When Angel McNall arrived at the hospital in labor with her second son in February, she was in excruciating pain. The baby was facing her front instead of her back, in a posterior position, which can make labor more painful because the baby's skull pushes against the mother's pelvis. She was close to asking for an epidural or a Caesarean section even though she had hoped for a natural, unmedicated birth.
Then she asked her husband to put on a CD from the hypnotherapy program she'd been studying at home over the previous two months, called Hypnobabies. "Within a few minutes, I was so quiet and relaxed, the nurse and doula weren't sure I was still having contractions," she said.
Using a hypnotherapy technique, McNall, 37, told herself, "My body is feeling this, but I don't have to follow it with my mind." She imagined going to a safe place — first, her bed, and then sitting in her grandparents' kitchen as a child, eating strawberry ice cream. She stopped feeling the pain, she said.
Her son Teddy was born an hour and a half later, at about 4 p.m. The nurses were surprised, she said — they had told her mother-in-law she would be there all night.
Alternative pain management
Self-hypnosis for childbirth is becoming more popular, used primarily as an alternative to pain medication during labor. It's one of several alternative methods that are making their way into the mainstream, said Dr. William Camann, director of obstetric anesthesia at Brigham and Women's Hospital in Boston and co-author of the book "Easy Labor" (Random House, $13.95). Others include laboring and giving birth in water, and using birthing balls, aromatherapy, Reiki and acupuncture.
Although 76 percent of U.S. women giving birth had an epidural during labor, according to a 2006 national survey by the nonprofit Childbirth Connection, both expecting mothers and health providers have become more aware of alternative techniques to manage labor pain, said Camann. Most are safe and compatible with more traditional hospital deliveries and medical pain relief, he said.
HypnoBirthing and Hypnobabies, two hypnotherapy childbirth programs in the U.S., have seen increased interest in recent years. Participation in Hypnobabies classes and home study has doubled each year since the program started in 2001, said its founder, Kerry Tuschhoff. Hypnobabies teachers are required to charge no more than $400 per couple for the program in a group class.
The programs teach expecting mothers, over 5 to 6 weeks, to train their minds to eliminate pain rather than manage it. Contractions are called waves, and pain is reframed as sensations of pushing, pulling, stretching and tightening. Mothers are taught to "breathe the baby down" between contractions rather than "purple pushing" with excessive pressure and struggle. Both programs are also available for home study.
In the Hypnobabies program, mothers imagine turning off a light switch in the abdominal area, which can create a state of "hypnoanesthesia" similar to hypnosis techniques used for surgery, Tuschhoff said. Mothers practice using words like "peace" and "release" to trigger this relaxed state. Participants also listen to CDs daily with affirmations like "My baby is strong and growing inside me."
Mothers can bring a hypnobirthing coach, often called a hypnodoula, to prompt them when giving birth, and partners can participate too, but the programs are designed to work without that support.
Hypnosis and laboring in water have been shown the most effective alternative pain relief techniques in studies, Camann said. Women using hypnosis rated their labor pain as milder than did control groups, and were less likely to use medical pain relief, according to a 2004 review of several studies in the British Journal of Anaesthesia.
Acupuncture — either to relieve pain during labor or to induce labor — is much less common, Camann said, and has not been proven effective in studies.
Aromatherapy, massage and Reiki relax the laboring mother but don't seem effective in reducing pain, Camann said. "All those things make you feel good," he said, "It's like going to a spa."
Lesser known methods to relieve pain during labor include water injections in the back, and transcutaneous electrical nerve stimulation, in which women operate a device that delivers a tingling sensation to areas where electrode pads are placed. Both "trick your nerves into thinking they're feeling something else," and help especially in posterior births, Camann said.
"There is an increased understanding and tolerance in more mainstream practitioners" of these alternative methods and the use of doulas, or birth coaches, Camann said. He coined the word "epidoula" to illustrate how epidurals compliment these methods.
Change the strategy if needed
The actress Tiffani Thiessen, who appeared in "Beverly Hills 90210," planned to use hypnosis when giving birth to her first child last June. She needed assistance having her water broken, and eventually had a Caesarean section after 30 hours of labor, she told People magazine in July.
"Some mothers are so specific with what they envision their labor will be like, when they have never experienced labor pains before," said Dr. Erin Tracy, an obstetrician and gynecologist at Massachusetts General Hospital in Boston. "Sometimes, once labor begins, they completely change their mind."
Tracy has seen patients in tears of disappointment when their birth turned out differently than they planned. "The ultimate outcome is to have a healthy mom and a healthy baby, and you're not a failure if you avail yourself of an epidural," she said.
The main risk, according to Camann, is if using alternative methods prevents mothers from getting proper medical care. It's important to see an obstetrician, he said.Copyright © 2015, The Baltimore Sun