The Experience Miracles Podcast

The Surprising Link Between Birth and Lifelong Health

Oct 29, 2024

Birth Interventions and Your Baby’s Nervous System: What an OB-GYN Wants Parents to Know

Episode 47, Experience Miracles Podcast | Host: Dr. Tony Ebel, DC, CACCP, Pediatric Chiropractor & Founder of PX Docs | Published: October 29, 2024 | Duration: ~62 min

Guest: Dr. Nathan Riley, MD, Home Birth Doctor & Holistic Gynecologist, Louisville, KY | Temple University MD | OBGYN Residency, Kaiser Los Angeles | Palliative Care Fellowship, UC San Diego | Dual Board Certified

Key Takeaways

  • Continuous fetal heart rate monitoring, used in nearly 100% of U.S. hospital births, was introduced to reduce cerebral palsy rates, but it didn’t. Instead, national C-section rates climbed to 37%, in part because about 80% of tracings fall in the ambiguous “category two” zone, and doctors face legal risk for C-sections they don’t do, not ones they do.
  • A mother’s HRV (Heart Rate Variability) during pregnancy and labor directly reflects her baby’s nervous system state. Over 16 years of clinical practice, Dr. Ebel has observed maternal HRVs plummeting, meaning more mothers enter labor in Sympathetic Dominance (fight-or-flight), a state that transmits directly to the infant’s nervous system in those critical first hours.
  • Preterm babies carry a compounded nervous system disadvantage: the Vagus Nerve and parasympathetic regulation system don’t reach full maturation until months after birth. Early delivery combined with NICU isolation disrupts critical co-regulation with parents, a likely contributing factor to elevated SIDS risk in preterm infants.
  • The Vagus Nerve, branching from the Brainstem down through the neck, heart, lungs, and digestive system, is highly sensitive to the physical forces of birth interventions. C-sections, forceps, and vacuum extraction all place stress on the upper cervical spine and brainstem, creating the neurological conditions that trigger The Perfect Storm.
  • Breath is the most accessible tool parents have to activate the vagus nerve and co-regulate with their infant. A regulated, calm parent creates the neurological safety cues a newborn’s developing nervous system needs to wire itself for resilience rather than chronic threat response.

How Do Birth Interventions Affect a Baby’s Nervous System?

Modern birth practices, including continuous fetal heart rate monitoring, labor augmentation, and surgical delivery, create cascading effects on a newborn’s nervous system that extend far beyond the delivery room. According to Dr. Nathan Riley, MD, a board-certified OBGYN and home birth physician, the shift toward hospital-based intervention in the late 20th century correlates directly with a rise in C-section rates (now 37% of U.S. births) and an increase in newborns exposed to high-stress delivery environments that dysregulate their developing Autonomic Nervous Systems.

The Vagus Nerve is the structure most vulnerable to this disruption. Branching from the Brainstem down through the neck, heart, lungs, and digestive system, the vagus nerve governs breathing, digestion, immune response, emotional connection, and social behavior. Physical birth interventions, forceps, vacuum extraction, C-sections, compress and stress the upper cervical spine and brainstem where the vagus nerve originates. Chemical exposures (routine vitamin K injections, erythromycin ointment) and high-stimulation NICU environments compound that initial stress. When vagal function is compromised from the earliest moments of life, it creates the neurological foundation for what Dr. Tony Ebel, DC, CACCP calls The Perfect Storm: a cascade of nervous system dysregulation that can manifest as colic, sensory processing challenges, sleep disruption, chronic illness, and, in more severe cases, autism and ADHD.

This conversation isn’t about condemning all medical intervention, some fetal monitoring genuinely prevents tragic outcomes. The deeper point is that nervous system regulation, not just physical survival, must be a metric for a successful birth. A newborn’s first hours outside the womb are a critical period of neurological development, when the quality of the environment, the calm or chaos of the delivery room, the presence or absence of skin-to-skin contact, the regulated or dysregulated state of the parents holding that baby, directly shapes how the infant’s nervous system wires itself.

Why Dr. Nathan Riley Started Questioning Modern Obstetrics [00:02:00 – 00:14:00]

Dr. Tony Ebel: One of the things that has fascinated me about you from the first time we connected is that you went through the full medical education pipeline and somehow came out the other side still asking questions. That’s not the norm.

Dr. Nathan Riley: Looking back, I’m not even certain how I got here. A high school physics teacher, Mr. Wargo, who has since passed away, once told me: “What was such a joy about you was not that you earned A’s. Anybody can earn an A. You were always just so curious.”

That curiosity drove me to obstetrics and gynecology, but it was never rewarded along the way. I was never incentivized to ask questions. Most of my colleagues are great people who went into science for the right reasons. They’ve somehow lost that desire to just be wrong. When you approach any problem, I’m hoping to be wrong, because then it allows me to find another door to open to try to find the right answer. But if we just accept everything we’re told, we tend to run into problems.

“When you approach any problem, I’m hoping to be wrong. Because then it allows me to find another door to open to try to find the right answer.”

Ivan Illich wrote in Deschooling Society that schools are designed on the assumption that there is a secret to everything in life, that secrets can be known only in orderly successions, and that only teachers can properly reveal them. An individual with a schooled mind conceives of the world as a pyramid of classified packages accessible only to those who carry the proper tags. Looking back as someone who has climbed the ranks of the academic world, I don’t feel like I have any answers. And that allows me to remain curious, and to put what’s most important first: the people who come to me for help with their health, their pregnancy, their fertility.

Dr. Tony Ebel: We know that medicine turned for the worse with the Flexner Report, when the educational system was shifted. If you run medicine like a business, you shut down doctors’ ability to go after root causes, shut down their ability to ask questions, and shut down their ability to collaborate with chiropractors, naturopaths, and anyone outside the system.

What parents are looking for is a doctor who has the humility yet the excitement to partner with them and say, “I might not have the answer to every question you have today.” I’ve always promised my patients: I will only answer your question if I can answer it with clarity and conviction based on my education and experience. If I don’t have that, give me 24 hours, I’ll go home and do the homework.

The Problem with Fetal Heart Rate Monitoring, and the C-Section Epidemic [00:15:00 – 00:25:00]

Dr. Nathan Riley: When we nearly universalized continuous fetal heart rate monitoring in the late 1990s and early 2000s, what we were hoping to see was a drop in cerebral palsy rates. We did not see that.

Instead, we saw C-section rates skyrocket. Most doctors would say, “I did a C-section because the tracing didn’t look good.” But what is this tracing in the first place? The tracing is meant to reflect heart rate variability, accelerations where sympathetic tone kicks on, and decelerations where the heart rate drops. This is reflective of the baby’s nervous system, not the heart itself. The heart is our surrogate.

If you put a hundred OBs in a room and asked them to interpret the same tracing, they’re all going to disagree. And if you ask those same doctors to review the same tracings a year or two later, at least 20% are going to give a different interpretation than their first assessment.

So we have a problem. We have a universal means of “keeping a baby safe” that is highly variable in how clinicians approach and interpret it. As a consequence of the business of medicine and medical-legal pressures, doctors are never sued for the C-section they do, they’re sued for the C-section they don’t do.

“Doctors are never sued for the C-section they do, they’re sued for the C-section they don’t do.”

That creates a lower threshold for surgical delivery. And now 37% of babies nationally are coming out of the abdomen. Nobody is asking what the consequences of that number are.

Dr. Tony Ebel: That’s fascinating, because in our work we use the same core technology, HRV scanning, as one of three key neurological assessments, alongside neurothermal scans and surface EMG. HRV is the leading tool for clinical decision-making. And what you’re describing is that the hospital’s version of measuring HRV has been universalized without adequate consistency in interpretation. That’s a massive problem.

About 80% of tracings fall into “category two”, somewhere in the ambiguous middle. Category one is fine, category three means act now, and category two is where most decisions happen. And the kicker is that almost anything can push a tracing into category two. Once you’re there in a hospital setting, with a mom who’s already exhausted and nervous and in an environment that doesn’t feel safe, the odds of returning to category one are low.

How Maternal HRV Shapes Your Baby’s Nervous System State at Birth [00:25:00 – 00:37:00]

Dr. Tony Ebel: There would be more than two factors contributing to birth outcomes, but let’s pull out the two biggest. First: most mothers are arriving at the hospital already in a state of nervous system distress. Their HRVs have plummeted over the past decade, COVID accelerated this, but the trend existed before it.

Over 16 years in practice, running HRV on every patient from pregnancy through infancy, I’ve been measuring resilience and adaptability. I’m measuring whether someone is stuck in a Sympathetic storm, poor HRV, or whether the vagus nerve and the parasympathetics, the safety and growth mode, are engaged. Across the board, moms entering labor are more sympathetically dominant, more in distress than they were a decade ago.

Here’s why that matters neurologically: nerves that fire together, wire together. In those moments, mom’s nervous system is baby’s nervous system. That connection is still there. So when we measure a mom’s HRV, we’re also measuring her baby.

Dr. Nathan Riley: And then the hospital environment itself makes it worse. The ambiance of a birth room compared to a home birth, right off the bat, you have a nervous system in shock. You can’t meaningfully reduce a category-two tracing back to category one in a hospital room with fluorescent lights and monitors alarming. How much essential oil and Bob Marley can you actually bring in? In most hospitals, not much. You’re far more likely to go from a two to a three.

“Mom’s nervous system is baby’s nervous system, that connection is still there.”

There’s also a polyvagal lens here that matters. The vagus nerve, above the diaphragm, is responsible for our capacity to connect, socialize, and feel safe. When a mother is in a chronic state of sympathetic activation, fight-or-flight, she can’t access that ventral vagal, heart-centered space. And that’s exactly the signal the baby needs to feel safe in the world.

SIDS, Preterm Babies, and the Missing Co-Regulation Piece [00:37:00 – 00:45:00]

Dr. Nathan Riley: Quickly, because it fits directly here, the babies with the highest likelihood of dying of SIDS are preterm babies. Why? They haven’t been in the womb developing and co-regulating inside the uterus with mom. Then they get whisked to the NICU, placed in an incubator for weeks, and never actually get that co-regulation with a person they can safely attach to.

Because they don’t have the full complement of upper vagal, lower vagal, and sympathetic auto-regulatory systems firing on all cylinders, they’re at higher baseline risk. The cigarette smoke connection in lower-income homes is real, but it may also be partly because these babies, and their parents, can’t co-regulate. We have a socioeconomic disparity in this country where lower-income families have higher SIDS rates, partly because those families are working three or four jobs and can’t regulate themselves. That’s a separate Perfect Storm layered on top of the birth storm.

Dr. Tony Ebel: The neurology behind preterm birth is exactly what you’d expect from how God designed the nervous system. It develops in a sequence, more sympathetically dominant early on. The vagus nerve and parasympathetic regulation system don’t reach full maturation until many months after birth. So if you arrive on the outside early, you start with a shorter neurological runway, and then get exposed to all the stress of the NICU without the co-regulation that would normally offset it.

It’s its own specified Perfect Storm.

When we look at asthma through the same lens, a 16-year-old reaching for an inhaler that mimics epinephrine, then graduating to a daily corticosteroid inhaler, nobody asks why this kid’s body can’t stay alive without external stress hormones. But if you recognize that their nervous system has been under compounding allostatic load, possibly since birth, the answer starts to come into focus.

“If we separate SIDS from the nervous system, we’re making the same mistake we make when we separate the nervous system from the body when treating asthma.”

The Vagus Nerve, Birth Interventions, and the Root of the Perfect Storm [00:45:00 – 00:52:00]

Dr. Tony Ebel: Let me make the anatomical connection explicit, because this is the one piece that closes the loop.

The Vagus Nerve is cranial nerve number 10. It branches from the Brainstem and travels down through the neck, into the thorax, past the heart and lungs, all the way down through and below the diaphragm into the digestive system. It also connects to our eyes and our social-emotional regulation system, the face, the voice, the capacity to connect, as Dr. Stephen Porges’ Polyvagal Theory taught us.

This nerve is physically very sensitive. Any compression, misalignment, or Subluxation anywhere along its tract can disrupt its function. Birth interventions, C-sections, forceps, vacuum extraction, stress the brainstem and Upper Cervical Spine exactly where the vagus nerve originates. And it doesn’t stop at the neck. We also see significant vagal disruption in fast labors, because the baby didn’t get adequate cranial and cervical-thoracic molding to integrate and stimulate the vagus.

The vagus nerve is also sensitive to chemical injury. The brainstem has the thinnest blood-brain barrier anywhere in the body, so chemicals inhaled, ingested, or injected affect it more directly than any other nervous system structure.

And the vagus nerve is sensitive to emotional stress. So The Perfect Storm, physical injury at birth, chemical exposures in the newborn period, and the emotional stress of an unsafe environment, hits the vagus nerve from all three directions simultaneously.

This is why the same conversation, nervous system regulation, vagal tone, HRV, applies equally to colic, constipation, chronic ear infections, sensory processing challenges, autism, and ADHD. It’s not that chiropractic care treats all these conditions. It’s that all these conditions share a common root: abnormal neurophysiological function from a dysregulated vagus nerve and autonomic nervous system. And that disruption was planted right at the beginning.

Dr. Nathan Riley: There’s a polyvagal concept worth naming here: the ventral vagal state. This is the state that allows us to be intimate with our partners, connect with friends, socialize, and feel the good vibes, what I describe as the “green state.” You can’t access that if you’re in a chronic state of threat. And for many babies entering the world via hospital birth today, the very first impression they get of the outside world is one of threat.

Imagine what it would be like to be born. You’re not going to picture a hospital room with fluorescent lights, sharp things, loud monitors, and weird smells. What you’d want is your mother’s chest, hearing her heartbeat, feeling her chest rise and fall, your parents’ voices close by. All of that is actively helping bring a newborn’s nervous system into a state of feeling safe in the world. That has to start, and it must start, in the moments right after birth.

What Parents Can Do: Breath, Co-Regulation, and Your Own Nervous System [00:52:00 – 01:02:00]

Dr. Nathan Riley: What I am genuinely an expert in is my own daughters, a four-and-a-half-year-old and a two-and-a-half-year-old. Every day feels like a new thesis to write.

My girls have language now, but they still have a gut sense of whether dad is safe right now. If I’m short-tempered and reactive while they’re trying to learn with their tiny bodies and growing brains, they’re going to live in a state of threat inside their immediate home environment. That’s the opposite of what their nervous systems need.

From the moment you bring your baby home, anything that helps keep your own nervous system regulated matters enormously. That might mean turning off the news. It might mean investing in your own chiropractic care. But at the most basic level, here’s what everyone can do right now: your breath is the primary driver of your vagus nerve.

When you breathe consciously, in through the nose, out through the mouth, ten slow breaths, you are literally activating your parasympathetic nervous system. You are signaling to your body that you are safe. And when you are safe, your children feel it. There’s a physical difference between just patting a baby on the back and when a baby actually melts into you. They will not melt into you if your nervous system is firing in threat mode.

For dads especially: your children need to feel that you have their back through anything. Even when there’s nothing to fix. Even when they just need to scream. You can hold them, breathe consciously, and love them without problem-solving. That is co-regulation. And that is what so many children are missing.

“Your breath is the primary driver of your vagus nerve. If you can remind your nervous system that you’re safe, your children will feel it, and they will melt into you.”

Dr. Tony Ebel: When you’re a pediatric chiropractor running a pediatric podcast, it might seem like 100% of the content should focus on your child’s health. But the only way to fully serve your child’s health is to include you in that conversation.

Healthy, regulated, adaptable, resilient kids come from healthy, regulated, adaptable, resilient parents. That’s not a platitude, it’s the neurology. Your nervous system leads the way. If you’re doing this journey for your child, make sure your journey to heal their nervous system includes healing yours.

I actually don’t tell the whole truth when I call myself a pediatric chiropractor, because I adjust moms and dads too. And the most persistent thing I’ll ever be in my practice is with the parents of my most complex Perfect Storm kids. I’ll surprise them: “Guess who’s up today?” And when they expect their child’s name, I tell them: “You are. Get your HRV done. Get scanned. Get on this table.”

Dr. Nathan Riley: That’s the truth of it. I may have every credential in obstetrics and gynecology, but I’ve never given birth. What I know, I know from listening to my clients and from the daily work of raising my daughters. The one consistent insight from both worlds is this: if you put yourself first, you are also putting your kids first. It starts with you. And it starts with making your nervous system a priority before you can effectively regulate theirs.

Frequently Asked Questions

Can birth trauma and birth interventions cause autism?

Birth injury alone is unlikely to be a single direct cause of autism, but it can significantly predispose a child to the cascade of nervous system disruptions that increase autism risk. According to Dr. Nathan Riley, MD, and Dr. Tony Ebel, DC, CACCP, birth interventions, C-sections, forceps, labor augmentation, disrupt Vagus Nerve function at the brainstem and upper cervical spine, creating the neurological conditions for what Dr. Ebel calls The Perfect Storm: compounding nervous system dysregulation that can ultimately manifest as autism in vulnerable children.

Why are C-section rates so high, and should I be concerned about one?

C-section rates have climbed to 37% of U.S. births nationally, in part because continuous fetal heart rate monitoring, used in nearly all hospital deliveries, produces ambiguous “category two” readings in about 80% of cases, and doctors face greater legal liability for not performing a C-section than for doing one. As Dr. Nathan Riley explains, doctors are never sued for the C-section they do, they’re sued for the one they don’t. If you’re facing a C-section decision, ask your provider specifically what tracing findings are driving the recommendation and whether any positioning or non-invasive interventions have been tried first.

What is HRV and why does it matter for my baby’s health?

HRV (Heart Rate Variability) measures the variation in time between heartbeats, a reflection of autonomic nervous system function, not just heart health. High HRV indicates a resilient, adaptable nervous system. Low HRV indicates Sympathetic Dominance, a stress-locked state. Dr. Ebel has observed maternal HRV declining over 16 years of clinical practice, and because a mother’s nervous system state directly transmits to her infant in those critical early hours, low maternal HRV entering labor means a greater likelihood of nervous system dysregulation in the newborn.

What causes SIDS, and is nervous system development a factor?

The connection is underexplored but significant. Preterm babies, who have the highest SIDS rates, are born before their Vagus Nerve and parasympathetic regulation system reach full maturity, then placed in NICU incubators without the ongoing co-regulation with parents that their developing nervous systems depend on. As Dr. Riley explains, this may leave these infants’ auto-regulatory systems unable to self-correct during respiratory events, independent of other commonly cited SIDS risk factors like cigarette smoke.

How can I help my baby’s nervous system after a difficult birth?

The most accessible tool is your own breath. Dr. Riley emphasizes that breathing slowly and consciously, in through the nose, out through the mouth, activates the vagus nerve and shifts the parent’s nervous system into a parasympathetic (safe) state. A calm parent creates the co-regulatory environment an infant needs to feel safe and develop a regulated nervous system. Skin-to-skin contact, holding your baby while breathing slowly, and minimizing environmental stressors (loud noise, excessive stimulation) all support this. For targeted nervous system support, Neurologically-Focused Chiropractic Care can assess and address vagal dysfunction in both infants and parents.

How do I find a PX Docs chiropractor trained in nervous system care for children?

The PX Docs Directory connects families with chiropractors trained in neurologically-focused pediatric care. Use the searchable directory to find a practitioner near you. Find a PX Docs Office Near You, PX Docs Directory

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