How The Nervous System Informs Birth & Birthwork

“Nature is the master regulator”, somatic therapist Kimberly Ann Johnson tells us. Our nervous system functions in waves, in cycles.  With our breath, we upregulate with our inhalation (a sympathetic nervous system response)  and downregulate with our exhalation (a parasympathetic nervous system response).  Everyday our bodies move through 90 minute cycles—75 minutes of activity—upregulation—and 15 minutes of rest—downregulation.  In birth we also see a wave or cyclical response.  Contractions come and go in waves.  Endogenous oxytocin release is pulsatile (whereas Pitocin comes in a steady infusion).

Functional physiologic labor lives in the realm of the parasympathetic:  The upper segment of the uterus responds with contraction of the longitudinal muscle fibers, which helps the baby descend.  There is relaxation of the circular fibers of lower uterine segment relaxation (circular fibers).  The parasympathetic nervous system stimulates blood vessel constriction after birth (via oblique fibers), which helps to control bleeding and prevent hemorrhage.  Dark, quiet, private, warm, safe environments cue the birthing body to labor.  When we perceive a lack of safety, the contractions can become uncoordinated, the cervix has more challenge in opening, and oxygenation to the baby is reduced.

Because we are social animals, with a social nervous system, the people supporting the labor (nurses, doctors, midwives, doulas, family, friends…) are actually the primary environment and the primary place where we take our cues of safety or threat.

So, how do we communicate safety?  Are we safe people?  Do we feel safe in our work environments?  How do we facilitate a sense of safety if we ourselves do not feel safe?  How do we anchor the nervous system of the room if we have not been taught how to hold the space?  How do we maintain our belief that birth is a normal physiologic process worth trusting when we’ve seen so much go wrong?  What if we are confident in our ability to communicate safety but our colleagues lack that skill and derail the birth?

This is where the rubber meets the road, so to speak.  There are no simple answers.  Mostly lots of questions!  But I do find that seeking answers together is useful, that curiosity keeps us flexible, and that there is always, always more to learn.