A Pharmacist Explains Why Warmth Matters More Than We Think
In many hospitals across Pakistan, labour rooms and operation theatres are kept heavily air conditioned. For healthcare staff, this may feel routine. However, for labouring women, the experience can be very different. Many lie partially exposed, shivering, anxious, and visibly uncomfortable, at the very moment their bodies are expected to perform one of the most physiologically demanding processes of life.
This modern setup contrasts sharply with traditional practices. In the past, labour rooms were intentionally kept warm, sometimes heated with fire. For years, this was dismissed as cultural belief rather than science. Yet when childbirth is examined through a physiological and pharmacological lens, temperature during labour proves to be far more than a comfort issue.
It quietly influences hormones, muscle efficiency, pain perception, infection risk, and even newborn survival.
Labour Is Hormone Driven, Not Mechanical
Childbirth is not simply a physical act. It is a finely tuned hormonal process.
At the center of normal vaginal delivery is oxytocin, the hormone responsible for uterine contractions and cervical dilation. Oxytocin release is strongest when a woman feels safe, calm, and warm. This is why labour often progresses more smoothly in relaxed environments.
In contrast, when a woman feels cold, the body activates a stress response. Adrenaline and noradrenaline levels rise. These stress hormones can inhibit oxytocin release and interfere with effective uterine contractions.
As a result, contractions may become less coordinated or less efficient. Over time, this may contribute to slower labour progression, maternal fatigue, and an increased likelihood of medical interventions. Temperature alone does not determine delivery outcomes, but it can influence the hormonal environment that supports physiological labour.
Labour depends on parasympathetic dominance, the body’s “rest and release” system. Excessive cold shifts the body toward sympathetic “fight or flight” mode, creating a biological mismatch during birth.
The Uterus Is a Muscle, and Cold Affects Muscle Function
From a pharmacological perspective, muscle physiology is central.
Cold exposure causes vasoconstriction, meaning blood vessels narrow and blood flow to tissues decreases. The uterus is a powerful muscle that relies on adequate blood supply to contract effectively.
Reduced perfusion may lower contraction efficiency and increase fatigue. At the same time, cold exposure often triggers shivering. Shivering consumes glucose and energy, both essential during prolonged labour.
Over time, this combination may contribute to slower progress and greater exhaustion, particularly in first time mothers or lengthy labours.
Cold Environments May Intensify Pain and Anxiety
Pain is not purely mechanical. It is neurologically modulated.
Cold stress increases cortisol and adrenaline levels, heightening pain sensitivity. Consequently, contractions may feel more intense and harder to tolerate. Anxiety often rises alongside physical discomfort.
On the other hand, warmth promotes parasympathetic activation, supporting relaxation and improving coping ability. It may also enhance endogenous oxytocin release. This physiological principle explains why warm showers, heat packs, and warm blankets are commonly used in modern midwifery practice.
Sometimes, the simplest interventions align best with biology.
Maternal Hypothermia Is a Clinical Concern
Labouring women are often lightly clothed, exposed for examinations, sweating, and receiving room-temperature IV fluids. When combined with strong air-conditioning, core body temperature can drop.
Even mild hypothermia may impair uterine efficiency and increase discomfort. In surgical medicine, unintended hypothermia is well known to increase bleeding and infection risk. Maintaining normothermia reduces complications and improves outcomes.
Cold does not automatically mean safer. Temperature balance is part of evidence-based care.
Therefore, applying operation theatre cooling standards directly to labour rooms may overlook maternal physiology and vulnerability.
The Newborn Is Even More Vulnerable
The impact of a cold delivery room does not end with the mother.
Newborns lose heat rapidly through evaporation, conduction, convection, and radiation immediately after birth. A cold environment significantly increases the risk of neonatal hypothermia.
Neonatal hypothermia is associated with low blood glucose, breathing difficulties, poor feeding, and higher infection risk, especially in preterm or low-birth-weight infants.
The World Health Organization (WHO) emphasizes maintaining a warm delivery environment as part of the “warm chain” strategy to prevent neonatal hypothermia. WHO recommends ensuring adequate room warmth and immediate skin to skin contact after birth to stabilize temperature.
Even in warm climates, delivery rooms must be adequately heated to protect newborns.
A freezing labour room works against this protective chain.
Why Are Labour Rooms Kept So Cold?
Hospitals do have valid reasons. Infection control, staff comfort, and equipment requirements are important considerations.
However, labour is fundamentally different from surgery.
Surgery requires strict environmental control for anesthetized patients and sterile fields. Labour involves a conscious, hormonally active woman whose physiology is highly sensitive to environmental cues.
Many modern maternity units now adjust room temperature dynamically, cooler, when necessary, warmer during active labour and immediately after birth.
In modern healthcare, adaptation is key.
What Does Evidence Based Balance Look Like?
Research and global recommendations support maintaining a comfortably warm environment that protects both mother and baby.
Practical measures include minimizing unnecessary exposure, using warm blankets or socks, warming IV fluids when possible, reducing excessive air conditioning during active labour, and ensuring immediate skin to skin contact after birth.
These steps are low cost, practical, and compatible with infection control standards.
Tradition and Science Can Align
Traditional warm labour rooms were not purely superstition. They evolved through observation of what supported smoother births. Today, physiology explains what earlier generations understood intuitively.
We do not need fire in modern hospitals. But we do need thermal awareness.
As healthcare professionals, we often focus on medications and protocols. Yet environment itself is a powerful intervention. Temperature influences hormones, muscle function, pain perception, infection risk, and newborn stability, all without a prescription.
Modern medicine excels at technology. But physiology still governs birth.
When the environment aligns with biology, birth is more likely to unfold smoothly.
Warmth is not a luxury in labour. It is part of safe, evidence informed care.
Bottom Line
Cold labour rooms are not just uncomfortable, they may disrupt oxytocin release, weaken contractions, increase pain perception, and raise the risk of neonatal hypothermia.
Maintaining a warm, balanced environment supports maternal physiology and newborn safety.
In childbirth, even temperature is part of the care, not just the setting.
FAQs
Q1: Can a cold labour room really slow down delivery?
Cold temperature itself does not directly stop labour. However, it can trigger a stress response in the body. When a woman feels cold, adrenaline levels rise. Adrenaline can suppress oxytocin, the hormone responsible for effective uterine contractions. Reduced oxytocin activity may lead to less coordinated contractions, potentially slowing labour progression.
Q2: How does warmth support natural labour?
Warmth promotes parasympathetic nervous system activity, the body’s “rest and release” state. This supports oxytocin release, improves uterine muscle efficiency, and helps reduce anxiety. As a result, contractions may feel more manageable and labour may progress more smoothly.
Q3: Is there a risk of hypothermia during labour?
Yes, Labouring women are often lightly clothed, exposed during examinations, and may receive room temperature IV fluids. Strong air conditioning can lower core body temperature. Even mild hypothermia may increase discomfort and affect uterine efficiency.
Q4: Why is room temperature important for newborns?
Newborns lose heat rapidly immediately after birth. A cold delivery room increases the risk of neonatal hypothermia, which is associated with low blood sugar, breathing difficulties, poor feeding, and higher infection risk, especially in preterm or low-birth-weight babies.
Q5: Are cold labour rooms necessary for infection control?
Hospitals often maintain cooler temperatures for infection control and staff comfort. However, labour is different from surgery. Many modern maternity units balance infection control standards with maternal and newborn thermal needs by adjusting room temperature during active labour and immediately after birth.
Disclaimer
This article is for educational purposes only and does not replace professional medical advice. Clinical decisions regarding labour room temperature and maternal care should always be made by qualified healthcare providers based on individual patient needs and institutional protocols.
Call to Action
If you found this article helpful, consider sharing it with expecting parents, healthcare professionals, and medical students. Awareness about simple physiological factors, like temperature, can help improve maternal comfort and newborn safety. Evidence based discussions start with informed conversations.
References
• World Health Organization (WHO), Guidelines on the prevention of neonatal hypothermia and the “warm chain” strategy for newborn care.
• American Journal of Obstetrics & Gynecology, Research on oxytocin physiology and factors influencing labour progression.
• British Journal of Anaesthesia, Evidence on unintended perioperative hypothermia and its impact on complications.
• The Lancet Neonatology Series, Data linking neonatal hypothermia with increased morbidity and mortality risk.