EDITOR’S SUMMARY: During your pregnancy, and while giving birth, cultivating a state of calm, relaxed energy throughout your body and mind can help decrease anticipated fear and physical pain. Self-hypnosis birthing programs teach you how to do this with a step-by-step approach. Practice is called for, so starting the “course” a few months into your pregnancy will give you plenty of time to embody the breathing, visualization, and hypnosis techniques—training your body to activate the parasympathetic nervous system.
By Tracy Reilly
If you watch almost any American movie or TV show portraying birth, you’re likely to come across different versions of the same theme: the agony of birth … until the merciful epidural. After all, a woman calmly breathing in a quiet room isn’t very dramatic, and doesn’t exactly lend itself to comedy. With the notable exception of an episode of “Grace and Frankie,” portraying (spoiler alert) a successful, natural home birth, you’d be hard-pressed to find much in the way of support for alternative birth choices. Between media portrayals and friends’ tales of excruciating pain, if you’re an expectant mother, you may be anticipating this same type of experience for your birth. But what if it didn’t have to be a choice between suffering and medication? Hundreds of thousands of women have used self-hypnosis as a tool for pain management. Mothers who’ve had success with this technique are often baffled and saddened that the method is viewed as “alternative,” and isn’t more well-known and accessible. If the idea of a calmer, more comfortable childbirth appeals to you, this method is worth a look.
Contrary to theatrical stereotypes of hypnosis where you’re left helplessly bawking like a chicken or barking like a dog, you won’t be clucking your way through delivery—you are always in control. Hypnosis for childbirth is a practice in which you learn to drop yourself into deep relaxation, which is the essence of self-hypnosis. The goal, with repeated practice, is to be able to place yourself into this state in a matter of seconds. The idea of a calm birth, without a focus on fear, is nothing new. Some birthing moms are drawn to seclusion, like prehistoric women who gave birth in caves, and Native Americans, whose expectant mothers would go alone to a spot near a river and make up small shelters for themselves. This is one reason some birth centers offer rooms with no windows—creating a feeling of safety that comes with a smaller, dimly-lit space.
Labor practices have taken twists and turns, even within the last century. In the early 1900s, most American women gave birth at home with a doctor or midwife. This was until the first maternity hospital came into existence in 1914, changing the trajectory of labor and delivery. It was also at this time that twilight sleep was introduced, which involved medicating a mom so she was not fully conscious throughout the entire birth. In the ’20s, doctors shifted to viewing birth as a “pathological” process, yielding far more interventions—forcibly opening the cervix, doing episiotomies, and using forceps—a far cry from the mostly natural home births that long-preceded this new approach. By the 1940s, 75% of moms were delivering their babies at hospitals, and by the ’60s, that rate jumped to 99%. It wasn’t until the 1970s that natural childbirth had a resurgence. Twilight sleep became mostly a thing of the past, replaced by breathing and relaxation methods like Lamaze, and in that same decade, the epidural gained in popularity as well.
Letting Fear Subside: Cultivating Calm
While the majority of American women elect to have an epidural in a hospital setting, recent years have seen increased interest in out-of-hospital births. Although still accounting for only 2% of births in the U.S., planned home births grew by a whopping 60% from 2016–2023. Obviously, home birthing moms won’t have an option for an epidural, but regardless of where you choose to have your baby, if a natural birth is your goal, it’s important to prepare, and self-hypnosis can be an effective option for both childbirth education and preparation. The primary programs that teach self-hypnosis for childbirth in the U.S. are HypnoBirthing® and Hypnobabies®. Both methods were created by certified hypnotherapists. HypnoBirthing® began in 1989 by Marie Mongan after her own birth experiences, and inspiration from British obstetrician Dr. Gantly Dick-Read’s “Childbirth Without Fear.” Hypnobabies® was created in the early 2000s by Kerry Tuschhoff after her own painful births, and watching other women’s as a birth coach and doula. She developed Hypnobabies® based off of Gerald Kein’s “Painless Childbirth Program,” with additions based on her research and feedback from moms.
Both methods begin with a focus on reframing birth. It may seem like a minor shift to refer to contractions as “surges and waves” (HypnoBirthing®) or “birthing/pressure waves” (Hypnobabies®), but looking through that lens can impact the way you view the powerful process that happens to your body in labor. Can words be that influential? Studies have shown that specific word choices can make a difference in how you perceive an experience, or even your identity. For example, people are more likely to vote when communication is shaped toward being “a voter,” vs. the act of “voting.” Similarly, children are more motivated to help when they are seen as “helpers,” rather than “helping.” So it follows that the words you use, even to yourself—maybe especially to yourself—can be impactful. Why do words have such power? Neuroscientists say that many areas of the brain responsible for language processing also control aspects of your body. They can alter your heart rate, glucose, and the distribution of immune system-supporting chemicals. Although “birthing waves” may sound like new-age gobbledygook, it’s quite intentional for visual creatures. As Tuschhoff explains:
“The words birthing wave basically actually cause imagery of a wave, something soft and moving. Pressure wave is fine, but it’s not a contraction, it’s just pressure like a blood pressure cuff. If you take a blood pressure cuff and let it go to its full capacity, it is a great big squeeze.”
Waves and surges are preferable to contractions, since generally, more tension means more pain. Of course, the uterus’ intense squeezing is natural and necessary to move a baby down, into, and through the birth canal, but that productive tensing is different. Emotional tension or anxiety resulting from fear of birth, or a lack of understanding of what your body is doing as labor progresses, can cause uterine and pelvic floor muscles to tighten. This can make for a more painful, challenging birth experience. Dr. Grantly Dick-Read, whose work helped inspire HypnoBirthing®, dubbed this the fear-tension-pain cycle: Heightened pain creates more fear, causing more tension, which can lead to more pain, and so on.
The antidote to this is twofold: reducing fear via education about what your body does during birth, and reducing tension via relaxation techniques. These are the primary focus of HypnoBirthing® and Hypnobabies® courses. The latter has audio tracks specifically called “Fear-Clearing”—for the expectant mom, and one for her birth partner. Hypnotic suggestions guide you to release fears and concerns in your conscious or subconscious mind. Both programs teach deep, profound relaxation to engage your parasympathetic nervous system (the opposite of “fight or flight”), and provide at-home recordings you can listen to daily. Hypnobabies® utilizes a specific image: that of a light switch that you control with a “finger-drop” technique. It allows a laboring mom to go “fully down” (aka, switch “off”), dropping into complete hypno-anesthesia—your body essentially going limp. This doesn’t mean numbness, but rather, a sensation changing from pain to pressure.
If you think such relaxation means you’re stuck lying down for your labor, this isn’t the case—a relief to many women who find that lying on their backs is the most uncomfortable laboring position. Counter to being confined to a bed in a meditative state, the type of hypnosis these methods utilize lets you remain mobile within this deep relaxation. Hypnobabies® refers to this as moving to “center switch,” allowing you to remain in hypno-anesthesia, but with the ability to open your eyes and move around as you desire. The somnambulistic (sleepwalking), medical-grade hypnosis that Hypnobabies® touts is especially helpful since movement during labor can help it progress more quickly, and help shift the baby into a good birthing position. This “switch” business may sound simplistic or too good to be true, but it takes weeks of practice with the technique to successfully use it. There’s no “cramming” with these methods—you have to put in the time … ahead of time. This in itself is one potential downside for expectant moms; the time commitment isn’t doable for everyone. Preparing for a new baby already consumes plenty of time and energy. Both programs involve assigned reading and daily relaxation practice (listening to audio tracks) in order to become effective at and comfortable with the techniques.
On one hand, the idea of adding “homework” to your life may feel unfeasible; on the other, it can provide an almost-forced “break” at a time when you may feel overwhelmed—a relaxation obligation, if you will. Being assigned to lie down and listen to calming tracks may be a welcome respite, and a wonderful way to bond with your baby. It’s gifting yourself a time to pause while you’re actually accomplishing something. Aside from the time required, the cost can be prohibitive for some families. HypnoBirthing® is offered as an in-person group course, although post-COVID-19, they’ve adapted to use Zoom if needed. The program is taught over 5 weeks, 2.5 hours per class, with rates varying based on location and instructor, often in the $200–$400 range. HypnoBirthing® instructors may also conduct private classes, which tend to be quite a bit more costly, and some even offer doula services for further support. Hypnobabies® offers 3 options: an online home study course for $190, a hard-copy home study course for $240, and a 6-week (3 hours per week) in-person group course that runs from $200 upwards of $500, depending on the local instructor. Some Hypnobabies® teachers are also doulas, and offer a different price if you’re combining their services.
While the in-person options are more costly, they provide a few advantages. These include an instructor to answer your questions as they arise, a community of potentially like-minded parents with similar due dates, and a weekly “deadline” so you may be more motivated to do your reading and practice regularly, which is key to success with the techniques. Another advantage to using a local instructor is that “maternity systems vary from country to country and even hospital to hospital,” says Serene Gato, a HypnoBirthing® instructor in Florida. “Having an educator nearby will allow parents insight into what to expect from standard care in their region.” The good news is that many flexible spending accounts (FSAs) and health spending accounts (HSAs) consider hypnobirthing classes eligible expenses, and they’re even covered by some insurance. Both HypnoBirthing® and Hypnobabies® are comprehensive childbirth courses, incorporating prenatal and postpartum education (and with Hypnobabies®, nutrition, breastfeeding, and newborn care), negating the need for other antenatal classes.
It’s also an investment that can reach beyond your baby’s birth. Once you’ve learned hypnobirthing skills, they’re yours. Should you decide to have more kids, you’ll already have the techniques, although practicing regularly as a new birth nears would be wise. Even after your birthing days are behind you, you can still use the hypnosis skills as needed for everything from headaches to injuries. Perhaps you’re thinking, okay, this all sounds intriguing, but does it work? A 2022 randomized control trial would argue it does. The trial split 80 women into 2 cohorts: a control group who received routine prenatal care, and an experimental group who received regular care plus 12 hours of hypnobirthing training. They found that the hypnosis group’s rates of birth intervention were significantly lower. Almost all of the “hypno-moms” gave birth vaginally, whereas more than half of the women in the control group had C-sections. The hypnosis group had shorter deliveries by almost half, and almost none needed epidural anesthesia. Nearly half of the control group were induced, with some choosing epidurals, as well. The hypnosis cohort also scored their “birth satisfaction” higher., A systematic review in the journal “Midwifery” sums up the overall experience of moms who undergo hypnobirth training:
“The results suggest a positive impact … on childbirth experience, in alleviating fear and pain and enhancing sense of control during labor. The hypnosis-based interventions improved women’s emotional experiences and outlook towards birth, with less anxiety, increased satisfaction, fewer birth interventions, more postnatal well-being and better childbirth experience overall.”
Interventions
Regardless of how successful or unsuccessful the hypno-anesthesia was, most moms were better able to manage their labor when armed with more information about what was happening within their body during this time. A 2023 hypnobirth study published in “Sexual & Reproductive Healthcare” found that women utilized hypnobirth techniques “to maintain focus on their body’s birthing process, using pain as a driving force.” The study concluded that when you perceive pain as being meaningful, it can be easier to manage, and cause less fear. While traditional, hospital-based childbirth classes inform soon-to-be parents of what to expect, hypnobirthing tends to delve more into the physiological details and labor processes. This aspect alone appears to make for a more satisfying, empowering experience. If you’re wondering whether all of this preparation is worth it when epidurals are so common among women (70–75% of American women who give birth end up using them), they’re not without potential consequences. As with any drug, there can be side effects. But it’s the “cascade of interventions” that concern some moms-to-be.
When you get an epidural, it can certainly ease pain, but it can also slow your labor. When your labor slows too much, you’re often given Pitocin (synthetic oxytocin) to “help things along.” The reverse can also happen: A laboring mom isn’t progressing at the “right” pace, so she’s given Pitocin, which can increase the intensity of contractions while decreasing time between them for her to recover. It’s no surprise that 78% of women who are induced with Pitocin end up getting an epidural. Getting an epidural is a personal choice, but if a vaginal birth is a priority for you, it’s important to know that while some studies have found no increased risk of C-section, there are data that contradict this. A 2018 report titled “Listening to Mothers,” surveying over 2,500 women who gave birth, found that the epidural route could kick up your risk of C-section from 5–8% to 20%. One reason for this jump may be that the pain of labor increases natural oxytocin, which in turn increases the strength and efficiency of contractions. As nurse and childbirth educator Judith Lothian writes, “If the pain is taken away (for instance, with an epidural), oxytocin levels drop and contractions become fewer and less effective.” This could lead to a need for Pitocin to help contraction progression. If you add Pitocin to the mix, the risk of C-section jumps to 31%.,
While the survey researchers didn’t address the reasons for such an increase when combining the two interventions, it could have to do with your natural hormone function. Lothian argues that the stress hormones (catecholamines) released at the end of labor help facilitate the quick birth of your baby, even if you’re tired. By interfering with the physiological process of labor, these chemicals, as well as natural endorphins, may not be produced, which could contribute to labor stalling or a mom too tired to push. The Pitocin-epidural combination has also been shown to significantly lower oxytocin levels during breastfeeding as far past delivery as two days. Even without an epidural, women who require Pitocin for labor augmentation or induction have been shown to be “significantly more likely to require supplementation during breastfeeding and have fewer number of breastfeeding sessions on average.” Pitocin and epidural interventions have their time and place, and every woman’s needs are different. If your goal is to avoid medications, and you’re considering self-hypnosis, a 2012 report published in the Journal of Prenatal and Perinatal Psychology and Health, “Outcomes of HypnoBirthing,” may be empowering. While it was survey-based, not a randomized trial, researchers found that only 28% of HypnoBirthing® mothers used an epidural. Even in late labor, 31% found that stage to be comfortable or mostly comfortable, and 74% said they agreed or strongly agreed that HypnoBirthing® helped them have a more comfortable birth.
After delivery, some moms may have a different type of pain emerge: postpartum depression. It’s a condition now estimated to affect somewhere between 10–14% of new moms. A 2017 study of 46,000 women found that Pitocin use during delivery came with an increased risk of postpartum depression and postpartum anxiety disorders within the first year after giving birth. In contrast, a small study published in The American Journal of Clinical Hypnosis, “The Effectiveness of Hypnosis Intervention in Alleviating Postpartum Psychological Symptoms,” found that at 2 months postpartum, women who had undergone “a hypnosis intervention” at weeks 16, 20, 28, and 36 had significantly lower rates of postpartum anxiety and depression symptoms than the group that received routine prenatal care.
Your Body, Your Decision
Plan though you might, there’s no way to know with certainty how your birth will go. As is oft-repeated, in the end, the most important thing is a healthy mom and baby. While both hypnobirthing courses teach about possible interventions and outcomes, some mothers who completed hypnobirthing programs and went on to have to have a C-section, epidural, or other interventions have come away feeling disappointed or that they’ve somehow “failed.” No one wants a new mom to feel let down or guilty, so it’s important to keep in mind that even if the unexpected happens, your hard work hasn’t been a waste. There are plenty of moms who feel good about having gone into their labors educated and prepared, even when their birth plans went awry. A 2023 Norwegian study discussed the experiences of a small sampling of women who trained using a hypnobirthing program. All of them felt empowered, and that they had a great experience regardless of outcome. Several participants felt such a sense of achievement that they described it as transformative.
“None of the women mentioned a childbirth experience which was traumatic, despite some of the women having an outcome they had feared. One of these women, who had an emergency C-section said, ‘I got through the birth that I had in a way feared the most. And I was left with … the best memory of my whole life.’”
As with so many things in life, the more knowledge you have going in, the more prepared you will be to make the best choices for your birth. The experience of birthing a baby is a feat, but it doesn’t have to be excruciating or scary if you go into it with tools and training. As one “hypno-dad” put it, “You wouldn’t run a marathon without training, and this is the ultimate marathon.”
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Published on November 07, 2024.
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