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Quanto dura un travaglio fisiologico?

Spoiler: abbiamo sempre sbagliato a farne una questione di tempo

Lucia Branchini, ostetrica

(Pagina 04)

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(3) Philpott R.H. & Castle W.M., 1972, Cervicographs in the management of labour in primigravidae. II. The action line and treatment of abnormal labour, Journal of Obstetrics and Gynaecology of the British Commonwealth, vol. 79, pp. 592-8.
(4) Buckley S., 2010, Hormonal Physiology of Childbearing
(5) Regalia A., Spandrio R., Bestetti G., 2014, Fisiologia della nascita: dai prodromi al post partum, Carrocci Ed.
(6) Neal J.L., Lamp J.M., Buck J.S., Lowe N.K., Gillespie S.L. & Ryan S.L., 2014, Outcomes of Nulliparous Women With Spontaneous Labor Onset Admitted to Hospitals in Preactive Versus Active Labor, Journal of Midwifery & Women’s Health, vol. 59, n. 1, pp. 28-34.
(7) WHO, Labour care guide: user’s manual, 2020, Geneva, disponibile su:
(8) American College of Obstetrician and Gynecologist, 2014, Safe Prevention of the Primary Cesarean Delivery, Obstetric Care Consensus, n. 1.
(9) WHO, Labour care guide: user’s manual,
(10) Garelli S., 2022, Il partogramma OMS – osservazioni integrative, D&D n. 117, SEAO Ed.
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(15) Belghiti J., Kayem G., Dupont C., Rudigoz R.C., Bouvier-Colle M.H., Deneux-Tharaux C., 2011, Oxytocin during labour and risk of severe postpartum haemorrhage: a population-based, cohort-nested case-control study, BMJ Open, vol. 1, n. 2, p. e000514.
(16) Reed R., Sharman R., Inglis C., 2017, Women’s descriptions of childbirth trauma relating to care provider actions and interactions, BMC Pregnancy Childbirth, vol. 17, n. 1, p. 21.
(17) Bernitz S., Øian P., Rolland R., Sandvik L., Blix E., 2014, Oxytocin and dystocia as risk factors for adverse birth outcomes: a cohort of low-risk nulliparous women, Midwifery, vol. 30, n. 3, pp. 364-370.
(18) Selin L., Almström E., Wallin G., Berg M., 2009, Use and abuse of oxytocin for augmentation of labor, Acta Obstetricia et Gynecologica Scandinavica, vol. 88, n. 12, pp. 1352-1357.
(19) Weckend M.J., Bayes S. & Davison C., 2020-2021, Exploring concepts and definitions of plateaus during normal labor and birth: a scoping review protocol, JBI Evidence Synthesis, vol. 19, n. 3, pp. 644-651.
(20) Norris S. & Murphy F., 2020, A community of practice in a midwifery led unit. How the culture and environment shape the learning experience of student midwives, Midwifery, vol. 86, pp. 102685-102685.
(21) Dixon L., Skinner J. & Foureur M., 2013, The emotional and hormonal pathways of labour and birth: integrating mind, body and behaviour, New Zealand College of Midwives Journal, vol. 48, n. 48, pp. 15-23.


Ossitocina sintetica: il meglio che possiamo fare?

Cecilia Antolini, co-fondatrice de Il Parto Positivo

(pagina 09)

(1) Rashidi M., Maier E. et al., 2022, Peripartum effects of synthetic oxytocin: The good, the bad, and the unknown, Neuroscience & Biobehavioral Reviews, vol. 141, p. 104859.(2) Bell A.F., Erickson E.N., Carter C.S., 2014, Beyond labor: the role of natural and synthetic oxytocin in the transition to motherhood, Journal of Midwifery & Women’s Health, vol 59, n. 1, pp. 35-42: quiz 108.
(3) Odent M., 2011, Nascere nell’era della plastica, Terra Nuova Edizioni.
(4) Uvnäs-Moberg K. et al., 2019, Maternal plasma levels of oxytocin during physiological childbirth – a systematic review with implications for uterine contractions and central actions of oxytocin, BMC Pregnancy and Childbirth,vol. 19, n. 285.
(5) Odent M., 2013, Synthetic oxytocin and breastfeeding: Reasons for testing an hypothesis, Medical Hypotheses, vol. 81, n. 5.


L’abuso di ossitocina sintetica

Enrica Schiatti, ostetrica

(Pagina 11)

Hayes E.J. et al., 2008, Improving patient safety and uniformity of care by a standardized regimen for the use of oxytocin, American Journal of Obstetrics and Gynecology, vol. 198, n. 6, pp. 622.e1-7.
Zhang J. et al., Oxytocin regimen for labor augmentation, labor progression, and perinatal outcomes, 2011, Obstetrics and Gynecology, vol. 118 (2 Pt. 1), pp. 249-256.
Saccone G. et al., Discontinuing oxytocin infusion in the active phase of labor: a systematic review and meta-analysis, 2017, Obstetrics and Gynecology, vol. 130, n. 5, pp. 1090-1096.
Odent M., Intervista del 2009.
Kanat M. et al., Oxytocin and the social brain: Neural mechanisms and perspectives in human research, 2013, Brain Research, n. 1580, pp. 160-71.
Okimoto N. et al., RGS2 mediates the anxiolytic effect of oxytocin, 2012, Brain Research, vol. 1453, n. 26-33.
Schmid V., 2011, Il parto sicuro,
Phaneuf S. et al., Loss of myometrial oxytocin receptors during oxytocin-induced and oxytocin-augmented labour, 2000, Journal of Reproduction and Fertility, vol. 120, n. 1, pp. 91-7.
Karahan N., Arslan H. & Çam C., 2018, The behaviour of pelvic floor muscles during uterine contractions in spontaneous and oxytocin-induced labour, Journal of Obstetrics and Gynaecology, vol. 38, n. 5, pp. 629-634.
Jiang D et al., 2022, Continued versus discontinued oxytocin after the active phase of labor: An updated systematic review and meta-analysis, PLoS One, vol. 17, n. 5, p. e0267461.
Moschetti A., Tortorella M.L., 2007, Ossitocina e attaccamento, Quaderni ACP.
Tyzio R., Cossart R., Khalilov I. et al., 2006, Maternal oxytocin triggers a transient inhibitory switch in GABA signaling in the fetal brain during delivery. Science, vol. 314, n. 5806, pp. 1788-1792.
Ceanga M., Spataru A. & Zagrean A.M., 2010, Oxytocin is neuroprotective against oxygen-glucose deprivation and reoxygenation in immature hippocampal cultures, Neuroscience Letters, vol. 477, n. 1, pp. 15-18.
Khazipov R., Tyzio R., & Ben-Ari Y., 2008, Effects of oxytocin on GABA signalling in the foetal brain during delivery, Progress in Brain Research, vol. 170, pp. 243-257.
Olza I., Uvnas-Moberg K., Ekström-Bergström A., Leahy-Warren P., Karlsdottir S.I., Nieuwenhuijze M., Villarmea S., Hadjigeorgiou E., Kazmierczak M., Spyridou A., Buckley S., 2020, Birth as a neuro-psycho-social event: An integrative model of maternal experiences and their relation to neurohormonal events during childbirth, PLoS One, vol. 15, n. 7, p. e0230992.
Torres G., Mourad M., Leheste J.R., 2020, Perspectives of Pitocin administration on behavioral outcomes in the pediatric population: recent insights and future implications. Heliyon, vol. 6, n. 5, p. e04047.
Kenkel W.M., Yee J.R., Carter C.S., 2014, Is oxytocin a maternal-foetal signalling molecule at birth? Implications for development, Journal of Neuroendocrinology, vol. 26, n. 10, pp. 739-749.
Mazzuca M., Minlebaev M., Shakirzyanova A., Tyzio R., Taccola G., Janackova S., Gataullina S., Ben-Ari Y., Giniatullin R., Khazipov R., 2011, Newborn Analgesia Mediated by Oxytocin during Delivery, Frontiers in Cellular Neuroscience, vol. 5, n. 3.
Fill Malfertheiner S., Bataiosu-Zimmer E., Michel H., Fouzas S., Bernasconi L., Bührer C., Wellmann S., 2021, Vasopressin but Not Oxytocin Responds to Birth Stress in Infants, Frontiers in Human Neuroscience, vol. 15, p. 718056.


Disempowerment in gocce

Se le madri diventano tutte mansuete e distimiche

Anna Maria Rossetti, ostetrica, SpBAT®

(Pagina 15)

  1. Kroll-Desrosiers A.R., Nephew B.C., Babb J.A., Guilarte-Walker Y., Moore Simas T.A., Deligiannidis K.M., 2017, Association of peripartum synthetic oxytocin administration and depressive and anxiety disorders within the first postpartum year, Depression and Anxiety, vol. 34, n. 2, pp. 137-146.
  2. Wiberg-Itzel E., Uvnäs-Moberg K., 2021, The Correlation between Synthetic Oxytocin Given during Labor and Women’s Personality Traits According to the SSP (Swedish University Scales of Personality) Survey: A Pilot Study Open, Journal of Obstetrics and Gynecology, vol. 11, n. 6.


Cambiare le domande

Non quanto è dilatata la donna ma quanto è neuromodulata

Anna Maria Rossetti, ostetrica, SpBAT®

(Pagina 20)

Buckley S., 2016, Physiology of childbirth, Free PDF download online from:
Dahan O., 2020, Birthing Consciousness as a Case of Adaptive Altered State of Consciousness Associated With Transient Hypofrontality, Perspectives on Psychological Science, vol. 15, n. 3, pp. 794-808.
Jowitt M., 2020, Dynamic Positions In Birth: A Fresh Look At How Women’s Bodies Work In Labour, Pinter&Martin Ltd.
ShynlovaO., Tsui P., Jaffer S., Lye S.J., 2009, Integration of endocrine and mechanical signals in the regulation of myometrial functions during pregnancy and labour, The European Journal of Obstetrics and Gynecology and Reproductive Biology, vol. 144, Suppl 1:S2-10.
Davis E., 2018, Labour Plateaus and Our Sexual Nature, Midwifery Today, Autumn 2018, n. 127.
Gutteridge K.E., 2013, Assessing progress through labour using midwifery wisdom, Essentially MIDIRS, vol. 4, n. 3.
Porges S.W., Furman S.A., 2011, The Early Development of the Autonomic Nervous System Provides a Neural Platform for Social Behavior: A Polyvagal Perspective, Infant and Child Development, vol. 20, n. 1, pp. 106-118.
Porges S.W., 1998, Love: An Emergent Property of the Mammalian Autonomic Nervous System. Psychoneuroendocrinology, vol. 23, n. 8, pp. 837-861.
Porges S.W., 1995, Orienting in a defensive world: mammalian modifications of our evolutionary heritage. A Polyvagal Theory, Psychophysiology, vol. 32, pp. 301-318.
Porges S.W., 2003, Social engagement and attachment: a phylogenetic perspective, Annals of New York Academy of Sciences, vol. 1008, pp. 31-47.
Porges S.W., 2007, The polyvagal perspective, Biological Psychology, vol. 74, n. 2, pp. 116-43.
Porges S.W., 1992, Vagal Tone: A physiological marker of stress vulnerability, Pediatrics, vol. 90, pp. 498-504.


Uscire dall’ostetricia cervicocentrica

L’osservazione clinica dei segni di travaglio iniziato e segni di progressione

Filomena Verde, ostetrica

(Pagina 27)

AA.VV., 2018, La crisi ossitocina, l’ossitocina in crisi?, I Quaderni di D&D n° 14, Seao Ed.
Berends et al., 2019, Oxytocin, vasopressin and trust: Associations with aggressive behavior in healthy young males, Physiology and Behavior, vol. 204, pp. 180-85.
Tiriduzzi M., 1977, Serum oxytocinase: an index of placental function, Minerva Ginecologica, vol. 29, n. 7-8, pp. 557-62.
Mansani F.E., Condemi V., Ceruti M., Serventi G., 1977, Oxytocinase in feto-placental insufficiency, Annali di Ostetricia, Ginecologia, Medicina Perinatale, vol. 98. n. 4, pp. 221-40.
Rossetti A.M., Il ben-essere della diade madre bambino in ottica PsicoNeuroEndocrina (PNEI),
Schmid V., 2008, Il dolore del Parto, I Quaderni di D&D n° 5, SEAO Edizioni.
Schmid V., 2021, Salute e Nascita. La salutogenesi in gravidanza, collana “Gli ElementaLi”, SEAO Edizioni.
Spandrio R., Regalia A., Bestetti G., 2019, Fisiologia della nascita. Dai prodromi al post-partum, Carocci Faber Ed.


Rallentamento fisiologico v/s arresto del travaglio

La clinica del distress

Valentina Baglioni, ostetrica IBCLC

(Pagina 29)

Schmid V., 2009, Apprendere la maternità, le nuove sfide di oggi, tra natura e cultura, Urra-Feltrinelli.
Bottaccioli F., 2022, Psiconeuroimmunologia, La grande connessione tra psiche, sistema endocrino, sistema nervoso e sistema immunitario, Red edizioni.
Schmid V., 2021, Salute e Nascita. La salutogenesi in gravidanza, collana “Gli ElementaLi”, SEAO Edizioni.
Reich W., 2000, La funzione dell’orgasmo, il Saggiatore.
Irestedt L., Lagercrantz H., Belfrage P., 1984, Causes and consequences of maternal and fetal sympathoadrenal activation during parturition, Acta Obstetricia et Gynecologica Scandinavica, Supplement, vol. 118, pp. 111-5.
Neuman I.D., Landgraf R., 2012, Balance of brain oxytocin and vasopressin: implications for anxiety, depression, and social behaviors, Trends Neuroscience, vol. 35, n. 11, pp. 649-59.
Okimoto N., Bosch O.J., Slattery D.A., Pflaum K., Matsushita H., Wei H.F.Y., Ohmori M., Nishiki T., Ohmori Y., Hiramatsu Y., Matsui H., Neumann I.D., Tomizawa K., 2012, RGS2 mediates the anxiolytic effect of oxytocin brain, Brain Research, vol. 1453, pp. 26-33.


Acidosi lattica miometriale

Quando l’ossitocina sintetica blocca ancora di più il travaglio

Anna Maria Rossetti, ostetrica, SpBAT®

(Pagina 34)


  1. Quenby S., Pierce S.J., Brigham S., Wray S., 2004, Dysfunctional labor and myometrial lactic acidosis, Obstetrics and Gynecology, vol. 103, n. 4, pp. 718-723.
  2. Wray S., Alruwaili M., Prendergast C., 2021,HYPOXIA AND REPRODUCTIVE HEALTH: Hypoxia and labour, Reproduction, vol. 161, n. 1, pp. F67-F80.
  3. Wray S. et al., 2004, Changes in contractions of human uterus in labour with lactic acid, Obstetrics and Gynecology, vol. 103, n. 4, pp. 718-23.
  4. Wiberg-Itzel E., Akerud H., Ellika A., Hellström-Westas L., Winbladh B., Wennerholm U.-B., 2011, Association Between Adverse Neonatal Outcome and Lactate Concentration in Amniotic Fluid, Obstetrics and Gynecology, vol. 118, n. 1, pp. 135-142.
  5. Wiberg-Itzel E., Pembe A.B., Wray S., 2013, Level of lactate in amniotic fluid and its relation to the use of oxytocin and adverse neonatal outcome, Obstetrics and Gynecology.
  6. Wiberg-Itzel E.,WrayS., ÅkerudH.,2018, A randomized controlled trail of a new treatment for labour dystocia, Journal of Maternal-Fetal and Neonatal Medicine, vol. 31, n. 17, pp. 2237-2244.
  7. Musaba M.W., Barageine J.K., Ndeezi G. et al., 2019, Effect of preoperative bicarbonate infusion on maternal and perinatal outcomes of obstructed labour in Mbale Regional Referral Hospital: a study protocol for a randomised controlled trial, BMJ Open, vol. 9, p. e026675.


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Buckley S., 2016, Physiology of childbirth, Free PDF download online from:
Garelli S., Rossetti A.M., 2019, Gli esami in gravidanza, capitolo La semeiotica delle mani (p. 159-179), collana “Gli ElementaLi”, SEAO Edizioni.
Schmid V., 1998, Il dolore del parto, Ed. Centro Studi il Marsupio.
Schmid V., 2007, About physiology and childbirth, Ed. Litografia I.P.
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Schmid V., 2021, Salute e Nascita. La salutogenesi in gravidanza, collana “Gli ElementaLi”, SEAO Edizioni.


E al posto dell’ossitocina sintetica?

La woman-centered care delle ostetriche

Francesca Lama, ostetrica

(Pagina 37)

Antonowsky A., 1979, Health, stress and coping, Jossey-Bass Inc Pub.
Iannuzzi L., 2016, An Exploration of Midwives’ Approaches to Slow Progress of Labour in Birth Centres, Using Case Study Methodology,
Schmid V., 2021, Salute e Nascita. La salutogenesi in gravidanza, collana “Gli ElementaLi”, SEAO Edizioni.


La chiave della nascita: il sistema parasimpatico

Strumenti per la stimolazione del sistema nervoso autonomo in travaglio

Silvia Garelli, ostetrica e autrice

(Pagina 43)

  1. Altemus M., Redwine L.S., Leong Y.M., Frye C.A., Porges S.W., Carter C.S., 2001, Responses to laboratory psychosocial stress in postpartum women, Psychosomatic Medicine,vol. 63, n. 5, pp. 814-821.
  2. Carter C.S., Altemus M., Chrousos G.P., 2001, Neuroendocrine and emotional changes in the post-partum period, Progress in Brain Research, vol. 133, pp. 241-249.
  3. Perry B.D., The Neurosequential model of therapeutics: using principles of neurodevelopment to help traumatized and maltreated children, in Boyd Webb N., Working with Traumatized Youth in Child Welfare, 2005, Guilford Press.
  4. Lund I., Ge Y., Yu L.C., Uvnäs-Moberg K., Wang J., Yu C. et al., 2002, Repeated massage-like stimulation induces long-term effects on nociception: contribution of oxytocinergic mechanisms, European Journal of Neuroscience, vol. 16, n. 2, pp. 330-338.
  5. Bell A.F., Erickson E.N., Carter C.S., 2014, Beyond labor: the role of natural and synthetic oxytocin in the transition to motherhood, Journal of Midwifery & Women’s Health, vol. 59, n. 1, pp. 35-42: quiz 108.
  6. Holman S.D., Goy R.W., Experiential and hormonal correlates of care-giving in rhesus macaques, in Pryce C.R., Martin R.D., Skuse D., 1995, Motherhood in Human and Nonhuman Primates: Biosocial Determinants, Karger.
  7. Rault J.L., Carter C.S., Garner J.P., Marchant-Forde J.N., Richert B.T., Lay D.C. Jr, 2013, Repeated intranasal oxytocin administration in early life dysregulates the HPA axis and alters social behavior, Physiology and Behavior, vol. 112-113, pp. 40-48.
  8. Wiklund I., Norman M., Uvnas-Moberg K., Ransjo-Arvidson A.B., Andolf E., 2009, Epidural analgesia: breast-feeding success and related factors, Midwifery, vol. 25, n. 2, pp. e31–e38.
  9. Etehadi Moghadam S., Azami Tameh A., Vahidinia Z., Atlasi M.A., Hassani Bafrani H., Naderian H., 2018, Neuroprotective Effects of Oxytocin Hormone after an Experimental Stroke Model and the Possible Role of Calpain-1, Journal of Stroke and Cerebrovascular Diseases, vol. 27, n. 3, pp. 724-732.
  10. Uvnäs-Moberg K., 1998, Oxytocin may mediate the benefits of positive social interaction and emotions. Psychoneuroendocrinology, vol. 23, pp. 819-835.
  11. Stock S., Uvnäs-Moberg K., 1988, Increased plasma levels of oxytocin in response to afferent electrical stimulation of the sciatic and vagal nerves and in response to touch and pinch in anaesthetized rats, Acta Physiologica Scandinavica, vol. 132, pp. 29-34.
  12. Uvnäs-Moberg K., 2004, Massage, relaxation and well-being: a possible role for oxytocin as an integrative principle?, in Touch and Massage in Early Child Development, 2004, Ed. Field T.
  13. Lupoli B., Johansson B., Uvnäs-Moberg K., Svennersten-Sjaunja K., 2001, Effect of suckling on the release of oxytocin, prolactin, cortisol, gastrin, cholecystokinin, somatostatin and insulin in dairy cows and their calves, The Journal of Dairy Research, vol. 68, pp. 175-187.
  14. Carmichael M.S., Humbert R., Dixen J., Palmisano G., Greenleaf W., Davidson J. M., 1987, Plasma oxytocin increases in the human sexual response, The Journal of Clinical Endocrinology and Metabolism, vol. 64, n. 27-31.


Un’orgia di interventi

Forzare il corpo delle donne

Annalisa Garzonio, antropologa della nascita

(Pagina 54)

1) Shorter E., 1984, Storia del corpo femminile, Feltrinelli.
2) Bourdieu P., 1998, Il dominio maschile, Feltrinelli.
3) Garzonio A., 2015, Partorire a Bali. Un viaggio attraverso diversi modelli di nascita, SEAO Edizioni.
4) Ibid., p. 71.
5) Filippini N.M., 2017, Generare, partorire, nascere. Una storia dall’antichità alla provetta, Viella.
6) Heritier F., 1996, Maschile e femminile. Il pensiero della differenza, Éditions Odile Jacob.
7) Cirlot J.E., 1969, Dizionario dei simboli, Ediciones Siruela (Venezuela).