Hormone Cascade in Labor and Delivery

During labor and delivery, there is a series of hormones which cause progressive intensity of uterine contractions and pain relief. This hormone cascade starts with prostaglandin from the placenta. Later oxytocin is added, then prolactin, endorphins and even epinephrine These hormones cause labor to progress while adding natural pain relief, a feeling of well-being, and get you ready for birth and breast feeding.  

Mothers like a dark, warm, quiet, and safe environment. They should be able to choose who is present, for example husband and/or Doula. Common activities which interfere with the hormone cascade include bright lights, loud noises, a cold environment, starting an IV, and all of the other testing which moms get when hospitalized during labor. Fear causes the release of epinephrine and norepinephrine which cause more anxiety, suppress labor, and interfere with the babies’ heart rate.  
In normal labor, the hormone cascade begins with natural oxytocin introduced after 5 centimeters dilation. How oxytocin interferes with the natural hormone cascade depends on when it is introduced. In normal labor, oxytocin presents at about 5 or 6 cm.  
The first half of labor is getting ready, that is, prostaglandin mediated. It includes softening of the cervix and vagina, and the baby’s head descending. Adding oxytocin increases pain and the need for an epidural. Since nature adds oxytocin in the last half of delivery and labor, the oxytocin interferes less with the cascade, but still makes contractions more intense.  

With natural labor, your hormone cascade will create what I call your “Zen world.” The hormone cascade prepares and augments your movement into an altered state of consciousness, which in turn relieves some of the pain of labor. The most important addition is a pain-reliever called endorphin, which is your body’s own morphine. Endorphin puts you in the “Zen World,” a state of altered consciousness, and is the primary driver in the performance of many athletes. This hormone cascade prepares a mother for bonding, increasing her feeling of well-being, and awareness of smell and touch to augment breast-feeding.  

While it is impossible to say exactly how the introduction of synthetic oxytocin will influence your labor, the truth is that it most likely does. Natural oxytocin is added to the second half of your labor with your prolactin, endorphins and epinephrine, your hormone cascade.  
Usually contractions hurt more with the addition of synthetic oxytocin and therefore an epidural is required. There are no research studies indicating how an epidural affects your hormone cascade during labor and delivery, including how synthetic oxytocin affects endorphins, prolactin, oxytocin and bonding instinct.  


Dr. Alan Lindemann

Obstetrician-Gynecologist (OB/GYN)​

He is an obstetrician and maternal mortality expert with 4 decades of medical practice beginning in Minnesota and presently in North Dakota. He has delivered around 6,000 babies with zero maternal deaths.

Why should you support Rural Doc Alan?

Dr. Lindemann delivered 6000 babies for over 40 years with no maternal mortalities, no eclampsia, and no babies with cerebral palsy. He tells his story here of how he did this in a medical environment that really doesn’t do well with deliveries. He openly admits that much he learned about safe pregnancy came from his patients, not medical books. Donating here will help spread the word to women everywhere so they can learn about safe pregnancy.