Aug 26, 2015

Interview Transcript

Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.

Interviewer: This is Scope Health Sciences Radio, broadcasting live at South Jordan Family Fair. It's part of Be Well Utah, which is going on all week. And, right now, Elizabeth Smith has stepped up to the microphone and we're going to talk about hormones during labor. Tell me, what, exactly, are we getting into here.

Elizabeth: Okay, so we're going to talk about the four main players in the labor and birth process, and how they each interact together to help that to work the way it's supposed to, physiologically happen the way it's supposed to.

Interviewer: All right, and what do we need to do to make sure that happens? I mean, doesn't it just happen?

Elizabeth: It happens, yeah, it just happens. So, I'm going to go through some of the things we can do to kind of help make things work better, I guess. So, I'm going to start with the four main players, and those are: oxytocin, prolactin, beta endorphin and catecholamines. So, the most important hormone is the oxytocin because that's the one that really starts things going. It's the smooth muscle contractor, so oxytocin starts to pick up in the body system in the end of pregnancy.
Once the baby's brain is developed, and the mom's body says, "I'm kind of done with this," both of them will work together to get oxytocin in the system to be picked up by the prolactin receptor sites. Sound good?

Interviewer: Yeah, that sounds fantastic. Does it always work that way, or are things that people do that prevent it from working that nicely?

Elizabeth: There are some diseases that can actually prevent that oxytocin from picking up. If somebody's got anything that might inhibit hormonal production, that could maybe interfere a little bit. But, for the most part, it's going to happen. That baby's brain is going to put out that oxytocin, mom's uterus is going to pick it up and she's going to put out her own oxytocin and everything is going to go.
So, we're pretty confident that that's going to happen. There are things that you can to increase the oxytocin in the system. Those are anything that has to do with bonding and love. If you've heard some of those wives' tales, they are true.

Interviewer: Really?

Elizabeth: That will help a little bit. Estrogen has to be in play for that to happen.
So, we'll put oxytocin aside for a minute now and let's talk about catecholamines. Catecholamines are your "fight or flight" hormones, so it's adrenaline and noradrenaline, and dopamine as well, but not quite as critical in there. So what you might want to think is that you don't want "fight or flight" in the birth process, but how many of us procrastinate? Procrastination gets things done. That's what the catecholamine does, it kind of gives the body that energy start to go into labor.

Interviewer: Wow. This is freaking amazing, isn't it, how all this works. Is there anything that could interfere with that? Because one of the things we're talking about here at Be Well Utah is how to "be well," so is there something that a person could do that could mess that up? Or, again, does that just kind of generally work?

Elizabeth: Generally, that works. Now a little too much catecholamine is going to push your oxytocin down. So you don't want to be fearful going into that labor process. You want to be confident of what your body can do and how it's going to work.
Interestingly enough, the baby's brain produces catecholamine right then as well, and that helps suppress memory so that they don't have as much memory of that process that they're going to go through. Then the catecholamine picks up in the baby's system at the end, but we'll get to that in a minute.

Interviewer: Okay.

Elizabeth: So then you've got prolactin, which is responsible for lactation, but it also does two other things. For moms, it helps them to wake easily, so they're attentive to their baby, so you start producing a little bit before the labor happens. It makes it so the third trimester, it's kind of hard to sleep.
In a male partner, they will also build prolactin. What the prolactin does is it makes them have the "papa bear syndrome" where they're very protective of their mate. It also makes them able to cope with menial tasks. So let's think about changing diapers 12 times a day for the next little while, it's nice to have a little bit of prolactin going on in there.

Interviewer: So all of that is caused by hormones?

Elizabeth: It is hormones, yeah.

Interviewer: So if you're a woman and you're not sleeping in the third trimester, that's totally normal because that's what the body is doing. How does the guy pick on that, though? No one knows?

Elizabeth: No one knows. People who are biologically related to one another when they live in the same space, and so it just happens.
So, endorphin, we know of that as the happy chemical that happens from runner's high or doing anything like that. Endorphins pick up during the labor and they continue to gradually increase throughout the labor process. Now, if you do use an epidural, which a lot of people do have an epidural, it actually decreases those endorphins. So you lose some of your natural high. It's kind of a trade-off for that. You do still have the endorphin going on. Baby is also going to produce some endorphin so that they can cope with the labor process with the compression of skull during that process.

Interviewer: So the endorphins would help with the pain during delivery mainly?

Elizabeth: Absolutely.

Interviewer: Does it help with the bonding process? Because it felt so good that you now just feel so positive about this new life you brought into the world?

Elizabeth: It might, but oxytocin, again, is your big one.

Interviewer: Okay.

Elizabeth: Okay, so what happens is, during the process the catecholamines drop; the oxytocin, the prolactin and the endorphins are going to all rise gradually during the labor process, unless mom is fearful for some reason. So, if you ever have one of those moms who gets to the hospital and stops the labor process, the catecholamines have come into play because she's in a scary environment. That might make it stop.

Interviewer: So try to stay relaxed.

Elizabeth: Try to stay relaxed, exactly. Then, at birth, what happens is mom gets a big dose of that catecholamine again so that she can deliver the baby, so it's a good thing. Then the baby is also going to get a big dose of the catecholamine, and what that helps with is the transition to new life. So, as the heart valves shut and the circulatory system re-routes, the catecholamines are protecting the baby and helping him or her to do that, so, it's a good thing that that all happens like that.
Then, as we put mom and baby together, skin to skin, which is the process (you put baby right on mom's chest), mom's going to get an oxytocin rush, which is going to heat the chest area so that the baby stays warm. It's better than using a radiant heater or any other way to warm the baby. Baby's also going to get another good dose of oxytocin, the catecholamines are going to drop, and baby is going to transition to life a lot better than he or she would if that didn't happen.

Interviewer: That's absolutely incredible. Is there a takeaway? So do you explain this to most . . .

Elizabeth: They're taking our prenatal classes, any of our childbirth classes, then we're going to cover that so they have an idea what's going on. And we do kind of talk about how you can increase oxytocin a little bit, how you can decrease catecholamines, all of those different things, we'll cover as well.

Interviewer: Is there another reason why you feel they need to know that information? Or is it just kind of interesting?

Elizabeth: It's just cool, you know. It's just cool to know all that.

Interviewer: Okay, well thank you very much. And the services, are you a nurse midwife or . . .?

Elizabeth: My background, I'm a Master of Public Health and I have a Board Certification in Lactation. My staff are either nurses or I have a couple of doulas and I have a couple who are health educators. They all do certifications in childbirth and/or lactation.

Interviewer: Okay, and a person that wanted to use your services, who would they ask for? What would they ask for?

Elizabeth: So all you need to do is contact our office, which is (801) 581-2328 and you can get scheduled. Or if you through the university website and put in "prenatal education" all the classes come up.

Announcer: is University of Utah Health Sciences Radio. If you like what you heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at

For Patients

Sign Up For Weekly Health Updates

Get weekly emails of the latest health information from The Scope