The Trauma of Birth from an Osteopathic Perspective

How can birth be traumatic? Birth is indeed a normal part of the cycle of life. Yet birth is certainly capable of becoming our very first trauma. This trauma may be extreme, producing obvious injury. However, even when a normal birth appears to be completely trauma free, the pressures applied to the infant’s cranium can still cause some problems.

The tiny infant is extremely resilient, able to withstand tremendous pressures as he/she is squeezed through the birth canal and forced to take the first breath. This first breath infuses our tissues with life, and expands our compressed bodies to ready us for the world.

The infant’s head (occiput) plays a significant role in opening the birth canal. The normal pressures of birth cause the cranial bones to fold over one another. The membranes (meninges) and fluid (CSF) surrounding the brain act as a buoyant shock absorber. The nervous system, always attempting to maintain stability under duress, organizes around these forces. These protective mechanisms allow for maximum brain capacity and minimize brain trauma. Many of the problems commonly experienced in infancy may be caused by the forces of labor and delivery.

The compressive forces of birth

If the compressive forces of birth are too great, the nervous system may become overwhelmed, and the skull bones may not be able to fully re-expand to their normal ease after the birth. Some births may not appear problematic, but can still produce substantial compression. An abnormally quick labor may prove equally overwhelming as one that is long and difficult.

The newborn may become firmly imprinted by these compressive forces, producing structural imbalances and a variety of symptoms. These symptomsmay range from minor variants of “normal” irritabilities to serious pathology.

Consider the birth process: the baby is squeezed head first down a canal too narrow to allow an easy passage, and the infant’s head is compressed and forced through this narrow canal during a process which generally lasts several hours, and which may last 24+ hours. Consider also the cranium of a new born baby: not a solid bony structure (otherwise it wouldn’t pass through the canal at all) but a delicate membranous balloon, the cranial vault consisting of plates of soft incomplete bone connected by membrane, and the cranial base being pliable, partly formed bone connected by areas of malleable growth cartilage.

Intense compression of this delicate structure over many hours (as is the case with most births) pushes the bones of the cranium up against each other and distorts the shape of the head considerably. This is normal and inevitable, but if the cranial bones remain in this state, or if they fail to release completely, then these distortions may prevent the proper formation of the skull and thereby restrict development of the brain.

Fortunately the body’s inherent self-healing and self-correcting mechanisms are also powerful and on emerging from the birth canal these self-corrective forces are able to remould the compressed cranium back into roughly the shape and formation for which it was designed. However, this innate remoulding is seldom completely successful, and the degree to which the restrictions and compressions are resolved varies considerably from individual to individual, depending primarily on the nature of the birth process.

For most of us the resultant cranial restrictions (and consequent effects on our health and brain development) will be relatively minor. But with a difficult birth or protracted labour, where compression of the baby’s cranium has been prolonged and forceful, or aggravated by bad positioning or over-zealous use of forceps, then the bones of the cranium may become so firmly compressed against each other or distorted to such an extent that the body’s inherent healing forces are not able to resolve the asymmetry. And this, depending on the degree of distortion involved, is when more severe symptoms may arise.

Cesarean section

Cesarean sections may be necessary to save the life of the newborn, or necessary when the infant becomes stuck in the birth canal for extended periods of time, putting extreme pressures on their little heads. They may also be scheduled for a variety of reasons.

Many infants born by Cesarean Section first endure a long period of labor, with their heads lodged in the maternal pelvis. The delivering physician also may sometimes place considerable force on child’s cranium, attempting to free the infant from the pelvic bowl. Though born by Cesarean Section, these infants may well suffer the ill effects of significant cranial pressure.

Some infants born via caesarean section do not encounter any compressive forces. We might think that the lack of trauma in a C-section is the best for the infant. But other factors come into play:

We need to be squeezed through the birth canal

This squeezing initiates a cascade of events that readies us for the outside world:

• Fluid is squeezed out of our lungs.
• Pressure is created for a powerful FIRST BREATH.
• Our central nervous system is stimulated and begins to organize.
• Dramatic changes take place in our circulatory system.

The changes taking place in the circulatory system are staggering. Intra-uterine life is very different than life outside the womb. Anatomical changes that take place for the child’s life outside the womb include:

The umbilical vessels spasm shut. Blood no longer comes from or goes to the placenta.

• A hole in the heart (foramen ovale) closes.
• The lungs now infiltrate and oxygenate the blood (ductus arteriosum closes).
• The liver now metabolizes (ductus venosum closes).
• The kidneys now filter the blood.
• The GI tract now absorbs all nutrients.

These adaptive changes must occur in a systematic and orderly manner, and place huge demands upon the newborn. When the transition from the womb is too quick, these changes in the vascular system become disorganized. Osteopaths perceive this disturbance as a “shock” or irritability that establishes itself in the nervous system.

Common problems associated with birth trauma

• Infantile Colic
• Chronic Upper Respiratory Infections
• Sleeplessness
• Chronic Ear Infections
• Spitting Up / Reflux
• Chronic Nose Bleeds
• Difficult Sucking
• Recurrent Urinary Tract Infections
• Clumsiness
• Bed Wetting
• Abnormal Muscle Tone
• Digestive Disturbances
• Learning Disorders
• Allergies
• Developmental Delays
• Eczema
• Seizures
• Asthma
• Cerebral Palsy
• Bronchitis

Craniosacral therapy (CST) can help the body regain balance after the trauma of birth, reducing a wide array of symptoms which could have long-term effects. In my next post, I will share more details about the process of CST and common questions parents might have when considering CST for their child. Bookmark our blog for the latest health tips from Body & Soul’s Shanghai health experts.

Marshall Gabin is a Registered Osteopath, providing craniosacral therapy and other osteopathic treatments at Body & Soul’s various Shanghai locations. Feel free to get in touch with us via WeChat to schedule an appointment with him.