Tuesday, May 11, 2010

Understanding "Painless" Childbirth

This post is inspired by a recent conversation on my natural childbirth forum, as well as a few birth stories I have read from Hypnobabies moms who were surprised to find that their pressure waves felt "painful" to them. It also is a response to something I stumbled upon while browsing the archives of a natural childbirth blog, in which the author said she would not want to have a painless birth.

So, what is up with "painless" childbirth?


A few women are rumored to have "painless" births without special preparation. I think this is probably pretty rare, but the fact that it happens is notable. The majority of women who refer to their births ans "painless" or "pain-free" are women who used hypnosis.

I think this is something that is commonly misunderstood, and I admit I didn't understand it when I was preparing for my first birth. I read the book Hypnobirthing by Marie Mongan, and listened to the CD that came with it a few times. As I understood it, Mongan was teaching that all "pain" in childbirth was a result of the fear/tension/pain cycle, meaning birth will not be painful if you are not afraid of it. I believed that what we experience in birth is a direct result of what we expect, so I chose not to expect pain. I was really oversimplifying things, and I was in for a rude awakening.

When I started having contractions (I refer to them as "contractions" here because that is what I called them at the time--I didn't buy into the idea of changing the words then) I admitted that "they hurt," but it was very manageable. They went on for quite a long time, going away and coming back, and then I was given a very low dose of pitocin, and those contractions really hurt. I was still able to cope using movement and deep breathing for a while, but I was really miserable. I do recognize that there was a psychological element to this pain. In my mind, something external (pitocin) was inflicting pain upon me, instead of it being caused by my own uterine muscles contracting. This, as well as exhaustion and pressure to dilate due to risk of infection, made it much harder for me to cope.

I think that I, as a first timer, espoused a common misconception about painless birth: believing that your birth will be painless just because you've heard of it and believe it's possible. I didn't think I needed to do anything to have a painless birth; I thought it would just happen because birth is not "meant" to be painful (right, Dr. Dick-Read?)

My understanding of this changed when I did the Hypnobabies program for my second birth. I don't know if there is really a difference in the two programs' views or if my experiences caused me to have this new understanding. I don't know if birth is really "meant" to be painful or not, but I do know that it involves a stimulus that the majority (at least in our culture) of women's brains interpret as "pain," which is generally experienced as a negative thing. Good hypnosis for childbirth provides a system for changing your mind so that the stimulus is interpreted as not painful, so that it can be experienced more positively. For me, with my second birth, experiencing it positively involved a conscious choice on my part.

Both Hypnobirthing and Hypnobabies use a technique of renaming some of the words commonly used in childbirth. This is a strange practice and, I admit, it's a little cumbersome at times, but many women find it helpful to avoid negative associations their subconscious may have with the words. One example is avoiding use of the word "pain" and using "discomfort" instead, because it is not as negative of a word. Some could argue that "painless childbirth" is about semantics, but it's really about what you choose to believe.

I believe that most women who have unmedicated births are able to find a way to experience the stimulus of the sensations of childbirth as not a bad thing, even if they do experience them as painful. In embracing a "pain with a purpose" ideology, women are choosing to tweak their understanding of the word "pain" (which is usually a negative word to describe a sensation that occurs when the body is being harmed) to include a kind of pain that is good. This essentially means changing the negative connotation of the word "pain" to be positive in this particular circumstance, while with hypnosis, we simply change the word, eliminating the negative connotation altogether.

I think some people, when they hear "painless," assume that means not feeling anything--that the "hypno-anesthesia" would be like an epidural and make them numb. It doesn't work this way. Hypno-anesthesia is very strong endorphins. It's like when you cut yourself or you twist your ankle and at first it hurts a lot, but then it doesn't hurt as much, that's endorphins. They soothe and dull pain, but they don't take away sensation. With a pain-free unmedicated birth with hypnosis, you would still feel your baby being born, it just wouldn't feel like pain to you.

Sometimes the talk of feeling "only pressure and tightening" in Hypnobabies leads women to expect that birthing waves will feel just like Braxton-Hicks waves. This is not true either. Braxtion-Hicks are just tightening sensations, for me, birthing waves (and also the pre-birth waves that can occur irregularly for weeks before the actual birth) have an extra level of intensity--what I now call a "downward pressure" which signaled to me that my uterus was now working to begin moving my baby down instead of just flexing itself for the exercise.

One of the changes in the new 6th edition of Hypnobabies is the re-recording and re-naming of a track that used to be called "Painless Childbirth" to "Easy, Comfortable Childbirth." Hypnobabies appears to be moving away from using the word "painless," which, considering all of the misconceptions about it, I think is a good move. I feel like "comfortable" is a more accurate description of how Hypnobabies helped me. Whatever sensations I felt (some of which I may have called "painful" under other circumstances), I knew they were normal and was able to not be afraid of them, which allowed me to feel calm and confident and not out-of-control or panicky (except during the cervical lip and the pushing, but I have theories about that). I wouldn't say I was "in pain," because for me, being "in pain" never involves that degree of serenity and self-composure.

I know there are some women for whom surviving the pain of childbirth provides a sense of accomplishment. It makes them feel like they are "hardcore." I, on the other hand, am not "hardcore," nor do I want to be. I can get a sense of accomplishment from seeing that I did something most people experience as very painful, and it was mostly comfortable to me, and I did it with my mind!

22 comments:

  1. I enjoyed reading this. You put to words a lot of what I am thinking, and it seems not too many people, pregnant woman even, think much about childbirth. Personally, I don't see myself either as "hardcore," or out to prove anything by my strong desire for a natural childbirth. For me, I'm more afraid of what goes on in the standard approach to hospital, OB-directed childbirth, than I am of natural childbirth after having experienced both. Thanks for sharing your thoughts on this.

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  2. Beautifully put! Not every woman will have a pain free birth but when they take an active role in mentally preparing themselves for a good birth, their body and mind will respond appropriately. They may feel what is considered pain by others but I belive that women learn to "deal" with it in the sense that they feel the discomfort is not as bad as they thought it would be. I have also heard that they learn to "turn down the volume" of the discomfort and focus their attention elsewhere so that the stimulus of the contraction is tolearable.

    Israel
    www.painlessbirth.com

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  3. I completely understand what you are saying about the fear and panic aspect creating the "pain." I think the concept of "painless" is what made my own mother feel as though hypnosis was ineffective. The whole medicalization of childbirth in the early 70s was awful too--my dad was ushered out of the room, etc.

    I also think it is easier to wrap your mind around the birth process after you have done it once. Again, it comes down to fear. We are often afraid of the unkown, but once we've done it we can anticipate the process and learn ways to cope. It becomes manageable.

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  4. Ooooo I enjoyed reading! I will be experiencing my first Hypnobabies birth soon and I am really looking forward to what I will bring from it. I also think that the perception of "pain" signals us to do something at times; for example change positions, use the bathroom, PUSH, rest, etc. So there again, like you said, there is a positive spin on the terminology. Thank you for sharing what you have learned along the way!

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  5. This is a great post! Thanks for your insights.

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  6. Wonderful post. I recently finished my Hypnobabies class, which was fantastic. My baby will be born in about two months. Your post really helped me understand what to expect during my birthing, and how to think about "pain with a purpose." This way of thinking will help me not feel like I'm doing something wrong if/when I feel what I might normally consider "pain."

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  7. Fantastic, this is very much what I observe in HypnoMoms as I serve them as a certified HypnoDoula, I love it more than you can say-after serving over 700 births, only 50 or so using mostly Hypnobabies, I am thrilled for the entire family. This is a serious breakthrough in Birth and is challenging for to wrap the mind around unless you do it or support it! Thank you:)

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  8. Thought provoking post. I experienced almost painless childbirth with and without drugs and never used hypnosis. I think it is different for everyone.

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  9. Whoops...me again. In five births, number one and two were painless with drugs. Number three was painful. Number four was not painful until the last ten seconds and number five was painless the whole time. No hypnobabies...nothing.

    I just started focusing on reassuring the baby and the surges never got painful with four and five. The crowning was not painful on number three and number five.

    The contractions hurt on number three (possibly because I was panting to keep the baby in on the dash to the hospital.)

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  10. Anonymous, you are one of the women I mentioned who can have painless birth without special preparation. I think some women's brains naturally don't interpret the sensations as "pain" so they don't need anything to reprogram their minds to experience it that way.

    I believe that a majority of women, especially in cultures where fear of birth is very common and horror stories abound, can benefit greatly from using hypnosis to prepare for birthing.

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  11. Great post! I had a wonderful birth experience with my second (after a traumatic birth with my first) - the sensations were intense, but I chose to focus on my body opening, and the baby moving down and choosing to feel the contractions as intense pressure. When I reached 10 cm, I couldn't believe it - I had been waiting for things to get nearly unbearable, and they never did. Two quick, very intense pushes and my daughter was born.

    However, that being said, I don't think all births are meant to be relatively painless - I was fully prepared for my third birth to be much like my first - however, laboring and birthing my son felt like a semi-truck plowing through my body. It hurt like hell. I had to just surrender to the whole experience - at one point, I said, "I'm not sure I can do this!", to which my widwife replied, "You ARE doing this, and your body will continue to do what it needs to until your son is born." And, it did - my 10 1/2 lb baby boy was born about an hour later!

    Should we have a 4th - I will expect a birth like my 2nd child's - an intense, but joyful experience, but won't be disappointed should it prove to be more like my third child's - I will surrender to whatever the journey is, and welcome my child at the end of it.

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  12. I love this! I didn't use any type of hypnosis for my NCB. I did embrace the "pain" and although I know it was painful at the time, my only strong memory is the incredible pressure I felt. At the end it felt like someone was pushing down on the top of my uterus with a brick and I kept thinking it couldn't possibly get more intense and it would. I was very much in control at all times, never panicky. I suppose I did "tweak" my understanding of the word pain.

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  13. I had a painless birth with my fifth baby. It was so painless that I didn't realize it was real until he was crowing. (Luckily my husband recognized subtle changes in my mood and called the midwife, who arrived just in time.)

    I did not do hypnosis. I just practiced relaxing my perineum with each braxton hicks. When I was lying in bed, in active labor, I thought I was having BH contractions so I just kept relaxing my perineum.

    It didn't even hurt when he was crowning. I tore a little and that stung but not bad at all.

    For the record: My son was 10lb 6oz and I have a ridiculously low pain threshold.

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  14. Thank you for your excellent article. I had painless childbirth with all my babies. I think it was because I did unassisted births and no one talked to me or touched me while in active labor. I was able to go into the zone and time seemed to stand still. But every time I looked at the clock an hour had gone by. When it was over I felt like I had just had the best sex ever. I was 17 and had a 5 and 1/2 hour labor with my first.

    As a midwife, I try to allow my moms to go to that zone, but I also have to listen to the baby, give drinks of water, etc. I tell my apprentices not to talk to her, just support as they see a need and be aware of the mom's response.

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  15. This was really helpful, Brittany! Thanks for your comment on my blog and for passing along this link. I'm assuming I'm the one you referred to in the first paragraph who "would not want to have a painless childbirth." Ha ha. Look at me now. Funny how things can change over time. :-)

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  16. I just gave birth to my second child. Both of my children were born naturally in birth centers where I was assisted by wonderful midwives. My son was born after 9 hours of labor, and was 9lb 12oz. His birth was intense, though I wouldn't really call it painful. Pushing with him was such a relief. My daughter who was born 2 weeks ago, now she is a different story. I did Hypnobabies to prepare for her birth, and I truly believed I would have a painless childbirth. I had already experienced one natural birth that was what I would consider the best day of my life, and I was ready to do it again, but this time without the pain that came with transition. Oh boy, it did not happen that way. I was in transition for about 2 hours with my daughter, and I was beyond miserable. Transition had only lasted for about 15 minutes with my son, so it was all new to me. I couldn't figure out why Hypnobabies was failing me at that time! It got me through all the other contractions, but nothing I did, or my husband did, could get my hypnobabies training to kick back in during that horribly difficult time. Pushing her out was totally different too! It was not a relief, it felt like she was going to split me in two. I still haven't come to terms with her birth, and I'm disappointed in myself for how it turned out, and what I perceive as my inability for hypnobabies to do it's job. :-(

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    1. its stories like this that dwell in my mind. and im looking for inspiration. just about to birth my second any day now. all of our birthing tramas are important but are they all helpful? please remember that those reading your stories might use them to help create their own miserable experience. lets create some new ideas about our births this is supposidly a free country?

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  17. Thank you so much for your honesty! I'm prepping for my 4th birth using an old, borrowed version of Hypnobabies, and the use of the word "painless" has made me skeptical of the whole program. This post (and the note about how Hypnobabies is not using the word "painless anymore) has really helped me restore my faith in it!

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  18. I don't think that there is such a thing as a painless labour but I do believe that women can get as close as possible even naturally. One doesn't need epidural but one does need relaxation and comfort. That is already half the battle.

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  19. painless delivery is now possible!but not every woman have painless delivery due to some reasons.The woman who get painless delivery they take an active role in mentally preparing themselves for a good birth, their body and mind will respond appropriately.

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  21. I had a pain free labor with my baby, without drugs or hypnosis. in fact the only way I knew I was having contractions is that the doctor told me he could see it on the monitors.

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