Hug the Monkey

A Paradoxical Reaction to Oxytocin?

A new blog from Alia Macrina Heise identifies a syndrome she calls depressive milk ejection reflex, or D-MER. She defines it thus:

"Depressive Milk Ejection Reflex is a condition that causes a prodromal effect of negative emotions that emerge only before the milk ejection reflex, or letdown, in a lactating mother."

According to her blog, she's the mother of three -- and a lactation counselor. Although breastfeeding is supposed to be a peak experience -- deeply rewarding, sensual and soothing, thanks to oxytocin -- she experienced something quite different.

Go to her blog, D-MER.org, to read more about her experiences and those of other women.

One theory Alicia has for the cause of this syndrome, which involves discomfort and depression during breastfeeding, is a paradoxical reaction to oxytocin. A paradoxical reaction is when someone has not the expected reaction to a drug, but a different one, often the opposite.

I would guess that, rather than a paradoxical reaction to oxytocin, D-MER might be caused by an excess of prolactin. Prolactin is involved in milk letdown, but it's also involved in sexual satiety. It's the hormone, released at orgasm, that tells our bodies we've had enough sex, so give it a rest.

People sometimes talk about a feeling of letdown following sex, a sense of depression and even of distaste for one's partner. I think this, too, is the result of a bit too much of prolactin's satiating ability. It makes sense to me that an excess of prolactin, or too intense a response to its effects, could be the cause of D-MER.

Here are studies indicating prolactin's effect on sexual satiety:

Krueger, Tilmann H.C.; Haake, Philip; Hartmann, Uwe; Schedlowski, Manfred; and Exton, Michael S., Orgasm-induced prolactin secretion: feedback control of sexual drive? (Neuroscience and Biobehavioral Reviews 26 2002) 31-44)

Krueger, Tilmann H.C.; Haake, Philip; Haverkamp, J.; Krämer, M .; Exton, Michael S.; Saller, B; Leygraf, N.; Hartmann, Uwe; and Schedlowski, Manfred, Effects of acute prolactin manipulation on sexual drive and function in males (Journal of Endocrinology (2003) 179, 357–365)

Home Birth Activism Hits UK

According to the Guardian, Rikki Lake's film, "The Business of Being Born," is helping to fire up a movement to provide greater access to home birth, as well as midwife-assisted birth in-hospital.

One really great quote from Angela Horn, who set up homebirth.org.uk to debunk the myths about how unsafe home birth was:

"It's incredible how a good birth can change a woman. You've brought new life into the world, and you've done it yourself rather than, as happens to so many women, finding yourself at the heart of a crisis that you need to be rescued from."

Read the article: Birth of a Revolution.

Orgasmic Birth Movie to Premiere

I'm excited that the wonderful film by Debra Pascali-Bonaro is finished. I can't wait to see it. Meanwhile, I'm publishing Debra's entire press release. I think this film could do much to change our understanding of what birth could be. Go to the site immediately to see astonishing video. This is world-changing!

 

The Best-Kept Secret--Unveiled

“Orgasmic Birth,” a new documentary film by internationally renowned childbirth educator, doula, and birth activist Debra Pascali-Bonaro, challenges cultural myths by revealing the emotional, spiritual, and physical heights attainable through birth. Viewers witness the passion of birth as an integral part of women’s sexuality and a neglected human right.

Five years in the making, “Orgasmic Birth” will have its world premiere on May 12 at the fifth annual World Respected Childbirth Week conference in Prague, Czech Republic. Subsequent screenings will be held in London on May 29; in Paris on May 30; and in Glasgow on June 4 at the 28th Triennial Congress of the International Confederation of Midwives.

On May 16, “Orgasmic Birth” will be featured on a segment of “20/20,” the acclaimed ABC-TV news show, as part of its Mother’s Day program. The reporters will interview Debra, who produced and directed the film; women’s health advocate Christiane Northrup, MD, who appears in it; and several of the 11 couples who courageously permitted their birthing experiences to be shown. Dr. Northrup, the author of “Mother-Daughter Wisdom” (Bantam, 2005) and “Women’s Bodies, Women’s Wisdom” (Bantam, revised 2006), appears frequently on PBS.

Among other well-known health professionals who present their views in the film and discuss evidence-based support of its claims:

 o Ina May Gaskin, MA, CPM, world-renowned midwife, author, and founder/director of the Farm Midwifery Center in Summertown, Tennessee

 o Maureen Corry, MPH, executive director, Childbirth Connection, a not-for-profit organization dedicated to improving the quality of maternity care

 o Sarah J Buckley, MD, a general practitioner/family physician with qualifications in obstetrics; author of “Gentle Birth, Gentle Mothering”

 o Marsden Wagner, MD, former director of Women’s and Children’s Health, World Health Organization

You too can be a part of this exciting project! Go to www.orgasmicbirth.com and:

 o Share your birth experience and read about the birth experiences of others.

 o Sign up to host a local screening of this important documentary. It’s easy with the comprehensive Community Screening Packet developed for the film. Download these materials at the website, where you can register your screening dates (which we will post online), watch a trailer of the film, find a Birth Planning Q&A section by our birth experts, and much more.

Joyous, sensuous, and revolutionary, this pioneering film will compel many to reexamine their perceptions about childbirth. Viewers will understand that the use of normal, undisturbed birthing methods can aid the health and well-being of future generations.

The DVD is available with subtitles in French, German, Spanish, and Portuguese and has a remarkable score by John McDowell, composer of the Oscar-winning documentary “Born Into Brothels.”

Questions? Please use the “Contact us” e-mail tab on the home page of www.orgasmicbirth.com.

 

 

Men, Stay Out of the Labor Room

Should men -- that logical, charge-taking, squeamish half of the human race -- be present when their mates give birth to their children?

This opinion piece flies in the face of modern thinking and all the work women and men have done in the past 50 years to move toward equality not only in the workplace, but at home. If it were written by anyone else, I'd sniff at it and leave it.

But "A top obstetrician on why men should NEVER be at the birth of their child" was written by Michel Odent, who was one of the first people to begin speaking out against the way medical birthing practices can break the bond between mother and baby -- and therefore someone I respect immensely.

Odent makes some very good points about how the presence of the father-to-be can keep a woman from going into that oxytocin-driven state where her body "knows" how to give birth.

First, a labouring woman needs to be protected against any stimulation of the thinking part of her brain - the neocortex - for labour to proceed with any degree of ease.

This part of the brain needs to take a back seat and allow the primal "unthinking" part of the brain connected to basic vital functions to take over.

A woman in labour needs to be in a private world where she doesn't have to think or talk.

Yet, motivated by a desire to "share the experience", the man asks questions and offers words of reassurance and advice.

In doing so, he denies his partner the quiet mind that she needs.

The second reason is that the father's release of the stress hormone adrenaline as he watches his partner labour causes her anxiety, and prevents her from relaxing.
This needs to be said. I can certainly see how feeling she needs to share the experience with her partner could distract a woman.

But Odent ignores another option: What about teaching the father ways to behave that don't activate the laboring woman's neocortex? A man can share the experience just by being there, as well as by offering loving touch in the form of massage, caresses and even sexual stimulation, which can help bring on labor.

Odent seems to feel that men are incapable of this, as well as often too put off by the messiness and blood. I'd like to think that the majority of men, if it were explained to them, would be willing and able to enter with their women into that primal, sensual state that can make birth an oceanic experience.

Should we deny them that opportunity?

Oxytocin Therapy for Indifferent Moms?

Oxytocin is being tested as a treatment for autism and social phobia, and it's under consideration for treating a variety of other disorders.

What about a mother who doesn't love her baby enough?

Despite the myth of the absoluteness of mother love, many new mothers don't feel attached to or excited about their newborns. There are myriad reasons for this, from the mother's inability to attach to anyone -- because of her own abuse or neglect as a child -- to a problematic or stressed pregnancy to that poorly understood neurochemical state known as post-partum depression.

Craig Kinsley, Professor of Neuroscience at the University of Richmond's Department of Psychology, has shown, in research with Kelly Lambert, how motherhood remodels the brains of rats. It increases the number of oxytocin receptors, increases the sensitivity of the receptors and also improves their memory.

Kinsley has begun to apply this research to human mothers. At the International Congress on Women's Mental Health, he suggested that this  research could lead to  interventions  aimed at helping new moms form a  secure bond.

According to the article in News in Science,

It may be possible, he says, with this template to then identify potential 'bad' mothers by examining how their brains behave when the mother is first interacting with the baby.

Kinsley says if females with a deficit of a critical neurochemical, such as oxytocin, can be identified, then "when they are first interacting with the baby you can give them a boost of oxytocin at a critical time".

The Women's Bioethics Blog predicted  this back in August 2007. See my post, Will Bad Mothering Become the Latest Disorder?

Kinsley's collaborator, Kelly Lambert, has found that fatherhood creates changes in the brains of male deer mice, as well. Maybe they could also give oxytocin to deadbeat dads.

Try the Middle Ground between Natural and Hospital Birth

Many things about a hospital birth have the potential to rupture or impede the first bonding between mother and child. For example, epidurals and anesthetic do seem to get into the baby's blood stream, so that both mother and baby are groggy and sickish following the birth. Babies delivered without anesthetic are alert and soon naturally begin to look for the breast, stimulating the release of oxytocin in mom and, likely, in baby.

Some think that the steady drip of pitocin, an artificial form of oxytocin, given to the laboring woman can create a sort of allergic reaction, or oversensitivity, in the baby. Later, according to this theory, that child may reject experiences that cause the oxytocin release. Some people think this may be part of the explanation for autism.

In any case, this article from Mother Earth News lays out a middle ground. Sharon Maehl suggests having the baby in the hospital, but staying there for as short a time as possible. She takes you through all the decision points and wraps up with the account of the birth of her second child.

The key to this way of giving birth, along with finding the right doctor and hospital, is making your mind up ahead of time that you won't stay, according to Maehl. She says,

Somewhere along the line you should tell the staff that you'll have to be running along soon (you left a cake in the oven?) Whatever you do, though, don't mention this to anyone in the hospital until the baby is born. If you tell the doctor during your pregnancy, he may even refuse to accept you for pre-natal care. Doctors are not known for their flexibility. Best wait until the baby is born and safely in your arms before you tell anyone your plans.

Her idea minimizes the time in hospital and the pressure from doctors and nurses for medical interventions, while making sure that if anything does go wrong, help is right there.

How to Stimulate Labor Naturally

This outstanding article, charmingly titled Come On, Baby,  from  Malaysian's The Star provides an overview and commentary on the many methods for bringing on childbirth naturally. The author, Dr. Nor Ashikin Mokhtar, offers a grounded, common-sense approach that's solidly backed up by medicine.

In addition to the list of different things to try -- and things you should not try -- she offers a very different opinion on just when to try to get labor going. It sounds like the majority of docs in the United States begin to push for induction of labor after week 39.

Dr. Mokhtar says,

I always tell my patients that there is a reason the baby is staying in there just a bit longer. This is the time when the baby is developing, and forcing it to come out too early may interrupt his or her growth.

That's a very refreshing -- and evidence-based -- piece of advice. And she's not exactly a voice in the wilderness in Malaysia; she is co chairman of Nur Sejahtera, Women & Family Healthcare Program, Ministry of Women, Family and Development.

How Natural Childbirth Prepares Mom and Baby

This column by Judith Lothian of Lamaze International provides a very nice overview of how the hormonal changes that take place during natural childbirth prepare both mother and baby for breastfeeding -- and for the bonding that accompanies it.

She writes that it's not only a baby being born; the laboring woman also is being born as its mother.

While the hormonal orchestration of labor and birth sets the stage in a more immediate way for the process of breastfeeding for both the mother and her baby, she writes,

The disruption of the hormonal orchestration of labor results in women giving birth with relatively low levels of naturally occurring oxytocin, endorphins, and catecholamines. Consequently, the outcome of low hormonal levels is a less responsive mother and baby.

Pitocin vs. Oxytocin

Robin Elise Weiss has an interesting and informative comparison of the effects of oxytocin and pitocin during childbirth. 

Oxytocin is the hormone and neurochemical produced in the body by the pituitary gland. It's released in waves to speed the baby through the birth canal. Pitocin is an artifical form, administered as a steady drip during medicalized labor or to induce labor.

A key point Weiss makes (although I don't think this has actually been proven scientifically yet):

Pitocin can interfere with bonding.
When the body releases oxytocin, also known as the love hormone, it promotes bonding with the baby after birth. Pitocin interferes with the internal release of oxytocin, which can disturb the bonding process.

Weiss is a childbirth and postpartum educator, certified doula, doula trainer, lactation counselor -- and mother of seven!

Read 5 Ways Pitocin Is Different from Oxytocin. And also check out Birth Faith, Lani's blog about natural childbirth.

A Friend or Family Makes for a Happy Birth

Doulas are trained to assist and support a woman during labor and childbirth. They're not nurses or midwives, so they don't help with the actual birth. But they provide physical and emotional comfort, everything from chatting with you to holding you while you cry to massaging you.

Susan Spicer of Canoe.ca reported on a study showing that a friend or family member can successfully stand in for a doula after just four hours of training. The study of 600 women found that having a lay doula significantly shortened labor.

Spicer points out that getting emotional support from someone likely helps you release oxytocin, the hormone of love and connection and also the hormone that speeds childbirth.

So, even if you don't plan to have a midwife or doula, you might want to have a designated friend. I imagine the training focuses on how to keep the laboring woman -- and yourself -- calm.