How Birth Interventions Contribute to Retained Primitive Reflexes
A common question I’m asked is “what causes primitive reflexes to be retained?” The answer is, there are many factors that can alter the integration of reflexes in the body and it is not possible to definitely attribute retained reflexes to one sole cause, however a big and very frequent factor contributing to retained primitive reflexes is birth intervention.
The Role of Birth in Early Brain Development
Birth is more than just a transition into the world—it’s the baby’s first major neurological workout and has been designed to play out in a very specific way.
During a vaginal birth, the baby’s body is compressed and stimulated through the birth canal. This process activates the vestibular (balance) and proprioceptive (body awareness) sensory systems, both crucial for integrating early reflexes.
The pushing, turning, and squeezing motions and forces also stimulate the brainstem and spinal cord—areas that control primitive reflexes—helping to “switch on” developmental pathways that prepare the infant for life outside the womb. When this process is shortened, bypassed, or medically assisted, some of that sensory and motor stimulation may be reduced or altered, which can influence reflex development.
Common Birth Interventions and Their Potential Impact
Ensuring a birth that is safe for mother and baby is paramount. In some births, achieving a safe birth requires using modern medical interventions, which have saved countless lives. But when used routinely or without physiological follow-up after the birth, these interventions used to save may inadvertently affect how the nervous system develops.
1. Caesarean Section (C-section)
Babies born via C-section often miss the compression and rotational forces of vaginal delivery. This mechanical stimulation is vital for activating certain reflexes, clearing fluid from the lungs, and providing vestibular input that “wakes up” the nervous system.
Without this sensory sequence, some babies may show delayed activation or poor integration of reflexes such as the Moro (startle) or Tonic Labyrinthine Reflex (TLR). These reflexes, when retained, can contribute to sensory sensitivity, postural challenges, or anxiety.
2. Induced or Accelerated Labour
Synthetic oxytocin (Pitocin) and other induction methods can cause stronger, more frequent contractions than spontaneous labour. This can stress both mother and baby, leading to increased cortisol levels and possible disruption of the baby’s autonomic (stress-regulation) system.
A baby exposed to prolonged stress in labour may enter the world in a heightened “fight or flight” state, which can make it harder for primitive reflexes—especially the Moro reflex—to settle naturally in the months after birth.
It may also speed a labour up to the extent that an infant does not receive the required exposure to the forces and sensations mentioned above.
3. Forceps or Vacuum Extraction
When mechanical assistance is needed, it can create asymmetrical pressures on the skull and neck, which may interfere with the baby’s early head-righting reflexes or cause tension in the nervous system. These babies may develop a retained Asymmetrical Tonic Neck Reflex (ATNR) or Spinal Galant Reflex, often seen later as poor bilateral coordination or discomfort with clothing on the lower back.
4. Epidural Anaesthesia
While epidurals can make labour more comfortable, they may alter natural hormonal signaling and maternal movement. Mothers are often less mobile, and pushing can be less effective. This may lengthen labour or increase the need for assisted delivery, both of which can impact the baby’s sensory and reflexive experience at birth.
5. Early Separation and Limited Skin-to-Skin Contact
After birth, skin-to-skin contact helps regulate the baby’s heart rate, temperature, and breathing, and it provides vital tactile input to help calm the nervous system. When babies are separated early for medical or logistical reasons, they may miss this early co-regulation, making it harder for reflexes to integrate smoothly.
From Reflex Retention to Developmental Challenges
If primitive reflexes remain active beyond the expected age, they can subtly influence a child’s posture, movement, and behaviour.
- A retained Moro reflex may contribute to anxiety, distractibility, or hypersensitivity to sound and touch.
- A retained ATNR can make crossing the midline difficult, affecting reading and writing skills.
- A retained TLR can affect balance, posture, and spatial orientation.
- A retained Spinal Galant may contribute to restless and hyperactive behaviour
While birth interventions don’t automatically cause these issues, they may increase the likelihood of delayed integration—especially when combined with other factors like prematurity, illness, or limited tummy time in infancy.
It’s not too late! How to Support Reflex Integration After Birth
The good news is that the brain remains capable of growth and change. Even if a child’s early birth experience was complex, movement-based therapies such as Rhythmic Movement Training (RMTi), reflex integration exercises, and neurodevelopmental play can help complete the developmental sequences that may have been interrupted.
These programs use gentle, repetitive movements that mimic those made in utero and early infancy, helping to strengthen neural connections and bring balance back to the sensory and motor systems.
Parents can also support integration through:
- Plenty of tummy time and free movement on the floor
- Infant massage and skin-to-skin contact
- Gentle rocking, rolling, and rhythmic play
- Seeking guidance from practitioners trained in reflex integration or infant development such as RMTi Consultants, paediatric Occupational Therapists, paediatric Physiotherapists, Craniosacral therapists or chiropractors who have done rigorous paediatric training.
A Balanced Perspective
Birth interventions are often life-saving and medically essential. Don’t let yourself linger with guilt if your birth involved intervention. Decisions in birth are often made in the moment and made on a need to happen basis. However when we understand how early experiences shape the nervous system, we can provide a baby with the right support afterward to build the neurological foundation needed for calm, focus, and coordinated movement throughout life.