There is so much confusing language and terminology surrounding birth and labour. This section is designed to assist you in understanding terminology when it is crucial to your decision making. For example if a caeseran is planned for you, would you prefer a Trial of Labour???

**This section is a work-in-progress. Please check back to see what new information has been added.

The Trial of Labour

THE BENEFITS OF LABOUR FOR THE BABY also termed the TRIAL OF LABOUR (TOL)

Towards the end of your pregnancy, the placenta passes antibodies through the umbilical cord from you to your baby, giving it immunity from infections for about three months after birth. However, it only passes on antibodies that you already have.

When labour commences, the mother's stress hormones stimulate a chain of reactions in her body which the baby responds to. Basically, what it boils down to, is that the stress of labour is a good stress. As the mother labours her body produces hormones to help her deal with pain. As she does this her baby's adrenal glands are stimulated and they begin to produce high levels of catecholamines, or stress hormones. The catecholamines are the same ones that everyone's bodies produce in the flight or fight response to a life threatening situation or stressful event. This fetal stress response is designed to help the baby make the transition to life outside the uterus.

Here is how it specifically makes a difference:

· Helps the baby breathe. The hormones produced increase the levels of surfactant that are secreted; this helps the newborn keep their lungs expanded. As it keeps the lungs open it helps the baby to clear fluid from his or her lungs. Lung compliance is improved and bronchioles dilate. As baby is birthed, his lungs are squeezed creating a negative pressure. When this pressure is released, air is drawn into the lungs, allowing baby to take a more powerful first breath.

· Increases blood flow to baby. There are dramatic changes to the baby’s circulatory system. Stress hormones help send more blood to the baby's brain, heart and kidneys, protecting these organs from low oxygen levels during the birthing process. The baby’s kidneys also begin to filter blood. The baby’s central nervous system is therefore stimulated and begins to respond to the outside world.

· Increase energy supply to the baby. This is what keeps the baby satisfied until breast milk comes in. This is because his gastrointestinal tract is absorbing nutrients. Fuel for energy is mobilised in the following fashion: Normal fats are broken down into fatty acids; glycogen is broken down into glucose (in the liver) and the liver therefore commences to produce new glucose, thus metabolising.

· Facilitates bonding. That alertness your newborn has is directly related to these hormones. This can be seen in dilated pupils. A more alert baby draws parents in and he or she is more responsive to parents and others. This can be seen in a baby that appears very calm and focused for up to an hour after birth.

· Increases immunity. White blood cell numbers are increased as the adrenal hormones are secreted

· After birth: When the baby is born, the muscles surrounding the umbilical vein and arteries constrict. The umbilical arteries (which carry blood to the placenta) close off first, and the umbilical vein (which carries blood from the placenta to the baby) closes off soon afterward, allowing nearly all the blood in the placenta to be transferred to the baby. After the umbilical cord is cut, a quick transition must be made. The baby can no longer receive oxygen from the mother and must begin oxygenating blood in the lungs. An increased level of carbon dioxide, lower temperatures, and possibly certain other factors all prompt the baby to take its first breath, Removal of the placenta from the circulatory pathway increases the baby's blood pressure. The umbilical arteries constrict to prevent blood loss and, after allowing a few minutes for blood to be transferred from the placenta to the baby.

Studies have shown that while epidural anaesthesia does not affect the levels of catecholamines, there is a significant difference in babies who are born vaginally versus planned cesarean. Even if a cesarean becomes necessary during labor, even early on, the baby has more catecholamines and responds better to extra uterine life than counterparts born via scheduled caesarean prior to the onset of labor. For this reason some practitioners will delay elective cesarean until after the onset of labour when possible.