To begin to address women's needs in a meaningful way, we must encourage a yielding relationship to the childbirth process. Pain in labor is a reality. And the expectation of pain, as well as some means for coping with it, goes a long way toward healthy birth outcomes.

THE BIRTH OF A BABY IS THE BIRTH OF A FAMILY. A myriad of births takes place at once: women become mothers, husbands become fathers, daughters become sisters and sons become big brothers. One birth ripples through generations, creating subtle shifts and rearrangements in the family web.

Unfortunately, we rarely regard pregnancy and birth as formative phases in family making. Nor do we realize that, as a woman enters motherhood, she feels new pressures, some of which derive from her own experience of having been mothered and some of which are engendered by family and societal beliefs and mandates. Moreover, hardly ever are the coping styles promoted in the marketplace applicable to the stress of labor.

To begin to address women's needs in a meaningful way, we must encourage a yielding relationship to the childbirth process. We must emphasize the sensation of following one's body, wherever that may lead. Above all, we must foster trust and cooperation in labor, rather than a desire to take control of the process.

Body-centered hypnosis does just that as it facilitates prenatal bonding, noninterventive birthing and healthy postpartum adjustments as well. When integrated into prenatal preparations, it creates a bridge between the unconscious bodily processes of pregnancy and childbirth and the emotional and psychological growth required during this sensitive time in a woman's life cycle.

Overcoming Anxiety through Hypnosis

Reduced maternal anxiety is the psychological factor most significant in normalizing pregnancy, labor and birth outcome. High-anxiety states, which affect oxygenation and the flow of nutrients to the fetus, have been correlated with abnormal decreases in fetal movement.(1) Anxiety has also been associated with uterine dysfunction in labor,(2,3,4) other debilitating labor patterns,(5) as well as prematurity(6) and miscarriage. As anxiety levels drop, these conditions improve.

To effectively transform maternal anxieties, several researchers and practitioners now recommend the use of hypnosis. Some point to the need for hypnosis in contemporary obstetrics, primarily to address the psychological needs of the mother.(7) Others use hypnosis to address the needs of the family as they prepare for labor.(8) Still others recommend hypnotherapy to reverse the potentially debilitating emotional factors that can arise with pregnancy.(9)

Over the past 17 years, I have developed a body-centered hypnosis to help women prepare for childbirth. Using techniques that engage portions of the brain, I create a hypnotic experience of birth, including the sensory patterning of labor. I link the pregnant woman's experiential input with hypnotic suggestions for labor and birth that are based on her personal history. I also link the hypnotic experience of childbirth to the woman's individual needs, weaving suggestions for conflict resolution via Ericksonian storytelling(10) into a guided journey through labor. Overall, I strive to create a subjective experience of having already mastered the birth process.

Women who have engaged in this form of hypnosis report that phrases and images from the hypnotic experience reemerge during labor. Many laboring women even feel that they are "reliving" the birth. My belief is that the sensation aroused by the hypnotic birth journey becomes encoded in the nervous system through the brain's memory tracings, and that the suggestions for coping with labor and birth become activated by the physiological processes themselves.

Whereas some forms of hypnotherapy involve dissociation from bodily experience, body-centered hypnosis deepens a woman's bodily sensation, taking her into a focused experience of physiological processes. Body-centered hypnotic suggestions are communicated, through a variety of images and sensations, to the visual, auditory and somasthetic cortices of the brain. Here, I believe, the images and sensations that carry sufficient emotional impact trigger the release of acetylcholine (a neurotransmitter involved in the formation of memories) through the hippocampus and into long-term memory storage. Later, the physical processes of the developing pregnancy and labor activate these hypnotic messages. If anxieties have been addressed successfully in hypnosis, then maternal anxiety lessens and labor is more likely to progress smoothly.

Hence, body-centered hypnosis mediates a woman's fears about childbirth and motherhood through bodily sensation and physical memory - and the effects are observable. Provided that pain has been adequately addressed, the flow of oxytocin during labor tends to be sustained and the ejectory reflex remains largely unimpeded. In addition, some birthing women retain a conscious awareness of the hypnotic messages given. Others do not; yet, upon recall, they will repeat a phrase or two, demonstrating that the messages have become an intrinsic part of their birthing experience. One woman reported the following recollection soon after her second birth: "And so 'straight down and out he came' (a phrase from her hypnosis session, used to help counteract the effect of her previous posterior birth) in a two-hour labor."

Facing Pain

Pain in labor is a reality. And the expectation of pain, as well as some means for coping with it, goes a long way toward healthy birth outcomes. The hippocampus plays a major role in this respect, for it mediates between the expectation of an experience and its actuality. One researcher notes that when differences between expectations and realities remain minor, the hippocampus "inhibits the reticular activating system," but as soon as major differences emerge, the hippocampus stimulates the reticular activating system "to alert the entire cortex to these discrepancies" and, in the process, precipitates higher levels of tension in the central nervous system.(11) Another researcher suggests that women who experience cognitive dissonance between what they expect and what they undergo have more birth complications than women who experience no such dissonance.(12)

Uterine inertia, or the cessation of contractions, is one such complication; another is the occurrence of strong, unrelenting contractions that produce no cervical dilation. In both instances, the involuntary processes of the uterus go haywire due to the firing of conflicting messages from the limbic system (a.k.a. the emotional center of the brain). Accompanying the message for labor to proceed comes a new message, elicited by the woman's response to unexpected pain or fear, for labor to turn off. When both "fight" and "flight" polarities of the limbic system are activated in this way, labor can easily become dysfunctional. When the expectation of pain is addressed in advance, however, the limbic system is better prepared to create a self-regulating feedback loop that will facilitate the progression of labor.(13)

Body-centered hypnosis reaches into this self-regulating limbic activity, helping women cope with the likelihood of pain in labor. Sensations evoked by the use of vivid imagery, meaningful metaphors and the repetition of certain phrases all produce memory tracings in the brain tracings that are further developed by listening to an audiotape of the hypnosis session. Stimulated by the hypnotic messages, pregnant women thus reexperience the sensations evoked during hypnosis, all the while reactivating limbic pathways that feed into the autonomic nervous system. The hypnosis is rendered even more effective when pregnant women identify their unique coping styles and utilize active coping techniques before labor begins.(14)

This body-centered approach to pain management not only decreases anxiety levels during the upcoming birth, but profoundly affects subsequent births as well. In contrast, most other forms of hypnosis used for childbirth focus on "transcending" the pain or blocking it out, offering few long-range benefits. The laboring woman whose experience of pain is denied or rendered inaccessible often has more difficulty resolving her birthing anxieties the next time around.

Body-Centered Techniques

The experiential quality of body-centered hypnosis is equally promising, and a far cry from methods that invite pregnant women to merely relax and absorb suggestions. The more actively women participate in the hypnosis process, the more it becomes an intimate part of everyday life. The more engaged they are in the experience of bodily sensations, the more motivated they will be to create positive suggestions, and the better prepared they will be to bring forth new life.

Some of the techniques used in body-centered hypnosis are these:

Through these techniques and others as well, body-centered hypnosis is able to support the contemporary woman's entry into motherhood, helping her meet calmly whatever comes her way in labor. In the event of a complication, it helps ease her anxiety so that she can better cope with a difficult situation. When used routinely in prenatal care, this form of hypnosis can free today's women to focus on the tasks at hand: gestation, childbirth and, ultimately, postpartum adjustment.

The best part is that everyone benefits. Women who are supported in transforming areas of distress into wellsprings of resourcefulness learn to make the delicate adjustments needed in giving birth, in creating family and - with each subsequent birth - in creating family anew.

Notes

1. H. Moroshima and H. Pedersen. "Maternal Psychological Stress and the Fetus," American Journal of Obstetrics and Gynecology, 131 (1978): 286.

2. R. L Gorsuch and M K. Key, "Abnormality of Pregnancy as a Function of Anxiety and Life Stress, Psychosomatic Medicine, 36 (1974): 352-362.

3. M. MacDonald, M. Gunther. and A. Christakes, "Relations between Maternal Anxiety and Obstetrical Complications," Psychosomatic Medicine, 25 (19v3): 74 77

4. G. Levenson and S Shnider. "Catecholomines: The Effects of Maternal Fear and Its Treatment on Uterine Dysfunction and Circulation," Birth and Family Journal, 6 no 3 (1979): 167-174

5. S E. Lederman, B A. Lederman, and 3 Work, "The Relationship of Maternal Anxiety, Plasma Catecholomines, and Plasma Cortisol to Progress in Labor.," American Journal of Obstetrics and Gynecology, 132 (1978): 495.

6. L. M Gunther, "Psychopathology and Stress in the Life Experience of Mothers and Premature Infants American Journal of Obstetrics and Gynecology, 131 (1963): 286

7. G. Di Bernando, "The Role of Hypnosis in Present-Day Obstetrics," Minerva Medicine, 66, no 6 (1975): 276 - 280.

8. N Poncelet, "An Ericksonian Approach to Childbirth," in J. Zeig, ed., Ericksonian Psychotherapy, vol 2 (New York: Brunner-Mazel, 1985).

9. L. E. Mehl, S. Donovan, and G. H. Peterson, "The Role of Hypnotherapy in Facilitating Normal Birth," in P. Freyburgh and L. Vanessa-Vogel, eds. Prenatal and Perinatal Psychology and Medicine, (Park Ridge, NJ: Parthenon, 1988).

10. J. Zeig, Ericksonian Approaches to Hypnosis in Psychotherapy (New York: Bnunner-Mazel, 1982).

11. Charles Hampden-Tumer, Maps of the Mind (New York: Macmillan, l981), p. 84.

12. Randi Ettner, Cesarean Birth: Risk and Culture (Berkeley, CA: Mindbody Press, 1985), ch.13.

13. Gayle Peterson, "Body-Centered Hypnosis for Childbirth" (unpublished dissertation).

14. For a discussion of visual, auditory and kinesthetic coping styles in labor, see Gayle Peterson, An Easier Childbirth: A Mother's Workbook for Health and Emotional Well-Being during Pregnancy and Delivery (Los Angeles: Jeremy Tarchare Publications, 1991).

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