Hypnobirthing: childbirth without fear

Can hypnosis help mothers to give birth pain-free? Emma Sheppard speaks to the experts and the women using this technique, and looks into where hypnobirthing originated (clue: the 1800s, before anaesthesia)…

Gisele has done it. Jessica Alba and Fearne Cotton are fans, and the Duchess of Cambridge is rumoured to have dabbled with the technique as she prepared for the birth of Prince George.

Hypnobirthing is the latest craze in childbirth that those in the know can’t stop talking about.

First-time mum Natasha Lambelin first heard about it at a pregnancy yoga class. ‘Graduates’ would come back and share their birth experiences with the rest of the group. Inevitably, some were more positive than others.

“The nicest story was one girl who had had the most amazing birth,” Natasha says. “She described it as being so incredible, so empowering, and that it wasn’t at all painful.

“Everyone just went, oh my god, if that’s possible, that’s what we want.”

Hypnobirthing is described as a “childbirth technique whose basic premise is to remove fear… [and] considerably reduce, or even eliminate, pain”. The theory behind it dates back to a book originally published in 1959, which caused widespread uproar in the obstetrics sector.

Using hypnosis for pain relief wasn’t a new idea. In the early 1800s, surgeons had used it for operations before anesthesia was available. But Grantly Dick-Read’s book Childbirth Without Fear (published by Pinter & Martin) was the first to suggest that this approach could be applied to labour, and that the pain women experience is caused by the ‘Fear-Tension-Pain Syndrome’.

 

Dick-Read argues that by activating the ‘Fight or Flight’ response, blood and oxygen are diverted away from the uterus so that it cannot perform without discomfort. Eliminating fear “unquestionably relieves pain and, in combination with the relief of tension, pain becomes almost negligible in over 95 per cent of normal deliveries”.

Today, the importance of removing trepidation from the labour room forms the foundation of everything else, says Suzy Ashworth, founder of the Calm Birth School.

Suzy was the first in the world to offer an online video hypnobirthing class when she launched the business in December 2014. More than 3,000 women across six continents have since signed up for the free tutorials, and 360 have taken the paid-for course. It’s been far beyond what she expected, but is a responsibility she feels keenly.

“Every thought we have, every word we use, there is a corresponding physical and chemical response in the body. The physical reaction to something negative is to tense up, and the chemical response is to produce adrenalin, which creates pain in the body. It’s a self-fulfilling prophecy.”

Negativity then is left firmly at the door and positive mantras are very much the order of the day. Affirmations like “I trust my body and I follow its lead” and “I feel confident, I feel safe, I feel secure” are bandied back and forth. Practitioners replace words like ‘contractions’ (“which immediately makes us think of closing up”, says Suzy), with talk of ‘surges’ that bring mums closer to their babies. The word ‘pain’ is exchanged for ‘sensations’ or ‘discomfort’.

“What child-birth practitioners and hypnobirthing teachers want to be doing is really planting the seed of positivity at every opportunity that they can”, Suzy says. “I’m pregnant with my third and I can’t wait to give birth again. It’s bloody amazing.”

Hannah Emerson-Thomas is not so sure. She gave birth to daughter Elin in January 2015, and while she and her husband were open to giving hypnobirthing a try, it was not the calming experience she had expected.

“In all honesty, it didn’t work when it came to the crux of it,” she says. “I was in a lot of pain from my contractions and that overtook everything else. It was the epidural that gave me calm and peace, more than anything from the hypnobirthing.”

There’s a lot of focus on natural birth right now… Everyone’s looking for perfection (in life and birth). There’s a competitiveness about it.

This is something that a recent three-year NIHR (National Institute for Health Research) funded study attempted to investigate. The so-called SHIP trial was the largest of its kind, involving 680 first-time mums across the north west of England. Half were given hypnobirthing classes and half were not. The study attempted to investigate whether self-hypnosis during childbirth minimised the instance of epidurals being used. Professor Soo Downe from the University of Central Lancashire, who led the study, says there was little or no difference in those numbers. However subsequent interviews with those in the hypnobirthing group did highlight a key distinction in their overall state of mind.

“Adding prenatal self-hypnosis training to usual care in a UK setting does not seem to affect rates of epidural pain relief,” Downe says. “However, the results do suggest that the therapy might reduce postnatal anxiety and fear about childbirth.”

For Hannah, while she admits she probably didn’t practice the hypnobirthing techniques enough before Elin was born, she still won’t be trying it again any time soon. “I know I can get through it without it,” she says. “I think it’s seen as an escape from a painful labour, but actually that’s something you should embrace. Labour does take blood, sweat and tears.

“I’m bloody proud of it. I did 12 hours with no pain relief and I feel like I’ve got a huge badge of honour for getting through it. You have to feel the pain, go with it and don’t think you can control it. No one can prepare you for what labour’s like.”

Wendy Purkiss has worked as a midwife at the Mid-Essex Trust for almost 10 years. She has seen a dramatic rise in the last year alone of the number of women that have either attended hypnobirthing classes, or been admitted to hospital armed with the books and CDs that they’ve used to teach themselves. She says that the breathing techniques can help anybody but agrees with Hannah that there is a limit to how far a woman can control her own labour.

“I have mixed thoughts about hypnobirthing. Some women have coped amazingly well with it and I’ve seen some lovely births with no other pain relief. Some people take it a bit far and don’t feel they can be flexible, which is difficult for the midwife when things don’t quite go to plan.

“Labour is not a choice. We all claim we have a choice but your body is going to do what it’s going to do. Most of labour is out of your control. Ultimately, we do what we have to do for the safety of the baby.”

For me, labour with hypnobirthing was powerful, not painful.

Historically, there has been some talk of tension between hypnobirthing practitioners and midwives. The NHS website still barely mentions it as an option on its ‘Pain Relief in Labour’ page. Hypnosis is listed in the same sentence as acupuncture, aromatherapy and massage, which it says, “are not proven to provide effective pain relief”.

This disparity was highlighted in the interviews taken after the SHIP trial had ended. A portion of the women in the hypnobirthing group said that they had been so calm when arriving at hospital; they had been sent back home again. Now, more and more midwives are learning about the techniques, and even running their own classes to try and bridge this divide.

Wendy says that women should always be examined before a decision is made about whether they will be sent home. “We technically class labour as from four centimetres, with regular contractions. Those that choose to do hypnobirthing often refuse examination and that is when there may be an issue.

“There’s sometimes a view that the midwives will be against it, so couples come in ready to fight against them,” she says. “But nine out of 10 midwives are happy to do it. It’s not down to us; it’s not our labour.

“What does do harm is when people build labour up to be a lovely womanly thing, so when you’re in an emergency c-section you feel like a failure because it didn’t go the right way.”

Vanessa and Chris Sheriff had baby Rosalie last November. They had attended hypnobirthing classes, listened to the MP3s and were looking forward to the arrival of their baby. But after 19 hours of labour, Vanessa was given an epidural and rushed to theatre.

“You do feel somehow that you’ve failed if you haven’t had a natural birth,” Vanessa says. “I felt quite jealous of a lady I saw today who had had one.”

No woman can fail at birth

Chris also noted the pressure to give birth in a particular way: “There’s a lot of focus on natural birth right now,” he says. “Everyone’s looking for perfection (in life and birth). There’s a competitiveness about it.”

That said, they both enjoyed the hypnobirthing course and found the techniques useful. Chris had suggested it to Vanessa after a colleague at a work dinner had told him about her experience. He had had hypnotherapy before and knew how powerful it could be. They decided to pull out of the NCT course they had been planning to attend and sign up for a local class.

“I thought the experience was great… we even grew a bit as a couple,” Chris says. “During labour, I felt I could support Vanessa because we had a point of reference. I knew what I had to do. And I still use the breathing exercises now if I can’t sleep.”

Vanessa agrees: “It’s a real skill worth investing in. You learn how to relax and there will be stressful times after the birth where you can use those techniques.”

And while Vanessa didn’t have the natural birth she had hoped for, hypnobirthing did play an important role on the day.

“It helped us get through during many hours of surges calmly”, she says. “And then make the right decisions in a calm way when necessary. I also really believe that we have a calm baby because we were calm.”

“I don’t think hypnobirthing and epidurals or other pain relief necessarily has to be done in isolation”, Chris says. “Both can help. It really depends on the situation.”

For Natasha and her husband Christian, the birth of George in May 2015 was not without its complications either. But she credits hypnobirthing for getting her through.

“My birth went a bit wrong – his head was at a funny angle,” she says. “We were in the natural birth centre and they wanted to take me to the labour ward. They kept saying ‘we need to assist the delivery, use forceps, do an episiotomy’.

“If I hadn’t done hypnobirthing, I wouldn’t have had the confidence to say no, I know I can do this. I know I can have a natural birth.

“We kept checking his heartbeat so I knew I wasn’t putting him in any danger. And, while it probably took another three hours (I’m sure they would have whipped him out in 10 minutes, given the chance), I knew that a natural birth was best for him and me, rather than going through the trauma of forceps.

“For me, labour with hypnobirthing was powerful, not painful.”

Suzy Ashworth agrees that confidence is key. “No woman can fail at birth,” she says. “It’s about having the most positive birth experience for you and your baby on the day. Whatever happens.”

Main image: cropped from cover of Grantley Dick-Read’s book Childbirth Without Fear

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