The Physical, Emotional, and Spiritual Aspects of Newborn Transition
To understand the transition from in-womb circulation to out-of-womb circulation in newborns is to understand and appreciate the magical qualities of the human body and our design.
What happens even on a purely physical level after the birth of a baby is mindblowing and awe-inspiring. When you throw in all the nuances of spiritual, emotional, etc levels… it just feels so massive and so … important. These first moments of life outside of the womb have the power to shape the rest of our lives and they do imprint our psyches and our souls forever.
Fetuses and newborns are people too (not getting into the “when is a fetus considered a person” debate here, but for the purposes of this blog post, when I mention “fetus” it is just to make the distinction between a full term baby IN the womb compared to “newborn,” meaning a newly-born baby, fresh out of the womb), so we can pretty easily imagine what it must feel like if we choose to put ourselves in their “shoes,” so to speak.
Not to mention the fact that we have all been born! So we know, in our cells, in our subconscious, in our bodies, what birth feels like and what those first few minutes, hours, and days feel like on all levels, physically, spiritually, and emotionally.
So I will briefly describe the physical aspects of newborn transition in breathing and circulation, then will move onto some of the metaphysical or spiritual/emotional aspects of the newborn transition.
When a baby is in the womb, their lungs are filled with fluid. All of the little air sacs called alveoli that will eventually expand and fill with air once the baby takes its first breath are filled with fetal lung fluid. The fact that there is low oxygen in the lungs causes the little blood vessels in the lungs called arterioles to constrict. This creates a very high resistance, which makes blood NOT want to flow in that direction.
The heart “decides” to either continue pumping blood to the lungs OR to find another direction for blood to flow. So, it reroutes the blood in the opposite direction. The challenge for the fetal heart is to be able to get blood from the right side of the heart into the aorta / left side while bypassing the lungs.
The way this happens is that the septum in the center of the heart that separates the left and right atrium is actually made of TWO layers side by side. These layers have holes (similar to how two pieces of swiss cheese would look, one on top of the other - the holes of the septum are not aligned perfectly, making some parts of the septum one layer thick and some parts two layers thick), and since the pressure is so high in the right atrium, it presses on this holey septum, which makes the left side of the septum flap open. So there is a little hole in the septum of the fetal heart.
Now blood can flow from the right side to the left side of the heart and into the aorta without having to exert so much energy to go through the lungs first.
The hole in the septum is called the foramen ovale. This hole closes soon after the baby is born (Unless it doesn’t! Which can cause some issues but is not super common.)
You can see here that the septum in the center of the heart has a little hole in it with a flap. This is the foramen ovale. And just FYI, when looking at images of the heart, when we refer to the “right” atrium or “right” side of the heart, it’s actually the portion that is on the LEFT side of the image.
Not all of the blood from the right atrium (top right chamber) goes into the left atrium (top left chamber) through this foramen ovale, though. Some of it goes down into the right ventricle (bottom right chamber) (which is good, so that part of the heart gets practice pumping and the muscle there gets stronger).
Normally blood from the right ventricle goes into the pulmonary artery (the blood vessel that goes into the lungs), but since the pressure is so high there in the lungs (remember, the lungs, which are filled with fluid, contract the blood vessels within them, which make the pressure there really high and harder to overcome), so in the fetal heart there is an extra little vessel that goes from the pulmonary artery near the heart DIRECTLY into the aorta (the large blood vessel that channels blood to the rest of the body), bypassing the lungs. This extra vessel is called the ductus arteriosus.
These two additional pathways (the foramen ovale and the ductus arteriosus) help 90% of the blood in fetal circulation to bypass the fetal lungs and go directly to the rest of the body via the aorta.
You can see the little ductus arteriosus here circled in yellow. This is open when the baby is in the womb, but closes shortly after the baby is born.
10% of the blood supply still does in fact go into and out of the lungs, though. All of the baby’s oxygen supply is coming from the mother through the placenta while the baby is still inside, so it’s ok that the fetal blood bypasses the lungs.
The baby actually practices breathing while in utero from about 10 weeks on, and even though there is no air in the womb and blood isn’t really flowing much into the lungs, the neural pathways are getting practice and becoming activated by this practice breathing, so by the time the baby is born the lungs are all set and ready to be turned on completely.
After the baby is born, there are some major shifts that happen.
The placenta is no longer used to deliver oxygen to the baby AND the baby starts using its own lungs to oxygenate its blood and body.
As soon as the temperature of the umbilical cord falls below the temperature of the mother’s body, the wharton’s jelly (a gooey substance within the umbilical cord that protects the vein and arteries within the umbilical cord while the baby is in utero and being born) contracts. This makes like a natural cord clamp effect of clamping those blood vessels in the umbilical cord shut.
This causes that blood pathway to have a high resistance (makes it harder or impossible for blood to flow through that way). So the baby’s body adapts SO quickly.
The little sacs within the lungs that were filled with fluid while the baby was in utero, now become filled with air because the baby is breathing/crying and taking in air. The air pushes the fluid from the alveoli into the surrounding blood vessels in the lungs, the capillaries and arterioles.
If you remember from earlier, we talked about how the low oxygen in the air sacs of the lungs caused those blood vessels in the lungs to constrict. Well, now that there is more and more oxygen coming into those sacs because the baby is crying or breathing, that sends a signal to the blood vessels surrounding the sacs to stop constricting and to open up. This causes less resistance and allows blood to flow much more easily.
Remember, the lungs used to have high resistance but now millions of alveoli are opening for the first time ever, which makes it easier for blood to flow through those vessels and makes less overall resistance in the lungs.
The pressure also subsequently drops in the pulmonary arteries (blood vessels that go into the lungs) and in the right atrium and ventricle. So blood is pouring into the lungs now, which is then oxygenating and then pouring into the left atrium of the heart.
Which is different than before the baby came out and not much blood at all was entering into the left atrium from the lungs because not much blood was passing through the lungs at all.
So now, because the pressures on the right side of the heart are so low and the pressure on the left side of the heart is much higher, the little flap of tissue in the center called the foramen ovale closes. The higher pressure on the left side pushes that flap closed.
This foramen ovale closure happens within the first few minutes of the baby being out of the womb.
The fact that the pressures have now essentially flip flopped and are higher in the aorta compared to the pulmonary arteries, means that the blood no longer likes to flow from the pulmonary artery into the aorta. You would think that it would now want to flow in the opposite direction – from the aorta into the pulmonary arteries – but now that the oxygen saturation levels in the blood are much higher, that signals to the little ductus arteriosus to constrict.
The lowered levels of prostaglandins in the bloodstream (because the placenta – which produces prostaglandins and circulates them in the blood of a fetus – is no longer attached) also signal the ductus arteriosus to contract/constrict. This little ductus arteriosus closes completely within hours of the baby being born.
And when the umbilical cord is fully closed, the resistance is super duper high in that direction, so no blood wants to flow there, (plus the umbilical arteries constrict the same way and for the same reasons as the ductus arteriosus constricts) and it just skips it and blood flows to the rest of the body instead of out of the umbilicus. This all happens within the first few hours after birth in new babies.
And that is how a baby physically transitions from fetal blood circulation (and not breathing) to newborn circulation and breathing.
So, if you would like to touch in on the emotional and spiritual aspects of this transition with me, please continue :)
In Chinese Medicine, the lungs are connected to the emotions of grief, sadness, and detachment. When lung qi (energy) is balanced, the emotion is said to be courage.
I find it SO interesting that feelings of detachment are associated with the lungs because that is basically what is happening in those first few minutes/hours after birth: detachment. Detachment from the mother and from the placenta. And the emotional process that a baby AND a mother go through after birth is more about coping with the swift transition from attachment to separation.
Allowing this process of newborn transition to breathing to occur smoothly and calmly and in a grounded way can help the newborn to come to terms with the transition and these aspects of detachment and separation in an aligned and calm way. And to have the “courage” necessary to be able to cope with all of the new experiences that life outside of the womb brings for a baby.
Imagine leaving someone you loved and taking the time you needed and wanted in order to say goodbye and get in the car and drive away
versus
being in a rush and overstimulated while also trying to say goodbye to this person you loved.
The first scenario would feel much more grounded and satisfying compared to the second!
We can apply this same logic to babies. They need their transition from intrauterine life to extrauterine life to be protected and held in a grounded way. Not rushed, not with fear or anxiety as the prevailing emotions in the people in the room.
In Chinese Medicine, lung imbalances cause excessive crying, depression, cold/flu/allergies/asthma.. I’m wondering if the energy around this transition can contribute to many babies’ experiences after birth of “colic” or “excessive crying.” Weak digestion and inability to regulate body temperature is also associated with weak lungs in Chinese Medicine.
Chinese Medicine often uses food to treat imbalances, and the ones recommended for lung imbalance or weakness are some of the same foods we recommend for new mamas in the early postpartum period:
Cooked foods
Restricting dairy
Cooked grains
Cooked squashes and root vegetables
Almonds, pine nuts, walnuts
Darker fowl meats like goose and duck
Anise seed, cinamon, licorice, sage, thyme
If a new mom was worried about the way her new baby had transitioned to breathing or if the baby needed to be resuscitated at birth because it never was able to establish regular breathing on its own (or even if the mom just wanted to hold the space and support this transition to happen smoothly regardless of how the birth went), I bet that encouraging the mom to consume these foods and spices would help the baby to balance its lung qi as well.
Chinese Medicine also believes that in order to “open the mind, you must clear the lungs.”
To me, this makes a lot of sense because after birth, a baby cannot fully come into its body unless it clears its lungs and the lungs begin performing the job of bringing vital life force energy from the surrounding environment into the body. Only then can the central nervous system regulate and allow for the rest of the body’s needs to be taken care of, including coping with the rest of the “stress” of transitioning to life outside of the womb.
The emotional aspects of newborn transition can be examined by just imagining yourself going through the same thing as your new baby.
Karen Strange uses the example of the float tank experience. If anyone has ever experienced a float tank, you know that it’s a calm environment where you are able to completely relax because you’re floating in body temperature salt water and there are no lights or sounds. It’s like being in a deep meditative state.
You can imagine how you’d feel if you came out of a float tank experience and there were a ton of people in the room who were all talking at you, rubbing you vigorously with towels, they had bright lights on, music playing, the essential oil diffuser going, and everyone was talking in SUCH AN EXCITED VOICE, either that or holding their own breath and experiencing immense anxiety until you took a breath or cried.
You’d probably feel overwhelmed by all of it. And you might even shut down because of all of the excitement and/or anxiety. Imagine your central nervous system trying to coordinate this huge physical shift in breathing and blood flow while at the same time dealing with feeling overwhelmed and anxious.
Ideally, the room would be a more seamless transition from the womb. Darkened, warmed, no talking except the mother and partner talking gently to their own baby and bringing them into their body.
Baby becomes familiar and prefers the sound of mom’s voice over all others from its time in the womb. They recognize and prefer the sound of mom’s voice AFTER birth as well… this is part of the reason that we suggest the mom talk to her own baby after birth if the baby takes longer than “normal” to start breathing… the baby wants to go toward its mother’s voice, and its soul probably does too.
Judeo Christian belief systems tell the story of Adam becoming a “living soul” when God breathed into him. We can also think of the commonly held belief that a soul leaves a body at death, after the release of the final breath. Do these beliefs mean that the newborn’s physical body and soul connect when the baby takes its FIRST breath? Should we be viewing this event as a supremely sacred and almost religious event in a baby’s life, holding the space with more reverence?
During my research down the internet rabbit hole in preparation for this piece of writing, I came across a really random post with a perfectly eloquent explanation of the spiritual essence of the newborn’s first breath:
“The newborn cry is a call for spiritual guidance and it is very symbolic because, at birth, the child separates from the mother, and becomes a new being. As the child separates, he or she accepts responsibilities for his own spiritual life. While this responsibility is not immediate, and the implications of the separations are not visible, it’s divinely innate in the child that one day he/she shall take responsibility for his/her own spiritual existence.”
So, whether you’re a religious or spiritual person or not, I think we can all agree that these moments of newborn transition are special and should perhaps be framed and protected as such.
By putting ourselves into our baby’s “shoes” we can really start to feel in our body how it feels to be born and what the transition should feel and look like. And by understanding the physical process that is taking place, we can hold the space for this transition to happen seamlessly and smoothly.
We might even be able to tap into the energy that surrounded our OWN births, and what our own first breaths felt like.
My dream is to help the world in the direction of really respecting babies. Respecting their emotions, their transitions, their spiritual journeys, and even just a more basic understanding and reverence for the complex and beautiful physical transition that takes place upon being born.
Please reach out if you have any questions, comments, or thoughts on this topic!
