Kerstin Ovnas-Moberg – Oxytocin and the impact on motherhood
I have long wanted to hear Kerstin speaking as I was introduced to her work before I became a doula, and her book, The Oxytocin Factor, became one of the first in my ever-expanding doula library. She described herself as having a helicopter vision, having been an MD in Pharmacology and Physiology. The focus of her work has been oxytocin which she says is the same in all mammals. She describes sex, birth and feeding as the 3 main activities for oxytocin release (though Mars Lord, fellow doula, thinks that eating chocolate is a fourth, and who am I to disagree with that!). What she described is that oxytocin is needed both to initiate and perpetuate bonding; that raised oxytocin levels increase curiosity in the mother, but also encourage the body to work better – our digestive systems are more effective, our skin more sensitive. If regularly administered, oxytocin influences other more well known neurotransmitters which leads to less stress, more growth and healing, and reduced blood pressure levels. It reminds me of the TED talk on oxytocin which summarises that if we all received 8 hugs a day the world would be a very different place.
In a breastfeeding woman the higher her oxytocin levels the higher her prolactin. The gastro-intestinal systems in Mum and baby are activated by breastfeeding leading to improved digestion and gut performance in both. Spontaneous breast seeking behaviour in the newborn – the buffing of the baby at the breast for example stimulates oxytocin and more maternal behaviour in the Mum. Kerstin emphasised the importance of skin-to-skin contact and how stress levels were lowest in babies kept on the chest and highest in those put for long periods in a cot. Babies who had skin to skin contact in the long term were better at interacting, more secure, calmer and able to self soothe. She described these as having two possible causes – one, the Pavlovian phenomena, and second, the epigenetic phenomena – it facilitates development of security.
Interestingly oxytocin release is stimulated more by touching the front of the body than the back. Kerstin mentioned warmth, vibration, stroking, brushing, eating and massage as means of encouraging oxytocin release – all those elements that come in to play when a couple are making love.
However, there are some negative effects of oxytocin. Kerstin said that women are very open to advice immediately after birth – are totally trusting of those around them in those heady first few hours with their babies – and that women should perhaps be a bit more “critical” of suggestions made by doctors, midwives etc. It’s an interesting idea and one that we, as doulas, can be aware of when protecting our clients’ space. How often have we heard of women accepting suggestions in the first hours after birth they would never have dreamt of tolerating during the birth process itself? She also talked about maternal aggression and how oxytocin can give rise to increased anxiety in terms of concern for and worry about the baby.
Some other concerns which relate so closely to our work as doulas in supporting undisturbed birth are the effects of caesarean and epidural analgesia on oxytocin levels. They result in less pulsatile oxytocin released in the body, less prolactin, inhibition of maternal psychological adaptations etc. I expect we have all seen that in play somewhere along the line. Also the use of oxytocin infusions (synto etc) which have been found, two days after birth, to cause higher blood pressure and increased cortisol levels. But, the concern is that the synto doesn’t just act on the uterus, but possibly on the baby too. In terms of evolution Kerstin talked about a decreased oxytocin state – a perspective of no pregnancy, no birth, no skin to skin and no breastfeeding.
To finish Kerstin talked about how we need both physical and mental hands to support women – having a continuous presence is essential. And as she closed her speech she mentioned doulas, and I couldn’t have been more thrilled. What an affirmation of the ways in which we are able to support women.