The uterus is essentially a hollow muscle. When this muscle contracts it transmits its force in the direction of the vagina. Thus, anything inside the uterus is pushed down and out. Problems involving this force are some of the most common causes of problems during labor. Efficient contraction of the uterus is dependent on several factors. As stated above (The Body Prepares for Labor) the uterus must be properly primed for efficient labor. This is largely the job of hormones; the prostaglandin hormones in particular. Once properly prepared, the actual contraction of the uterus during labor is regulated by a hormone produced in the pituitary gland (in the brain). This hormone, oxytocin, is the single greatest factor in the strength and frequency of uterine contractions.
One theory proposes that prostaglandins prepare the uterus for the action of oxytocin by increasing the number of oxytocin receptor sites on uterine muscle cells. One might think of this process like this: the uterine muscle cells are the power-producing motors; oxytocin molecules are the batteries; and, prostanglandins are the workers which produce the connections between battery and motor…..the more connections there are, the more batteries the motor will accept. Prior to labor if the prostaglandin workers are not given adequate time to produce the battery connections on the motors, one may have all the motors one needs and all the batteries which one needs, but not enough connections to put the two together. This may be the reason that patience and time are often considered virtues during childbirth.
In most modern hospital settings, problems involving inadequate powers during labor are usually addressed by the use of synthetic oxytocin, known most commonly in the U.S. as “Pitocin”. Pitocin is one of the brand names of synthetic oxytocin. Pitocin, diluted and given in small doses intravenously, is very effective at increasing the strength and frequency of uterine contractions.
Some women would argue that Pitocin does its job too well, producing contractions that feel excessively strong and too frequent. This drug is probably used far more often than it needs to be, and its reputation is somewhat justified. But the availability of a pure, synthetic form of oxytocin has revolutionized obstetrics…….not that all appreciate or hail the revolution. However, for some women, truly entwined in what was once labelled “desultory labor”, the use of synthetic oxytocin has saved many from a childbirth experience which might otherwise prove fatally exhaustive to mother and/or baby. It may be difficult for young women on the edge of the 21st century to appreciate an understanding of the childbearing experience of young women prior to the last few decades. But deaths of mothers and babies were once common events (and still are in some countries). The use of Pitocin may at different times represent a glimpse of the best and worst of late 20th-Century science. We will pass into the 21st century needing to refine the essence separating the art and the science of midwifery and obstetrics.
A “natural” approach to problems associated with the powers of labor and birth would involve “tincture of time”, patience, and movement (walking and freedom to change position). Many would argue that a labor which ebbs and flows allows a mother to rest, and that maternal movement encourages efficient labor and proper positioning by the baby. The creed, “Primum Non Nocere” (First, Do No Harm), is a tenet espoused by both midwives and physicians which refers to the risks involved when natural forces are disturbed. Many accoucheurs (Glossary) feel that Mother Nature should always be given some chance to address problems in labor which do not involve aspects of an emergency. Most of the problems associated with the powers of labor are not emergencies.
The uterus can be encouraged to contract more frequency and more intensely without resorting to medical options. Stimulation of the nipples causes the uterus to contract. However, over-stimulation can produce contractions of over 2 minutes duration which may not allow the fetus sufficient rest between contractions. Herbalists and some midwives use blue cohosh and red raspberry to stimulate uterine contractions, but usually use these herbs to “tone” the uterus prior to labor or to induce labor, rather then to augment labor.
Immersion in water may be one of the most effective non-medical therapies to address a difficult labor. It is uncertain why water immersion seems to work so well. It is possible the human brain is too large for its own good when we are called upon to do our animal thing. Our large brains may actually interfere with the birth process if a woman is sufficiently disturbed or stressed during labor. Water immersion may provide a physical and emotional time-out and allow the body a period to readjust and recommit to the task at hand……efficient uterine contraction while the rest of the body relaxes. What better way to relax the body than to suspend it in warm water?