest peaks of oxytocin that she will ever experience in her whole life.
[14:02] This is a peak oxytocin experience during birth, but we've been ill-informed about this. And so women don't realize that we've got the power to tap into this most incredible natural oxytocin high. And oxytocin is released by the woman's brain and it travels into her bloodstream and down to her uterus where it locks into receptors and tells her uterus to contract and to labour and to give birth to the baby. It's a tiny piece of the labour and birth process but there is another function of oxytocin so oxytocin is also the hormone that gets released when we're having a great time and when we feel happy during a shared meal with friends when we eat chocolate when we orgasm all these feelings are because of oxytocin. So oxytocin is both a hormone of birth, of orgasm, but also of joy and love and bonding. And in the presence of oxytocin, we feel good. It's responsible for that good feeling of elation. It's the hormone of positive association. I just wrapped that.
[15:16] Can we just make sure that that becomes a reel?
[15:23] What did I say? It's the hormone of elation, of positive association. I'm not a rapper, but there you go. It brings us closer together. If you're having a shared oxytocin experience, we feel closer together. It makes us feel good. It's released during orgasm. As I said, it makes us fall in love. It bonds us to the people around us. And it is the key and predominant hormone of birth. And the highest peak, here's where I'm going to tell you why I laughed my baby out, the highest peak of oxytocin is released right at the moment that the baby is emerging. That moment of insane laughter that I described as my baby emerges correlates with the peak oxytocin in the labour process. So right at that moment and very soon after the birth of the baby is when oxytocin is highest and there's a few reasons for that. What is the purpose of this peak of oxytocin at the time that our baby is emerging. Firstly if we look at the purpose of oxytocin we get strong contractions to push our babies out with superhuman ability. Of course we need extra oxytocin in this superhuman state. Next we are primed to feel joy and bliss while doing it.
[16:42] And then we are hormonally wired, Sarah Buckley would call it nature's blueprint.
[16:49] We're wired hormonally to fall in love with and bond with our babies. And as it turns out, oxytocin creates attachment to your baby because we are designed to want to look after our babies and to actually enjoy it. So not only does oxytocin facilitate that initial bonding with your baby, that way you fall in love with your baby, you then are rewarded each time you care for your baby's dopamine, you get a dopamine hit into your brain. So you're rewarded by caring for your baby. It's designed to be an experience that has some bliss and joy built into it. Otherwise, honestly, why would we do it? It's a really hard job. But we fall in love with our babies and we're rewarded hormonally by doing it. Now, not only that, for those relational reasons, but oxytocin is responsible for the contraction of your uterus. So a peak at the very end, the powerful end of birth where your uterus has to push your baby out makes complete sense. But then oxytocin also needs to keep working on your uterus after the birth of your baby because the contraction of your uterus is a key factor in how the placenta detaches and is born. And when you have an intense contraction after the birth that detaches the placenta.
[18:16] Once your uterus is empty, your uterus will clamp really deep hard down and the blood vessels that were feeding the placenta are entrapped in those muscles and the contraction of the muscle cuts off the blood vessels. We call them living ligatures that literally functionally ties off the blood supply that was feeding the placenta so that blood doesn't keep flowing out. So you're already realizing now that the peak of oxytocin, not only do we need it to bond and fall in love with your baby immediately after you meet it, we need those super strong and forceful contractions for your uterus to push the baby out. But your uterus is also preparing to prevent you from bleeding too much, preventing a postpartum hemorrhage. So already we're seeing three major functions of oxytocin that are designed to keep your baby safe in the long term, to make you fall in love with your baby, to facilitate an effective birth of your baby out of your vagina, and also stop you from bleeding. We should be protecting oxytocin at all costs. If we're thinking about how do we make birth safe, we're thinking how can we protect oxytocin.
[19:35] So not only is oxytocin the hormone that's pulsing through a woman's body during labour and birth. It has this peak at the end and is designed to help you feel joy and bliss in that process as well. But if it's flowing through the mom, it's also flowing through your baby. And so your baby's experience of birth can also be a time of bliss, joy, and positivity. And your baby's body is now primed for bliss and joy with their oxytocin system being primed during this labour and birth process.
[20:12] But not only does the baby benefit from this maternal oxytocin, but we now know that oxytocin is contagious. I mean, midwives have always said oxytocin is contagious because when you're in the birth space with a woman and she's full of oxytocin, everybody kind of catches it. The partner's a bit high on oxytocin, the midwife's high, everybody around is high on oxytocin. We now know actually oxytocin transmits like a pheromone and so it has a propensity to fill the room with love and bliss and bonding. And so there's a propensity to be more closely bonded with the people who are in that birth space, especially if the oxytocin is high and hasn't been inhibited.
[21:04] So what we know if we just looked at the hormonal experience of labour and birth is firstly that our bodies are designed to do it because that's what the function of oxytocin is, all those things I just explained. But we're designed to feel good doing it. The oxytocin that's in the mix is creating a scenario of joy and bliss, but also contractions. So I know your next thought is, how can I enjoy the process of labour and birth when contractions actually hurt? So you're right. There's this pleasure and pain conundrum that oxytocin gives us the contractions that then cause us the pain of labour, but also has this immense capacity to deliver us blissful feelings. So let's go into that now. What's that about? We already know that we're wired for bliss and joy, and that's just how our bodies work. But with bliss comes pain. So these two things go hand in hand. So let's have a look at what hormones your body gives you when you feel the pain of labour. So in response to the pain of labour, your body will release another hormone called beta endorphins. And we'll just call them endorphins for short. beta endorphins are released by your body in scenarios of pain.
[22:30] And labour and birth is no different. So in life, if this happens, your body will respond to pain by releasing endorphins. And like oxytocin, endorphins are released during other times of bliss and joy, like lovemaking while kissing. During breastfeeding, we also release endorphins, but also during times of pain and discomfort, similar to oxytocin. And endorphins are known to induce a state of euphoria. So in times of pain, your body is offering comfort and relief, but also endorphins are present during times of typically joyful times in your life. Now, when your body releases endorphins, again, from your brain, what we know is that they hook into opioid receptors in your body. So an opioid medication does the same. That opioid medications are powerful medications that are designed for pain relief by blocking pain signals between your body and brain, and they work on the opioid receptors in your nervous system. So if somebody gave you an opioid medication, that's designed for pain relief.
[23:50] Endorphins hook into the same receptors as an opioid medication. And so not only do they have pain relieving impact and certainly it's relational to the amount of pain. So as your contractions peak and become stronger and harder, your body will release more endorphins in response. And they hook into the opioid receptors in your body, act like an opioid medication without all of the side effects and, But the added benefit is that they also elicit a feeling of euphoria. And this, paired with the oxytocin, is what makes women look and feel high on drugs during birth. And you'll know if a woman's endorphins are flowing because she goes into another world, this psychedelic internal labour land. Nobody else can access it. She's having her own personal oxytocin and endorphin experience.
[24:57] So if there's anything that we conclude about birth, just from these two little pieces of information about oxytocin and endorphins, is that we're hormonally wired to feel elation, bliss, absolutely high on the process of childbirth. And endorphins and oxytocin help us slip away into that internal labour land that feels like some psychedelic internal trip.
[25:26] And in my work as a home birth midwife, I see this all the time. We don't have any pain relieving medications at home. There's very few interventions that we can offer that will interrupt the birth process. So at home, I watch women labour uninhibited. Their oxytocin and their endorphins are relatively uninhibited. The whole space is designed to support that hormonal cascade of labour and birth. And women just they you can tell that they're going into that because they really they close their eyes they stop engaging with the outside world they go internally in labour where you know your body is just trying to help you through this really big hard thing and so it's offering you it's gifting you all these amazing hormones to help you work through it and it's a otherworldly experience. So when we get away from the fear language over pain, oh my gosh, it's going to hurt a lot. Oh, you can't do it. Oh, you're going to need epidural. All these things that people say about labour and birth, they forget to mention how much our body is gifting us during that process to help us work through it.
[26:40] And I want to tell you how to tap into that bliss, how you can birth your baby and literally think 20 minutes later, oh my gosh, I would love to do that again. Women get addicted to birth and I'm convinced it's because of this hormonal moment that we never get to experience again unless we are having a baby. Now, here is what I want to tell you about something that I've created with this whole situation in mind. What can you do to work through the pain of labour and birth while facilitating and supporting the oxytocin and endorphins so that you have an opportunity to tap into this bliss to this incredible experience of labour and birth now the first thing i'll tell you is that if you choose pharmaceutical pain relief to take away the pain you are and this is no judgment on anybody who has chosen to use pharmaceutical pain relief. But the fact is, is that you are going to impact the flow of both oxytocin and endorphins. You will not get this thing that I'm explaining, this bliss and the euphoria, if you interrupt the flow of oxytocin and endorphins by interrupting labour with pharmaceutical pain medication. This is not a judgment. It's just scientific fact. It's what happens.
[28:03] So if you want to facilitate oxytocin and endorphins during your labour and birth, give yourself an opportunity at this bliss, you need to try and do it without pharmaceutical pain relief.
[28:17] And there are some really basic strategies that you can use to do that. In the show notes below, I've created this whole package of all the different pain management strategies that I've ever seen women use during labour and birth that I used myself. I've been a home birth midwife for 18 years and I've collected all the strategies that women use to work through the pain of labour so that they can avoid pain medication. So I've created a guide to giving birth without pain medication and the whole idea is that you get an opportunity to tap into this amazing physiological experience that your body is gifting you so if you go to the show notes you can purchase that for yourself it's only 27 it's like cheaper than lunch it's barely a thing but also in there I've included a whole section on how your partner and support people can apply the strategies that I've mentioned in the guide to giving birth without pain medication, they will also be able to help you work through it because it's all well and good if you already are prepared to work through birth without pain medication, but all the people on your crew.
[29:28] On your team who are there to help you give birth are doubting you and encouraging you against it and pushing you towards pain relief, then they could sabotage your birth so in there I've also put a whole little section for your support people and your partner to listen to so that they also have the strategies to know how to help you so if you want to tap into the possibility of bliss during your labour and birth go to the show notes click the link to the guide to giving birth without pain medication you can get it for yourself it's only 27 it's it's as I said cheaper than lunch and it can give you all the strategies that you need to avoid pain medication in labour and birth. But there are some other ways. So, of course, that is jam-packed full of information. But if I was going to give you a little bit more here in this podcast episode, how do you tap into the bliss of labour and birth? So the first thing is to avoid pharmaceutical pain relief. And all those strategies are in the Guide to Giving Birth without pain medication.
[30:29] But the other thing to do, and this also involves the people who are around you, is that you've got to work out ways to stay in that labour zone. So what we know is oxytocin and endorphins are considered shy hormones. So if you get a fright or something unexpected happens or you're hypervigilant, then you are kind of shocked out of this labour zone. And that does impact upon the flow and function of your hormones during labour. And when you go into labour land under the influence of oxytocin and endorphins, your brain changes along with this complex hormonal cocktail that takes over. And the front part of your brain, the frontal lobe that's responsible for communication and decision-making and sort of more complex conversations, it shuts down. It doesn't really have a specific purpose in labour and birth. Your limbic system, another part of your brain, then takes over. It's a sort of an automatic part of your brain. It's involuntary. It's considered to be the more intuitive, non-thinking part of your brain. And it takes over and dictates the function of your body without your conscious effort during labour and birth. And what we know in humans and also animals is that the limbic system fires when you are in labour and birth. It's part of what governs it.
[31:59] So not only does your brain activity become more internal into your limbic system, but your behaviors also become more internal in response to the changes that are happening not only in your brain, but in the hormonal cascade. And midwives describe this as a woman going into herself, into labour land. Women cease to interact with the outside world. They disappear into this internal land. They can no longer string complex sentences together or bring a thought together or try and get words out. It's always very difficult. And this is because that frontal part of your brain is closing down and your limbic system is taking over. So this is perfect. This is exactly where you should be in labour and birth. You're not typically in a place to be able to advocate for yourself, to have complex conversations, to make complex decisions. You are relying on the people around you to help with that so that you can stay in your limbic system and in labour land and feel safe and confident that the people around you have your best interests at heart. And one of the purposes of other people in your birth space is to protect the birth space. And when we say protect the birth space, what we mean is to make sure nothing interrupts your labour bubble and interrupts you and busts you out of that limbic system and draws you out of labour land. And part of staying in the zone is how you allow for those hormones to keep flowing.
[33:28] So anything where the woman is required to communicate or make a decision, anything that she feels like she needs to protect herself from, brings her out of her limbic system and back into her frontal brain, and this interrupts the birth process. And this is where I get really bothered by the process of countless strangers walking in and out of women's rooms, birth rooms in hospitals. There's this weird process. I've never understood it and I will always be like so aggressively against it. I'm sure somewhere along the line, someone thought this was a great idea, but it really isn't. If we're thinking about women, it's not a good idea. But there is this hospital process where when the new shift of doctors comes on, they feel inspired to go and introduce themselves to every single woman who's labouring in the birth unit, just in case they need to see their face during some kind of emergency or medical procedure. They think, wow, this woman will have really wanted to have met me, to see my face, to know my name. Can I tell you now, they do not. They do not want to meet you while they're in labour. If there's an emergency, they don't care what your name is or what your face is. Just deal with the emergency.
[34:47] Because every time you go in there and you introduce yourself to a woman, she's been drawn out of her limbic system. She's got to engage maybe make eye contact somehow remember your name or face or maybe maybe your face is frightening maybe the experience she has with you there she thinks oh my gosh I'm terrified I do not want that person in my birth space can we stop introducing ourselves to every single woman thinking that this is what she wants to stay out of the birth space she's trying to labour she's in her limbic system she doesn't need to know your name or see your face I am ranting far too long and of course if you disagree with me I would love to hear from you but also if you agree with me please send me a message social media at Melanie the midwife or at the great birth rebellion go yes oh my gosh I agree or say actually no I disagree and here's why all the reasons I'm willing to be convinced otherwise but if I'm thinking of oxytocin and endorphins and women feeling safe and the fact that oxytocin is a hormone that requires privacy, then this is not the right scenario to have strange people introducing themselves in the middle of your labour.
[36:02] So there goes my rant. Okay. Science tells us that if you are given the right ingredients, that your bodies are wired for bliss during labour and birth. I mean, women feel it all the time. If you heard last week's episode with Deborah Pascali Bonaro, we talked about orgasmic birth, then you'll know as well what I'm talking about. But society tells us a different story. and that's what you might be feeling right now is is mel really telling the truth with this because that's not when what we're normally told women are told that birth is dangerous.
[36:39] And that both you and your baby because it's so dangerous you should have constant medical supervision and that you need to give in give birth in a hospital where all of the emergency services are available to you in case something goes wrong or when something goes wrong and i'm not denying that labour and birth can have life-threatening dangers. I'm not saying that's impossible. However, I think we are, the danger of childbirth is so disproportionately marketed that women don't have a balanced conversation about the other possibility of labour and birth, where it's most likely nothing will go wrong in your labour and birth. And given the right ingredients, you can actually enjoy this scenario, this experience in your life, this peak human experience where you get peak oxytocin and peak endorphins and the best high you'll ever feel. That's the other alternative to a fear soup full of danger, hospital and strange medical professionals.
[37:42] So women are asked to believe that birth is dangerous, and then we are told to respond and react with fear and compliance. And it's assumed that because birth is marketed as dangerous, that we will be instilled with fear and that will put our trust in medical experts to save us from all the dangers of birth.
[38:04] And to not fear birth is countercultural. People think you're an idiot. They think you're a fool if you don't fear birth.
[38:13] So it's odd to not be fearful of birth in a culture that expects you to be terrified. But in my work as a home birth midwife and as an academic, I want to open you up to the possibility of birth, firstly, not being as dangerous as what you've learned to believe.
[38:32] You and your baby will not surely die without a medical professional in the room. midwives are beautifully qualified to supervise and care for women in labour and birth. The other thing that happens when you feel fear is that it steals the joy of birth. What we also know is that fear is an antidote to oxytocin. So just as I spoke about oxytocin being the hormone of contractions and love and bonding, orgasm, happiness, bliss, joy and all of the work of oxytocin then releases all of those endorphins, we know that the one thing that will inhibit oxytocin is fear because adrenaline gets released. And I'm going to explain that situation by sharing five things that you can do to help make it more likely and more possible that you can tap into the bliss and joy of birth and experience a positive transformation rather than a negative one. We know birth always transforms us for the better or the worse. And these five things that I'm going to help you with now will tip the scales to make it more likely that you will be changed for the better and not the worse. And as I'll go, I'll talk about the things that inhibit oxytocin and the things that get in the way of your experience and the birth that your body is capable of.
[39:59] So just to recap, there's two things that you need to have in order to have a great birth experience.
[40:07] Firstly, you have to feel safe physically, emotionally, socially, culturally, spiritually, mentally, psychologically, or cross that whole safety spectrum. You need to feel safe.
[40:20] Secondly, you need to feel in complete control of the decisions that you're making and have a care provider who's going to listen to that and who's on your side. Now, I told you the blissful story of my great birth, but you don't have to have a normal vaginal birth without all those interventions in order to still feel like you've had a great birth. So there's one thing to feel like you've had a blissful birth and that your birth was great, but you can still feel as though your birth was great, even without any of that. And I want to tell you a story of a client of mine. She stands out as really unique to me, but she's not unique because as you'll hear, there's a reason why she felt so good about her birth. But let me tell you. So she came to me having previously had an induction of labour that she didn't believe she needed. She went overdue, overdue, in inverted commas, over 42 weeks. Was given an induction of labour that she didn't feel like she wanted. It ended in a cesarean section that she also did not want. And she hired me with her second baby to help change her story. She wanted to avoid all of the things that had previously happened to her in her last birth. She felt quite traumatized.
[41:47] So she planned a home birth, she hired a private midwife, heavily invested in educating herself in the hope that her scenario would be changed. Fast forward to her labour and birth, she went to 42 weeks again. She had a long drawn out labour that over eight days we were talking about what she'd like to do. Long, long labour.
[42:10] And on day eight, when I arrived to her home, she opened the door and she said, I am ready for a cesarean section and I thought rightio she's done eight days she's post dates we couldn't have an induction because she'd had her previous cesarean section and that she knew that that would increase the risk of her having a uterine rupture so we weren't going to explore that she knew that she either needed to labour spontaneously and have her baby or she was planning a cesarean section and that's what happened so we went to the hospital and when when we arrived she was obviously exhausted after eight days of a long slow labour and the doctor who came to speak with her was genuinely interested in her experience and acknowledged how big this decision was for her to come to hospital considering her previous experience considering she was planning a home birth she'd invested a lot of time and money into her preparation and here we were in a scenario, the one scenario she was trying to avoid.
[43:15] He acknowledged all of that and saw her exhaustion. And he said, we can give you a cesarean section, but it will have to be this afternoon. And she was so upset by that because she was so exhausted and she just wanted to have her baby. And at the time of seeing her so upset, I remember the doctor sort of saying, wait here, just wait a second. And he raced off and he came back soon after. He said, actually, I can take you right now. I'm going to take you right now to have your caesarean, which she was very happy about. But as they wheeled her off for her caesarean, I thought, well.
[43:51] This is going to take some real recovery from her. She's going to be really disappointed about this scenario. And I'd prepared myself as a midwife to help her work through the possible disappointment that she would feel. And so in the coming days, I visited her and cared for her as tenderly as I could. and I was trying to pick the right time to sort of have a talk about her feelings over the birth. And on day three, I said, you know, how are you going? How are you feeling about how the birth turned out?
[44:23] She said, I am so happy. I'm so happy with how everything went. She said, I got to try every single thing to go into labour. You gave me the space to try different things. You never rushed me into different decisions. You listened to what I needed. You came when I needed you. I was definitely going back and forth for a lot through that week. The doctor listened to me and gave me what I needed in that moment. She feels as though she got care that she not only believed was necessary, but everybody in her scenario listened to her and kept her physically, emotionally, socially, culturally, spiritually, psychologically safe. Even though she didn't get the birth she was planning, she still felt happy and, and positively transformed by her birth experience. She described it as great because she was allowed full control and autonomy over her decisions. She had care providers who were willing to listen and help her get what she wanted and all the elements of safety were covered. Now she did not get the hormonal bliss that I spoke about for my birth but she
[45:37] did describe her birth as great. All right so Now I want to give you the things I was just talking about.
[45:47] How to set yourself up for a great birth experience that could also result in some pretty insane bliss and elation.
[45:57] So firstly, you want to avoid the things that inhibit oxytocin, the things we spoke about. If you are uncomfortable with the people in your birth space, or if you have to be hyper vigilant and protect yourself, and if you're on guard and you have to fight for the things you want, then your labour and birth is going to be more governed by adrenaline and fear and hypervigilance. And you won't be able to go into that limbic brain. And the thing that if you imagine oxytocin and adrenaline are on like a seesaw. So if oxytocin is high, there's not a lot of room for adrenaline and fear. But if adrenaline and fear are high, there's not a lot of room for oxytocin and those endorphins. So anything that fills you with fear or requires you to be hypervigilant and come out of that limbic space and into a more conscious alert space, then your oxytocin is inhibited. So you want to set up a scenario in your birth that is not oxytocin inhibiting, where you feel safe, where there's no noise and interruptions, no strangers, no very bright lights that are going to make you feel exposed? I know people in that space who are making you feel a little bit frightened or concerned. Is there somebody in your birth team who you feel like is going to take advantage of you in your vulnerable state?
[47:22] Those are the things that are going to inhibit oxytocin. If you don't feel safe and comfortable in the space, then your oxytocin is going to be inhibited. And what we often say is that the things that get the baby in is what gets the baby out. If you wouldn't have sex in that environment with those people, I mean, we don't often have sex in front of people, but birth is an intimate and private experience. It's governed by oxytocin. So you want to feel safe by the scenario. If you're worried that someone's going to walk through the door, so, you know, at home, if you're having sex and you've got kids, you might be locking the door because you don't want strangers in the room. Same thing with labour and birth. Okay. Anything that would prevent you from enjoying and orgasming during sex is going to prevent you from enjoying and having an oxytocin peak during labour and birth.
[48:18] So that's my next point is choose who will be with you. If you want to reduce fear and increase oxytocin at birth, you have to take an active role in choosing who will be your care provider through your pregnancy, birth and postpartum and consciously choose who will be with you in the birth space. Choose relationship-based continuity of care with somebody who aligns with your philosophy and who's focused on helping you get what you want and who wants to give you the care that you want to receive rather than the care that they want to give. So I'll say that again. You want a care provider who will willingly give you the care that you want to receive and will not give you the care that they want to give despite what you want.
[49:04] So the third point is that you have to know what you want. Know what you want for your birth so that you can choose the appropriate birth location, choose the appropriate people to be around you and prepare your support people to help you get the thing that you want. Next, you have to be educated and informed so that you can make your own decisions. My client who I spoke about was very, very educated. She knew at each fork and opportunity in the road what felt best and right to her. And so when you start choosing the things that feel best, right and safest for you, that's where you feel the safest. That's where you feel like all of the things that you accepted, if there was lots of different forks and changes in the roads, all the things that you accepted were the best and right and safest decision at the time. And that will make you feel much better about your birth scenario than if you felt forced into something that you didn't really want or that you didn't really believe was the safest.
[50:03] So here's where you need that support network of people who are going to defend you during times of vulnerability. Labour and birth is a time of vulnerability. The birth space needs to be protected and the oxytocin needs to be protected and you need to have people around you who will protect you from oxytocin interruptions and possible pressure from external people to change your mind because the two things that you need for a great birth are to feel safe physically, emotionally, socially, culturally, spiritually.
[50:37] Psychologically safe, and to be the one to have chief decision-making power and for the people around you to accept and help with that.
[50:47] That is the recipe for a great birth. And then not only will you consider it will be feeling great if you get all that, but if you also do it physiologically, oxytocin and endorphins are on your side and you choose not to use pharmaceutical pain relief you could also possibly tap into the incredible bliss high and elation of birth where maybe you might feel like doing something wild like laughing your baby out and I just want to remind you here that I've got a very cheap it's only $27 a course on how to get through labour and birth without pharmaceutical pain relief so that you can give yourself the opportunity of tapping into that bliss and high of labour. Just tap on the link below in the show notes to get my guide to giving birth without pharmaceutical pain relief.
[51:39] That is what I've got for you today. If you want to have a great birth and enjoy yourself while doing it, listen to this episode on repeat. Share it with the people who are going to be with you for the labour of birth. Choose care providers who align with your philosophy and intentions and pick a birthplace that feels best and safest to you. I'm Melanie Jackson. This is the Great Birth Rebellion podcast and I will see you in the next episode.
[52:07] To get access to the resources for each podcast episode, join the mailing list at melaniethemidwife.com and to support the work of this podcast, wear the rebellion in the form of clothing and other merch at thegreatbirthrebellion.com. Follow me, Mel, @MelanieTheMidwife on socials and the show @TheGreatBirthRebellion. All the details are in the show notes.
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©2026 Melanie The Midwife
