Friday 11 March 2011

Managing Expectations

In 2009 I wrote an article about hypnosis for childbirth, reiterating the importance of managing realistic expectations (‘Great Expectations’, The Hypnotherapist, Volume 11, No. 3, September 2009). In my personal pregnant quest for knowledge I was seduced by Grantly Dick Reade, Marie Mongan and Ina May Gaskin1 into expecting a pain free, orgasmic and empowering childbirth experience. When my 7lb first-born burst onto the scene morphing my progressive, hypnotic affirmations into one long drawn out agonising primal scream, my beliefs about hypnosis for childbirth had to be re-examined and re-evaluated. Some women can feel that they have ‘failed’ if they take the time to learn self-hypnosis and subsequently do not achieve the ideal birth that they had planned. My own labour was thankfully relatively short, efficient, uncomplicated and un-medicated. After a candle-lit homebirth on our narrowboat you couldn’t have got much closer to my idealistic birth plan, yet I was disappointed in what I had expected of hypnotherapy, and made it my business to investigate further.

Research indicates that the use of hypnosis in childbirth promotes shorter labour, reduced use of pain relief, medical and surgical intervention. Studies conclude that hypnosis can encourage a reduced time in hospital, reduced instances of post natal depression and higher Apgar scores in infants (a measure of newborn health). Hypnosis can reduce fear, increase mental calmness and confidence and help the client to manage pain. It is misleading to suggest that by using a particular technique pain free childbirth is achievable for all, but positive suggestions can encourage a more calm and comfortable pregnancy and childbirth.

For my own journey into motherhood, I recorded myself some self-hypnosis CDs and listened to them throughout pregnancy. In addition to my basic training as a hypnotherapist I did two further courses in the use of hypnosis for childbirth, and read around the subject on both the physical and emotional elements of the childbirth process. Because of the pain and exhaustion I experienced in my first labour, I wanted to improve my preparations during my second pregnancy. I now had a more realistic expectation that birth was indeed likely to be painful, but that preparing myself with hypnosis could indeed offer many benefits. I wrote and recorded a new script for the birth of my second child, putting more emphasis onto pain management and accepting the sensations. I recorded a separate program purely for practicing glove anaesthesia.

Three weeks before my due date I felt some uncomfortable cramps during the night, and relished the opportunity to practice my glove anaesthesia. It went really well and I managed to doze through the night, controlling the sensations with self-hypnosis. I thought that it was too early to actually be in labour, because the midwives were not even intending to deliver the homebirth equipment until the following week. However, by 5 am I could no longer sleep and was too uncomfortable to continue lying down. I changed position to all fours and my husband continued to snooze, assuming that I was experiencing ‘Braxton Hicks’ practice contractions. By 6 am my husband was awake and although I was now claiming to be in labour he thought that we had better wait and see, as these things can take a long time. By 6.30am I was shouting,
“Get the babysitter! Phone the midwives! Get the TENS machine!”
“I’m a man – I can’t multi-task!” he quipped, and I think I might even have smiled. Although the contractions were painful I felt I was very much in control using some breathing techniques and self-hypnosis. A phone call to the babysitter revealed that he was on tour with a band in Sweden, the TENS machine was nowhere to be found and the midwives said,
“Hang up, and call an ambulance.” My two year old daughter woke up just before seven, and my husband began dividing his time between reassuring her in her bedroom, and comforting me in what was now the noisiest throes of labour.
“My wife is having a baby, right now,” he told the emergency services telephone operator. She began to ask questions and issue instructions. I experienced a huge involuntary push and the head was on its way. One more intense contraction later and the baby was delivered into my husband’s hands, directed and coached by the lady on the end of the phone. The ambulance arrived but the paramedics could not get through the locked gate to access our narrowboat’s mooring. My husband fetched our bewildered daughter from her bedroom and introduced her to her newborn sister. The paramedics called my husband’s mobile and he walked up the towpath to find them wandering in the patch of woodland above the canal tunnel, trying to find a way in over the fence or the gate.

Another ambulance crew arrived and then two midwives. Professionals loitered awkward and redundant in our small living space, after doing some basic health checks on the baby and I. The midwives said they call this a BBA: Born Before Arrival (of the midwives).
The baby was born at about 7.15am, after just two hours of ‘active labour’. The experience was intense, efficient and empowering. There was no TENS machine, gas and air or pharmaceuticals. The Apgar score was high; the baby was quiet, calm and feeding well. I felt that my labour was calm and confident, only panicking briefly at the moment of transition; (“I can’t do this!”) a common sign that the birth is imminent.
After conducting this experiment on myself, I can conclude that a combination of realistic expectations, knowledge of the physical process, self-hypnosis and pain management techniques can result in a wonderfully positive childbirth experience, and an interesting anecdote to share at dinner parties.

1) Authors: Grantly Dick Reade ‘Childbirth Without Fear’, Marie Mongan ‘Hypnobirthing’, Ina May Gaskin’s ‘Guide to Childbirth’.

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