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The Science Behind Support in Pregnancy

Denying partners access to 20 week scans has potential to be harmful to mum and baby

· Pregnancy,Hormones,Partner,Maternity

There is good reason why Calm Mum calm Baby Calm Birth is our mantra at SBB. It is not just old wives tale or even ancient wisdom. It is nueroscience. A pregnant mother needs to feel safe, calm and supported and undue or prolonged stress can adversely her health and that of her baby. From this perspective denying partners access to the anomily scans and any other point of maternity care may have the potential to cause harm to mothers and their preborn babyies. 

Pregnancy can be a very vulnerable time for many women.  A pregnant mother is more susceptible to stress than at any other time in her life. Paradoxically she also has the ability to relax more completely and to connect deeply into her inner world. This is because of the naturally occurring cocktail of hormones or chemicals which support the changes in her body and her baby’s development. These delicately balanced hormones are essential for maternal and foetal wellbeing.  The research is clear: stress in pregnancy is associated with adverse outcomes for both mother and baby. It increases the risk of pregnancy complications and is associated with the need for interventions including serial scans, hospital admissions, induction of labour and assisted and surgical birth as well as premature birth.  Based on research, providing support and reassurance for pregnant mothers and protecting them from stress should be our absolute priority.

In its simplest form, the nervous system can be thought of as a binary response. The Autonomic Nervous System is largely under unconscious control and is made up of the Sympathetic Nervous System (SNS) and The Parasympathetic Nervous System (PNS). The SNS governs stress hormones and the fight/flight/fear response and the PSN governs calm hormones and the calm or “rest and be thankful” response.

Throughout pregnancy six key hormones are released into a mother’s bloodstream and these can have  a powerful effect on her body and mind. The hormones are responsible for growing her uterus, supporting her babies development and preparing her body to open in labour. An abundance of pregnancy hormones allows a woman to relax. Relaxation in turn promotes further hormone release leading the mother to a state of calm.

The delicate balance of hormones is easily disturbed. Hormones are directly influenced by the environment. Neurochemicals are generated by the brain according to sensory inputs from the environment and our responses to them. A constant sensory-motor feedback loop governs our emotional and physical states. A pregnant mother needs to feel supported and safe. Support, security and love increase “feel good” hormones such as oxytocin and endorphins. Stress, worry and fear increase cortisol levels.

A woman is more susceptible to stress in pregnancy than at any other time in her life and is more likely to experience stress towords the end of her pregnancy. Studies show that in the first and second trimesters a woman typically experiences calm because the PNS (as measured by markers such as IGA levels and Heart Rate Variability) is more dominant. As pregnancy moves into the third trimester the SNS dominates.  This is because a mother is programmed to protect her growing baby and so is sensitive to her environment and alert to danger signals.

The earlier a mother experiences stress the more likely that stress is to persist throughout her pregnancy and the more likely she is to experience complications as pregnancy progresses. Research shows that when the stress response dominates in the first and second trimester it continues to dominate throughout pregnancy. Research also shows that high markers in the first and second trimester are associated with complications such as hypertension, pre-eclampsia and diabetes in the third trimester. Hormones also cross the placenta and affect the baby. Chronic exposure to the stress hormone cortisol in utero can affect a baby’s development. Tense uterine muscles can reduce blood flow to the placenta. A baby also absorbs excess cortisol which can cause blood to be redistributed away from the baby’s kidneys and lead to a reduced growth rate (intrauterine growth retardation).

In order to maintain the delicate balance of this cocktail of hormones, an expectant mother needs to feel safe. She needs to feel that she has a choice in what happens to her body and her baby without coercion or urgency, that she is fully informed of all her options, that she is listened to, heard, respected and supported in those choices and that she has someone in her corner who will advocate for her if needed. In short, she needs to feel that she can trust that her individual needs and desires are central to her care and that she is not just a number in the “conveyer belt” of birth. When a pregnant woman’s emotional needs are not met she is likely to experience stress, anxiety, rumination and escalating fear. Who better to support a mother through pregnancy and birth than the person of her chosing, her birth partner? Who better to allay her fears and help her to access the very response that keeps her calm and helps to keep her and her baby safe.

As a midwife I often meet mums who are worried about having the 20-week scan alone. It is a significant milestone in the timeline of birth. Deep down a mother may be feeling doubtful, concerned or even anxious. “Is my baby ok? Will they have 10 fingers and toes? what if I get bad news? Many are young healthy and vibrant women who have never been in a hospital before and having no idea what to expect feel intimidated. Even the smallest niggling doubts and uncertainty can escalate into needless worry and stress. 

The research could not be clearer and is worth repeating. Support, information and choice from early pregnancy help a mother to take control of her birth experience, reduce the risk of complications and protect both mother and baby from birth trauma. Lack of support, information and choice creates uncertainty and has the potential to put a mother and baby at risk. Knowing all of this how can we justify excluding partners (and any other support person a mother chooses) from any stage of the birth process- whether the 20-week scan, subsequent antenatal appointments, the induction process, early-onset labour, labour itself or the post-natal period?

I would like to join my colleagues and birth workers all over Ireland in supporting this campaign to allow full and free access of partners and support workers into maternity units at all stages of pregnancy and birth.

The way we treat the vulnerable in our society is a reflection of our society as a whole and the way we treat young mothers will impact each and every one of us into the future. It is time that we stand up for our mothers and afford them the absolute right to birth with dignity and respect in the manner of their choosing.

Have you had your anomaly scan since the restrictions lifted? What was your experience?

Or perhaps you have been admitted to the labour ward in early labour. Was your partner “allowed in”?

We would love to hear your comments below

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