Most women you encounter who have given birth vaginally will tell you… it hurts! However the way in which women describe labour pain varies. Some experience it as something akin to severe muscle pain like you might get if you over-exercised, for others it’s like really bad period pain. Some women perceive the pain as productive – proof that their baby is on the way – and others as agony akin to torture. Women are designed to give birth and have the ability within them to labour and birth without medication should they so choose. Having continuous support and employing natural strategies such as hypnosis can help to reduce pain during labour and birth.
The reason women perceive the pain of labour and birth differently is because, quite simply, we are all individuals. Each of us comes to birth with different prior experiences and pain thresholds. But beyond that, we also come with differing fears, levels of stress and senses of self-efficacy (belief in our own ability). All of these factors will affect how we approach and respond to pain in childbirth.
So too, how labour and birth is managed (or mismanaged) will also affect our experience. We do not labour and birth in a vacuum. Everything occurring around us will affect how we feel within and so affect how we then cope. Seemingly simple things like upright labouring positions (rather than lying in a bed) and the use of water, whether in the form of a bath or shower, have been demonstrated to assist pain management. Beyond these very concrete strategies though, a woman’s sense of security, that is whether she feels safe or under threat during labour, will greatly impact on how she perceives pain. A woman who has a continuous support person, believes in her ability to birth, and is reminded of this if her courage falters, will tend to report pain in labour and birth as less intense than women who are fearful and receive inconsistent care.
There are a wide range of ways in which the pain of labour and birth is managed. Most obviously this includes pharmacological methods (the use of drugs) such as nitrous oxide gas, pethidine and epidurals. The usefulness of water for pain management is also now becoming more widely accepted in modern day pain management, with many hospitals offering and encouraging ready access to water for immersion. This is not a new strategy. In fact water has been used to manage the pain of labour and birth for centuries. You could say that in western society we lost sight of its value and then found it again!
Another long established pain management strategy which has seen a revival is the use of hypnosis. The term was first coined in 1840 but the practices themselves were in use long before that and prevalent in ancient Egyptian and Chinese societies. There is a great deal of debate about what type of ‘state’ we are in when experiencing hypnosis and no doubt there is more than one person reading this, who has suddenly conjured up the mental imagine of a person clucking like a chicken on stage! The ‘classic’ characteristics most people experience when under hypnosis are a reduced awareness to what is going on around them, greater receptiveness to suggestion and a high degree of focused attention generally directed inward.
Our clucking friend aside, it is not too hard to see how hypnosis could assist birth. Theoretically it could provide a woman with the ability to close out the world and all its worries and concerns, and focus inward on her baby and the very natural process her body is employing to bring her baby earth-side. Her natural receptiveness to suggestion in this state would also, theoretically, make the provision of support from others more effective. The words ‘You can do this’, ‘You are amazing’, ‘You are doing so well’ and the like would carry a great deal more meaning in this state cutting through our everyday natural dismissiveness of compliments.
Whether used for labour and birth or other purposes, there are two main forms of delivery of hypnosis – that delivered in person by a practitioner and self-hypnosis. While there have certainly been trials involving practitioners attending women during labour and birth, generally the most common way in which hypnosis is used by women is self-hypnosis. This involves women being taught, either individually or in a group, to induce a state of mental calm within themselves. Commonly this involves visualisation, teaching the woman to conjure up a mental image of a place, real or imagined, in which she feels safe, calm and at peace. Generally classes with a practitioner are supported by audio recordings which women use to practice these skills daily. In Australia the most commonly used programs for pregnant women are Hypnobirthing and Calmbirth.
So why does it matter? Wouldn’t the drugs available be faster for pain management? Maybe. But the reality is that all drugs have side effects, most cross the placenta and affect your baby, and not all drugs are available in every setting. In addition, long before you arrive at the hospital to make a selection from the drug menu, there will likely be many hours of irregular but still painful contractions to contend with.
Perhaps more importantly though, the use of drugs has been shown to interfere with the delicate hormonal balance generated by a woman’s body during labour and birth. This disruption can lead to unwanted interventions, the use of more drugs and ultimately a birth far from what the woman hoped. This is called the spiral of intervention and is a common scenario leading to traumatic births. Birth trauma is not to be underestimated. Women who experience birth trauma often go on to experience difficulty bonding with their baby, post natal depression, and an intense fear of birthing again. Like any other traumatic event, a traumatic birth can adversely change a women’s life, affecting the way she feels about herself and her relationships with others.
Beyond this though an important reason to explore the value of self-hypnosis, in particular, for pain management is that it is a strategy which women can employ themselves. In and of itself this can give women a sense of control, self-confidence and belief in themselves during labour and birth. As we have noted a sense of self-efficacy – of her body’s ability to deliver her baby – directly impacts on how a woman experiences pain. But more than that it paves the way for a birth which changes a women’s life… for the better – an empowering birth which gives the woman a new found sense of self-worth, power and presence, and the belief they she can truly do anything she sets her mind too.
Madden, K, Middleton, P, Am, C & Matthewson, M 2011, Hypnosis for Pain Management During Labour and Childbirth (Protocol), John Wiley & Sons Ltd, no. 10, pp. 1–13. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009356/pdf