PAMELA PROHOROFF

What is hypnosis for labor?

Hypnosis is a state of deep mental and physical relaxation that enables the hypnotized person to focus intensely on a thought or feeling, blocking outside distractions. In this state, proponents say, the mind is more open to suggestions that change our beliefs and behavior. When a woman prepares for childbirth with hypnosis, these suggestions aim to replace fear and expectations of pain with confident expectations of a safe, gentle – even comfortable – birth.

Getting hypnotized doesn't involve a sinister man swinging his pocket watch in front of your eyes, telling you you're getting sleepy. In the most popular hypnosis for childbirth programs, women learn to hypnotize themselves, using techniques such as deep breathing, visualization, and affirmations or hypnosis scripts. For example, a woman using this technique may concentrate on the sound of her deep breathing, taking her further into a hypnotic state, and visualize her baby easing downward with each breath.

In childbirth hypnosis programs, women and their partners are also taught a new vocabulary to describe labor and birth, to break the traditional association of birth with pain. For instance, women may call a contraction a surge or refer to dilation as blossoming.

While the idea of entering an altered mental state gives some people goose bumps, hypnotherapists say we all experience this state in our everyday lives. Daydreaming, being deeply engrossed in a book or movie, or driving someplace and having no memory of the journey when you arrive are described as examples of the hypnotic state.

Hypnotherapists also stress that you can't be made to do something that is against your will or ethics while in hypnosis, that you can choose to come back to your normal state whenever you wish, and that you are fully awake, aware, and in control during the experience.

How does hypnosis for labor work?

Hypnosis advocates give several explanations of how the process works. One theory holds that when a woman feels fear during childbirth, her body releases stress hormones that trigger the body's "fight or flight" response. This causes muscles to tighten and interferes with the birthing process. By training the subconscious mind to expect a safe, gentle birth, they say, women can avoid going into the fight-or-flight state, allowing for a smoother birth.

"The subconscious mind is responsible for many of our bodily functions, and it's also the house of our belief systems," says Rachel Yellin, a HypnoBirthing instructor in San Francisco, California. "In this state of relaxation we fill the mother's mind with positive images and associations of birth, so she can call on these while she's giving birth. It's combining the positive powers of the mind with the natural animal body."

Proponents say women can respond to hypnotic suggestions so well that they release "feel-good" hormones, such as endorphins and serotonin, while giving birth. This, they say, relaxes the mother's muscles and nervous system to the point that she feels less pain – or even no pain at all.

The idea that hypnosis might ease labor by helping women avoid the fight-or-flight state hasn't been verified in studies. However, it makes sense based on experts' understanding of how the body works, says William Camann, director of obstetric anesthesia at Brigham and Women's Hospital in Boston, Massachusetts, and author of Easy Labor: Every Woman's Guide to Choosing Less Pain and More Joy During Childbirth.

"For example, relaxation can lower maternal levels of circulating catecholamines [stress hormones], and lower levels of catecholamines can facilitate uterine contractions. The converse is also true – heightened stress and fear can elevate catecholamines, which can slow or stop labor," says Camann.

Camann says there's also validity to the practice of using a gentler vocabulary to describe birth. He points to a 2010 study he published, which found that when doctors used intimidating language to describe the injection of local anesthetic before placing an epidural – for instance, "This will feel like a big bee sting; it will be the most painful part of the experience" – women rated the injection as more painful than when doctors used gentler language, describing the sensation as a small pinch. "The words we use are very powerful," he says.

How effective is hypnosis for labor?

Unlike a pill or procedure, therapies such as hypnosis are difficult to evaluate scientifically, says Camann. A 2004 review of previous researchconcluded that better-quality studies are needed, but noted several studies finding women who used hypnosis needed less pain relief medication and rated their pain as less severe. With outcomes such as c-section rates and length of labor, the results were more mixed.

Hypnosis proponents don't promise a pain-free birth but say many of their students feel only discomfort or a sensation of pressure well into labor, or all the way through delivery. They cite other benefits as well. The HypnoBirthing program  reports that surveys of its clients found that 23 percent of women who used the technique for a vaginal birth got an epidural, compared with a national average of greater than 50 percent, and that 17 percent delivered via c-section, compared with the national rate of 32 percent.

"We've now had thousands of birth stories from women who had completely pain-free births," says Kerry Tuschhoff, founder of the HypnoBabiesprogram. "But it's dependent on whether they've learned, practiced, and used the techniques as directed. If they do that, they will have a better birth."

Camann notes that anecdotally, he does see benefits. "I've seen many patients who've used epidurals and hypnosis. This is just a generalization, but it usually goes better than with the average woman having an epidural," he says. "In my experience, the patients are quieter and more relaxed, even if it got to the point where they're asking for an epidural. It's a nice environment ­– I like being present for these births."

As Camann notes, part of this may be due to these moms' extensive preparation for the birth. Compared with women who take a short childbirth preparation class or no class at all, women who try this technique have often attended a class series, listened to hypnosis CDs daily, and practiced for hours at home.

What are the advantages of using hypnosis for labor?

Although better research is needed, some studies have shown that mothers using hypnosis in childbirth use less pain medication and rate their pain as less severe. Anecdotally, some mothers who used hypnosis report feeling little or even no pain. Others report less success. Hypnosis may be a good choice for moms who want a pain relief option other than medication. And unlike medication, hypnosis has no side effects or risks.

Hypnosis programs for childbirth present birth as gentle, perhaps even comfortable, and teach women that they can rely on their body and mind to get through the process. For some women, this is in keeping with their beliefs about birth, and they may find a hypnosis program the best childbirth preparation class for them.

What are the disadvantages?

Learning self-hypnosis takes time and money. Both HypnoBabies and HypnoBirthing teach their techniques through a class series – although HypnoBabies also offers a home study course – and both want you to practice at home. The programs run about $200 to $500, depending on where you live.

Because many women who study self-hypnosis for childbirth hope to avoid pain medications or medical interventions, it's possible you'll feel disappointed if you wind up asking for an epidural or needing interventions.

 

Who can't use hypnosis during labor?

If you can afford the time and money to learn it, virtually anyone can use self-hypnosis, say proponents. Tuschoff says the only real requirement is the willingness to hear the suggestions and believe them.

"If you're following the program and accepting what you're hearing as your new belief system, it's going to work as best as it possibly can," she says. "People who may not have as good results may think it's neat, but their belief system is that it won't work for them or that they don't deserve for it to work. In these cases, they can block any message that comes through."

Although many moms who study self-hypnosis for childbirth hope to avoid medications, interventions, and c-section delivery, self-hypnosis can help women in any type of delivery, proponents say.

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