By Carolyn Hecken
Are you really all that surprised?! Did you really think you were doing all that work by yourself?
I know, in many run-of-the-mill childbirth preparation classes or books, your baby’s role as an active participant during labor and birth unjustly receives little to no recognition for her exceptional contributions.
You’re not alone in working hard to meet your sweet babe. She’s working just as hard to meet you!
(Please note that there is much variation in birth and how babies position themselves. Sometimes babies choose a certain position for a specific reason. These examples merely represent the myriad of ways many babies instinctively move and prepare for birth when in a head-down presentation.)
1. Your baby tucks his chin. In preparation for birth, your little one has to work his way down into your pelvis. Through your frequent upright activity, the force of gravity and a balanced pelvis, the increasing weight of your growing baby helps him to turn head down.
Once head down, the weight of his body against the soft tissues around your pelvis helps him to bend his next forward and rest his chin on his chest. Tucking his chin in this way allows the part of his head with the smallest possible diameter to be positioned at the cervix. It is thought that a baby presenting with this part of the head exerts an even amount of pressure on the cervix which enables it to open easily and steadily.
Experiment: To gain a better understanding of the difference this can make for you and your baby, form a circle or a sun with your two hands. Now place your hands palm-down on the crown of your head (the rounded portion of your head between the top and the back). Notice how nicely your head fits the opening formed by your hands. Now slide your hands up along the top of your head. You can feel a definite change in the way your head “fits” the opening less comfortably and evenly.
2. Your baby moves down into the pelvis – aka “engagement”. This can happen in the weeks leading up to labor – which is common for mothers giving birth for the first time – or even during labor itself. A mother giving birth to her second, third or subsequent child is more likely to experience the baby engaging once labor has begun. Engagement means that the widest diameter of the baby’s head has passed through the brim of the pelvis.
Before moving down into the pelvis, many babies tuck their chins to aid in the navigation process. The hormones your body releases toward the end of pregnancy and during labor both loosen ligaments and soften tissue which supports your baby’s descent into the pelvis.
3.) Your baby is responsible for starting labor. Scientists have long been perplexed by the exact underlying processes that trigger the onset of birth. Recently, researchers at the University of Texas Southwestern Medical Center believe that just prior to labor babies release a protein, surfactant, from their lungs. This protein functions as a hormone of labor signaling to the mother’s body that the baby’s lungs are adequately developed to make the transition from life in utero to breathing in air outside the womb.
In adults and children, this signaling protein is also known to help immune cells to fight off infectious bacteria and viruses that may have found their way into the airway, which would certainly be beneficial in the time during and after birth as well
4. Your baby exerts pressure on your cervix – with your help, of course! Okay, you’re probably not too terribly surprised by this one as you’ve probably been feeling those poking sensation for quite some time before and during labor, especially if your baby has already dropped some.
However, your baby’s head isn’t doing all of the work. In fact, it is the muscle fibers of your fundus, the top of your uterus, that are predominantly responsible for drawing up the circular, band-like muscles that form the neck of the uterus, or cervix. These muscle fibers contract and shorten throughout labor causing the top of the uterus to become increasingly thicker which, in turn, results in the circular muscle fibers of the cervix being pulled up. In other words, the work of your fundus greatly contributes to the thinning and opening of your cervix much like the collar of a turtle neck as you pull it over your head.
Your baby’s role is more specific. It is the position of your baby and/or her head can have a bearing on the shape of your cervix as it opens. Think back to the experiment in number one. Recall how snuggly and evenly your hands fit over the crown of your head vs the top of your head. Now imagine your hands are your cervix and your head is your baby’s head. Do you notice the difference and the impact it could have?
On her blog, Midwife Thinking, Dr Rachel Reed explains that a baby with the back of her head toward her mother’s front, described by birth professionals as occiput anterior, exerts pressure that often opens the cervix more evenly in concentric circles. For a baby whose back part or the head is against the mother’s back, occiput posterior, the cervix may dilate less evenly. Don’t worry! Your cervix will still dilate with a sunny-side-up baby.
5. Your baby adjusts it position during labor in order to move down. Babies intuitively know how to move through the pelvis. This movement is called internal rotation. In fact, one of your baby’s inborn reflexes, the step reflex, is thought to be activated by the fundus which aides your baby in the process of rotating through the pelvis.
Because the open space created by the bone structure of pelvis is shaped differently from top (brim) to the middle (cavity) to bottom (outlet), your baby rotate making use of its step reflex, your powerfully contracting uterus and pelvic floor muscles, in order to gently maneuver through the pelvic space.
At the brim of your pelvis, the opening closely resembles an oval shape with the long poles spanning from left to right. This means that your baby is either looking toward your left or right side as it comes down into your pelvis. When he reaches the middle cavity, which is round like a circle, he has the space to turn so that the back of his head is facing your front or back. This makes it possible from him to now pass through the outlet of the pelvis shaped like a diamond, with the longer points or wider area spanning from back to front.
6. Your baby’s head can shift shapes. Provided that she is head down, you may notice an oblong or even cone shape of the head after she’s born. This is because there are gaps in between the boney plates that form your baby’s skull. The flexible nature of your little one’s head not only allows room for rapid brain growth inside and outside the womb, it enables her to navigate her way through the birth canal and out into the world with ease. Sometimes, the extent and length of pressure may cause the plates to overlap. This is a normal process, called ‘molding’, and is your baby’s natural way of helping you. By the time you’ve had several days to cuddle and get to know her, the plates will have spaced back out, giving her head a more rounded look.
7. Your baby descends slowly – and it is a good thing. As your baby begins to pass through your open cervix, there are at most a mere distance of 13cm separating you and your baby from your first worldly embrace. Admittedly, it doesn’t sound like much – it’s about the length of an average avocado.
For most moms and babies, going this distance in this sense means working bit by bit, and sometimes even millimeter by millimeter. And there’s a good reason for it, too. The surrounding tissues must accommodate the size of your baby as he passes through what is an otherwise narrow opening. Bearing down to help little one move often means taking two steps forward followed by one step back. This progressive rocking motion down the birth canal gives your body an optimal chance to birth over an intact vagina and perineum.
Beyond that, descending through this space naturally compresses the baby, allowing fluid in his lungs and nose to be expelled in preparation for breathing once earthside.
8. Your baby rotates her shoulders. Once your baby’s head has emerged, you and she are afforded a rest or pause between the repeated ebbing and flowing of your urge to bear down. During this time, your sweet babe rotates her shoulders which, in turn, causes her head to now face either one of your inner thighs. Following your next urge to bear down, her shoulder at your front, gently slips beneath the pelvic arch and the rest of your baby is born.
9. Inborn reflex thought to support baby in taking first breath. Experienced moms know this reflex all too well! The Moro reflex is triggered when you place your baby on his back too quickly, his head doesn’t feel supported all of the sudden or he hears a loud noise. This response involves the extension of the hands, neck and head in conjunction with a sudden intake of air.
It is thought that this reflex occurs as your baby is born, facilitating the first breath of air into his lungs. In the meantime, his pulsating umbilical cord continues to provide a steady source of oxygen as he grows accustomed to his new terrestrial environment. At some point the cord will cease to pulsate, possibly signaling to the placenta that its job is now complete.
10. Additional infant reflexes help you birth your placenta. Most people think of birth as being ‘over’ as soon as the baby has arrived. That’s not true. The baby’s placenta, the life-sustaining organ you grew from scratch, still needs to be born as it has fulfilled its purpose.
Once you have taken your baby in your arms, the skin-to-skin contact and intense bonding continues the natural release oxytocin within your body. The receptors along your uterus pick up the oxytocin and carry on contracting (comparatively speaking, these contractions usually feel less intense – unless it’s your third, fourth or fifth child). They serve to reduce the size of your expanded uterus and release the placenta, effectively sheering it off the uterine wall as the uterus gradually decreases in size.
Your baby’s reflexes contribute in this process as well. When skin-to-skin on your chest, your baby begins coordinated movements toward your breast and, if given enough time and not too exhausted from birth, uses these reflexes to position itself to latch onto the breast. This set of undisturbed coordinated movements are a natural phenomenon often referred to as the ‘breast crawl.’
Using the stepping reflex your baby pushes her feet against your lower abdomen. Doing so stimulates further contractions, ultimately aiding in the expulsion of the placenta and possibly even reducing bleeding within the uterus.
Similarly, the rooting and suckling reflex at the breast culminates in latching onto the breast itself, additionally stimulating the release of oxytocin in the mother. The uterus continues to contract and the placenta is born.
It’s all pretty amazing, isn’t it?
Carolyn Hecken is a mother to three energetic, inquisitive children with one on the way. She holds a BA in Linguistics (University of Washington) and a MA in European Linguistics (University of Freiburg). Since June 2013 she has been supporting mothers and their families as a certified D.A.M.E. Doula and, more recently, as an AFS peer-to-peer volunteer breastfeeding counsellor (January 2016) and HypnoBirthing Childbirth Educator (June 2016). Click here to get to her website.