Labor day is getting closer and you to want to make your birthing experience as smooth as possible. You wonder if you’re overthinking it: Surely births happen all the time “in the wild” without all the white-coat medical staff, hospital walls, bright lights, encouragement to push. Doesn’t the kid just come out on their own at some point?
Well, yes — kind of. You might be thinking of the fetal ejection reflex. Let’s take a look at how it works when “nature takes its course” — and why it may be ideal for some but isn’t for everyone.
The fetal ejection reflex, also known as the Ferguson reflex, is when the body “expels” a baby involuntarily — that is, without forced pushing on your part.
How does it work? Well, as you approach your big day, the density of oxytocin receptors in your uterus increase as much as 200-fold. This means that your uterus is perfectly primed to react to this hormone. During the process of giving birth, your body releases oxytocin in pulses, and the receptors stimulate contractions.
The contractions thin and dilate the cervix — by pulling it upwards — and then move your baby down the birth canal. As pressure on the cervix and in the birth canal increases, neural pathways send messages to the brain to release more oxytocin. The additional oxytocin leads to two or three powerful contractions of the uterus that eject your baby into the world.
So if birth without pushing is possible (notice that we didn’t say without pain), why haven’t most of us experienced it?
Take a look at nature — mammals birth in a place where they feel sheltered and safe. That’s because the fetal ejection reflex happens naturally when these animals feel safe and supported.
In other words, think of it like hanging up a “do not disturb” sign. If you feel frightened or threatened, your body sends out the stress hormone catecholamine to shut down the natural labor process, and therefore the fetal ejection reflex doesn’t get triggered.
Not surprisingly, research draws parallels between the labor-intensive experiences of giving birth and running a marathon. Although your hamstrings aren’t burning, plenty is happening to your body during the moments of fetal ejection.
The muscles of your uterus have already flexed upwards, pulling the tightly drawn cervix open. Now that your cervix is fully dilated, your body prepares for the final moments of birth. Your uterus flexes upward even further and then bears down pushing your baby out.
At this point, you may feel an urge to move into an upright position, to lean over the back of the raised bed, or to move onto your knees in a crawling position. Expect to feel two or three powerful thrusts before your baby emerges.
When you enter labor, your uterus becomes a highly coordinated, strongly contracting organ. Changes in the density and activity of ion channels and pumps in the cells of the muscles of the uterus allow the needed biochemical processes to take place. The hormone noradrenaline helps activate the oxytocin receptors.
Oxytocin is released in brief, intermittent, high-frequency bursts. It seems that a feedback loop is built: The pressure of your baby against the birth canal stimulates the release of oxytocin which causes the uterine muscles to push the baby further down.
This in turn leads to increased pressure in the canal, which leads to another firing of oxytocin. The cycle continues until, voilà, your baby emerges.
The fetal ejection reflex is exactly that — a reflex. And that means that it’s something you can’t voluntarily control. It may take you by surprise and you may feel overwhelmed by it.
As your body exerts itself to the fullest, you may grunt involuntarily. Call these sounds the shouts of victory.
Michel Odent, a researcher who studied pregnant people in labor, pointed out that giving birth is “
Many hospital settings work against this premise simply because of how things run. You’re disturbed continually by machines, procedures, and midwives and doctors (who are sometimes accompanied by students).
Intrusions may hinder the natural birthing process by forcing your prefrontal cortex into action instead of letting your hindbrain, which is responsible for reflex actions, rule the roost. Your body reacts to the intrusions and the general lack of privacy by putting out stress hormones that stop labor.
Note, though, that we’re not suggesting hospital settings are bad, especially for those with potentially dangerous birthing complications. Hospitals and modern medicine have significantly improved maternal and infant mortality rates.
Is the fetal ejection reflex something that you want to experience in your birth? It depends. If you’re drawn towards giving birth naturally with as little intervention as possible and have had an uncomplicated pregnancy, this may well be for you.
Some people who have experienced the fetal ejection reflex report feeling that the birth happened almost by itself. Certainly a win!
However, if you’re uncomfortable about letting a reflex contribute significantly to your birth, you may want to let your birthing team guide you according to hospital procedures. And of course, if you’re high risk for complications, a hospital setting may be your safest bet.
As you prepare for birth, you’ll want to discuss your labor and delivery wishes with your medical team. Here’s a list of some of the questions you may want to ask:
- Who will be with me during the birth?
- Which pain interventions are available if I decide I want something?
- Does the birthing room have a tub?
- Will I be allowed to stand or get on my hands and knees if I feel the sudden need to?
- What is hospital protocol concerning medical students accompanying doctors?
- Will the lights be dimmed during labor and when will the lights be switched on?
- Is there a music system available?
While not always possible, experiencing the fetal ejection reflex can be magical. But remember: However you give birth, meeting your little one will make it all worth it.