Natural Biology of Labor

When we think of labor and delivery, nutritionally, many of us think of the snacks (or lack of snacks allowed) during the 24-ish hours of actual labor. But, let me tell you a secret....the real nutritional works begins about 8 weeks BEFORE labor. This is when you are building up your nutritional stores that will fuel the natural birth processes. 
 
Most women are not aware of the role nutrients play  in the process of labor. I want to spend the next several articles discussing the important role that nutrition plays in processes of labor. 

I want to start, today, by talking about the natural biological processes of labor. By understanding HOW our body goes into labor and the natural biological changes that happen in the process, it will be easier to explain how nutrition plays a role in your natural birth goals.

Understanding the Physiology of Labor

Onset and progression of labor are measured and described by the frequency and strength of contractions, the cervical effacement, the cervical dilation, and the position of the baby. But, there is so much more to this beautiful process. So much that is never explained or discussed. 

No woman goes into labor the same. Even the same woman can have very different birthing experiences. This makes it very difficult to put together a flowchart of birth. Instead, we will discuss possibilities and end results (birth). ​

​Before a mother goes into active labor, there can be a period of pre-labor. During this time, the mother may be aware or unaware of changes in her body. Mild contractions, horribly termed false labor, can occur. Like a marathoner trainer for the big race, your body is training for the big event. These weeks leading up to the active labor are crucial for preparing the body physically for labor and delivery.

What causes pre-labor (better term)  or Braxton Hicks contractions?

These contractions are typically mild and can go unnoticed by the mother, or they can be bothersome. There are a couple of factors that control these early labor contractions. 

As the placenta begins to age, chemicals called corticotropin releasing hormones (CRH), are produced. These hormones have many roles during pregnancy, but towards the end of pregnancy, as the placenta nears the end of its functional life, the numbers increase drastically. As the levels of CRH rise, this begins the signal the mother's body that it is the end of gestation. Oxytocin in the brain (pituitary) is stimulated in small amounts, which then begins to affect the uterus, causing mild early labor contractions. 

At the same time estrogen levels increase, which stimulate the increase of oxytocin receptors in the fundus of the uterus.

In the early stages of pre-labor very slow progression may be occurring at this time as well. As the small amounts of oxytocin affect the uterus, causing the pre-labor contractions, there is irritation (normal part of the labor process), that occurs in the uterus. Oxytocin stimulates the production of prostaglandins and cytokines, which cause localized inflammation. This is GOOD inflammation, as it signals a multitude of reactions necessary for labor and delivery. 

What is the difference between pre-labor and premature (preterm) labor?

Premature (or preterm) labor is different than pre-labor. Premature labor is the start of labor prior to full gestational age. There are many causes of premature labor; infection, inflammation, trauma, nutritional deficiencies that cause poor clotting and thinning blood​. All of these underlying issues can create a BAD inflammatory environment that triggers labor before the baby or mother are ready. (We will discuss complications in future articles...in this series, we are focused primarily on nutrition for optimal labor)

What causes true active labor?
The mechanisms of labor are still being studied (I love that there are things that science still doesn't know). 

As the progesterone levels begin to drop, and estrogen begins to rise, this stimulates an increase in oxytocin receptors, as well as prostaglandin receptors. As the number of receptors increase, so does the affects of the oxytocin, causing more and stronger contractions signalling the beginning of active labor. At the same time the amount of CRH secreted by the placenta is at its peak, stimulating more oxytocin from the pituitary. This oxytocin not only stimulates uterine contractions but stimulates the prostaglandin production needed for cervical ripening. 

Recent research points to the role of the baby in the signalling the onset of labor. As the baby reaches full developmental age, and the lungs become fully developed, a protein is secreted from the baby's lungs. This protein reacts with macrophages (immune cells in the amniotic fluid) and create inflammation that irritates the endometrial lining of the uterus. This inflammation stimulates the production of prostaglandins, cytokines, and oxytocin. The baby also releases Dehydroepiandrosterone (DHEA), which is converted to estrogen. Estrogen stimulates cervical ripening, as well as the production of relaxin. Which keeps the ligaments, and muscles loose and flexible, allowing the pelvis to widen.



Estrogen, Oxytocin, and Beta endorphins stimulate the production of prolactin. Prolactin is a hormones produced by the pituitary that stimulates milk production in  mammals. 

We have talked quite a bit about oxytocin and contractions, but before those contractions can push the baby out, the cervix has to open. To do so, the cervix must first ripen (soften/efface). The process of cervical ripening is, in my opinion, the most important component of successful labor and delivery...if it's not soft, it cannot stretch with the contractions, and there will be no or slow dilation (I am going to talk about this IN DEPTH in the upcoming articles.) 

The end goal is the natural vaginal birth of a healthy baby. So, knowing a bit more about how the hormones work to facilitate birth. Tomorrow we will jump into the production and function of oxytocin and nutrition. 

DAY 1 Meal Plan

BREAKFAST #1: Banana Date Quinoa Porridge

Quinoa is a great "grain" for prenatal nutrition. It is rich in minerals (magnesium and zinc). It is a complete protein (providing all 9 essential amino acids, but specifically high amounts of isoleucine which we will talk about tomorrow in regards to oxytocin formation). 

Bananas are one of the only plant sources of hyaluronic acid (more on that to come)

Old wives tales talk about dates for shortened labors. Research actually supports this. It is also linked with a reduction in postpartum bleeding in those induced with synthetic pitocin.

Pumpkin Seeds are one of my superfoods. They contain large amounts of zinc, iron, magnesium, vitamin e, proteins, and healthy fats. Love these guys for anything reproduction. 

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LUNCH #1: Roasted Beet and Goat Cheese Salad with Mache and Slivered Almonds

Mache is the green I used in my salad today. It is rich in Vitamins A, C and folate. The vitamin C in the mache, aids in the absorption and function of the non-heme iron in the beets.

Beets are a great source of non-heme iron, magnesium, vitamin c, and folate. Combining with good fats (like those in the goat cheese and almonds) increases their functions.

Almonds are one of the best nut sources of Vitamin E.

DINNER #1: One Skillet Oregano Chicken with Sweet Potatoes and Brussels Sprouts; Watermelon

Hyaluronic Acid is something I bring up a lot in the office when talking about prenatal nutrition. It plays a significant role in cervical ripening (although no one ever seems to talk about it). It is found in the skin, cartilage, and connective tissue of animals. Eating chicken with the skin and bone on is a great way to increase your intake of hyaluronic Acid (we are going to talk about this A LOT in the up coming articles).

Brussels are a good source of Vitamin C.

Sweet Potatoes are a natural source of hyaluronic acid. They are also a good source of magnesium (which helps with the absorption and use of hyaluronic acid), and Vitamin A. Adding a fat to the cooking aids in the absorption of vitamin A, as well as the utilization of the magnesium and hyaluronic acid in the body.

Edema during pregnancy is a common complaint, but it can be a sign of preeclampsia. Watermelon is one of my secret weapons agains edema, and high blood pressure. In traditional chinese medicine, high blood pressure can be described as heat rising. Watermelon is cooling and hydrating. It is also full of water, and electrolytes.

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To Continue...

Planning Nutritionally for Labor and Delivery Part 2 - Oxytocin "the Love Hormone"
Planning Nutritionally for Labor and Delivery Part 3 - Estrogen and Progesterone
Planning Nutritionally for Labor and Delivery Part 4 - Cervical Ripening
Planning Nutritionally for Labor and Delivery Part 5 - More Than Just Progression
Planning Nutritionally for Labor and Delivery Part 6 - Probiotic Health
​Planning Nutritionally for Labor and Delivery Part 7 - Top 10 Foods for Labor and Delivery