How Your Nervous System Impacts Your Pregnancy and Birth

Adriana Lozada: Welcome to Birthful. I’m Adriana Lozada. 

Parijat Deshpande: 

Do I even know where my body is? Do I? If I close my eyes right now, do I know where my hands are? And you’d be surprised. Depending on what has happened and how long you have lived there, you may not even be able to feel parts of your body. 

Lozada: That is high-risk pregnancy and somatic trauma specialist, Parijat Desphande. Today, we’ll be talking about the importance of connecting with your body to release trauma, increase resiliency, improve pregnancy and birth outcomes, and get out of survival mode so you can truly start thriving. Make sure you stay until the end of the episode for my two things to do, one for you, one for the rest of us. You’re listening to Birthful, here to inform your intuition. 

Welcome, Parijat. It is a delight to have you here and it’s been a while, so for those listeners who don’t know you, why don’t you tell us a little bit about yourself, and also how you identify? 

Deshpande: Yes. Hello! I’m so glad to be back here and chatting with you again. I am Parijat Deshpande and my pronouns are she/her, and I guide women who are trying to conceive and are pregnant after second and third trimester losses or preterm delivery on how to support their bodies to reduce their risk of complications and preterm delivery in their next pregnancy. And I do all of this work all inspired by my own experience of going through a very high-risk pregnancy after infertility and fertility treatments and a loss, and then developing multiple complications, and delivering my son extremely preterm, but delivering him later than my medical team thought was possible, and it was during that personal experience that I recognized that there is a missing piece in prenatal care that I am just so honored to bring to my clients’ lives and to their experiences in growing their family. 

Lozada: And I love that how you bring all this work together is cemented on that things aren’t out of your control even if you’re having a high-risk pregnancy and that there’s a lot you can do to influence it positively in terms of outcomes and experiences. 

Deshpande: Exactly. 

Lozada: Yeah. 

Deshpande: That’s right. 

Lozada: Before we get into it, though, we have to lay some groundwork. Why don’t you get us started with a rough explanation of the nervous system and more specifically about the autonomic nervous system? 

Deshpande: Yes, absolutely. So, the autonomic nervous system is a part of our nervous system that is kind of broken up into two branches that you may have heard of: the sympathetic and the parasympathetic branch. And I like to think about those in terms of the analogy of a car. So, the sympathetic branch is like the accelerator of the car and the parasympathetic is like the brake of the car if you will. Really rough analogy. 

Essentially, the sympathetic nervous system is designed to keep us alert, alive, and awake, and the parasympathetic nervous system is what you might have heard as the rest and repair branch of that nervous system. And we need both of them. There needs to be a balance of going from back and forth, back and forth, and a healthy nervous system is one that has the flexibility to lean into one or the other branch as needed to help support optimal health. 

Lozada: And so, so exciting to expand a little bit of that concept of the nervous system, because pretty much that’s what… The two branches is what I learned in school. I’m sure that’s what you learned in school. But in the ‘90s, there were some really amazing developments in neuroscience and the concept of neuro psychoimmunology came up, which is something that I know you talk a lot about, so can you explain? It’s a really big word. What does it mean? 

Deshpande: Yes. It’s one of my favorite words. So, it’s essentially something that we found recently and is, as you can imagine, slow to titrate into actual practice of all kinds. But we have robust data on this that shows us that there is a very tight, very almost predictable relationship between our nervous system, our immune system, and our endocrine system, and essentially what it’s showing us is we generally have this idea that while stress is bad for health, we know that to some degree, but how exactly? This field, psychoneuroimmunology, sometimes called psychoneuroendoimmunology, just to make it a little bit longer, is really how. It shows us the dynamics between these various body systems and how they work together, and how they’re influenced by each other when we are in a situation of threat, and when we live in that situation of survival mode for longer than it is intended to be activated and what that does to our bodies. The issue arises when we are stuck there or frozen there. Chronic stress or traumatic stress. That’s when the issues arise and that’s when that cascading effect of long-term health issues start coming up. Chronic health issues both postpartum, who are generally outside of pregnancy, and that’s also what sets the stage for pregnancy complications and preterm delivery during pregnancy. 

Lozada: And as a side note, that sustained stress can affect the health of Black and people of color, along with institutional racism and intergenerational trauma, and it’s not from genetics. 

Deshpande: Yes. 100%. 

Lozada: Now, in terms of the nervous system, so many breakthroughs. This breakthrough happened and another one that happened in the ‘90s is how they view the nervous system with the Polyvagal Theory of Stephen Porges. Is that how you say his name? 

Deshpande: I think it’s Porges, but we may also be butchering that entirely, because I don’t think it’s-

Lozada: We’re trying. 

Deshpande: We’re trying. Sorry. 

Lozada: Sorry, Stephen. He first outlined it in 1995, but that has been getting more traction in recent years, for sure. And he talks about breaking that nervous system into three branches rather than two. 

Deshpande: That’s right. 

Lozada: How would you explain that Triune Autonomic system? 

Deshpande: Right. So, I would explain it as we just talked about, right? We’ve got the sympathetic, which is the fight or flight, the one that keeps us awake, alert, alive. The parasympathetic, which is the rest and repair. And then we’ve got what he offered as the social relationship, social kind of connection nervous system, basically identifying that another way to modulate our bodies is through being around and integrated with safe social relationships. Human beings are social animals. We do not function in isolation. We are not meant to be in isolation. And so, he identified this additional part of our nervous system that is attuned to and is always looking for that social connection with safe others.

Lozada: And can play a huge part in us being able to feel safe, even if we have a lot of stressors. 

Deshpande: That’s right. 

Lozada: Right. If we’ve got people around us that fill our cup, right? That we feel we have that village of support. 

Deshpande: Right. Absolutely. But here’s the thing, right? It’s all on a continuum, and so if for example… What we’ve also found is for example if you’re living in a body with traumatic stress, where your nervous system is frozen in that sympathetic dominance of fight or flight in experiencing your world through survival mode, so to speak, right? When you’re in that mode, we cannot tap into the social nervous system. We cannot get there. And so, and this is really important, because when we’re in that frozen state of survival, even if we are surrounded by the safest people in our lives, our bodies and our brains cannot accept that safety yet. Not yet. 

We have to actually unfreeze the nervous system to be able to allow for that impact of the safe others to happen to our bodies. 

Lozada: Why is it important to feel safe in terms of pregnancy development and outcomes?

Deshpande: Because when our body is living in sympathetic dominance, meaning in that fight or flight, that survival mode, danger mode, whatever you want to call it, the impact that that shifted nervous system has on the immune system and the endocrine system specifically, those three, they have to be in a particular balance in order to support pregnancy. Now, the interesting thing here is that balance is actually different in pregnancy than outside of pregnancy, so we do expect a shift of some kind from pre-pregnancy to pregnancy. That in and of itself, again, is not the issue. It is when it’s outside of that balance and it comes out of balance because you are living in that survival mode, sympathetic dominance, it impacts the immune system and endocrine system in a way that we know is tied to significantly increasing risk of pregnancy complications, such as preeclampsia, gestational hypertension, gestational diabetes, PPROM, preterm contractions, incompetent cervix, and preterm delivery among many others. 

Lozada: Alright, so then can we talk about some of those approaches depending on where you are in the spectrum? Because like you were saying, if someone who’s stuck in fight or flight, it might be impossible to do breathing exercises which we hear so much, “Just take deep breaths.” 

Deshpande: Right. Yes, because I think we touched on this earlier. It is a continuum, right? It’s a fluid dance that we’re doing in between all these different phases and all these different… I guess parts of our nervous system that we’re activating. And that is in a healthy nervous system, that dance is allowed to be very fluid. But when we are, for example, living in a body that has experienced trauma, and that trauma has not been released, and I use the word released very intentionally because it is… Trauma is essentially the nervous system frozen in fight or flight. That’s survival mode that we’ve been talking about so much. And when it is frozen there, you cannot access certain “tools,” or certain resources that you might have been able to access in other points of your life when the stress was more caused by an acute situation, or a chronic stress situation even is very different than traumatic stress. 

And we talked about this earlier too, for example, turning to safe loved ones. Very important. So critical for our overall health. And also, we don’t get the full benefit of that when we are living in a body with traumatic stress, and deep breathing is a great example of that. And the number one goal at that point is not to breathe more deeply, or to get more sleep, or to drink more water, or anything like that. Those are all extremely important things to do, but in that moment it is to help your body feel safe. You have to find a way to feel safe in your body first before any of those other tools are actually gonna make a difference. 

Lozada: And that safety has to be both cognitively and physically. You need to feel safe both cognitively and physically on your body. 

Deshpande: So, I would say that the cognitive aspect of safety comes when you feel physically safe in your body. It’s gotta start with the body first. The cognition follows. And then it creates a feedback loop of when I think I feel safe, I do feel safe, and when I do feel safe, I have thoughts of reminding myself that I feel safe. But the kind of the unlocking of that has to start at the body level first. 

Lozada: So, how do you unlock it? 

Deshpande: There are so many, so many, so many ways, and I will say that the first way, and this might sound really frustrating to some of the listeners. I apologize, but it really does start here, is you’ve gotta recognize that you’re frozen there. And that can be really hard to do because if you have lived that way for so long, you don’t realize that that’s where you are. Your thermometer has shifted. Your baseline has shifted. And a good way to identify that then is have I developed new chronic health issues? Have I developed any new pains? Has digestion changed? Have I been getting sick more often? Has something changed? And if yes, track it back. When did that start? 

I’ll give you an example. A lot of my clients, my private clients I work with identify that well, they had a preterm delivery before, or second trimester loss, and after that experience they developed say insomnia, or they developed a digestive issue, or an autoimmune disease, which I see a lot in my NICU parents. Something happened and it has been long enough, two years, three years, four years, five years, they go, “Well, that’s just how it is and I’m ready to try to conceive again. But I don’t know why this is happening. How do I improve my health?” And we can track it back to, “Well, when did that start?” 

“Oh yeah. Well, my son came home from the NICU and I didn’t sleep because he was a newborn, and then I didn’t sleep because he was a toddler, and then I didn’t sleep because he was in preschool, and I just kind of never slept again.”

Lozada: Yeah, because your body is definitely constantly giving you signals of… If we would listen, right?

Deshpande: Yeah. 

Lozada: So, so wise. So, say you have acknowledged it. What are some possible next steps? And I know that everybody has their own figuring out to do and what works for one person won’t work for the other, but what would be, after you identify it, what would be a next step? 

Deshpande: Then the next step is to follow physiology. And so, I like to give the example of being chased by a bear. There’s a very predictable pattern that our bodies go through. When you identify that there’s a bear that’s chasing you, your whole body goes into complete survival mode, right? The only goal right now is to survive that bear attack. That’s it. Everything else is deprioritized. And that’s where we’re frozen when we’re living in a body with traumatic stress, is mid-bear attack all the time, all day, every day. 

So, I ask people to think about if you were being chased by a bear and… Well, let me tell you, I’ll tell you what the pattern is. So, then let’s say you’re running from the bear, you’re getting away from the bear, you find a cave, catch your breath, you look around, okay, the bear is maybe still there, but I just want to get home. You keep running, you run, you run, you  get into your car, turn on the car, right? You can imagine you’re frantically, “Gotta get out of there!” And pushing on the pedal and I’m getting onto the road. And what happens when you get on that road and you start driving away? You start noticing, “Oh my God, I’m really hot.” You start taking your jacket off. And then you start noticing, “My hands are really sweaty. Oh my gosh, my heart’s racing. I’m really thirsty.” 

And then you hear the music that’s been on the radio this whole time that you couldn’t hear until then. And then you start… You turn to whoever was running with you and you go, “Can you believe that just happened? We just ran away from a bear!” Right? There’s a very predictable pattern that goes from bear attack to coming back out of that into baseline, and that is the exact pattern we have to follow in your body. And so, that starts with first how can you feel safe in your body again? 

Usually, for most people that involves learning how to feel your body again. Most people living with traumatic stress, and again, with my clients it’s usually after a loss, or preterm delivery, or complications, for any number of reasons. We lose connection and feeling and sensation in our body, and that’s where it has to begin. 

Lozada: And in that same release response that you were talking about, I was remembering my talk with Leslie Everest about shaking and the primal nature of birth, and how it’s very common during labor, but especially during right after the baby’s been born, to just shake uncontrollably. 

Deshpande: Yes. Yes. That happens after surgeries, when you’re coming out of anesthesia, yes, and after delivery. Absolutely. 

Lozada: And which is just part of your body’s mechanism of releasing that trauma, of releasing that stress, and being able to complete the circuit into safety. 

Deshpande: Yep. That’s exactly it. I really like to highlight what you just said, that it’s uncontrollable. It is unconscious. You have to create a body that will allow for the shaking to happen and it will happen, and again, to backtrack then to do that requires you to be able to feel your body first. And sometimes for some people it’s even before sensations, do I even know where my body is? Do I? If I close my eyes right now, do I know where my hands are? And you’d be surprised. Depending on what has happened and how long you have lived there, you may not even be able to feel parts of your body, and that’s where we start. 

Lozada: How do you build resiliency so that you can navigate between one and the other? Is there a way? Is that helpful? 

Deshpande: Yes. There’s so many different ways for that too, but I think the core piece of that is learning to tolerate discomfort. Again, not a glamorous answer I realize, but one of the things that we know is essential for healing, for completing that cycle that you’re talking about and coming out of it and being able to restore health to the nervous system so you can do that dance back and forth is not, “I feel pain, let me get rid of it. I feel grief, let me get rid of it. I feel guilt, let me get rid of it.” It is, “Can I sit and tolerate it without doing something to it first?” 

And in doing that, I’ll tell you, I have seen this happen so much with my clients, is as you are able to sit, and notice, and tolerate it, your body knows how to digest it. And that’s oftentimes when you see things like the shake, or the shiver, or some other unconscious automatic response your body is doing, because it knows how to digest and release what you have been holding onto. 

Lozada: That was stuck in your body somewhere. And I love that idea of instead of getting rid of it, almost feeling into it. 

Deshpande: Yeah. Right. 

Lozada: Yeah. Which is something that I see being so helpful and vital during labor itself-

Deshpande: Exactly.

Lozada: … and how to deal with the contractions, which, you know, talk about leaning into and being able to tolerate discomfort. I tell my clients instead of resisting, go into it, explore it, see what it’s all about. 

Deshpande: Exactly. And I love that you said that about don’t resist it, right? Because if you think of that word, resisting, you can imagine for anyone who’s had any kind of pain before, whether it’s labor related or not, what happens when we resist the pain? Our body tightens up and we go into this protective mode of… I mean, our entire body and our posture changes completely, right? And what happens to the pain then? It usually gets worse! And you have seen that in labor specifically and how that translates to how labor progresses, right? 

Lozada: Right. And fear increases too, and it’s what Grantly Dick-Read identified way back in way many years ago as the Fear-Tension-Pain cycle that then creates more fear and you get stuck in that. 

Deshpande: Yep. That’s exactly it. And you’re not doing it on purpose. Let me just be really clear about that. This is not by choice. This is not at all by you’re some kind of masochistic person who likes to torture yourself or anything like that. You’re not doing this by choice. This is not your fault. And so, it’s so important to be continually tapped into your body and how is it feeling, and am I in that space where I’m doing and able to do this dance? Or is there a place where I’m frozen a little bit? There’s no judgment. Just notice. Notice it, acknowledge it, and your body will know what to do. 

Lozada: That’s where that mind-body connection, you start with the body, but then you need to consciously bring your mind into it, and then they’re talking. Your body and mind are talking to each other. 

Deshpande: Exactly. Once you come out of that frozen state, now they’re talking to each other again. That communication is open again. And it’s not just open between mind and body, but now this is now… It’s open between you and others. You can now take in that sense of safety from others and allow for their presence to help you stay regulated. 

Lozada: And then bringing it all full circle, it provides for better outcomes because you’re less stressed, your systems, all of them are working together more fluidly, and then you’re not stuck in that freeze flight or fight response, and so you’ve seen with your clients and the work you do, and I’ve seen it with my clients and the work that I do, of better outcomes both in pregnancy and in birth, and better health for the birthing people, for the pregnant person, and for the babies. 

Deshpande: Yes. Absolutely. It just shows up so consistently that way too. 

Lozada: Thank you so very much. 

Deshpande: Loved it. 

Lozada: It’s always a delight to talk to you. 

Deshpande: Likewise! Thanks for letting me nerd out a little bit today. 

Lozada: That was Parijat Deshpande, author of the book Pregnancy Brain: A Mind-Body Approach to Stress Management During a High-Risk Pregnancy. Parijat helps those who experience second trimester complications during their first pregnancy feel safe being pregnant again. You can find her on Instagram @Healthy.HighRiskPregnancy, or her website, ParijatDesphande.com. 

And both Parijat and I would love it if you take a screenshot of this episode right now, if you are not driving, and post it to Instagram sharing your biggest takeaway from this episode. Make sure to tag @BirthfulPodcast and @Healthy.HighRiskPregnancy. One thing you can do for you is to take a step to move the needle closer to the thriving end of the surviving to thriving continuum. Depending on where you are, this could look like calling a friend that fills your cup, taking a trauma-sensitive movement class, or diving deep into communal healing by joining the Embodied Communal Consultations at EducationForRacialEquity.com. And then the one thing you can do for the rest of us is learn about the long-lasting impacts of trauma on the body. A couple of ways to do this are by reading Resmaa Menakem’s book on intergenerational trauma called My Grandmother’s Hands, or by watching Nadine Burke Harris’s TED Talk on how childhood trauma affects health across a lifetime. 

You can connect with Birthful on Instagram @BirthfulPodcast, and to learn more about Birthful and my birth and postpartum preparation classes, go to Birthful.com. 

Lozada: Birthful was created by me, Adriana Lozada, and is a production of Lantigua Williams & Co. The show’s senior producer is Paulina Velasco. Virginia Lora is the managing producer. Cedric Wilson is our lead producer. Kojin Tashiro mixed this episode. Thank you for listening to and sharing Birthful. Be sure to subscribe on Apple Podcasts, Amazon Music, Spotify, and everywhere you listen. And come back next week for more ways to inform your intuition. 

CITATION: 

Lozada, Adriana, host. “How Your Nervous System Impacts Your Pregnancy and Birth.” Birthful, Lantigua Williams & Co., February 3, 2021. Birthful.com.

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