Warning message

This content is filtered. APPPAH membership is required for full access to journal articles.
-A +A
Publication Date: 
May, 2003
Page Count: 
Starting Page: 

When a woman labors and gives birth without disturbance, her body produces peak levels of birthing hormones. These include oxytocin, the hormone of love; beta-endorphin, hormone of pleasure and the body's natural analgesic; adrenaline and noradrenaline (epinephrine/norepinephrine) hormones of excitement; and prolactin, the mothering and breastfeeding hormone. This paper outlines current knowledge of the functions, and interconnections of these hormones, and the hormonal interferences caused by medical interventions, in particular, induction and augmentation (acceleration), opiate and epidural pain relief, cesarean surgery, and early separation of mother and baby. The author argues that an undisturbed birth creates maximum ease and safety for mother and baby, as well as making birth a potentially ecstatic experience.

KEY WORDS: Oxytocin; beta-endorphin; adrenaline; noradrenaline; epinephrine; norepinephrine prolactin; induction; pitocin; syntocinon; augmentation; acceleration; opiate analgesia; epidural; mother-infant attachment; bonding, labor; birth; undisturbed birth; ecstatic birth.


ACOG-American College of Obstetricians and Gynecologists. (1996). Obstetric Analgesia and Anesthesia Technical Bulletin number 225, July.

AIHW-Australian Institute of Health and Welfare (2001). National Perinatal Statistics Unit Australia's Mothers and Babies,1999. www.aihw.gov.au/npsu Retrieved March 2003.

Axel, R. (1995). The molecular logic of smell. Scientific American, 273(4): 154-159.

Bacigalupo, G., Riese, S., Rosendahl, H., Baling, E. (1990). Quantitative relationships between pain intensities during labor and beta-endorphin and cortisol concentrations in plasma. Decline of the hormone concentrations in the early postpartum period. Journal of Perinatal Medicine, 18(4):289-296.

Baker, J.P. (2001). Prenatal Yoga and Natural Childbirth, Silver Anniversary 3rd edition. Berkley: North Atlantic Books.

Baumgarten, D. J., Muehl, P., Fischer, M., Pribbenow, B. (2003). Effect of labor epidural anesthesia on breastfeeding of healthy full-term newborns delivered vaginally. Journal of the American Board of Family Practice, 16(1): 7-13.

Behrens, O., Goeschen, K., Luck, H.J., Fuchs, A.R. (1993). Effects of lumbar epidural analgesia on prostaglandin F2 alpha release and oxytocin secretion during labor. Prostaglandins, 45(3): 285-296.

Biagini, G., Pich, E.M., Carani, C., Marrama, P., Agnati, L.F. (1998). Postnatal maternal separation during the stress hyporesponsive period enhances the adrenocortical response to novelty in adult rats by affecting feedback regulation in the CA1 hippocampal field. International Journal of Developmental Neuroscience, 16(3-4): 187-197.

Bidgood, K.A., Steer, P.J. (1987). A randomized control study of oxytocin augmentation of labor. 2. Uterine activity. British Journal of Obstetrics and Gynaecology, 94(6): 518-522.

Brinsmead, M., Smith, R., Singh, B., Lewin, T., Owens, P. (1985). Peripartum Concentrations of Beta Endorphin and Cortisol and Maternal Mood States. Australia New Zealand Journal of Obstetrics and Gynaecology, 25:194-197.

Brinsmead, M. (1987). Fetal and neonatal effects of drugs administered in labor. Medical Journal of Australia, 146:481-486.

Buckley, S. (1998). Epidurals-real risks for mothers and babies. First published in Australia's Parents as "All about epidurals," Australia's Parents Aug//Sept. Also www.birthlove.com/free/sarah.html

Buckley, S. (2000). Leaving Well Alone-A Natural Approach to the Third Stage. IN Lotus Birth, Shivam Rachana, (Ed.) Melbourne: Greenwood Press. Also published in Midwifery Today, 2001, 59: 33-38, www.cordclamping.com/Buckley.htm

Chard, T. (1989). Fetal and maternal oxytocin in human parturition. American Journal of Perinatal Medicine, 6: 145-152.

Christensson, K., Sues, C., Moreno, L. (1992). Temperature, metabolic adaptation and crying in healthy newborns cared for skin-to-skin, or in cot. Acta Paediatrica Scandinavica 8:488-503.

Christiansson, K., Sues, C., Cabera, T., Belaustequi, A., de la Fuente, P., Lagercrantz, H. (1993). Lower body temperatures in infants delivered by caesarean section than in vaginally delivered infants. Acta Paediatrica, 82(2):128-131.

Christensson, K., Cabera, T., Christensson, E., Uvnas-Moberg, U., Winberg, J. (1995). Separation distress call in the human neonate. Acta Paediatrica, 84(5):468-73.

Colson, S. (2002). Womb to World: a metabolic perspective. Midwifery Today 61:12-17.

Costa, A., deFilippis, V., Voglino, M., Giraudi, G., Massobrio, M., Benedetto, C., Marzio, L., Gallo, M., Molina, G., Fabris, C. (1988). Adrenocorticotrophic hormone and catecholamines in maternal, umbilical and neonatal plasma in relation to vaginal delivery. Journal of Endocrinological Investigation, 11: 703-709.

Dawood, M.Y., Raghavan, K.S., Pociask, C., Fuchs, F. (1978). Oxytocin in human pregnancy and parturition. Obstetrics and Gynecology 51: 138-143.

Dawood, M. (1993). Neurohypophyseal hormones. In Endocrinology of Pregnancy 3rd ed., Fuchs, F. and Koppler, A. (Eds.), pp. 204-228. Philadelphia: Harper and Row.

De Chateau, P., Wiberg, B. (1977). Long term effect of mother-infant behavior of extra contact during the first hour post partum II, A follow up at three months. Acta Paediatrica Scandinavica, 66:145-151.

DiMatteo, M.R., Morton, S., Lepper, H.S., Damush, T.M., Carney, M.F., Pearson, M., Kahn, K.L. (1996). Cesarean childbirth and psychosocial outcomes: a meta-analysis. Health Psychology, 15(4): 303-314.

Douglas, A.J., Bicknell, R. J., Russell, J.A. (1995). Pathways to parturition. Advances in Experimental Medicine and Biology, 395:381-394.

Eliot, R.J., Lam, R., Leake, R.D., Hobel, C.J., Fisher, D.A. (1980). Plasma catecholamine concentrations in infants at birth and during the first 48 hours of life. Journal of Pediatrics, 96(2): 311-315.

Enkin, M., Keirse, M.J.N.K., Neilson, J., Crowther, C., Duley, L., Hodnett, E., Hoffmeyr, G.J. (2000) A Guide to Effective Care in Pregnancy and Childbirth. Third edition. Chapter 42, pp 404-^08. Oxford: Oxford University Press.

Facchinetti, F., Lanzani, A., Genazzani, A.R. (1989). Fetal intermediate lobe is stimulated by parturition. American Journal of Obstetrics and Gynecology, 161(5): 1267-1270.

Facchinetti, F., Garuti, G., Petraglia, F., Mercantini, F., Genazzani, A.R. (1990). Changes in beta-endorphin in fetal membranes and placenta in normal and pathological pregnancies. Acta Obstetrica Gynecologica Scandinavica, 69(7-8): 603-607.

Falconer, A.D., Powles, A.B. (1982). Plasma noradrenaline levels during labor. Influence of elective lumbar epidural blockade. Anaesthesia, 37: 416-420

Faxelius, G., Hagnevik, K., Lagercrantz, H., Lundell, B., Irestedt, I. (1983). Catecholamine surge and lung function after delivery. Archives of Disease in Childhood, 58(4): 262-266.

Feifal, P., Raza, T. (1999). Oxytocin modulates psychomimetic-induced deficits in sensorimotor gating. Psychopharmacology, 141(1): 93-98.

Fernando, R., Bonello, E. (1995). Placental and maternal plasma concentrations of fentanyl and bupivicaine after ambulatory combined spinal epidural (CSE) analgesia during labor. International Journal of Obstetric Anesthesia, 4:178-179.

Fisher, J., Astbury, J., Smith, A. (1997). Adverse psychological impact of operative obstetric interventions: A prospective longitudinal study. Australia New Zealand Journal of Psychiatry, 31:728-738.

Franceschini, R., Venturini, P.L., Cataldi, A., Barreca, T., Bagni, N., Rolandi, E. (1989). Plasma beta-endorphin concentrations during suckling in lactating women. British Journal of Obstetrics and Gynaecology, 96(6): 711-713.

Freidman, E.A., Sachtleben, M.R. (1978). Effect of oxytocin and oral prostaglandin E2 on uterine contractility and fetal heart rate patterns. American Journal of Obstetrics and Gynecology, 130(4): 403-407.

Fuchs, A., Fuchs, F. (1984). Endocrinology of human parturition: a review. British Journal of Obstetrics and Gynaecology, 91:948-967.

Genazzani, A.R., Petraglia, F., Facchinetti, F., Galli, P.A., Volpe, A. (1985). Lack of betaendorphin plasma level rise in oxytocin-induced labor. Gynecologic and Obstetric Investigation, 19(3): 130-134.

Gilbert, L., Porter, W., Brown, V. (1987). Postpartum haemorrhage: a continuing problem. British Journal of Obstetrics and Gynaecologyl, 94: 67-71.

Giovenardi, M., Padoin, M.J., Cadore, L.P., Lucion, A.B. (1998). Hypothalamic paraventricular nucleus modulates maternal aggression in rats: effects of ibotenic acid lesion and oxytocin antisense. Physiology and Behavior, 63: 351-359.

Goland, R., Wardlaw, S., Blum, M., Tropper, P.J., Stark, R.I. (1988). Biologically active corticotrophin releasing hormone in maternal and fetal plasma during pregnancy. American Journal of Obstetrics and Gynecology, 159: 884-890.

Goodfellow, C.F., Hull, M.G.R., Swaab, D.F., Dogterom, J., Buijs, R.M. (1983). Oxytocin deficiency at delivery with epidural analgesia. British Journal of Obstetrics and Gynaecology, 90:214-219.

Grattan, D.R. (2001). The actions of prolactin in the brain during pregnancy and lactation. Progress in Brain Research, 135:153-171.

Gutkowska, J., Jankowski, M., Mukaddam-Daher, S., McCann, S.M. (2000). Oxytocin is a cardiovascular hormone. Brazilian Journal of Medical and Biological Research, 33(6): 625-633.

Hagnevik, K., Faxelius, G., Irestedt, L, Lagercrantz, H., Lundell, B., Persson, B. (1984). Catecholamine surge and metabolic adaptation in the newborn after vaginal delivery and caesarean section. Acta Paediatrica Scandinavica, 73(5): 602-609.

Hale, T. (1997). Medications and Mother's Milk. 6th ed. Texas: Pharmasoft Medical Publishing.

Hale, T. (1998). The effects on breastfeeding women of anaesthetic medications used during labor. Paper presented at Passage to Motherhood Conference, Brisbane.

Hawkins, J.L., Beaty, B.R., Gibbs, C.P. (1999). Update on obstetric anesthesia practices in the US (abstract) Anesthesiology, 91 A1060.

Heasman, L., Spencer, J.A., Symonds, M.E. (1997). Plasma prolactin concentrations after caesarean section or vaginal delivery. Archives of Disease in Childhood. Fetal and Neonatal Ed., 77(3):F237-8.

Hemminki, E, Merilainen J. (1996). Long-term effects of caesarean sections: ectopic pregnancies and placental problems. American Journal of Obstetrics and Gynecology, 174(5) 1569-1574.

Insel, T.R. (1999). Oxytocin, vasopressin and autism- is there a connection? Biological Psychiatry, 45(2): 145-147.

Irestedt, L., Lagercrantz, H., Belfrage, P. (1984). Causes and consequences of maternal and fetal sympathoadrenal activation during parturition. Acta Obstetrica et Gynecologica Scandinavica, Supplement 1,18:111-115.

Jackson, M., Dudley, D. (1998). Endocrine Assays to predict preterm delivery. Clinics in Perinatology, 4:837-857.

Jacobsen, B., Nyberg, K., Gronbladh, L., Eklund, G., Bygdeman, M., Rydberg, U. (1990). Opiate addiction in adult offspring through possible imprinting after obstetric treatment. British Medical Journal, 301:1067-1070.

Jevremovic, M., Terzic, M., Kartaljevic, G., Filipovic, B., Filipovic, S., Rostic B. (1991). The opioid peptide, beta-endorphin, in spontaneous vaginal delivery and cesarean section. [Article in Serbo-Croatian (Cyrillic), abstract in English] Srp Arh Celok Lek, 119(9-10):271-274.

Jones, C.M., Greiss, F.C. (1982). The effect of labor on maternal and fetal circulating catecholamines. American Journal of Obstetrics and Gynecology, 144(2): 149-153.

Jones, C.R., McCullouch, J., Butters, L., Hamilton, C.A., Rubin, P.C., Reid, J.L. (1985). Plasma catecholamines and modes of delivery: the relation between catecholamine levels and in-vitro platelet aggregation and adrenoreceptor radioligand binding characteristics. British Journal of Obstetrics and Gynaecology, 92(6):593-599.

Jowitt, M. (1993), Beta-endorphin and Stress in Pregnancy and Labor. Midwifery Matters, 56:3-4.

Kellogg, C.K., Primus, R.J., Bitran, D. (1991). Sexually Dimorphic Influence of Prenatal Exposure to Diazepam on Behavioral Responses to Environmental Challenge and on Gamma Aminobutyric Acid (GABA)-Stimulated Chloride Uptake in the Brain. Journal of Pharmacology and Experimental Theraputics, 256(1): 259-265.

Kimball, C.D. (1979). Do endorphin residues of beta lipotrophin in hormone reinforce reproductive functions? American Journal of Obstetrics and Gynecology, 134(2): 127-132.

Kinsley, C.H., Bridges, R.S. (1986). Opiate involvement in postpartum aggression in rats. Pharmacology, Biochemistry and Behavior, 25(5):1007-1011.

Klaus, M. (1998). Mother and infant: early emotional ties. Pediatrics, 102(5) Supplement 1244-1246.

Kloosterman, G.J. (1982). The universal aspects of childbirth: Human birth as a sociopsychosomatic paradigm. Journal of Psychosomatic Obstetrics and Gynecology, 1(1): 35-41.

Knox, S., Uvnas-Moberg, K. (1998). Social isolation and cardiovascular disease: an atherosclerotic pathway. Psychoneuroendocrinology, 23(8): 877-890.

Krehbiel, D., Poindron, P., Levy F., Prud'homme M.J. (1987). Peridural anesthesia disturbs maternal behavior in primiparous and multiparous parturient ewes. Physiology and Behavior, 40:463-472.

Laatikainen, T. (1991). Corticotrophin releasing hormone and opioid peptides in reproduction and stress. Annals of Medicine, 23(5):489-496.

Lagercrantz, H., (1986). The stress of being born. Scientific American, 254(4): 100-107

Leake, R.D., Weitzman, R.E., Fisher, D.A. (1981). Oxytocin concentrations during the neonatal period. Biology of the Neonate, 39(3-4): 127-131.

Lederman, R., Lederman, E., Work, B., McCann, D.S. (1985). Anxiety and epinephrine in multiparous women in labor: relationship to duration of labor and fetal heart rate patterns. American Journal of Obstetrics and Gynecology, 153(8): 70-77.

Lieberman, E., O'Donoghue, C. (2002). Unintended side effects of epidural analgesia during labor: a systematic review. American Journal of Obstetrics and Gynecology, 186: S31-68.

Lindow, S.W., van der Spuy, Z.M., Hendricks, M.S., Rosselli, A.P., Lombard, C., Leng, G. (1992). The effect of morphine and naloxone administration on plasma oxytocin concentrations in the first stage of labor. Clinical Endocrinology, 37(4): 349-353.

Liverzey, G.T., Rayburn, W.F., Smith, C.V. (1992). Prenatal exposure to phenobarbital and quantifiable alterations in the electroencephalogram of adult rat offspring, American Journal of Obstetrics and Gynecology, 167(6): 1611-1615.

Lowe, N., Reiss, R. (1996). Parturition and fetal adaptation. Journal of Obstetric, Gynaecologic and Neonatal Nursing, 25(4): 339-349.

Lundblad, E.G., Hodgen, G.D. (1980). Induction of maternal-infant bonding in rhesus and cynomolgus monkeys after cesarean delivery. Laboratory Animal Science, 30(5): 913.

Lundeberg, T., Uvnas-Moberg, K, Agren, G., Bruzelius, G. (1994). Anti-nocioceptive effects of oxytocin in rats and mice. Neuroscience Letters, 170(1): 153-157.

Marchini, G., Lagercrantz, H., Winberg, J., Uvnas-Moberg, K. (1988). Fetal and maternal plasma levels of gastrin, somatostatin and oxytocin after vaginal delivery and elective cesarean section. Early Human Development, 18(1): 73-79.

Matthiesen, A.S., Ransjo-Arvidson, A.B., Nissen, E., Uvnas-Moberg, K. (2001). Post-partum maternal oxytocin release by newborns: effects of infant hand massage and sucking. Birth, 28(1): 13-19.

Mirmiran, M., Swaab, D.F. (1992). Effects of Perinatal medication on the developing brain. Fetal Behavior, Nijhuis JG (Ed), Oxford: Oxford University Press.

Mueller, M.D., Bruhwiler, H., Schupter, G.F., Luscher, K.P. (1997). Higher rate of fetal acidemia after regional anesthesia for elective cesarean delivery. Obstetrics and Gynecology, 90(1): 131-134.

Murray, A.D., Dolby, R.M., Nation, R.L., Thomas, D.L. (1981). Effects of epidural anesthesia on newborns and their mothers. Child Development, 52: 71-82.

Myerson, B.J. (1985). Influence of early B-endorphin treatment on the behavior and reaction to B-endorphin in the adult male rat. Psychoneuroendocrinology, 10:135-147.

NCHS (National Center for Health Statistics) (2002). Birth-final data for 2000. Also, Births-preliminary date for 2001. www.cdc.gov/nchs retrieved March, 2003.

Nissen, E., Lilja, G., Widstrom, A.M., Uvnas-Moberg, K. (1995). Elevation of oxytocin levels early post-partum in women. Acta Obstetrica Gynecologica Scandinavica, 74(7): 530-533.

Nissen, E., Uvnas-Moberg, K., Svensson, K., Stock, S., Widstrom, A.M., Winberg, J. (1996). Different patterns of oxytocin, prolactin but not cortisol release during breastfeeding in women delivered by Caesarean section or by the vaginal route. Early Human Development, 45:103-118.

Nyberg, K., Buka, S.L., Lipsitt, L.P. (2000). Perinatal Medication as a Potential Risk Factor for Adult Drug Abuse in a North American Cohort. Epidemiology, 11(6): 715-716.

Odent, M. (1994). The Fetus Ejection Reflex. In: The Nature of Birth and Breastfeeding. CT: Bergin and Garvey.

Odent, M. (1998). Don't manage the third stage of labor! The Practising Midwife, 1(9): 31-33.

Odent, M. (1999). The Scientification of Love. London: Free Association Books.

Parker, C.R., MacDonald, P.C., Guzick, O.S., Porter, J.C., Rosenfield, C.R., Hauth, J.C. (1989). Prolactin levels in umbilical cord blood of human infants: relation to gestational age, maternal complications, and neonatal lung function. American Journal of Obstetrics and Gynecology, 161(3): 795-802.

Pearce, J.C. (1995). Evolution's End: Reclaiming the Potential of Our Intelligence. N.Y.: Harper San Francisco.

Petrocelli, T., Lye, S. (1993). Regulation of transcripts encoding the myometrial gap junction protein, connexin-43, by estrogen and progesterone. Endocrinology, 133:284-290.

Phillippe, M. (1983). Fetal catecholamines. American Journal of Obstetrics and Gynecology, 146(7):840-855.

Primal Health Database www.birthworks.org/primalhealth Promom.org. http://www. promom.org/101.

Queensland Health. Perinatal Statistics 2001. www.health.qld.gov.au/hic/1999peri/ home.htm Retrieved Nov., 2001.

Ransjo-Arvidson, A.B., Matthiesen, A.S., Lilja, G., Nissen, E., Widstrom, A.M., Uvnas-Moberg, K. (2001). Maternal analgesia during labor disturbs newborn behavior: effects on breastfeeding, temperature, and crying. Birth, 28(1):20-21.

Ringler, N.M., Kennell, J.H., Jarvella, R., Navojosky, B.J., Klaus, M.H. (1975). Mother-to-child speech at 2 years-effects of early postnatal contact. Journal of Pediatrics, 86(1): 141-144.

Riordan J, Gross AS, Angeron J, Krumwiede B, Melin J. (2000). The effect of labor pain relief medication on neonatal suckling and breastfeeding duration. Journal of Human Lactation 16(1):7-12.

Rivier, C., Vale, W., Ling, N., Brown, M., Guillemin, R. (1976). Stimulation of in vivo of the secretion of prolactin and growth hormone by beta-endorphin. Endocrinology, 100: 238-241.

Roberts, S.W., Levino, K.J., Lucas, M.J., Kelly, M.A. (1995). Fetal acidemia associated with regional anesthesia for elective cesarean delivery. Obstetrics and Gynecology, 85(1):79-83.

Rosenberg, K.R., Trevathan, W.R. (2001). The Evolution of Human Birth. Scientific American, 285(5): 72-77.

Russell, J.A., Douglas, A.J., Ingram, C.D. (2001). Brain preparations for maternity: adaptive changes in behavioral and neuroendocrine systems during pregnancy and lactation: an overview. Progress in Brain Research, 133:1-38.

Saito, M., Sano, T., Satohisa, E. (1991). Plasma catecholamines and microvibration as labor progresses. Shinshin-Thaku, 31: 381-389 (Abstract in English) (Also presented at the Ninth International Congress of Psychosomatic Obstetrics and Gynecology, Amsterdam 28-31 May 1989, Free communication no 502)

Salariya, E.M., Easton, P.M., Cater, I. (1978). Duration of breastfeeding after early initiation and frequent feeding. Lancet, 2(8100): 1141-1143.

Sarnyai, Z., Kovacs, G.L. (1994). Role of oxytocin in the neuroadaptation to drugs of abuse. Psychoneuroendocrinology, 19(1): 85-117.

Sepkoski, C.B., Lester, G., Ostheimer, G.W., Brazelton, B. (1992). The effects of maternal epidural anesthesia on neonatal behavior during the first month. Developmental Medicine and Child Neurology, 34:1072-1080.

Steer, P. (1990). The endocrinology of parturition in the human. Balliere's Clinical Endocrinology and Metabolism, 4(2): 333-349.

Stubbs, T.M. (2000). Oxytocin for labor induction. Clinical Obstetrics and Gynecology, 43(3): 489-494.

Taylor, S.T., Klein, L.D., Lewis, B.P., Grunewald, T.L., Gurung, R.A., Updegraff, J.A. (2000). Biobehavioral responses to stress in females: Tend and befriend, not fight or flight. Psychology Review, 107(3):411-429.

Thomas, T.A., Fletcher, J.E., Hill, R.G. (1997). Influence of medication, pain and progress in labor on plasma beta-endorphin like immunoreactivity. British Journal of Anaesthesia, 54:401-408.

Thomas, S.A., Palminter, R.D. (1997). Impaired maternal behavior in mice lacking norepinephrine and epinephrine. Cell, 91(5): 583-592.

Thomson, A.M. (1994). A re-evaluation of the effect of pethidine on the length of labor. Journal of Advanced Nursing, 19(3): 448-456.