Hormonal physiology of childbearing: evidence and implications for women, babies and maternity care.

Abstract

Report review runs alongside Guideline commentary and the other evidence series articles, examining local, national and international reports that have implications directly or indirectly for midwives. It helps readers to understand what reports mean for midwifery practice and to place report recommendations into context. As with all our evidence series articles, report reviews support you to critique recommendations and have implications for your own practice. This month, Alys Einion celebrates the common-sense approach of Sarah Buckley's 2015 report from the USA.The report summarises the ways in which the human female is physiologically designed to birth in a protected environment. The hormonal interactions around labour and birth, when fully expressed, facilitate better birth experiences and longer-term wellbeing for mothers and babies. The report shows how obstetric interventions and routine medical practices during labour and birth, many of which are not fully evidence-based, can disrupt the hormonal processes fundamental to labour, birth and maternal/neonatal wellbeing in the postnatal period and beyond, and recommends that women are educated to understand their own physiology so that they can birth confidently. It provides further evidence for a physiological basis for core midwifery practices including one-to-one care, a quiet calm environment, and extended skin-to-skin contact after birth, as part of a physiological approach to birth and the transition to parenthood.