Hypnosis in Childbirth – How to use the trance state

by Helen McPherson

A hypnotic state is a completely natural state that we all go into at least twice a day. That moment between sleeping and waking, when we are semi aware of what is going on around us but we do not react, even though we could. That moment when we are “miles away” and do not even hear someone speaking directly to us. Those times when we have driven home and wondered where the last few miles have gone as were completely unaware of them. All these are examples of trance states.

And in trance states we become extremely suggestible. Have you ever heard a song on the radio in the morning and cannot get it out of your head all day? That’s because it went straight into your head when you heard it. It bypassed the “critical factor” of your mind. This critical factor is your filter, which rejects ideas, statements, suggestions that do not accord with what you believe. If someone told you that they had just been to a place where the grass was blue, your critical factor, your filter, would filter out this idea and reject it because it does not accord with the belief system you have built up. Every blade of grass you have ever seen was green and as far as you know, every other person you know has only ever seen green grass, and that is the way life is – grass is green. We build up our critical factor through experience. It starts as a baby, when you drop the toy out of the pram it goes down. Every time. The toy never goes up. Hey presto, you have learnt about gravity. The critical factor of gravity has been created in your mind.

Unfortunately in the western world, very many women have built up a negative critical factor surrounding childbirth. When mothers talk about their birth experience they relish telling the most difficult bits, as if it were a competition – “I’m so tough because I endured 24 hours of labour.” “No, I’m harder. I suffered for 30 hours and had no pain relief and the hospital didn’t even believe me….” “Well you should hear about my aunty. She had her second twin 30 hours after the first! With no pain relief – she was in AGONY.” And so it goes on. Every TV drama or soap opera films a character giving birth in a screaming agony of pain. As children, childbirth is not talked about, kept behind closed doors. We never learn what it is really like. The conspiracy of fear has started.

So as we carry on through our teenage years, childbirth is not something that usually features. We can put the fear behind us, although every screaming labouring actress on the screen contributes to the critical factor that we are building up – childbirth is painful, VERY painful. Until one day we become pregnant ourselves. And then we cannot ignore it any longer, we WILL be giving birth to our baby. So we buy a few books. What do they talk about? PAIN relief. We go to antenatal classes. What do we learn there? How to manage PAIN. How to manage LABOUR.

And what associations do we have with the words employed for birth? The word Labour conjures up words such as work, hard, tough. What do you think of for the word Hospital? Most people think of sickness, illness, pain, even death. Many midwives talk about labour pains. Some midwives still assume that a labouring woman wants pain relief and ask her immediately what she would like “for the pain.”

We have been conditioned to expect that labour is long, arduous, agonising. When you enter any experience with an expectation, it is very often the case that your expectation is proved correct. If you expect a long, agonising labour, where you feel helpless and out of control then it is very possible that you will have a labour just like that.

Would it surprise you to know that this does not have to be the case? Women in many countries around the world give birth without the drama and screaming that we in the West associate with childbirth. When you use hypnosis in the process of birthing you stand to gain so much. Research has shown that birthing with hypnosis can help to achieve the following:

• Faster labour

• Efficient labour

• Less pain relief

• Less interventions

• A relaxed and healthy baby/less chance of distress

• Faster recovery

• Reduced incidence of post-natal depression

• Breast-feeding success

Isn’t this what every pregnant woman wants?! A comfortable birth, with a healthy baby and a swift recovery. So how does hypnosis help birth?

  1. Relaxation. The state of hypnosis is highly relaxing for the mind and body. In this state the entire body relaxes and so do the blood vessels. This relaxing or dilation of the blood vessels ensures a better blood flow throughout the body and especially to the womb.
  2. Efficient Birth. During labour, a relaxed body will ensure that blood is diverted to the uterus in order that it can contract efficiently and progress labour smoothly and swiftly. A relaxed mind and body will ensure that the womb has the blood supply it needs. Post-natally a better milk supply is encouraged through good blood flow.
  3. Calm the Emotions. The effect on the mind and emotions is profound. With hypnotherapy a woman can relieve stress and anxiety. This relief can help to achieve a calm birthing experience and later calm the emotions during the post-natal period.
  4. Overcome Fear. Fear is the single greatest factor that you can change about your labour. Fear inhibits labour, constricts the blood supply and increases the perception of pain. This leads to the Fear-Tension-Pain cycle, where fear creates tension, which creates pain, which creates more fear of pain and so it goes on. If you can remove fear then you can aid your own body to do what comes naturally and that is to birth a baby comfortably and easily.
  5. Stress Relief. When we are stressed or fearful we release adrenaline and other stress hormones into the blood stream. This tenses our bodies and a tense body feels pain and creates its own pain. Blood rushes to the arms and legs ready to fight or run, taking blood away from the uterus where it is needed to help the uterus to contract. If there is not enough blood flow to the uterus, it works less efficiently and slower and blood flow to the baby can be disrupted, resulting eventually in distress. Other blood vessels can be constricted, again stopping the uterus from working well. You can see that when hypnosis removes stress from the experience of childbirth, then a swift, comfortable birth of a relaxed baby will normally result.
  6. Relaxed Baby. A tense mother will release stress hormones, adrenaline and cortisol into the blood stream. These can in turn stress the baby, who then appears distressed to medical staff and interventions can result in order to speed up labour or bring the baby out quickly. Babies are designed to withstand many hours of labour and a relaxed baby will cope well even if labour does not progress as smoothly or quickly as hoped.
  7. Post-Natal Recovery. A relaxed mother will have good blood flow around the body. This blood flow will assist soft tissues in recovery and promote a good milk supply. Stress is known to have an adverse effect on milk production so the relaxed mother has a head start.

By using hypnosis, a mother in labour can help herself to remain calm. Blood flow is improved and comfort increased. A relaxed mind and body can ease a labour to feel in control and positive. This good perception of labour and good blood flow will help post-natal recovery and the production of milk.

So how is all this achieved? A hypnotherapist will help you first with your fears. Remember the critical factor? If you have a negative view of childbirth then we need to work on that critical factor, challenge fears and negative beliefs and install positive ones. A woman’s body is designed for childbirth, it naturally opens up to allow a baby through, the brain naturally releases pain-relieving endorphins. But if you are too tense and trying to run away from the sensations then you can interfere with this process and end up feeling pain.

Many women fear feeling out of control during labour. But what do they really mean by this? Yes, the body is doing something strange that we are not in total control of but it is giving birth to a baby – a happy event. Firstly the cervix is opening and then the uterus is contracting hugely, it is a big muscle working hard. With a first baby, the woman has never felt these sensations before. But they are only sensations, just as tensing up an arm or a hand produces a sensation, a sensation of muscle contraction. If you can overcome the fear of something never before experienced then you are halfway there. The sensation of the uterus contracting to push out a baby is a powerful feeling, and you cannot stop it. You need to embrace the feeling, acknowledge it and accept it and then you will be able to achieve relaxation and allow your body to get on with what it needs to do. If you try to fight or run away, that’s when tension is produced and the fear-tension-pain cycle is started. So use therapy firstly to address the fear.

Fears don’t always come only from negative conditioning. They may come from real or imagined situations. A woman who has had a long, difficult or painful first labour or even a stillborn baby can be overcome with fear for a second labour. In this case, revisiting and processing that first experience will be immeasurably helpful and this re-processing can be done in a number of ways, with a therapist, by talking to a midwife about the previous experience, or even by talking with other women. Other women may be experiencing fear due to not wanting a baby or because of fears about how life will be after the baby is born. One teenage mother I knew was in so much fear that she was even disbelieving that she was really going to have a baby as she was taken to the delivery suite in active labour. She did not want a baby and her fearful mind tried to fight the body’s compulsion to birth her baby; it was not a positive experience for her. If this fear is addressed first then the experience can be entirely different.

It is worth at this point to re-visit the state of hypnosis or trance. A trance can also be described as a state of focussed awareness. Remember the times when we have been “miles away,” engrossed to the point of not hearing when someone says our name? This is a trance and a labouring woman is so focussed on her labour and the sensations she is feeling, that she too is in a trance. And this is how hypnosis can help. If we accept that a woman in labour is in a trance then we can use this trance to our benefit. The woman herself can use it for pain relief and achieving a relaxed physical state. And the midwife, birth partner and other care-givers can also use it to give positive suggestions.

While in a trance state, the critical factor can be bypassed so a labouring woman will accept things that are said to her. One woman was labouring fabulously on arrival at hospital with a baby who was taking his time to turn the correct way to be born. The first midwife she saw simply said, “that baby’s not coming out, he’ll be coming out of the sunroof.” From that minute the woman became a passive patient and forgot she was supposed to be upright and open. She lay on her back on the bed and her caregivers also completely forgot what they should be doing and did not assist her into helpful positions. That one careless remark may have contributed to a labour that resulted in a Ceasarean section. The labouring woman accepted the remark that bypassed her critical factor (a factor that until that point expected her to birth her baby), as did her birth partners. A powerful suggestion indeed.

Caregivers, birth partners, midwives, doctors should be extremely careful what they say to a woman in labour. It should always be positive, always suggesting that all is well. The woman will believe what you say! Every remark should be carefully calculated to relax and induce calm and never anything to suggest fear or pain. Contractions are contractions or surges, not pain. Never ask or assume that a woman is in pain, don’t mention the word. She is probably just very highly focussed in her own world, miles away, in a trance. Don’t disturb that trance by introducing negative language, she is using it for her own benefit.

Another trance phenomena that can be used is time distortion. A labouring woman does lose track o f time and it usually goes by far quicker than normal time. This is also a feature of hypnotic trance and it can be manipulated and used for the woman’s benefit. Imagine that the time between contractions is long, very long and a contraction is over within seconds. How very useful! As I have said earlier, a labouring woman is in a trance and she can learn to use it.

Women who have used hypnotic techniques as part of their childbirth preparation will have learnt how to induce their own trance, how to turn off pain, they will have addressed their fears and will have learnt how to use time distortion. Their lack of fear and acceptance of powerful feelings in the body usually contribute to a very comfortable and positive birth experience, which in turn contributes to a positive post-natal phase and less instances of depression. Hypnotic trance is a completely natural state and one which labouring women go into naturally. Harnessing the power of that natural state is how the real benefits can be achieved: comfort, a faster labour, with fewer interventions and a relaxed and healthy mother and baby at the end.

Author’s biography:

Helen McPherson MSc DCH NRH GQHP is a clinical hypnotherapist specialising in fertility and pregnancy issues and preparing expectant mothers for labour and birth with hypnosis. At her clinic in the Midlands, Golden Health Therapy Centre, she runs a natural fertility program which incorporates nutritional supplementation with acupuncture, herbal medicine and hypnotherapy.

www.northamptonhypnosis.co.uk

Research & notes:

Effect of hypnosis on length of labour

Hao et al in China measured the effect of nursing suggestions to labouring women and recommends that the conversation of the nurses be “controlled carefully for the purpose of advancing the birth process”. This randomized control trial examined 60 first time mothers with a matched control group of 60 first time mothers and found a statistically significant reduction in the lengths of the first and second stages of labour.

Jenkins and Pritchard found a reduction of 3 hours for prim gravid women (from 9.3 hours to 6.4 hours) and 1 hour for multi gravid women (from 6.2 hours to 5.3 hours) for active labour (262 subjects and 600 controls). Pushing was statistically shorter for first time mothers (from 50 min to 37 min).

In a study that compared hypnosis and Lamaze training, 96 women chose between hypnosis (n=45) and Lamaze (n=51). The first stage of labour was shortened in the hypnosis group by 98 minutes for first time mothers and by 40 minutes for second time mothers. These women were more satisfied with labour and reported other benefits of hypnosis such as reduced anxiety and help with getting to sleep.

A British study found a statistically significant reduction in the length of labour of first and second time mothers: 70 hypnosis patients (6 h 21 min) compared to 70 relaxation patients (9 h 28 min) and 70 control group (9 h 45 min).

Mellegren noted a reduction of two to three hours of labour.

Abramson and Heron found a shorter first stage of labour for 100 women trained with hypnosis (by 3.23 hours) compared to a control group of 88 women. Forty-five Hypnosis for Childbirth clients (first time mothers) had an average of 4.5 hours for the active labour, a significant reduction compared to the usual 12 hours.

Medication use
In a British study, 55% of 45 patients (first and second time mothers) required no medication for pain relief. In the other non-hypnosis groups, only 22% of 90 women required no medication. Two research pieces reported on 1,000 consecutive births: 850 women used hypnotic analgesia resulting in 58 percent rate of no medication. Five other research pieces reported an incidence of 60 to 79 percent non-medicated births.

A retrospective survey notes an epidural rate of 18 percent in Southern Ontario, where the epidural rate in most hospitals is 40 to 95 percent (depending on the setting) for first time mothers.

Rates of Intervention
In a randomized control trial of 42 teenagers in Florida, none of the 22 patients in the hypnosis group experienced surgical intervention compared with 12 of the 20 patients in the control group (p=.000). Twelve patients in the hypnosis group experienced complications compared with 17 in the control group (p=.047).

Harmon, Hynan and Tyre reported more spontaneous deliveries, higher Agpar scores and reduced medication use in their study of 60 women. Of the 45 Hypnosis for Childbirth clients, 38 delivered without the use of caesarean, forceps or vacuum, a rate of spontaneous birth of 84%. This is a higher than average rate of normal birth for the general population of first time mothers.

Postpartum
In a randomized control trial of 42 teenagers in Florida, only 1 patient in the hypnosis group had a hospital stay of more than two days compared with 8 patients in the control group (p=.008).

Postpartum Depression
McCarthy provided five 30-minute sessions to 600 women and found a virtual absence of postpartum depression, compared to the typical rates of 10 to 15 percent. Women with a history of postpartum depression did not develop this condition, even though an estimated 50 percent eventually do. Harmon et al also reported lower depression scores in the hypnotically treated group.

It appears that a simple intervention, hypnotherapy, has far-reaching effects both medically and socially. Some, but not all, of the above studies are randomized, have large numbers, include control groups and demonstrate statistical significance. There remains, therefore, a clear need for more research, in the use of hypnosis for childbirth preparation.

Links for Research into Hypnosis for Childbirth

http://findarticles.com/p/articles/mi_qa4087/is_200404/ai_n9353151/pg_1?tag=artBody;col1 Mehl-Madrona and Lewis E, 2004

Harmon, T., Hynan, T., & Tyre, T. (1990). Improved obstetric outcomes using hypnotic analgesia and skill mastery combined with childbirth education. Journal of Consulting and Clinical Psychology. 58, 525-530.

http://www.academyforguidedimagery.com/research/procedures/cb/index.html

http://www.homebirthsa.org.au/PDF%20Files/Abst_Hypnosis&Birth.pdf

http://www.ncbi.nlm.nih.gov/pubmed/9495995?dopt=Abstract

http://bja.oxfordjournals.org/cgi/content/full/93/4/505#SEC3

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1450315

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