Dahan Orli, Odent Michel
J Perinat Educ. 2023 Jul 1;32(3):149-161. doi: 10.1891/JPE-2022-0007.
There are two concepts of neuroendocrine reflexes associated with the expulsion of the fetus through the birth canal during the second stage of birth: the Ferguson reflex and the fetus ejection reflex. These concepts are often confused with one another and treated synonymously, thus interchangeable. However, the two not only refer to different phenomena, but they also represent the birthing woman differently. The Ferguson reflex treats the birthing woman as simply a biomechanical body. In contrast, the fetus ejection reflex does not ignore women's conscious states during birth and recognizes what is currently a well-known empirical fact: The event of birth is a complex biophysical process affected by many mental, social, and environmental factors. In that, it has a connection to the phenomenon of birthing consciousness, which is the positive altered state sometimes experienced during a physiological and undisturbed childbirth. We argue that birthing consciousness and the fetus ejection reflex, made possible by reduced cortical control, are extremely helpful in promoting physiological human childbirth. Therefore, treating a woman giving birth as a biomechanical body is not only erroneous but can also lead to medical mismanagement of the second stage of physiological childbirth with associated mental and physiological consequences.
在分娩第二阶段,胎儿通过产道娩出过程中存在两种神经内分泌反射概念:弗格森反射和胎儿娩出反射。这两个概念常被相互混淆且被视为同义词,因而可以互换使用。然而,这两者不仅指代不同现象,而且对分娩女性的描述也有所不同。弗格森反射将分娩女性仅仅视为一个生物力学机体。相比之下,胎儿娩出反射并不忽视女性分娩时的意识状态,并且认识到当前一个众所周知的经验事实:分娩过程是一个受诸多心理、社会和环境因素影响的复杂生物物理过程。就此而言,它与分娩意识现象相关联,分娩意识是在生理且未受干扰的分娩过程中有时会体验到的积极改变状态。我们认为,由皮层控制减弱促成的分娩意识和胎儿娩出反射对促进人类生理性分娩极为有益。因此,将分娩女性视为生物力学机体不仅错误,而且可能导致生理性分娩第二阶段的医疗管理不当,并产生相关的心理和生理后果。