GAS AND AIR – BIRTH AND SUGGESTION

GAS AND AIR: Birth and suggestion. How vulnerable are you?

Gas and air, nitrous oxide, is almost synonymous with labour in the UK, and becoming more popular in other parts of the world. It’s a form of pain management, easy to administer and it leaves the body quickly – some people love it, some people hate it, some may use it on their own or even use it alongside other tools such as hypnosis massage and movement.  

But while the side effects are said to be minimal, no one has really explored how the drug affects the decision-making process. Why does this matter you?  Because there are studies showing that when people use gas and air it makes them more open to suggestion. It’s not dissimilar to being in a state of hypnosis -when women can also be open to suggestion.

However, unlike hypnosis for birth, and some other antenatal classes, women using just gas and air may not have done the preparation to understand the nature of suggestion, and perhaps aren’t equipped with the tools to explore the choices that are offered.

Why is this important for birth?  Because suggestion is powerful, it can’t make us do anything we don’t want to do, but it can interfere with our decision-making when the suggestions given align with intention – which for mothers is to keep their baby safe. Ultimately that’s what we want, so anything that helps us achieve that is a powerful form of suggestion, often welcomed and acted upon.

Healthcare providers are in an influential position when it comes to suggestion. Everyone from a healthcare assistant, midwife, or a doctor can wittingly or unwittingly steer you into having interventions that you may not usually have agreed to without finding more about it. The language they choose to use matters.

Suggestions can be direct or indirect for example

Direct:

“Ah your contractions have slowed. Don’t worry. Shall we just break your waters and see if that gets contractions starting again. We do it all the time, it’s very straightforward.”

With a clear head it may be easy to say this is something you don’t necessarily want unless there is a medical reason. However, think about the language used, versus what you really hear when someone says to you “don’t worry”. What do you want to do when someone cries “don’t turn around!”.  A seed of doubt sown in those words can start to play on your mind.

Indirect:

“When contractions have slowed, sometimes women have their waters broken. It can be a really great way of getting contractions going again.”

Talking about other people’s stories is a very powerful suggestion technique.  So even though the intervention hasn’t been offered the indirect suggestion is that there may be something to worry about and that the intervention will help. It also suggests other women have had this intervention and been fine. That may true, but is it the right intervention for you and your circumstances? Often the type of suggestion can prompt us to ask for the intervention without applying a decision process to it, like BRAINS* for example.

Remember, suggestion can be positive as well as negative!

Not all suggestion is negative of course! When using hypnosis or not during birth, any encouraging suggestions, gestures of kindness can be deeply beneficial.  If the people around you are aware of their language and are positive, thoughtful and careful with their words it can have a lasting effect. As a doula I’ve seen how this type of compassionate language can mean that a high-risk birth with significant intervention where a mother feels she has agency, can be a very positive experience. Positive language during moments when a choice may be offered may sound something like this

Direct:

“Your contractions have slowed, that can be completely normal, do you want me to talk to you about why that may be and what choices you have?”

Indirect:

“Contractions slowing happens for many women; sometimes they may wait, sometimes they use anything they have learned to help, sometimes they talk through their choices with us.”

What can I do about it?

The best thing you can do is to prepare yourself.  Be aware of situations that may make you vulnerable to suggestion and learn tools to ground yourself before making a choice. Take some time, perhaps just 10 or 15 minutes to reflect on all decisions whether they are suggested to you directly or, whether you feel like making a decision independently. This is especially important if there is a fairly significant deviation from your preferences.

 You can use this checklist to help ensure that you are engaged fully with the decisions that are made.

1. Use your BRAINS.  This is a widely used decision-making process. It helps you to ask questions about benefits, risks, whether there are alternatives or to explore the possibility of waiting and doing nothing.  You can download a copy from the link at the bottom of the blog.
2. Prepare your birth partner, talk to them about anything you really don’t want. This means that if your preferences seem at risk at any point during birth they can create the space to talk it through without distraction, noise or the pressure of time.
3. It can be very helpful to write down why you have made a particular decision, especially if it deviates from your plan.
4. Learn grounding techniques like the Spotlight in Mindful Hypnobirthing to help you reconnect in those moments.
5. Ask yourself if you could have 10 minutes without gas and air to think through your choices.

Further resources:

Books:

Mindful Hypnobirthing – Sophie Fletcher

Give Birth Like a Feminist – Milli Hill

Websites:

Birthrights.org.uk

Aims.org.uk

For the Brains Sheet go to  https://www.penguin.co.uk/articles/2016/mindful-hypnobirthing/