Fetal Ejection Reflex

Dr. Sarah Buckley is a trained General Practitioner in New Zealand who is qualified in obstetrics and family planning. She advocates for homebirth, having had her own four children at home. On her episode of The Ultimate Health Podcast, she discusses a small portion of the information she has on the hormonal physiology of labor. More of her experience and knowledge on pregnancy and childrearing can be found in her book, “Gentle Birth, Gentle Mothering” her report, “Hormonal Physiology of Childbearing ” , or by checking out her website at https://sarahbuckley.com/ .  During the podcast episode, she said something striking and worth talking more about, “every extra person at the labor adds an hour to it”. 

dr sarah buckley
from Dr. Buckley’s facebook page: @drsarahbuckley


This was a lighthearted and not exactly scientific way of summing up a very important concept to understand about labor: if the birth-person is undisturbed and feels safe and comfortable, the labor could naturally occur with relative ease. Likewise, if that person is being probed and interrupted by a bunch of strangers, they might never experience what Dr. Buckley talks about as the “fetal ejection reflex”. 


This reflex is a process that often happens in pregnant and laboring mammals that triggers quick and strong contractions that lead to birth. It happens when the mama mammal knows that they are in a safe space with no potential harm around such as predators. However, if that mammal near the beginning of labor experiences a release of catecholamines (stress hormones) labor will be put on pause.  On the other hand, it is a surge of catecholamines near the end of labor that trigger this fetal ejection, and only will occur if the mammal feels completely safe. It works that way with humans too. 


U.S. Americans tend to imagine birth in a hospital setting with bright lights, a bunch of nurses and doctors, machines, frequent tests, and absolutely no privacy. Some people choose hospital births because they believe that hospitals are “safer”. Whether or not in their mind, they believe that they are safe, their body is getting another message. All of the probing and disruptions of intrusive tests and different people walking in and out of the room constantly indicate to the instinctive and physiological part of the birth-person and will affect how their hormones react. 


Another thing Dr. Buckley talks about is how in a hospital, one is more likely to have procedures that prevent that natural hormonal flow. That is especially true for prelabor cesarean sections and the use of epidurals. Epidurals, in particular, limit the oxytocin that triggers labor, and so the hospital probably will opt to inject the affected birth-person with Pitocin (artificial oxytocin). Other than helping to induce labor, Pitocin does not have the benefits of the naturally produced catecholamine surge. It is that surge during the last stage of labor that helps the baby in several ways including: helping to warm-up the baby, starting to prepare their lungs for breathing after birth, and beginning to store up metabolic fuels like glucose and fatty acids.  She explains that a lot of babies will go to the NICU after c-sections because they cannot maintain a healthy equilibrium possibly due to the fact that they never experienced the catecholamine surge. 


A home birth with people that the birth-person has a relationship with, especially in a space with familiar smells, furniture, pictures, lighting, etc. with minimized intervening from your midwife, experiencing the fetal ejection reflex is much more possible. If there is a lot of trauma or stress, the labor will be paused and if the mother feels safe and calm the baby could potentially come with an overwhelming sense that it is time to push without external efforts. The latter outcome is much better and results in happier birth experiences overall. U.S. American general understanding of birth is something that is hands-on with several people and machines and an artificial process. But Certified Midwives know that actually, the best way to labor is with the least amount of disruptions as possible. It is not necessary to experience the fetal ejection reflex for the birth to be a healthy and positive one, however birth-people should always have the freedom to be independent and in-tune with their bodies and feel safe and comfortable where they are so that their births can happen the way nature intended. It should be minimal external effort, and just following the physiological rhythms of their body and baby. 




Written by Gabrielle Cappelletti, the intern.

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