Theories of Labor Onset

Labor is a coordinated sequence of involuntary, intermittent uterine contractions. It is the series

of events that expels the fetus and placenta out of the mothers body. This is made possible by
the presence of uterine contractions and abdominal pressure that push the fetus out during the
expulsion period of delivery. Regular contractions result to gradual cervical effacement and
dilatation. Adequate pressure from abdominal muscles allows the baby to be pushed outside the
mothers womb.
Labor and delivery require a woman to utilize her coping methods psychologically and
physiologically. Normally, labor begins when the fetus reaches a mature age (38-42 weeks age of
gestation). This is to ensure survival of the fetus with the extrauterine life. The mechanism that
converts Braxton Hicks Contractions (painless contractions) to strong and coordinated uterine
contractions is unknown. In some cases, labor occurs before the fetus reaches the mature age
(preterm birth) while in others it is delayed (postterm birth).
Although the exact mechanism that initiates labor is unknown. Theories have been proposed to
explain how and why labor occurs.

Uterine Stretch theory

The idea is based on the concept that any hollow body organ when stretched to its capacity will
inevitably contract to expel its contents. The uterus, which is a hollow muscular organ, becomes
stretched due to the growing fetal structures. In return, the pressure increases causing physiologic
changes (uterine contractions) that initiate labor.

Oxytocin theory
Pressure on the cervix stimulates the hypophysis to release oxytocin from the maternal posterior
pituitary gland. As pregnancy advances, the uterus becomes more sensitive to oxytocin. Presence
of this hormone causes the initiation of contraction of the smooth muscles of the body (uterus is
composed of smooth muscles).

Progesterone deprivation theory

Progesterone is the hormone designed to promote pregnancy. It is believed that presence of this
hormone inhibits uterine motility. As pregnancy advances, changes in the relative effects
estrogen and progesterone encourage the onset of labor. A marked increase in estrogen level is
noted in relation to progesterone, making the latter hormone less effective in controlling
rhythmic uterine contractions. Also, in later pregnancy, rising fetal cortisol levels inhibit
progesterone production from the placenta. Reduce progesterone formation initiates labor.

Prostaglandin theory
In the latter part of pregnancy, fetal membranes and uterine decidua increase prostaglandin
levels. This hormone is secreted from the lower area of the fetal membrane (forebag). A decrease
in progesterone amount also elevates the prostaglandin level. Synthesis of prostaglandin, in
return, causes uterine contraction thus, labor is initiated.

Theory of Aging Placenta

Advance placental age decreases blood supply to the uterus. This event triggers uterine
contractions, thereby, starting the labor.