Hug the Monkey

Connection, Loss, Science and Mothering (Poem)

My friend Alan Phillips has written a poem that intertwines many of the things this blog is about -- love and attachment, labor and birth, mothering, oxytocin, connection.

It's a wonderful poem, and extra wonderful to me because it lets me see all these ideas and scientific studies in a different light.

Please check it out: Legend of My Birth.

Acupuncture and Oxytocin: Not So Strong

So often, people ask me how they can get more oxytocin. Is there something they can buy? I often tell them to try acupuncture, asking for the "points forbidden in pregnancy."

The idea is, they don't want acupuncturists to go there for pregnant women because those points may stimulate the release of oxytocin, thereby causing contractions of the uterus that would expel the fetus before its time. On the other hand, if the woman is feeling that it's time enough already, needling those same points could jumpstart labor.

A new study found that acupuncture doesn't do a great job of inducing labor, reports Reuters. 

"Researchers found that among 125 pregnant women who were past their due dates, those who were randomly assigned to undergo two acupuncture sessions were no more likely to go into labor over the next 24 hours."

I would like to note that according to the article about the study, post-term pregnancy is defined as one that lasts longer than 41 weeks. My understanding is that the due date is a guesstimate -- although 41 weeks allows for a full month beyond when a couple thought they got pregnant.

Still, there is something to be said for letting the baby and the mother's body determine what's the right time. Still to be determined: Whether stimulating these points may cause a release of oxytocin that's enough to tune up the parasympathetic nervous system, whether or not it's enough to push a baby out before it's ready.

Skin Contact Reduces Risk of Postpartum Depression

We all need skin-to-skin contact with other humans. Period.

This contact is vital for newborns. Placing the newborn on her mother's chest as soon as possible after birth seems to trigger the reflex of crawling up to the breast and nursing.

A new study shows that ongoing skin-to-skin contact between mother and baby can increase attachment and reduce the risk of postpartum depression. According to the National Post:

The study also looked at how skin-to-skin contact affects babies’ cognitive functions and their relationships with their mothers.

And infant is also more aware when awake and sleeps more deeply while lying skin-to-skin on the mother’s chest, Dr. Bigelow says.

Read more: http://news.nationalpost.com/2010/07/09/canadian-study-skin-to-skin-cuddles-beneficial-for-new-moms/#ixzz0tJ2Pa3d4

Docs Starting to Rethink Pitocin

There's a fair amount of scientific evidence -- along with tons of anecdotal evidence -- that the routine use of Pitocin to speed or manage labor is a bad idea.

Pitocin is a synthetic form of oxytocin, commonly administered in a steady drip to "keep labor on track," that is, deliver the baby within a timeframe determined by the hospital or doctor, not by the woman's body. In an unmedicated birth, the woman's hypothalamus and pituitary gland deliver spurts of oxytocin to the brain and bloodstream, causing the uterus to contract, pushing the baby down the birth canal. These pulses also give the woman's body time to rest between contractions, while reducing her anxiety.  The pauses also relieve pressure on the baby, allowing blood to flow through the brain.

In the hospital, Pitocin can make these contractions too strong and too close together. Too-strong contractions can compress the baby's head, causing brain damage.

Some natural birth experts believe that an overload of Pitocin can flood the oxytocin in the baby's brain, causing them to be less sensitive throughout life and contributing to autism spectrum disorder.

According to the Columbus Dispatch, doctors in the seven-state Trinity Health System are now using a standard protocol to limit the amount of Pitocin given. According to the article:

Pitocin should be used only to stimulate the uterus to behave as it would during a delivery progressing normally, not to make contractions stronger and faster, [Dr. Augustus Parker, an obstetrician who works on improving quality at Mount Carmel East] said. Before this, dosing was left to individual obstetricians.

In addition to striving to keep Pitocin-use at a safe level, the hospital system is working to make sure doctors who are inducing labor have good reason to do so, he said.

I hope the tide is beginning to turn, and we're moving toward an era when we don't automatically think we know more than Mother Nature.

Could Pitocin During Labor Program Oxytocin Receptors?

Many natural birth activists believe that the heavy dose of Pitocin, a brand of synthetic oxytocin, can program the oxytocin receptors in the baby's brain to be less sensitive to oxytocin.

There have not been any journal articles or studies to back this up. But a new report showing that exposure to endocrine-disrupting chemicals can program the fetus for life provides a link.

According to Newswise, prenatal exposure to bisphenol-A (BPA) and diethylstilbestrol (DES) altered production of a protein that helps to regulate genes. This alteration remained into adulthood.

“BPA is a weak estrogen and DES is a strong estrogen, yet our study shows both have a profound effect on gene expression in the mammary gland (breast) throughout life,” said Hugh Taylor, MD, of the Yale University School of Medicine in New Haven, Conn. and lead author of the study. “All estrogens, even ‘weak’ ones can alter the development of the breast and ultimately place adult women who were exposed to them prenatally at risk of breast cancer.”

The study found a new way that external chemicals can regulate tissue development. Perhaps a similar mechanism could change the expression and sensitivity of oxytocin receptors?

Other posts covering this question:

Studying the relationship between Pitocin, labor and behavior

The Case for Harm from Pitocin in Labor

Why Dad Should Be in the Delivery Room

Ann Douglas at The Mother of All Parenting Blogs talks about the special challenge of taking her 12-year-old son with Asperger's to the orthodontist.

Her husband was the one who took their son for the dreaded extraction, and Douglas credits the strong father/son bond to the moments right after delivery, when he held the newborn in his arms while she got stitches. 

I strongly disagree with the idea that men should be barred from the delivery room because they'll make the laboring woman too tense.

Why Fathers Should Be There for Birth

The New York Times has a really inspiring guest post from Josh Tyson, describing his feelings during the birth of his two children. What struck me was how the experience of watching his wife in natural childbirth deepened his perception of her as a woman.

He writes,

I am a very proud and humbled husband, looking forward to tapping my wife’s immense fire and might as we continue along the divinely beleaguered path of parenthood.

Michael Odent, the French natural birth advocate, has been warning that men should stay out of the delivery room, because they get anxious and try to fix things. This, he explains, increases the woman's stress level and reduces her production of oxytocin, which is necessary to produce strong enough contractions to push the baby out.

This is based on his extensive experience in the delivery room, and I"m sure what he says is true.

Still, the Tysons' story shows how letting fathers share this experience can profoundly deepen not only their bond to the baby but also to the mothers of their children.

Autism an Imprinting Error?

Do newborns imprint on the mother, just like baby ducklings attach themselves to the first thing they see, whether that's the mother duck or Konrad Lorenz? Could autism begin when the newborn fails to imprint?

I was ready to dismiss this Psychology Today blog post by Bill Ahearn out of hand. But it's too well-reasoned -- and also, Ahearn is director of research at the New England Center for Children, a private nonprofit educational facility for children with autism.

Ahearn is not arguing that newborn humans have the same, simple kind of imprinting mechanism that baby birds do. But he does argue that a lack of response to the initial "social" cues of the mother's smell and nipple may interfere with the normal brain and physiological development that takes place after birth.

He writes,

... one of the earliest indicators that an ASD may be present is atypicality, at birth, in primitive reflexes, like rooting and sucking. As I mentioned above, imprinting establishes the significance of a cue and if that cue is not imprinted to, it does not have this same significance. Is it possible that something is going wrong in social learning that is akin to an imprinting error? Well, one thing we know about individuals with autism relative to people without it is that social cues do not hold the same significance for people with ASDs.

This is a fascinating article that takes some attention to read, but will reward the attention.

Another View of "Christmas Miracle" Baby

Many of us had an oxytocin moment contemplating the despair and joy experienced by Mike Hermanstorfer, the Colorado Springs man whose wife and baby died in childbirth, but were revived.

Jasmine Jafferali points out that the focus on this ultimate happy outcome overshadows the fact that the bad part of the story is an all-too-common scenario: 

Knowing the side effects of both pitocin and the epidural, Hermanstorfer's history of having unmedicated births, she probably experienced a dropped heartrate from the pitocin which may have caused her cardiac arrest upon administering the epidural. We all like the story of hearing "miracles" and they do happen, however, we have to know a little more about modern medicine and the side effects and dangers of modern drugs.

She details the known side effects of epidural drugs and Pitocin (the artificial oxytocin used to speed labor) on mother and baby. Her tacit conclusion is that while it's a miracle this mom and baby survived, it's a tragedy that so many are injured in hospital births. 

Maybe this miracle never needed to happen.

The Case for Harm from Pitocin in Labor

Christof Plothe is a doctor of osteopathy who works at a pediatric clinic in Alzy, Germany.

His paper, in press for 2010 publication in the International Journal of Prenatal and Perinatal Psychology and Medicine, reviews the scientific literature on oxytocin in relation to bonding between mother and child, and then examines studies showing effects of oxytocin or Pitocin (a synthetic brand) used during labor.

Plothe writes,

"For over 50 years Oxytocin has been used in modern obstetrics during  birth. Whilst the physiological aspects of the hormone have been  studied intensely the psychological mechanisms of its function have  only started to be known since the nineties of the last century. I  have been working with newborns for over a decade now and observed  fundamental differences after the oxytocin related births in the  babies, later in the adolescents and even in the adults. The  article is a summary of the contemporary research  of Oxytocin and hypothesizes that Oxytocin can have a lifelong   imprinting on the psyche when used during the delivery. 

He has observed that some children seem "oxytocin-imbalanced." These kids may be insecure, have difficulty with school work, and problems with relationships within the family. Plothe has been treating some with oxytocin, and found that such symptoms improved or even disappeared.

He calls for more studies and discussion among health professionals and researchers to try to determine how much modern birth practices may have lifelong consequences.

You can read the entire paper here: The perinatal application of oxytocin and its potential influence on the human psyche.