As a doula I assisted at nearly 300 births before I stepped back from active practice. Certainly not all of these were unmedicated labors. In fact there were numerous labors I attended which made use of an epidural to help mom rest, relax, and ultimately release into the process of birth. I loved attending these births every bit as much as the natural ones. Every birth was truly magical. But I began to notice an occurrence in the immediate postpartum hour that seemed more common with the epidural and cesarean births. Shaking.
I first encountered this at a birth in Boston. The labor has been no more intense than others I had seen, but it had definitely gone beyond what the birthing person wanted to handle and she had opted for an epidural as the best way for her to continue birthing. The labor had continued- I think there may have been some augmentation at some point, but after several hours mom had begun to feel pressure, the midwife had found she was 10 cm opened, we had pushed, and the baby had been born into a room of celebration and smiles and placed directly against her mother’s skin. All in all a beautiful birth.
And then as the intensity of the moment of birth began to fade, and the placenta was born, I noticed my client shaking. When I asked if she was cold, she replied no, but she didn’t seem to be able to stop shaking. The midwife responded that this was normal, nothing to worry about, and that she would do best not to fight it, but to let it happen as this would actually make it less. At the time I thought nothing about it, and simply held my client’s feet (for grounding) as she communed with her baby. Gradually the shaking subsided, and mom and baby settled in for their postpartum stay.
I would see this response numerous times throughout my 12 years as a doula, and would often repeat that midwife’s words, about letting the shaking move through you. Years later, in my own unplanned cesarean birth experience when I found my body shaking so violently, I asked my husband to hold the baby for a moment because I was afraid I would drop him. I began wondering what was it that was leading this response. I could tell it was primal, and definitely not something in my conscious control. I had heard people say it was just the body processing the last hormones of labor- but then why didn’t my other clients have this experience.
It wasn’t until I read Emily and Ameila Nagoski’s book, Burnout, that I gained an insight into the physiology of why the shaking might be occurring, especially following something like a epidural or cesarean birth. In my earlier blog post I talked about the Fear, Tension, Pain response in labor and how the body can have different responses in labor depending on which side of the nervous system is activated. Key among these is the Freeze side of the sympathetic nervous system, where the body becomes like a deer in the headlights and tries to shut down labor to avoid birthing in an environment which feels unsafe.
But the process doesn’t stop there. As Nagoski explained, the freeze response in the animal world is effectively the “play dead” reaction, where having determined that a situation is untenable to either fight or flee, an animal may “choose” to go limp. The thought is that the predator, believing they have made their kill, will stop the chase, go back to get any others, and then return to eat. During this time the frozen animal might be feeling less pain, and is effectively catatonic. This is while the threat still exists, but it was Nagoski’s next description which caught my attention. She likens freeze to hitting the gas and brakes of the car at the same time, causing a system overload. But once the threat seems to have subsided, the frozen animal doesn’t just hop up and race off. They start to shake. The shaking, according to Nagoski, is like the brake slowly bring released, or from a neurochemical perspective, the adrenaline and cortisol slowly subsiding as the nervous system perceives it is once again safe. The shaking, actually helps them process through the trauma of a near death experience, so they can then get up and walk off.
Let me just point that out again, the nervous system comes out of a freeze state by shaking to help integrate what it has just gone through. When we get an epidural during labor, often we have become caught in trying to either fight or flee the labor process, and we need the cycle to stop. The epidural does this, and creates an imposed freeze state so we can hopefully let go of the fight and the body can relax. But the freeze state is artificially imposed. So when the threat finally subsides, even if the epidural has not worn off- my shaking begin in the operating room, when I was still most definitely numb-the body begins working through the trauma it knows it has undergone, even if we are not yet consciously aware of it.
The shaking is the way the body lets go of the experience on a somatic level, so as it turns out the midwife’s advice all those years ago was exactly right. Letting the shaking move through you, not only allows it to subside more quickly, but actually helps the body process and let go of the shock of the fight or flight being suddenly shut down. While it can be very disorienting to feel one’s body shaking without conscious control, this can actually be the first step in a healing process from a challenging birth. Giving the body space and time to go through its internal process may help us later when we reflect back on how we first met our children.
I should also be clear, just because someone experiences shaking following a birth doesn’t mean they were abused, or traumatized during the experience, or that they have somehow failed in welcoming their babies. The trauma I am speaking of here is the internal struggle we may have encountered, and while the environment and people around us may have played a part in it, they may also have helped it be less stressful than it might have been otherwise. My own birth began as a home birth which required a transfer to hospital and ultimately a cesarean, throughout all of which I felt loved and supported. But the surgery itself was a physical trauma for my body, and the fear around why it was happening was quite real, even thought I intellectually knew I was safe. The nervous system goes beyond our rational mind into our instinctual and animal brain, and that is where we birth from, and from where we process our experiences.
Key takeaways
Shaking after labor is a side effect which is common but not often talked about
Shaking is the body’s way or processing a forced Freeze state in the nervous system
Allowing the shaking to happen lets the body process through the hormones and physical experience more quickly
Just because someone shakes after labor doesn’t mean they have psychological trauma, but it does mean the body had some challenge during labor, and is working it through on an animal brain level. Best to let it process all the way through.