There's Something that Should Happen in Every Birth, that You've Probably Never Heard Of
We can learn something from women who give birth in cars and corridors.
Today, most births take place in hospital—at least in the modern Western world. Only 50 years ago, most births took place at home, but now it’s typical to pack your bag for hospital and deliver your baby on a maternity ward.
Because you’re generally not admitted into hospital until you're in full-swing active labour, there are women every day, everywhere who don’t make it. There are births of babies who end up arriving in the car, in a lay-by, or even a hospital corridor!
You'll have seen the viral videos shared online where this has happened to a woman. They make one thing abundantly clear: these babies don’t wait for a signal from anyone! In a culture that stereotypes the image of birth as being a heaving, straining affair on your back under hospital lights and a cheerleading team urging PUSH, what these stories give away is that babies evidently don’t need any coercion. Not only may they come right out, but even against attempted suppression. In fact, there have even been women unconscious in comas who have given birth.
So what does this mean? Why do they need so much coaxing out in hospital? Are all these corridor-birthing women just oddities, or is there something else afoot in physiology?
What these stories reveal, like peepholes in a drawn curtain, are strong examples of the ‘fetal ejection reflex’. It’s a strange sounding term (that sounds more like a baby in-utero kicking an inquisitive hand off the belly) but what the term conveys is simply the fact of the act: a baby coming out with an enormous sense of urge, via the body's own expulsion, that when unimpeded in physiological birth, requires no inordinate 'pushing' at all.
The term 'fetal ejection reflex' was first used by scientist Niles Newton in the 60s in reference to birthing mice, then in the 80s by Michel Odent about women in labour. It usually occurs in a completely undisturbed labour when the woman feels safe and supported without bother from noise or bright lights.
That’s why the 1% of women who give birth at home will normally experience the fetal ejection reflex, but it’s rare to see it in hospital settings. A labouring mother upon entering hospital, whether or not she realises it, has her neocortex/'thinking brain' overstimulated and disturbs her deeper primal brain, even if she consciously wants to be in hospital. She will either give birth in spite of the disturbance, or receive intervention to rescue it.
By nature's design
So when a labouring woman transports suddenly into an alien environment of a car or hospital corridor, her labour might slow down or, sometimes stop altogether. But if she's too far gone, her body can eject the baby quickly. This is a design of nature. At the end of the labour process, a surge of adrenalin clears away her endorphin-trance and the muscles of the uterus bear downwards. Sensing a 'predator' can in fact trigger that last stage (in some societies historically, they’d fire a gun or shock the woman in some way, to produce the same effect!)
What is meant by ‘pushing’—excessive, coached force in a supine body position or imposed time limit (sometimes called 'purple pushing')—is not the same as 'bearing down'. A woman may have felt like she pushed but actually she is bearing down along with her own body’s force, on her body’s cue, not on the cue of other people.
That's why it's important for women to listen to their bodies in labour, following its cue—and in turn, for caregivers to listen to the woman, and follow her cue.
"Let us dream of a time when the art of midwifery will be primarily the practice of not hindering the fetal ejection reflex" (Michel Odent)
Many of us don’t think about the effect our chosen environment has on birth, or of how the same birth could play out in another place—and what our bodies might have done differently there.
In pursuing the ultimate safest place to give birth, we may have traded biology—and the fetal ejection reflex itself—for a different sense of safety. Might we come to question the 99% of babies born away from their homes, and recognise that a higher ratio of births can take place in an environment that actually helps facilitate a normal healthy outcome?
The picture you see in this post, of the woman birthing in the back of a car, is a staged scene I created as a fine-art photographer. Although you don't have to look far on the internet to find real photos and videos of women birthing 'accidentally' in unusual places, I wanted to make a polished photographic version, like a movie-still, for my fine-art series Birth Undisturbed. It was the term 'fetal ejection reflex' itself that inspired me—I wanted to take the term out of obscurity, to help more of us understand the biology behind it.