Monday, October 18, 2010

Bypassing the Natural Protection of the Placenta: Drugs in Labour.

Ah, the placenta. That wonderful organ which sustains, oxygenates and protects the fetus through its gestation. The placenta is the only temporary organ that the human body grows, for the express purpose of making a healthy baby. The placenta also performs a complex function which allows the mother and baby’s blood to transfer nutrients and waste without ever mingling. This process is referred to as the placental barrier. The fetus is protected from much potentially harmful stuff that may be present in the mother’s body by the placental barrier. This marvellous organ can even prevent a fetus from catching HIV from an infected mother. As much as the placenta proects the baby its protection is not perfect. Pregnant women are encouraged not to drink or smoke – as some of these toxins can cross the placental barrier. Listeria, Toxoplasmosis and Salmonella can also cause fetal problems or miscarriage so women are told to avoid everything from sushi and soft cheese to cat pooh. Some illnesses can also infect and damage the baby – Rubella is a prime example.  Many medications can cross the placental barrier too, hence women are encouraged not to take most medicines. Even some vitamins supplements are considered too dangerous to risk. So the average woman will go through her entire pregnancy avoiding caffeine, medicine, alcohol, and camembert to protect her fetus from the dangers inherent in these substances, however tiny the risks may be.

However, as soon as the mother is in labour – arguably the most dangerous time in the fetus’s existence, doctors and nurses are quick to introduce a host of substances which – in their insidious chemical nature – cross the placental barrier easily. The first is often a ‘prophylactic’ intravenously administered antibiotic, which can cause thrush in both mother and baby, potentially damaging the breastfeeding relationship. It has been shown that antibiotics are usually completely ineffective at combating GBS which is the major reason they are given, so this is a completely unnecessary procedure. What it does do, however, is provide the doctors and nurses with direct entry, via the IV, to the mothers bloodstream so that they can start to administer all the drugs they want. Next they give the labouring mother Syntocin or Pitocin which is a synthetic version of Oxytocin, the naturally occurring hormone that causes contractions. Oxytocin has no detrimental effect on the baby and is released in waves so it causes a gentle ebb and flow of contractions. Pitocin on the other hand, is given continuously and in high doses and causes intense and extremely painful contractions. For the baby Pitocin is very unpleasant. Oxytocin – the love hormone – causes warm and happy feelings which comfort the baby during labour, but the synthetic version does not produce any feeling of wellbeing. Also a Pitocin labour is very intense and painful for the baby as the contractions are longer and harder with less recovery time between. Doctors have been know to use this to their advantage when they want to get the mother to agree to a c section.  Pitocin has also been linked to fetal asphyxia and neonatal asphyxia, physical injusy and jaundice. The use of Pitocin may also be a factor in cerebral palsy and autism from fetal oxygen deprivation during the long and unrelenting contractions. Some hospitals are using a drug called Cytotec or Misoprostal vaginally. These drugs can cause uterine rupture and are not indicated for use in pregnancy, in fact the makers of these drugs have warned that they cause uterine rupture and should NEVER be used as a labour inducing drug.


These powerful and painful contractions soon cause the labouring mother – who is usually flat on her back by now – the most painful position for labour – to ask for an epidural. The epidural blocks out the pain from the chest down so relieves the mother’s pain, but has a serious side effect for the baby. Natural contractions cause a degree of discomfort and pain in the mother. In response, the mother’s brain releases natural endorphins – which have a similar but much stronger pain relieving effect than pethadine – and these endorphins, which are non toxic and non narcotic, cross the placental barrier and flood the baby too, so the baby also is protected from the discomfort of contractions, which can be uncomfortable and cause fetal distress. When the epidural is placed the mother’s body no longer produces these endorphins, which means the baby is now feeing the brunt of labour with no pain relief. This, coupled with the lack of happy Oxytocin hormones due to the use of Pitocin or Syntocin, means that the baby is getting no relief of any kind and is much more likely to go into fetal distress. The anaesthetic effect of the epidural also crosses the barrier and is likely to cause breathing difficulties for the baby. Anyone who argues that the effect of drugs on the fetus during labour is negligible needs to watch this video. The babies who were a product of unmedicated labours were all able to self attach and suckled well while most of the medicated babies didn’t manage to breast crawl or self attach. All the medicated babies sucked badly. 

If the mother is lucky enough to have avoided an IV and any of the other interventions, she may be offered Pethidine or gas and air – laughing gas. Both of these drugs will cross the placental barrier and enter the baby’s bloodstream. Pethidine may also cause extreme nausea - one in three women has an unpleasant reaction to it. It can cause breathing difficulties in the baby. It can also cause neonatal drowsiness which can last for days and seriously affect the breastfeeding relationship. Gas and air (Nitrous Oxide) is less invasive. Doctors have maintained for many years that it does not cross the placental barrier, however gas and air babies are also liable to be drowsy. New studies have shown that it may have side effects for the baby but it is nevertheless the least harmful painkiller of all the drugs used in birth. Its effects are also usually short lived.

Western medicine has saved thousands of mothers and babies in labour. Induction – when necessary, can save a mother and baby. In a very tiny percentage of cases, induction is a necessary intervention. However, when drugs are used inappropriately – or as in many hospitals, routinely, a domino effect occurs which leads to more and more interventions. Up to 70% of women who give birth in American hospitals have their labours augmented by Pitocin or cervical ripening agents like Cytotec. Doctors like to be in control of their patients in the hospital environment. They apply time frames to labour and issue ultimatums. Unfortunately for women, labour is an uncontrollable event. The drugs that are routinely administered during labour have been proven to lead to a much higher c- section rate.

Painkilling drugs are also more necessary in hospital labours because women are often still forced to labour on their backs, whether due to being hooked up to the electronic fetal monitor or because their doctors don’t “allow” women to labour in any other position than the lithotomy position.  Lying on ones back restricts the pelvis by up to three centimetres. So naturally labour will be more painful for a woman whose movements are restricted and who spends most of her labour flat on her back. It takes an unusually strong woman to labour drug free in those circumstances.


  1. Oh My Goodness!! I had no idea about any of this! I guess now that I do know it seems common sense, but it still has me thanking my lucky stars (for my daughter's sake) that I only had gas during my labour.
    I knew I didn't like the idea of epidurals :-S the poor babies. If the mother cant take the pain, how can the baby possibly take it?

  2. I've known for years that if a mother gets an epidural, it eliminates the baby's pain killing because the mother is no longer producing endorphins. Yep, get the pain meds, don't be a martyr...just make your baby one. I wonder how many women would still choose an epidural if they had any clue what it does to their babies.

  3. I know, I often have to bite my tongue when someone says 'I had a natural birth with an epidural.' Um, no... you had a vaginal birth with an epidural. There's nothing natural about it. You probably have some pelvic floor damage from coached pushing and your doctor probably sliced your vagina to get the baby out because lying on your back compressed the opening!

    And to answer your question Lisa, almost no women know about the lack of endorphins and oxytocin for their babies because doctors dont tell them this. Women are told that these drugs are 100% safe for their babies.

  4. All of this and then insurance companies don't want to pay for more than 24-48 hours of hospital stay. Women in labor enter the hospital healthy, true...but become 'sick' and in need of recuperate care as a result of delivering their babies there.

    After reading this blog, so many things make sense now that didn't before. My natural children are 30, 28, 23 and 21. I noticed a HUGE difference between the deliveries of my first two babies and those of my second two. I now see Pitocin as that difference. I never had an epidural, but labor was slow, long, and excruciating with my third, and I was told to push long before my body was ready with my last. To say the least, that baby was born blue-ish and a bit listless and, as a result, was whisked over to the examining table instead of being placed on my chest..which made me angry at the time, and makes me angry all over again now that I've read this blog!

    I don't recall anything about Pitocin with my first three, but clearly recall being told I would be started on "Pit" as soon as I was admitted with my youngest. My youngest had severe apnea at 4 weeks that landed him back in the hospital for 4 days and $10,000 worth of tests. As an older infant, every cold settled into his lungs, and by the time he was 2 he was diagnosed with asthma.

  5. In addition, having four daughters and being a daycare provider, I know many women who are having children. What I am seeing as a current trend is the actual SCHEDULING of labor induction! 'Back in the day' we were told that two weeks either way of due-date was considered 'on-time'. Why then are we now inducing AT the due-date...which is only an educated guess to begin with? My daughter knew the earliest possible date of conception was, yet she had to fight with her doctor about inducing at her due-date.

  6. It's terrifying Catherine! Women have been trained to give over their power to doctors and allow them complete autonomy over them whil they are in hospital. Informed consent is a joke - half the time women are not even told what meds they are getting - and that's one of the major dangers of the IV, doctors can load you up with whatever they like without telling you what's happening.

    I was induced and ended up with a C Section. I was extremely well educated on birth and yet I allowed myself to be pressured into an induction when my doctor, my midwife and I all knew it was unneccessary. I get really worked up when I htink about it!

  7. im due christmas eve, a vbac after 10 years, and i am absolutely terrified. i have faith in my body that it knows what to do, but scared sh*tless over what the nurses and even my midwife are going to try and pull on me while i'm there. my last appt, she said to me, "so you are going to try to labor?" call me paranoid, but it sounds like she is setting me up for another c-section. i was 17 with a breech presentation, and had planned for a natural birth with my first, and i really felt pushed around and taken advantage of. i am determined that this is going to be different. all i know for sure is that the hospital staff is going to be relieved when we are gone, because i am not going to be an easy patient. please send energy of support and affirmation. im not going to let them jerk me around, its just getting prepared for the fight but in the right mental state that i dont allow it to stress me out too badly so i can focus on the birthing. deeeeep breath.

  8. ashley where are you? can you change health care providors? is it possible for you to find a vbac friendly midwife? if not, i reccomend getting a doula and making sure she has worked with vbac moms before. a doula is probably your best hope if you are having a hospital birth. if you cant change providors, ask the current midwife what her protocol with induction, breaking of membranes and active birth is. tell her you dont conssent to any interventions and that you would like to be left alone with your doula as much as possible. if u're in the uk, find out if you can homebirth - if you want to that is... a homebirth will ensure you dont get interventions unless your midwife thinks you need to transfer - and then you KNOW you needed them... also, please read every article on this blog - it's my favourite, full of great info....

  9. sorry about the typo's, multitasking!!!