Endocrine Intelligence For Birth & Beyond

Revisit the hormonal architecture of women, remember the deep link between the central nervous system, emotions and the endocrine system, and the mindshift from intervention in birth to a more natural experience will be easy, says Sensitive Midwifery.

The intricate balance between hormones enables women to pace themselves in labour, keeping pain at a level that they can handle. This is one reason a woman feels so powerful if she has given good natural birth and why one forgets the pain of childbirth relatively easily.  If a series of interventions are advocated unnecessarily, a cycle of disempowerment begins, none of the hormones can function optimally and it is unlikely that a woman will have a good birth experience.

Oestrogen and Progesterone

Apart from their important role in sustaining pregnancy, these two hormones:

  • Activate and inhibit all other hormonal responses involved in labour & birth
  • Are involved in the initiation of labour
  • Activate opiate painkilling pathways in the brain and spinal cord


Oxytocin is known as the hormone of love because of its interlinked ‘triple L’ sphere of influence – lovemaking, labour & lactation. It is responsible for uterine contractions and offers various other advantages, like:

  • It counteracts stress and induces positive mood states
  • In second stage there are higher levels of oxytocin to promote baby’s descent
  • Oxytocin increases during latching, eye & skin-to-skin contact between mom and baby
  • It keeps the uterus well-contracted helping prevent PPH

Maternity professionals need to create an oxytocin-friendly environment in labour room as well as all units after birth.


This natural occurring opiate is also known as the hormone of pleasure and transcendence, and is crucial in a woman’s experience of birth.

  • It is excreted by the pituitary gland when there is severe pain and stress
  • High levels inhibit oxytocin release to keep pain manageable
  • Beta-endorphins facilitate release of prolactin in labour to prepare breasts for lactation
  • It helps mature the developing baby’s lungs 
  • Beta endorphins release intensely pleasurable feelings for mom and baby


This hormone has broad spectrum action, helping enhance tender mothering putting the needs of one’s infant ahead of one’s own.

  • It rises steadily in pregnancy, declines during birth, then rises steeply directly after birth
  • It aids lactation, prepares the breasts for feeding and helps synthesise breast milk
  • It helps suppress fertility
  • It contributes to development and function of the immune system
  • Together with oxytocin it elevates mood and makes a breastfeeding mom feel calmer
  • Some studies show that it plays an important role in the maturation and development of the newborn’s brain, possibly explaining the optimal brain development amongst breastfed babies

Adrenaline and noradrenalin (Catecholamines)

These are produced in response to stress, initiate the body’s fight or flight response and are sometimes referred to as hormones of excitement.

  • High adrenaline levels in early labour may inhibit contractions and progress
  • Noradrenalin is involved in instinctive behaviour
  • High noradrenalin levels in labour reduce blood flow to the uterus and placenta
  • They peak at transition, when a woman will typically have a rush of energy and strength if not interrupted by unnecessary disturbing of physiological birth
  • Levels drop rapidly postpartum but more slowly if the mother is kept warm, benefiting her against PPH
  • They ensure that baby is wide-eyed and alert for the first contact with its mother

Anxiety in the labour room will unbalance the oxytocin/beta-endorphin/catecholamine see-saw, leading to unnecessary interventions and poor progress.

For the birth hormones to function optimally, a woman needs to feel private, safe and secure. Midwives can help to create an environment where this is possible. By making a few easy adjustments. Most interventions in labour are totally avoidable in the hands of skilled birth attendants. Midwives need to embrace their power to change the face of birthing, never forgetting that once active labour is established, very little will interfere with the unfolding of an experience which is after all one of the most natural of life.