The importance of pauses

All organic activity, starting with the first embryonic cell, is regulated by a rhythm alternating between contraction and expansion. In other words, you could say that any living being is a pulsating being.  

Yet, this active rhythm is periodically interrupted by a pause. In the neurophysiological language, this pause is called default mode network. While in default mode, the brain- or creative activity (of the being) stops, to integrate what has been moved, the experiences they have had, the dynamics coming into play.  

Therefore, the pause or default mode is an important phase, in order to “enter oneself”, learn, and evolve.

Labour follows this law of physiology, too.

Its dynamic is made of contractions and pauses. The more birth progresses, the deeper pauses (entering in oneself) become, the more the progression towards birth evolves.

This rhythmic alternance between contraction and pause is periodically interrupted by transition phases, in which labour completely or almost completely stops for a longer period of time.

Obstetric medicine has eliminated these pauses through the active- and medical direction of birth, without wondering about the importance of transition phases.

It is easy to imagine how such an intense process as labour contractions, which is demanding from the physical-, metabolic-, energetical- and psychic point of view (for both the mother and the baby), requires various adaptations on multiple levels, and, how, consequently, transitions have this precise integrating- and rebalancing function of reconstruction of new resources.

Taking the cue from the slow progesterone, which is only present in human birth, might the progesterone in the serum and possibly the progesterone “stored” by PR-C receptors on the uterine fundus be a resource staying available for adaptation moments in which a pause becomes necessary? Might it induce the default mode?

This hypothesis is also supported by another factor: besides the genomic action of progesterone, a more rapid and direct non-genomic action has been observed. Such action directly regulates the intracellular calcium level and, as a consequence, the contractile capacity of myometrial cells (Mesiano 2004, Vrachnis 2011). Therefore, progesterone could have a regulating function also on the ready-for-contraction uterus (Krueger 2018).

Here is the possible “on-off” function of progesterone in regard to the contraction!

During slow transition phases, when everything calms down (contractions, brain, metabolism), the parasympathetic nervous system, which is the expansive system of the boy, takes the lead. It allows an energetical rebalancing through the stimulation of internal organs and the increase in vascularisation, the improvement in oxygenation, and the complete regain of full placental functions.

It activates the “calm and connection” system, which stimulates again, among others, oxytocin and prolactin. It activates all sexual hormones that are useful for the physiological course of labour and, why not, maybe progesterone too, which, alongside prolactin, helps with energy restoration.

The reactivated progesterone may promote default mode, when needed.

That is why the midwife Nele Krueger, in her qualitative research “Of progression during pauses” (FH Salzburg 2018) describes how the adaptation taking place during pauses is the condition for a following rapid progression, in case of eustress, preventing the so-damaging distress.

Respecting pauses, taking advantage of the “unknown” action of progesterone, restoring homeostasis means, in the end, making birth faster but, above all, more harmonious and safer for baby and mother.

By Verena Schmid

Bibliography and reference websites

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