Get Out of Fear and Have the Birth of Your Wildest Dreams

Why is it that some people’s labor progresses so much faster and easier while others are long, drawn out, and terribly painful? How are birthing people and mothers having such wildly different experiences of birth from person to person?

The answer lies in understanding our nervous systems and how it affects labor and birth.

As a doula, I know that there are actionable steps you can take to have an easier, more confident and less painful birth. Here’s how.

Sympathetic Nervous System

The sympathetic nervous system is also called “fight-or-flight” but I refer to it as Fight, Flight, Freeze or Fawn. It’s common to see the Freeze and Fawn response in feminine-identifying people, especially during labor — and especially in a hospital environment.

The sympathetic nervous system tells your body’s resources to divert toward keeping you alive: increased heart rate, increased breathing rate, and increased vigilance. It feels like being restless, anxious, sometimes feels like a racing heart. Often being in the activated sympathetic state comes with feeling on edge, muscle tension, and trouble sleeping. This is a reaction from your brain to protect you… it’s not something happening consciously or intentionally. It can even happen without our knowledge.

One major contributing factor to being in the sympathetic nervous system state is fear. Fear of labor, fear of pain, fear of the unknown, fear of hospitals, fear of something going wrong. Fear leads to adrenaline in our bodies that stops the cocktail of good hormones which is designed to help during labor. As a doula, I hope to help dispel some of these fears before labor even starts through information, evidence, and childbirth education. I want to find out what makes you feel safe, in order to help you have an easy, less painful birth. Doulas know how to help maintain the energy of the environment, creating a safe space for labor to progress.

During labor, it’s actually more painful when in the sympathetic nervous system state. The “flow” of labor is interrupted in fight-or-flight, sometimes causing contractions to slow or stall. Contractions can space out. Folks are more likely to need pain management, as they are literally experiencing more pain when they are in fight-or-flight.

“There is evidence that the activation of these receptors causes an inhibition of uterine contractions and therefore a slowing of labor.”

Lawrence AB, McLean KA, Jarvis S, Gilbert CL, Petherick JC. (google scholar)

“Exogenous stress during labor leads to a dominance of the sympathetic nervous system, a shift in response from tend-and-befriend towards fight-or-flight and the release of catecholamines, which can slow labor progress.”

Schmid V. The Meaning and Functions of Labour Pain. (pubmed)

Parasympathetic Nervous System

Most folks know about the parasympathetic nervous system as “rest and digest” or “tend-and-befriend.”

Our parasympathetic nervous system is engaged when we are relaxed and feel safe. The parasympathetic system has HUGE benefits in labor, producing anti-stress enzymes such as acetylchloline, prolactin and oxytocin, helping you stay relaxed and calm.

When we’re in the parasympathetic state, the brain allows all the resources that went toward keeping you alive to rest and go back to finding equilibrium and balance in the body. Breathing rate slows down, heart rate stabilizes, digestion works again, you’re able to access the more empathetic, connecting, creative parts of your brain and feel the bond of love you have with your baby. The parasympathetic allows the hormones of labor to flow (oxytocin!)

When the oxytocin is flowing, labor progresses more quickly and easily, the mother/birthing person has more positive feelings, associations and memories of labor and birth, and experiences less pain throughout labor. We LOVE that!

Activation of the parasympathetic nervous system can restore optimal function of the lower uterine segment, which is has the added benefit of allowing your baby to rotate into the most ideal position for birth leading to a smoother, faster, less painful experience according to Spinning Babies.

“Oxytocin causes a shift in activity of the autonomic nervous system from the sympathetic to the parasympathetic nervous system.”

Kovács L, Tőzsér J, Kézér FL, Ruff F, Aubin-Wodala M, Albert E, et al.. (pubmed)

“The pulsatory stress caused by the rhythmic contractions of the uterus during labor causes a tend-and-befriend reaction of the mother, contrary to the usual fight-or-flight response to stress mediated by the sympathetic nervous system. The biological basis of this tend-and-befriend reaction, first described by Taylor et al., appears to be oxytocin and its interplay with estrogen, which ensures the safety of delivery and the appropriate behavior of the mother after birth.”

Taylor SE, Klein LC, Lewis BP, Gruenewald TL, Gurung RA, Updegraff JA. (pubmed)
and Acevedo-Rodriguez A, Mani SK, Handa RJ. (pubmed)

Your Labor Environment

Imagine these two scenarios:

Scenario #1

• You arrive at the hospital in full-blown active labor
• There are bright lights, loud sounds, and beeping machines
• You are asked to wear two elastic belly bands that are tight and uncomfortable for 20 minutes to monitor baby and monitor contractions, plus a blood pressure cuff+cable on one arm and an IV in the other arm, making you feel tethered and trapped
• When you move, the monitor comes off and resets the 20 minute strip, so you feel like you have to sit in the hospital bed unmoving, making it harder to cope through the waves
• You are met with strangers wanting to insert their fingers into your vagina (cervical exam) to “see” if you’re in labor
• You are being asked health questions that you know are already in your chart, bringing you into your thinking, logical brain and OUT of labor land (what’s your blood type? how much do you weigh? etc)

Scenario #2

• You are at home in your own space where you feel safe
• You have created a dark, quiet environment that feels like a warm safe cocoon
• The curtains are drawn, the lights are off, and candles are burning for low intimate lighting
• People entering your space (doula, partner, midwife, family, etc) speak minimally in soft quiet voices
• You’ve met and formed a trusting relationship with everyone in the room, including your partner, doula, and midwife
• Your midwife uses intermittent monitoring, periodically listening to the baby’s heart rate with a non-invasive doppler (a small device touching a tiny area of the belly and not strapped on for 20 minutes or more)
• You have the comforts and smells of your own home, like your own bed, your own shower, and your own food

Which environment encourages the parasympathetic nervous system and the flow of oxytocin?

Which environment encourages fight-or-flight, labor slowing, more painful labor, and the sympathetic nervous system?

In my experience as a doula, the hospital environment itself is what leads to unwanted interventions because the normal physiologic process and flow of labor has been interrupted.

The important of choosing your birth location and provider (midwife or doctor) cannot be understated. It is by far the most important decision you will make when it comes to your birth.

So what can we do?

Solutions

In addition to deeply considering your birth environment and your labor attendants, there are other actionable tools that you can use. Don’t worry, as your doula I’ll be there to remember all these things when you’re in labor.

• Jiggling the fascia (spinning babies)
• Intentional deep breathing
• Use “om” sounds
• Stimulate your vagus nerve
• Meditation
• Deep abdominal breathing from the diaphragm
• Deep warm water bath
• Humor and laughing
• Cuddling and kissing someone you love
• Oxytocin bath
• Use visualization, picturing yourself in a peaceful place that you love, such as a field of wildflowers, a mountain stream, or the ocean at sunset

The Jiggle, Spinning Babies

The Jiggle is a move that stimulates the parasympathetic nervous system through the fascia. I like to use it when we first arrive to the birth location, or if there’s a shock or a scare that has slowed labor down. It’s also great to use at the beginning of an induction.

The jiggle can be performed by anyone on the laboring person. It involves using ones hands to vibrate the legs and buttocks so that body fluids in the muscle tissues oscillate and is calming and pain-reducing. The goal is to create an oscillation, increasing the hydration of the substance within the fascia. Fascia is a specific type of connective tissue that forms a continuous three dimensional web surrounding every tissue in the body.

Keep it fluid, as if the movement ripples between your hands. The receiver needs to be comfortable if they are going to get the most benefit. They lie on the left side with pillows under the knee and ankle with the left leg a bit straight and behind them.

You can find the full instructions for the jiggle here on the Spinning Babies website.

Note from Natalie: it wasn’t until I personally took a Spinning Babies training that I fully understood the subtlety of this movement and all it’s benefits. The movement is more of a gentle vibration than a jiggle. You can find a video of how subtle the movement is (it’s just the fascia level!) on my instagram story highlight named “Spinning Babies.”

“Fascia and the autonomic nervous system appear to be intimately connected.”

Robert Schleip MA Rolfing Faculty, European Rolfing Association e.V., Kapuzinerstr. 2S, D-80337, Munich, Germany (science direct)

Intentional Deep Breathing

Our breath is one of the most effective relaxation tools that we possess. All relaxation and meditation techniques have breath in common. Breathing is automatic; we go through the day without thinking about it. We do, however, from time to time feel stressed, and in this state tend to take shallower, shorter breaths, not fully exhaling. Most of us have a built-in response that makes us take deep breaths to calm ourselves in stressful situations. Our bodies know that it is difficult to be stressed or panicked when we are taking deep, slow breaths.

Deep breathing:

• Calms the nervous system
• Releases feel-good neuro chemicals in the brain
• Relaxes the muscles
• Lowers blood pressure
• Activates the parasympathetic nervous system, or “rest and digest” state

Take a deep diaphragmatic belly breath. Feel your belly fill and expand. Exhale completely by pulling your belly button towards your spine. The next inhale will be automatic and you will be able to fill your lungs and belly with more volume than the first breath. Continue this style of inhale/exhale for 3-4 breaths. As you exhale release tension from your forehead, jaw, throat, and shoulders. During the next inhale/exhale cycle, release tension from your chest, hands, and belly. Check in with your baby and say (out loud or silently) hello, I love you, or whatever you want to say, and feel the effects of oxytocin wash over you. Any and all practice is beneficial, so do what you can.

The Oxytocin Bath

You have the ability to flood your brain and body with oxytocin anywhere, any time. This is called an oxytocin bath. Oxytocin is a naturally occurring hormone, which stimulates feelings of bonding and trust and reduces fear and anxiety by reversing the stress response.

Produced in the hypothalamus, deep in the midbrain, oxytocin is released naturally into the bloodstream through warmth, touch, and movement. Orgasm and breastfeeding generate oxytocin. It also floods our brains and bodies when we’re in close proximity to someone by whom we feel deeply loved and cherished. Even evoking memories of people close and dear to us will spark its release.

How to give yourself an oxytocin bath:

• Take a moment, close your eyes, take a few deep breaths and focus on slowing down your breathing
• Place your hand on your pregnant belly or place your hand on your heart
• Breathe any calm you can muster right down into your baby, or your heart center. Let yourself relax into that calm.
• Remember any moment you can of safety, trust, and love you have ever felt in your life. Get the sense of that memory in your body. Feel the love and trust in your body.
  
• Out loud or in your head, connect with your baby. Say,
  
  “Hey baby, I know that was a scary moment back there… But we are safe now. Everything is okay. I just wanted to tell you that I love you so much, and I can’t wait to meet you. I can’t wait to have you in my arms, skin to skin, and feel your slippery vernix on my hands. I love you. I can already hear your tiny voice and your beautiful cry when I meet you for the first time. I want to hold your little fingers and kiss your head. I love you, baby.”
  
• You may feel tingles spread through your body as the oxytocin courses through you when you use the words I love you.

You can use the oxytocin bath when you get a startle or a jolt of adrenaline in traffic, or when you’re feeling stressed, or if labor is slowing or stalling. I’ve even seen it lower blood pressure before!

The “OM” Sound

By chanting Om, the mind becomes aligned with the breath, which enables a person to get into an elevated state of consciousness called Samādhi in Hinduism and Buddhism. In many Indian religious traditions, the cultivation of Samādhi through various meditation methods is essential for the attainment of spiritual liberation.

This is one of those things that sounds like woo-woo but actually has some pretty solid evidence for how it affects the brain. When you look it up, you’ll see things like chanting “OM” allows you to align with the vibration of the Universe because it vibrates at the frequency of 432 Hz, which is the same vibrational frequency found throughout everything in nature.

Now, I’m all about good vibes and raising your vibration, but the science-y part of my brain also wants to know WHY?

“A sensation of vibration is experienced during audible ‘OM’ chanting. This has the potential for vagus nerve stimulation through its auricular branches and the effects on the brain. The neurohemodynamic correlates of ‘OM’ chanting indicate limbic deactivation. As similar observations have been recorded with vagus nerve stimulation treatment used in depression and epilepsy, the study findings argue for a potential role of this ‘OM’ chanting in clinical practice.”

Dr. B. N. Gangadhar, Department of Psychiatry (pubmed)

You can find om sounds and om meditation music on YouTube and this would make perfect background music for your labor and birth. Don’t be shy about making those deep OM moaning sounds during your labor.

The Vagus Nerve

The vagus nerve or vagal nerves are the main nerves of your parasympathetic nervous system. Your vagus nerve calms your body after you’ve been in a stressful situation.

Evidence shows that stimulating the vagus nerve can help people with stress, anxiety, and post-traumatic stress disorder (PTSD) as well as a myriad of other conditions, such as epilepsy, diabetes, treatment-resistant depression, inflammatory autoimmune conditions like Crohn’s disease or rheumatoid arthritis. There is even some preliminary research suggesting that long Covid symptoms could originate, in part, from the virus’s effect on the vagus nerve. (pubmed) Whoa!

One way to stimulate your vagus nerve is to massage your outer ear. The outside of the ear contains a branch of the vagus nerve, called the Arnold’s or Alderman’s nerve, according to research. That makes vagus nerve massage something that you can do right now as you’re sitting at your computer or phone, or even in labor! There are various ways you can do it (here’s a how-to on YouTube), but you’ll just need to gently massage the inner part of your ear using slow circles, pull your ear, and massage the area behind and below your ear.

One study (pubmed) found that a head and neck massage also activated the body’s de-stressing response, possibly because it targeted the vagus nerve, though the authors note that massage tends to make people breathe in a deeper, more relaxed way, which could have the same benefits.

Other vagus nerve stimulating activities include laughter, meditation, deep breathing, humming or OM-ing or making low/deep moaning sounds in your chest.

Childbirth Education Methods

I recommend childbirth education methods that teach medication and deep relaxation, including the Bradley Method and HypnoBabies.

Note from Natalie: HypnoBirthing and HypnoBabies are different! I don’t have the best experiences with HypnoBirthing because it teaches folks that there is no pain in labor, which sometimes leads to feeling out of control, feelings of failure and even birth trauma from my experiences as a doula. In contrast, HypnoBabies explicitly discusses the pain of labor and builds coping skills to manage it. HypnoBirthing classes do not include discussion of the dangers in pregnancy, medication use, complications, or cesarean surgery in the curriculum, based on the stated philosophy that discussing certain dangers will cause fear of pregnancy/childbirth for some women, instead of accomplishing the intended goal of education. For me, this is out of alignment with my values as a doula.

My personal philosophy is that education and information is powerful and can even have the fear-reducing effect by removing the fear of the unknown. When we have more information, we can come to a decision and create a plan for what we would do in various unexpected scenarios. I believe it’s super beneficial to create this plan while you’re still “sober” and not yet in the altered state of consciousness that is Labor-Land. It’s hard to learn about various medical interventions for the very first time in the midst of labor. As your doula, I want to help guide you through this information gathering, education and decision making during your pregnancy, before labor begins.

The Bradley Method teaches “the six needs of the laboring person”: deep and complete relaxation and abdominal breathing; quiet, darkness and solitude; physical comfort; and closed eyes and the appearance of sleep. The method relies heavily on training fathers/partners/doula/support person to be labor “coaches”. Many partnered people like how much Bradley makes the partner an active participant in their labor. The Bradley Method involves a set of classes that are intended to educate on multiple components of pregnancy, labor, birth, and postpartum. Class content includes ways to stay healthy in pregnancy as well as dangers in pregnancy and dangers of medication use in labor.

• This is the Bradley class I recommend by doula Sherilee Peters
• This is the HypnoBabies class I recommend by doula Rebekka Maye (not HypnoBirthing)

Conclusion

You are resilient. You have the ability to withstand the all of the experiences, known and unknown, that may lay in your path throughout pregnancy, birth, and parenthood. Because of your resilience you have the ability to adapt to whatever challenges arise in life and parenthood. You have the ability to cope in the moment, you have the ability to recover from stress, and you know how to bring a sense of calm to your body and mind.

Information is power! Now that you know how important your nervous system is for labor progression, your emotional experience of your birth, and pain reduction, you can take steps to get out of fear and have the birth of your wildest dreams. ✨

• Get my guide to comfort measures for home birth
• Take a childbirth education class
• Hire a doula who is trained in Spinning Babies
• Consider your birth location very carefully
• Create a comforting birth space
• Be selective about the provider you choose, midwife or doctor

With heartfelt warmth,

“Thank you for the space you held for all of my feelings during birth. I was watching the documentary and when I say ‘I don’t want to be screaming like this’ you just said ‘it’s okay’ and I just felt so seen and so safe in that moment.

“Your presence at my birth was more than your words… it’s your aura, you have this beautiful intuition that brings oxytocin levels higher in birthing spaces. Because imagine someone telling me ‘yeah you’re not coping well, chill out’ it makes my heart ache because that would just send oxytocin plummeting and prolonging birth.

“My baby came efficiently because I felt safe and so held, I just know it. I don’t know how I can ever properly thank you!”

– Jen, Portland OR, a past client