Hypnosis And Childbirth: Imagine!
"When can we do this again?" These were the first words of a new mother to her husband minutes after giving birth. Most women will admit that this is the last thing they felt like saying at that precise moment. And far from being stoic, this same woman had previously been so afraid of pain that the thought of having children was immobilizing. Yet she described the gentle birthing of her son as an incredibly wonderful, calm and serene experience that produced a calm and serene baby.
"I had been very frightened by the whole prospect of labor," Fiona Johnston-Manby of Upton admitted. "When I met my husband and he indicated he wanted lots of children, I was terrified at the thought. Even the prospect of an injection had me undone."
What helped Johnston-Manby, and dozens of other women, is a relaxation technique called HypnoBirthing®. A similar technique was publicized widely in a Dateline NBC episode two years ago. In that show, women traumatized by previous difficult labors were seen looking energized and fresh, walking down hospital corridors minutes after giving birth. Clinical hypnotherapist Marie Mongan has developed a complete program of childbirth education classes that teach women how to use self-hypnosis to facilitate the moving in and out of that relaxed state at the appropriate times. This technique is based on the work of the late English obstetrician, Dr. Grantly Dick-Read, who wrote Childbirth Without Fear in 1944. Marie Mongan founded the HypnoBirthing® Institute in New Hampshire to teach hypnosis and to further educate certified hypnotherapists in these birthing techniques. Recently, she has expanded her teachings to non-hypnotists so that nurses, midwives and others in the field can in turn teach the technique to couples.
Mongan states in her own book, HypnoBirthing® – A Celebration of Life, (Rivertree Publishing) that she had begun looking for alternatives to the American method of birthing during her own childbearing years in the 1950's. That was in the days when mothers were rendered unconscious in the last moments of labor, presumably so that the doctors would have complete control of the birth. Prevented from taking part in the magic of bringing a child into the world, women of that era were routinely subjected to leather straps, ether cones, spinal anesthesia and stirrups. Mongan said that when she found Dick-Read's book she knew immediately "that this was the drug-free, painless birthing that I was seeking." Although he never once mentioned the word hypnosis, Mongan said that it became obvious that self-hypnosis was being utilized in his teachings.
"In 1944, little was known about the therapeutic benefits of hypnosis and the field was held in disrepute," Mongan states. "Dr. Dick-Read was ridiculed and chastised for forwarding his theory that birthing need not be accompanied by pain. There was no way he was going to go farther out on that limb and admit that it was a form of self-hypnosis. But I know that wonderful feeling that can almost be compared to swaying in a hammock at the peak of labor and yet being fully alert and aware of everything around me." That feeling is self-hypnosis, Mongan says.
Taking Hypnosis Home
Kathryn McGlynn, CHt, of Sturbridge, MA is a certified hypnotherapist and HypnoBirthing educator who teaches the technique in a wide range of New England locations including Worcester, Sturbridge, Charlton and Hopedale. Mothers and their birth companions – husband, doula (birthing assistant) or friend, can take the course in either two 5-hour sessions (total 10 hours) or a series of shorter evening sessions. The course includes a copy of Mongan's book and a set of two cassette relaxation tapes to be used to practice self-hypnosis.
"All hypnosis is actually self-hypnosis," McGlynn says. "The hypnotherapist is not needed in the labor room because birthing women who have learned the technique create their own state of profound mental and physical relaxation all by themselves. This is a naturally induced state of relaxed concentration – the same state of mind that you are in when you are engrossed in a book or movie or staring at the fire. Unlike the media's image of hypnotism in which a person makes a fool of themselves on stage, you are always totally in control and aware of what is going on in the room, just as you are when absorbed in a book or movie. This relaxation allows the muscles of the uterus to work as they are designed to."
With the breathing exercises and relaxation techniques that have been learned in the classes and practiced at home, women can learn to turn on natural anesthesia and use visualizations and guided imagery to aid their own body in doing its natural work of birthing. With such a calm, unstressed and often brief labor, the baby is most often also calm and unstressed. These infants are more likely to measure high on the Apgar test of a newborn's vital signs, to nurse well and to sleep through the night more quickly.
Although Marie Mongan is reluctant to use the words "pain-free labor and birth," the majority of the women interviewed for this article said they experienced only a tightening sensation or felt pressure during labor. Those who did use the word "pain" said that it was tolerable and totally manageable.
"Think about it. When you lift something, you are using muscles, but they don't hurt," McGlynn says. "You may ache the next day if you have done strenuous work, but they don't hurt at the time. The reason women feel pain in labor is because they are afraid and tense and their muscles cannot work properly under those conditions."
Dr. Dick-Read labeled this syndrome "fear-tension-pain." The fear that sets off this cycle is reinforced with every Hollywood image of a woman in agony from the very first contraction, and in Western society, with every well-meaning horrendous labor anecdote.
"In other cultures, childbirth is regarded as a natural, normal event in a woman's life, with the birthing women given support from other women, and many times with children in attendance," Kerry Tuschhoff, HBCE explains." In this way, birth is celebrated and honored. The young girls grow up with the belief system that birth is a positive event in a woman's life, and their expectations of childbirth reflect this attitude. As a result, their births are similar to their predecessors: without pain and fear. In our culture, it is very much the opposite. For many generations we have been told that delivering a baby is many hours of painful, agonizing work. We have heard stories from well-meaning friends and family that send shivers up our spines, and so the legacy continues. We experience pain in childbirth in part because we very much expect to!"
A Body of Knowledge
The physiological explanation for all this is simple. Because of this fear, as soon as labor starts, nature responds by flooding the body with adrenaline – the hormonal response to fear in the fight or flight syndrome. Designed to protect us, the anatomical response is that the heart beats faster, we breathe more quickly, our eyes dilate, and blood flow shunts away from all non-essential muscles. There are two bands of muscles in the uterus – one vertical and one circular, which work together to open the cervix and gently push the baby out. If these muscles are relaxed, they can function properly.
"'Fight or flight' is the reason why we see people's faces become white when they are afraid," McGlynn explains. "When a woman is afraid going into labor, the blood is shunted away from the uterus, which basically shuts the uterus down. Dr. Dick-Read states that during a C-section of a woman who had been scared in labor, he found the uterus to be literally white." Positive affirmations and practice can counteract that condition.
"There is a theory that says the body acts like a robot," McGlynn explains. "One of the ways you can help your body is to change the language to positive imagery. For example, we use the word 'surge' instead of 'contraction,' because it is more positive. It's all happening in your mind, just as that movie or book is happening in your mind, and the mind controls the body. During the surge you will feel pressure, pulling and tightening. You will have sensation, and when you are done it's a pretty fabulous experience – pleasurable and manageable. You are going with the experience instead of fighting against it."
The use of hypnosis in the medical and dental fields is not new. In 1958, the American Medical Association approved the therapeutic use of hypnosis, and it is now widely used and accepted for treatment of many medical and psychological conditions. Sometimes, however, even hypnotherapists forget the power they have in their own minds to heal themselves.
Dr. Erin Acevedo, a chiropractor who experienced two very different labors, is the first to agree. "I didn't think this would work, even after I took the course, but it really did! It's amazing. With my first baby I did a home birth because I thought it would be a great experience. I used the Bradley method (of no medical intervention), but I found it didn't prepare me for the contractions. I have a pretty low pain threshold and I didn't handle it well at all. I tried to 'grin and bear it,' but I was screaming and moaning, so the birth was anything but peaceful – and neither was the baby. She screamed for three months! With this birth, I kept thinking I wasn't really in labor because I kept waiting for the pain to start and it never did. Instead, it was a wonderful experience. I chose to have my daughter in the hospital with a doula to help me, and it was very natural, very peaceful; a beautiful experience. I felt the baby just dropped out of me and you can tell. She's a really calm, happy baby, one who nurses well."
Acevedo said the imagery she used was of filling up a balloon while breathing slowly and counting to 20. "At the same time I pictured my uterus pulling up and the cervix opening, and the pain would go away each time I did that at the snap of a finger," she relates. "In between each surge, I would be very social, talking on the phone, but the minute I needed to, I was right back in that relaxed state and the pain would become pressure, just like that."
Prep and Delivery
The ability to move from the deep, inward-looking relaxation during surges and the "what's next?" energy once the surge is over is vividly illustrated in the video tapes of other births that are a standard part of the classes. Some doctors and nurses who have never experienced this technique before have been alarmed at first by what appears to be "aberrant behavior" on the part of the birthing mother because she seems so relaxed. Their fears dissipate, however, when they witness the quiet, calm and joyful births that result from this so-called aberrant labor.
Birth companions learn key words or massage that will help the mother get back into her calm state of mind for a surge. One couple had key words on a laminated card to help them focus. Often a companion will stroke a woman's arm, as a pre-set suggestion to flood her body with natural anesthesia. With the instruction in hypnosis, women are taught to take themselves mentally to a safe place. One woman related how she imagined walking through a cathedral after the tourists had left and the doors were locked. For this woman that imagery was soothing, peaceful and safe. Others imagined themselves on beaches or in a meadow.
Certified nurse midwife Donna Towne has experience with all types of natural childbirth techniques including hypnotherapy. "HypnoBirthing works well for those who have worked at it," she comments. "It definitely includes what I would call homework, and for those who do their homework, it works. Pregnancy is not a disease. You don't need a physician to give birth; you merely need tools to help yourself birth."
Towne, however, always delivers in the hospital. "I don't do home births because I want to be able to access any and all medical interventions if they are needed. But I prefer to stand back and wait for the woman to birth. I think HypnoBirthing infuses a woman with faith in herself that she can do this. And she can. Even for what I would call a dysfunctional labor, in which medical intervention is necessary, I have seen HypnoBirthing do an excellent job in getting a woman right up to the moment where medicine needs to intervene, so it becomes less intrusive and traumatic."
"It's good to find out about your obstetrician's record beforehand so that you can make informed decisions," McGlynn says. "One of the things we have couples do is to make out a birth plan, and give it to the hospital and the doctor or midwife and nurses beforehand. In it will be your wishes – not to use a fetal monitor, for instance, to have soft lighting and music, to be able to move around if you wish."
"It's your day," Martha Davis, mother of three and HypnoBirthing advocate, says. "You need to make sure it is your day because it is the start of your baby's life."
Fiona Johnston-Manby agrees. "I didn't understand how it could work. Yet as I listened to the tapes and practiced my relaxation techniques every day, I realized I was less and less afraid. I won't say I felt no pain, but it was tolerable. I could feel my baby moving all the way down the birth canal, and frankly it was wonderful. I was in control, I could release endorphins in myself as a natural anesthesia any time I needed to, and in between each surge I was so relaxed I looked as if I was sleeping. It was a wonderful, empowering experience."
Dr. Christiane Northrup, author of Women's Bodies, Women's Wisdom might have been talking about this birthing method when she wrote the introduction to her book. She starts with the word "imagine."
"Imagine what might happen if the majority of women emerged from their labor beds with a renewed sense of the strength and power of their bodies..When enough women realize that birth is a time of great opportunity to get in touch with their true power, and when they are willing to assume responsibility for this, we will reclaim the power of birth and help move technology where it belongs – in the service of birthing women, not as their master."
Maggie Head Meehan is a freelance writer in Southborough, MA who writes frequently about parenting, health and education issues.