News that Britain's National Health Service is launching an 18-month study of "hypnobirthing" to try to cut the use of epidurals and other painkillers during childbirth — six out of ten mothers in some hospitals rely on expensive medicines — has resurrected an old debate. Is intense pain unavoidable or is it triggered by fear and tension? The new study, at Central Lancashire University and involving more than 800 women, will investigate self-hypnosis techniques which induce a deep sense of relaxation. "The women will have a 90-minute training session and are given a CD they can listen to," says Professor Soo Downe, a midwifery specialist who is leading the trial. Some women already extol its virtues: "I can't imagine how anyone gives birth without it," was one comment on the Hypnobirthing UK website. "The technique kept me calm and in control throughout labour so the contractions were no problem."
The naysayers
Other mothers have greeted the idea with derision. "I wanted a ‘natural' childbirth, partly because I was worried about the side-effects of medicines," recalls one, whose only child, a son, is now five. (Pethidine, commonly used in labour, can cause nausea and drowsiness, while epidurals are associated with a higher risk of interventions such as forceps.) "I practised relaxation, yoga and breathing techniques for months. But when it came to the crunch, the pain was indescribable and none of the techniques I had learnt made it easier. I wanted an epidural but by the time I asked it was too late. I don't think hypnotherapy would work any better."
"The pain can be intense,'' says Dr Katrina Erskine, consultant obstetrician at the Homerton Hospital, London, who has had three children. It can be hard to bear, she says, if a labour is prolonged or complicated, or if a woman gets exhausted. "We need to have epidurals and other pain relief available so women can access them if necessary." And Maureen Treadwell, of the Birth Trauma Association, is concerned that "women who genuinely want pain relief in labour may be denied it". The idea that pain is the result of anxiety, and can be eliminated through relaxation techniques, was first aired in the 1930s by Dr Grantly Dick-Read, the obstetrician regarded as the founder of the natural childbirth movement.
A follower of his, an American called Marie Mongan (she had four children using his techniques) developed "hypnobirthing", now used in more than 26 countries.
The surge to let go
Some practitioners say self-hypnosis is intended to help women experience contractions not as pain but as "surges".
"When the ‘surges' come, women learn to let go rather than fight them," says Renee Buchanan, a hypnotherapist from Scotland and member of the UK's Hypnobirthing Advisory Board. She says many first-time mothers are frightened of birth, which exacerbates pain levels.
Maggie Howell, a hypnotherapist based in Guildford who specialises in childbirth, believes that hypnotherapy cannot give a pain-free guarantee but the relaxation it induces can alter physiological responses, helping the body to cope better. "When a woman is relaxed, breathing is even and rhythmic so she is getting plenty of oxygen, which stimulates the production of oxytocin and endorphins (natural painkillers). Her blood pressure remains stable and her body conserves more energy for when the contractions get stronger.'' Most experts believe yoga, breathing, birthing pools and hypnotherapy can help women cope better with pain; but conventional pain relief must always be available. Visit Hypnobirthing.co.uk and Natalhypnotherapy.co.uk for details.
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