Can hypnosis lessen birth pain?

Advertiser Staff and News Services

For more information The HypnoBirthing Institute in Epsom, N.H.: hypnobirthing.com, or call (603) 798-3286 for a referral In Hawai'i: Hypnobirthing educator Judy Koch, 526-4766

When the contractions grew more intense, and sea images became impossible to hold onto, she switched to visualizing the sensations as colors — the pain as red, painlessness as blue — as her husband and sister coached her. "I told myself, 'Change to blue, change to blue, change to blue,'" recalls the 37-year-old.

For 20 hours of labor, she rode the contractions like waves this way, requiring no medication for pain relief.

She felt, she says, "only some discomfort" on the rare occasion that she let her concentration waver.

She finally took an epidural only when it was determined that she needed a Cesarean section to deliver baby Malia, who was born to Thibaut and her husband, Jean Claude, on Dec. 2.

"Labor doesn't have to be this scary, painful experience that the movies and TV portray it to be," Dianne Thibaut insists. "There's a different relationship with what people call pain if you're subjective experience of it is not fearful."

The Thibauts are among the thousands of parents nationwide who are swearing by the benefits of hypnobirthing, the latest trend in so-called natural childbirth.

Believers contend that labor can be easy, even blissful — not through drugs, but through the power of the mind. The premise is simple and similar to other mind-body disciplines: By overcoming your fears and relaxing your body, you will be able to deliver your baby with minimal trauma.

Practitioners contend there are dramatic results: fewer complications, fewer Cesarean deliveries, shorter labor and less suffering.

"We get letters all the time from women who have experienced pain-free births," said Marie Mongan, founder of the New Hampshire-based HypnoBirthing Institute.

Technically, hypnobirthing is not new. People have used hypnosis for decades to have babies, as well as to overcome such problems as smoking and overeating. But the application of hypnosis specifically to address childbirth pain has become more mainstream since Mongan, an educator and hypnotherapist, formalized her theories on childbirth in 1989.

It's hard to say how many people are using the technique, but Mongan estimates them in the thousands in America alone, because the institute has trained 1,000 instructors, 700 of them in the last three years. She has held training sessions as far away as England and Australia, and her 1998 book, "HypnoBirthing: A Celebration of Life," is being translated into French.

A spokeswoman at Kapi'olani Medical Center for Women and Children, Hawai'i's leading birthing hospital, said that, based on a quick survey of staff, few if any parents have been known to use hypnobirthing techniques for birth.

But Mongan said in a phone interview from Arizona that Hawai'i has at least seven instructors certified by the HypnoBirthing Institute. And Judy Koch of Nu'uanu, a hypnobirthing educator trained by the HypnoBirthing Institute, says she for one typically attracts one to two new clients each week. She theorizes that because patients don't require a doctor's or nurse's help to use hypnobirthing methods, health providers often are unaware of their use.

'Totally relaxed state'

Not everyone is buying into hypnobirthing.

Denise Roy, director of The Birth Center in Bryn Mawr, Pa., which gets about five or six hypnobirthers a month, said the technique was "a wonderful tool to help cope with labor and delivery."

However, she said, "It does not make for a pain-free delivery. There's no such thing."

The relaxation and visualization techniques are to help a woman remain calm during the labor and delivery. The goal is to become so relaxed, so focused on a mental image — a peaceful color, a tranquil scene, a favorite place — that the mother is distracted from the pain.

Usually a husband or companion is trained to help keep the mother focused. The words uttered during labor are considered to have influence on a mother's well-being; for instance, a neutral word such as "surge" replaces utterances with possibly negative connotations, such as "contraction."

Mongan said she used self-hypnosis to deliver her own four children.

"I had four children with absolutely no pain whatsoever, and this was when women were totally anesthetized and the baby was delivered with forceps," said the 68-year-old grandmother. "I brought myself to such a totally relaxed state, without an aspirin or anything."

Mongan based her teachings on the works of Grantly Dick-Read, an English obstetrician who believed that fear and tension cause pain and that profound relaxation produces an opiate-like effect on the body.

She has no studies or data to prove her theories, just "the serene look on a woman's face" as she brings a baby into the world.

Patients in control

"There's actually no scientific reason for women to have pain at childbirth," said Larry Goldman, a Fort Myers, Fla., ob-gyn who has been using hypnosis on his patients for 25 years. Goldman said the practice had kept his Cesarean rate at 5 percent, compared with the national rate of 20 percent.

He credited a New York obstetrician named Bill Warner with first using hypnosis to deliver babies in the 1950s. He believed that pain was a learned process in childbirth.

"Through hypnosis we can teach people to unlearn the response they learned to contractions," said Goldman, who studied with Warner.

"It's nice to give control back to the patients. Labor and delivery should be a very happy, enjoyable time. It shouldn't be a holler, scream-fest where everyone is uncomfortable," he said.

But Julie Crystal, director of Midwifery Associates at Pennsylvania Hospital, says childbirth goes much smoother if a woman can learn to let go.

"Part of what we have to do in labor ... is accept the fact that this is a physical process that we cannot control. We have to let it happen. ... What happens with these techniques, we use it as a way to stay in control. In a way, that's counterproductive, and it also sets you up for failing."

To say childbirth is not painful is "nonsense," said Thomas J. Bader, an assistant professor and director of general obstetrics and gynecology at the Hospital at the University of Pennsylvania.

When muscles contract, as they do during labor, there is a buildup of lactic acid, which stimulates pain fibers, he said.

"What frustrates me about this whole approach," Bader said, "is why can't there be pain? The debate about whether or not there is pain is irrelevant. The important part is how they (mothers) deal with it, how they get through it and whether they have a successful outcome, in terms of the mom's health and happiness and the baby's."

It's that kind of bottom-line thinking that irritates hypnobirthers who believe the quality of the birthing experience is just as important as a successful outcome.

"Some mothers need help, but you don't have to apply all the wonders of obstetrics to every birth," said Robin Frees, who teaches hypnobirthing in Malvern, Pa. "Why does childbirth need to be medically managed?"

Assistant features editor Esme Infante Nii contributed to this report.