QUESTION: I am expecting my first
baby in a few months and I am worried that I will end up with a cesarean
-- even though I'm not considered high risk. One of my friends has
told me that if I keep thinking this way I will end up having one.
I have heard there is a mind-body connection and now I am worried
that my thoughts can actually affect the way I give birth. What do
you think?
ANSWER: The mind-body connection is
commonly oversimplified, and misunderstandings about psychological
influences on childbirth are no exception. It is true that our beliefs
and expectations influence our ability to cope with labor, which can
impact the hormonal flow and physiology of the process. But this effect
is related to more complex biological responses to fear, rather than
the superficial interpretation that your thoughts will cause you to
have a cesarean! This simplistic association denies not only the complexity
of the relationship of brain-within-body, but implies a false assumption
of mind "control" which does not exist in labor.
Labor is an autonomic process. In other words, it
is a spontaneous physical process that you do not have control over!
It must happen by itself, just as digestion, gestation, and millions
of other automatic bodily functions. Your thoughts have no more "control"
over your body than over the rising and setting of the sun. Instead,
it is the emotional beliefs communicated through the limbic system
that interact with our biology.
The limbic system is often described as the emotional
center of the brain because it sends messages to the body based on
emotional arousal. Hormones, neurochemicals and other substances are
released according to an individual's perception of the world. During
labor, the hormone oxytocin is released by the pituitary gland. In
addition, prostaglandins are circulated throughout the blood stream,
helping to soften the cervix as the oxytocin causes the uterus to
contract. The amounts of oxytocin released and the secretion of hormones
that control prostaglandins during labor are determined by the hypothalamus,
which is affected by the limbic system.
The brain regulates labor in response to many messages,
including the woman's emotional state. Heightened levels of fear and
anxiety during labor have been found to decrease the flow of oxytocin.
In this way, emotional factors can influence your labor. But anxieties
are normal during any life transition and becoming a mother is a transition
of great magnitude! So what can we do about our anxieties?
One woman's emotional response to her situation will
be different than the next, although the external circumstances are
similar. Therefore, individualized preparation and care is far more
effective when it deals with a woman's specific "birth inventory,"
which is a profile of her significant fears and concerns about upcoming
motherhood and childbirth.
Although childbirth preparation classes may teach
you relaxation techniques, anxiety about this life transition will
be calmed only be addressing your individual concerns. Let's take
a look at the following areas that contribute to normal delivery.
Given that you are medically low-risk and receiving adequate nutrition
and prenatal care, you will benefit from turning your attention to
the following areas of personal development:
BECOMING A MOTHER
Having a baby creates a myriad of changes in our lives.
Becoming a mother is one of the greatest life changes you will ever
experience.
Our past childhood relationships with our mothers,
our fathers and the overall connection we experienced in our parents'
marriages form the backdrop for our emotional readiness for motherhood.
If we felt positive support in our relationships with parents, or
have worked through disappointments and childhood wounds to the extent
that we trust our own marriages and abilities to mother, we will enter
labor with confidence, rather than anxiety of what lies on the other
side of childbirth.
What is your expectation for motherhood? Do you feel
confident about your ability to nurture and guide your child? If not,
what will help you develop trust in yourself to mother?
PAST CHILDBIRTH HISTORY
The stories about birth, both real or mythologized
in the family, influence our underlying sense of safety and trust
in the childbirth process. Our own births, too, may impact the subliminal
expectations we carry into labor. More than relaxation techniques,
our true ability to trust the process of labor allows our bodies to
relax and function more smoothly.
Birth visualization which engages the limbic system
of the brain through body-centered relaxation can help women change
past negative experience and encourage positive associations. Refer
to chapter eight in "An Easier Childbirth" and the audiotape "Body-Centered
Hypnosis for Pregnancy, Bonding and Childbirth" to construct a childbirth
visualization that addresses your specific concerns during this life
transition.
What are your associations and experiences related
to childbirth? If you have had a negative childbirth experience in
the past, what would you want to change this time? Can you see the
possibility for a positive experience in your next childbirth?
REALISTIC LABOR PREPARATION
The hippocampus of the brain mediates between what
we expect and the reality of our experience. When a woman is not adequately
prepared to meet and cope with the normal pain of labor contractions,
she may become frightened, even believing that something is going
very wrong for her. The belief that something is wrong disrupts breathing,
increases tension and catecholomines (hormones produced in stress).
These stress hormones are thought to produce a signal to shut down
the production and/or release of oxytocin in the blood stream during
labor. They may also be responsible for decreased oxygen supply to
the baby during pregnancy.
If a woman is realistically prepared to cope with
labor, knowledgeable of the process and receiving adequate emotional
support through labor, she is likely to actively approach each contraction,
rather than attempt to avoid it. Avoidance response in the limbic
system is akin to "fight or flight." This physiological response uses
up resources in the body, directing blood to the external muscles
for defense or running. This may drain the autonomic muscles, such
as the uterus, of the blood flow needed to function smoothly.
Are you realistically prepared to cope with pain during
labor, whether or not you are planning on pain medication (as medication
is usually not available until labor is progressed to a certain point)?
Do you have emotional support to help you through labor?
PRESENT FAMILY RELATIONSHIPS
Our expectations that our partners and immediate family
members are available for support after the baby comes helps us enter
labor with a sense that the future is secure. Anxiety related to the
expectation that a baby will propel you into deprivation and chaos
as a couple will increase anxiety, while nurturing family relationships
will engender a sense of calm, resulting from trust that the couple
will be able to handle the changes that a baby will bring to their
lives and their marriage.
What are your plans for sharing caretaking responsibilities
after your child is born? Have you discussed the ways in which having
a baby will change your life as a couple? Have you committed yourselves
to communicating about your experiences of parenthood, after your
child is born?
Keep in mind, that there is no perfect preparation
for labor or motherhood. Psychological "readiness" occurs because
we are given encouragement and opportunity to address the concerns
we have as women who are giving birth and becoming mothers.
Our psychology lives inside our bodies. There is no
war of mind over matter here. The mind-body connection is based on
a relationship with, rather than control over, our physicality.
Give yourself the opportunity to face your fears.
Reflect on the many ways you may be afraid of "losing control." Childbirth,
motherhood and life itself cause us to yield to the power of nature.
Turning inwards to reflect on your development will help you strengthen
your inner resources at the same time you express your specific needs
for support from others.
Facing your fears and reaching out for emotional support
increases your ability to handle whatever situation lies before you
with a sense of calm and well-being. Achieving this state of mind
ensures that you have done your part to increase the potential for
a smooth and uncomplicated delivery.
