Saturday 26 February 2011

Great Expectations


When I was pregnant with my first child I was smugly confident that my experience and knowledge as a hypnotherapist would allow me to reap so many of the emotional and psychological benefits that hypnosis promises to mothers. I also expected to use self-hypnosis to manage pain during childbirth. I had a comfortable, relaxed and uncomplicated pregnancy. When people suggested that I must be experiencing the various expected difficulties of pregnancy, not to mention the obligatory terror of childbirth, I contradicted them and explained that self hypnosis kept me healthy and calm, and that during childbirth this would reduce the cycle of fear, tension and pain discussed in Grantly Dick Read's pioneering book, 'Childbirth Without Fear'. I made my own personalised self-hypnosis CDs for a healthy pregnancy and calm birth and recorded a script to practice glove anaesthesia. I used a birth preparation CD created by another hypnotherapist and with my husband, I attended an antenatal hypnosis course for couples. I also attended a two day professional workshop for practicing hypnotherapists, entitled 'Painless Childbirth'. The courses provided me with valuable information on the physiology of childbirth and practical techniques and ways of using hypnosis. Marie Mongan's book ‘Hypnobirthing’ was an informative, encouraging and comprehensive overview of her methods and suggested that comfortable childbirth was natural and achievable. Ina May Gaskin's 'Guide to Childbirth' provided me with inspiring and uplifting stories of positive, even orgasmic, birth experiences.

All of my hypnotic preparations and studies lead me to set my heart on an idealistic birth experience. The harsh reality, pain and exhaustion I experienced were a real shock to me, as was the perineum tearing, the swelling, the baby blues and slow postnatal recovery. I wondered if hypnotherapy had worked, or whether I had failed. I was stunned, traumatised and depressed about my childbirth experience. I felt that I had expected too much from hypnotherapy and that it had not fulfilled what I had hoped it would do.

I am not alone in my initial disappointment with the expectations that I had. I emailed the members of my NCT antenatal class to ask if any of them had any experiences of hypnosis that they'd like to share. From the brief, anecdotal (and therefore admittedly unscientific!) evidence I have gathered, women seem to agree that hypnosis definitely reduces fear and increases confidence during pregnancy.

However, they described that hypnosis did not meet all of their positive expectations and some had a feeling that they had 'failed' because their birth experience did not match descriptions such as this one found on the Hypnobirthing(R) website,

“Just imagine welcoming each surge! Feeling peaceful... relaxing... and even smiling as your baby comes closer to you!”

Most mothers I spoke to found childbirth far more challenging than that!

“After being told that eight hours of early labour and regular contractions had made zero impact the hypnosis stopped working.... I look back with a positive feeling and gratitude, still love the music, but would include something about accepting pain” (Mother who used a hypnotherapy CD).

“I unfortunately have to say that when I did go into labour EVERYTHING I'd learned i.e. hypno stuff, NCT breathing and stuff from books flew out the window and I was practically unable to breathe despite my husband’s best efforts to calm me down... After ten hours at home I was only 2.5cm and was desperate for the epidural...” (Mother who did a hypnosis for childbirth course, and ended up with an emergency C-section).

“My labour progressed really, really quickly... I had gas and air and an epidural... in the end I got quite tired and they used the ventouse.” (Mother who did a hypnosis for childbirth course and used some self-hypnosis CDs.)

So what are realistic expectations of hypnosis in childbirth?

The Hypnobirthing(R) website states, “We can't promise you a 'perfect' birth - no one can - but we can promise you a much, much more comfortable and relaxed birth than you would have had otherwise.”

After meeting other new mums and having a meeting with my midwives I learned that my own labour was shorter and more efficient than most. I required no interventions, pharmaceutical pain relief, or gas and air – I got by with just my hypnosis and a Tens machine. My labour notes repeatedly comment “excellent breathing technique” and my midwives said that I was very “in control”. I had a candlelit Frederic Leboyer (1) style homebirth, and my calm little baby didn't cry when she was born, took to the breast straight away and had an Apgar score of 10/10, (a measure of newborn health). I now realise that to have this cosy uncomplicated homebirth at the age of 35 I was very lucky. I have met many mothers who had interventions, caesareans and bad hospital experiences. In 2007-08 the UK national caesarean rate was 24.6 per cent and the number of instrumental deliveries was 12.1 per cent. More than a third of women (36.5 per cent) had an epidural, general or spinal anaesthetic during labour. (2)

I was shocked to find childbirth so exhausting and painful, but in comparison with other births, I now realise that my daughter's birth was a very natural one. My midwives were reportedly “on a high” after attending my childbirth and confirmed to me that hypnosis was a big factor in the success of my birth experience.

The measurable benefits of using hypnosis, shown by scientific research (3), have included a shorter labour and a reduced use of pain relief, medical and surgical intervention. There are also reports of shorter hospital stays, reduced instances of post natal depression and higher Apgar scores.

The emotional benefits of using hypnosis for childbirth are generally suggested to be;

A reduction in fear of childbirth and an increased confidence in the body's abilities to birth naturally. Hypnosis encourages expectant mothers to feel more calm, relaxed, prepared and in control. It can also provide increased pain management abilities during childbirth.

From my own childbirth experience I can thankfully tick most of the items on these lists of suggested benefits of hypnosis. However, it seemed to me that many women felt they had been given unrealistically high hopes. I now believe that it is important to be aware of the need to manage these expectations and balance them with the need to encourage a positive outlook.

In her book 'Life After Birth', Kate Figes writes,

“Christina McKenzie (midwife) believes that ‘the way back to the middle ground is to be absolutely honest with women about the outcomes. Women get bombarded with glowing views of motherhood. There’s a fear of scaring women and putting them off, but it’s patronizing to assume that they can’t cope with the full facts. I still hear discussions where people say that if you give women that much information, then you’ll just confuse them.’

It is well documented that hypnosis can provide anaesthesia during surgery and dentistry and that it produces many beneficial effects for pregnancy and a more comfortable birth. There are even anecdotal reports of pain free birth. However, such incidents are rare and not always related to the use of hypnosis. Myself and other pregnant women have placed great faith in these positive anecdotes. I believe that it is misleading to suggest that by using a particular method or technique that painless childbirth is achievable for all. However, there is still a real need to balance and challenge the ubiquitous childbirth horror stories with positive anecdotes from women who have had empowering and beautiful experiences. This kind of optimism will produce a more relaxed and enjoyable pregnancy. Hypnosis can provide a more comfortable, easier and natural birth experience, it also provides practical techniques for managing pain. However, I want to provide my clients with a realistic viewpoint so that if they do experience pain they aren't left wondering where it all went wrong.

What do you think?

Did you use hypnosis in childbirth? What were your expectations of hypnosis, childbirth and motherhood?

For further information about hypnotherapy go to http://www.hypnoticloop.co.uk/


(1) 'Childbirth Without Violence', by Frederic Leboyer recommends a quiet, dimly lit environment for the child's gentle transition into the world.
(2) NHS Maternity Statistics, England: 2007-08 from the NHS Information Centre http://www.ic.nhs.uk/
(3) A summary of the scientific research supporting these points can be found at www.hypnobirthing.co.uk/hypnosis_in_childbirth_research.shtml

This article was first published in The Hypnotherapist Journal, September 2009.
(c) Peggy Melmoth
http://www.thehypnotherapyassociation.co.uk/
http://www.thehypnotherapistjournal.blogspot.com/

3 comments:

Mother's Always Right said...

Very interesting, makes me seriously consider hypnotherapy if I have a second baby. Although I agree, it's important to be realistic about the pain. I went into my first labour with an open mind. I knew I would rather do it naturally, but accepted if the pain got too much I would use gas and air and have pethidine. This acceptance meant I did not feel like a failure when the pain got too much and was much calmer. I think women can sometimes put too much pressure on themselves to have a natural birth, almost as if there is a reward at the end of it (other than your baby!). All women experience labour differently so you can't predict how it will affect one woman to the next.

mother.wife.me said...

I am sure it was a course of hypnotherapy that finally helped me get pregnant - it was all taking a while. So, I did a Hypnobirthing course and planned a home birth.

Unfortunately at 42 weeks I was induced, the whole process lasted 4 days, my baby suffered trauma at the point of birth - Ventouse - and came out barely breathing. Cue 5 days in NICU.

Looking back, Hypnobirthing certainly kept me calm in the run up to the start of labour - I had been quite scared of the whole process - and I used the relaxation techniques successfully to get me through several hours of the induced labour - with my husband overhearing two midwives discussing that I would end up with a C-Section if I carried on!

But all in all, I wouldn't consider relying on it again for another birth. I think I had unrealistic expectations of how birth would be and the realities are that we are lucky to live in a society where so much can be done for mothers and babies compared to countries like Bangladesh where the death rate of mothers and babies is heartbreakingly high.

I do have concerns about the level of intervention - not least because of what happened, but I don't think I would go to 42 weeks with another pregnancy and I would perhaps use a Doula to get me through the experience, rather than rely on Hypnobirthing.

Sorry, I've written an essay for a comment, your post really got me thinking!

Narrowboat Wife said...

Thanks for your thoughts Luci. Sorry I've only just picked it up as I have never worked out how to get an email when someone comments! (I really need a technical assistant on here!) Your birth experience sounds so scary :-( Yes I think I relied on hypnosis too much and thought it was going to give me a miracle. But actually, as you say, it's the luxury of modern medicine that really gives us miracles, like a much better survival rate for mothers and babies!