Undisturbed birth. Nature's blueprint for ease and ecstasy.
Undisturbed birth. Nature's blueprint for ease and ecstasy.
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不受干扰的诞生。
DOI：
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发表时间：
2003
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影响因子：
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通讯作者：
S. Buckley
中科院分区：
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作者：
S. Buckley
摘要：当女性顺利分娩时，她的身体会产生最高水平的分娩激素。其中包括催产素，一种爱情荷尔蒙；-内啡肽，一种愉悦的荷尔蒙，是人体天然的止痛剂；肾上腺素和去甲肾上腺素（肾上腺素/去甲肾上腺素）兴奋激素；还有催乳素，一种哺乳激素。本文概述了目前对这些激素的功能和相互联系的了解，以及医疗干预引起的激素干扰，特别是诱导和增强（加速），鸦片和硬膜外疼痛缓解，剖宫产手术和母婴早期分离。作者认为，不受干扰的分娩为母亲和婴儿创造了最大的舒适和安全，同时也使分娩成为一种潜在的狂喜体验。关键词：催产素；β-内啡肽;肾上腺素;去甲肾上腺素;肾上腺素;去甲肾上腺素催乳素;感应;催产素;syntocinon;增大;加速度;鸦片镇痛;硬膜外;母婴依恋;结合劳动;出生;安静的诞生;狂喜。当我在家里生下第四个孩子时，“无干扰分娩”这个词对我来说有了很大的意义。它很好地描述了这种美丽的经历，它把我重新唤醒到出生的狂喜中，我意识到，如果我们不打扰它，出生的过程可以很简单。将这次分娩与我之前三次在助产士的帮助下在家分娩，以及我参加过的在家和医院分娩相比，我也看到了我们干扰的习惯是多么根深蒂固，我们“做点什么”的需求经常在产房里自我实现。我意识到出生也是非常复杂的，这个过程对外界的影响非常敏感。做爱和生孩子之间的相似之处对我来说变得非常清楚，不仅在激情和爱方面，而且因为我们需要基本相同的条件来体验这两种体验；感到私密、安全、不被注意。然而，我们为生育妇女提供的条件几乎与这些截然相反；难怪现在对大多数女性来说生孩子是如此困难。什么干扰了分娩？正如我所暗示的，任何扰乱待产妇女的安全感和隐私感的事情都会扰乱生产过程。这一定义涵盖了大多数现代产科，它创造了一个围绕观察和监测孕妇和分娩妇女的整个行业。使用的一些技巧是痛苦的或不舒服的，大多数涉及到一些身体和/或社会界限的突破，而且几乎所有的技巧都是由女人自己根本不认识的人表演的。所有这些因素对孕妇和产妇都是破坏性的。在这些程序的背后，是对女性身体的极度不信任，以及对怀孕和分娩的自然过程的不信任，这种态度本身就有很强的反安慰剂效应，或有害效应。在此之上，还有一个产科层致力于纠正这种中断可能产生的“功能失调分娩”。由此导致的分娩过程的扭曲，我们可以称之为“胎动紊乱”，已经成为女性在生孩子时所期望的，也许，在一个奇怪的循环中，它起作用了。在这种模式下，女性几乎肯定会“需要”医疗模式所提倡的干预，无论她们的经历多么困难或创伤，她们都会感激被“拯救”。这些干扰也会对助产士产生反作用。当助产士的时间和精力都用在监控和记录上时，她就不太可能作为自然分娩的监护人“和女性在一起”。当她的直觉技能和简单的了解方式被埋没在为系统服务时，将需要越来越多的侵入性程序来获取信息，而在其他时候，助产士的心和手就能照亮这些信息。…
ABSTRACT: When a woman labors and gives birth without disturbance, her body produces peak levels of birthing hormones. These include oxytocin, the hormone of love; beta-endorphin, hormone of pleasure and the body's natural analgesic; adrenaline and noradrenaline (epinephrine/norepinephrine) hormones of excitement; and prolactin, the mothering and breastfeeding hormone. This paper outlines current knowledge of the functions, and interconnections of these hormones, and the hormonal interferences caused by medical interventions, in particular, induction and augmentation (acceleration), opiate and epidural pain relief, cesarean surgery, and early separation of mother and baby. The author argues that an undisturbed birth creates maximum ease and safety for mother and baby, as well as making birth a potentially ecstatic experience. KEY WORDS: Oxytocin; beta-endorphin; adrenaline; noradrenaline; epinephrine; norepinephrine prolactin; induction; pitocin; syntocinon; augmentation; acceleration; opiate analgesia; epidural; mother-infant attachment; bonding, labor; birth; undisturbed birth; ecstatic birth. INTRODUCTION The term undisturbed birth came to have great meaning for me when I gave birth to my fourth baby, unassisted (and unexpectedly breech) at home. It describes well this beautiful experience which awakened me anew to the ecstasy of birth, and I realized that the process of birth can be very simple, if we avoid disturbing it. Comparing this birth to my three previous midwife-assisted home births, and to home and hospital births that I had attended, I saw also how ingrained is our habit of disturbance, and that our need to "do something" so often becomes self-fulfilling in the birth room. I realized that birth is also very complex, and that the process is exquisitely sensitive to outside influences. The parallels between making love and giving birth became very clear to me, not only in terms of passion and love, but also because we need essentially the same conditions for both experiences; to feel private, safe, and unobserved. Yet the conditions that we provide for birthing women are almost diametrically opposed to these; no wonder giving birth is so difficult for most women today. WHAT DISTURBS BIRTH? As I imply, anything that disturbs a laboring woman's sense of safety and privacy will disrupt the birth process. This definition covers most of modern obstetrics, which has created an entire industry around the observation and monitoring of pregnant and birthing women. Some of the techniques used are painful or uncomfortable, most involve some transgression of bodily and/or social boundaries, and almost all are performed by people who are essentially strangers to the woman herself. All of these factors are disruptive to pregnant and birthing women. Underlying these procedures, is a deep distrust of women's bodies, and of the natural processes of gestation and birth, and this attitude in itself has a strong nocebo, or noxious effect. On top of this, is another obstetric layer devoted to correcting the "dysfunctional labor" that such disruption is likely to produce. The resulting distortion of the process of birth, what we might call "disturbed birth," has come to be what women expect when they have a baby and perhaps, in a strange circularity, it works. Under this model, women are almost certain to "need" the interventions that the medical model promotes, and to come away grateful to be "saved," no matter how difficult or traumatic their experience. These disturbances are counterproductive for midwives also. When a midwife's time and focus is taken up with monitoring and recording, she is less able to be "with women," as the guardian of natural birth. When her intuitive skills and simple ways of knowing have been buried in service to the system, more and more invasive procedures will be needed to get information that, in other times, a midwife's heart and hands would have illuminated. …