Each day this week, I’m tackling #birthfears. One of those which comes up time and time again, is pain and birth. The issues around pain and birth are complex and not just physical but also psychological. In this blog I can only scratch the surface but I hope that it will start you thinking about fear and expectation in relation to pain.
Thinking positively about pain and birth
by Sophie Fletcher, Author of ‘Mindful Hypnobirthing‘ (published by Vermillion 2014), clinical hypnotherapist and doula.
Today I’m going to talk about the P word. Yes I am going to write it, “pain’. Some hypnobirthing models don’t mention the word as the mere suggestion of it creates an expectation of it. Although it’s true that suggestion is very powerful, just because I don’t mention the word pain doesn’t mean that your friends, television, radio, or even your midwife will use the word without fail in relation to birth.
It’s important to be upfront about the word and about what pain actually is and why women experience it when they give birth. But haven’t you always wondered why some women have an easy time of it, while others complain of the worst pain ever experienced? It’s not coincidence; think carefully about your friends that have had an easier time of it, perhaps they are your friends that are more laid back generally in life, more relaxed. Perhaps the friends that experienced more pain are generally more anxious, wanting to be in control more.
Anxiety can create tension and increase pain
If you are starting to categorise yourself as an anxious person, relax; hypnosis and mindfulness can help you to shift that mindset. But first before you start analyzing yourself, I want to draw your attention to what anxiety does. Whether it’s birth, back pain, or arthritis, anxiety is known to increase levels of pain. When our muscles are relaxed they work harmoniously, when they are tense they create pain. During birth we are not meant to feel intense pain, pain is a signal from our body that something is wrong. There is all sorts of research emerging at the moment about our physiology and our pain/pleasure centres in the brain that is beginning to support this hypotheses.
Our uterine muscles are meant to be relaxed, this way they work harmoniously. When we are free of anxiety or fear, our bodies are designed to produced hormones that make us drowsy, spaced out and which can make birth, for some women, an ecstatic experience. When these muscles are working, it’s a powerful and intense sensation; these sensations have a role and help guide how we move during labour to help our babies be born.
Ahhh did you see that, I used the word sensation, instead of pain. This is because of the second rule of pain – expectation. If we expect pain, and are focused on it we are likely to experience it, even when it’s not there. This is not to say it’s a phantom pain, and I’m not going to say that someone who has severe chronic back pain isn’t experiencing it, they do, but it comes from the brain not in their back where they think it is. It’s as if the original injury has been hardwired into the brain. If you want to learn more about this read this fantastic little book by Dr Grahame Brown.
Expectation of pain creates pain.
I’m fascinated about suggestion and expectation of pain, I think it’s extraordinary and the most misunderstood parts of our physiology/psychology.
A study that came out in 2011 by Prof Irene Tracy shows this rule of expectation and, with MRI added to the mix, is really starting to open our eyes to what our brains are capable of.
This study in this took 27 volunteers and placed them in an MRI. They were each given an IV to administer a strong opioid anesthetic. Before the experiment started they had a control run where heat was applied to their leg until it reached 70, on a scale of 1-100, and they were given an IV line. Then, unknown to the participants, the team started to give the drug to see what the effects were when the participants didn’t know they were getting the drug. The average pain rating when down from 66 to 55. Then the participants were told they were getting the drug, but there was no change in the amount, the pain rating dropped to 39!
Now this is the interesting part, the people volunteering were led to believe that the drug had been stopped and told, that means given the suggestion, that ‘there may be a possible increase in pain’, the drug was still being administered with no change. Their pain intensity increased to 64 close to the original pain level of 66 which was without drugs. Even more remarkable the MRI showed that the brains in the volunteers showed that their pain networks responded to their expectations and the suggestion at each stage.
These volunteers were told that they ‘may expect an increase in pain’. What must it be like for pregnant women who are bombarded with messages that birth is so painful that we are primed to forget it so we’ll have more? Their expectation is unquestionably focused on pain. The midwife may say things like “how far apart are your pains’, or ‘do you want pain relief’, ‘where are you feeling the pain’, this gives the suggestion of pain during labour as well.
So why don’t some women feel pain during birth?
I’ve heard women describe birth as intense and powerful, I’d heard the word ‘hurtment’offered up by one woman, other said that there is not a word in the dictionary to describe what the experience is. I’ve heard women who were terrified of the pain before, turn to me and say “I can do this” half way through their labour when they realise that actually the horror stories were wrong.
Of course these women feel something, they are aware of the intensity, and power of birth, but they don’t call it pain. They may call it energy or sensation, or tightening. By changing its name you can change the experience but you also take the power back to yourself. If I were to say to you, you will feel a very strong squeezing or tightening during each contraction, it changes how you feel about it. It feels better, achievable, less frightening. You can decide how you wish to experience it, the sensation of birth is not foreign to you, it doesn’t invade you, it come from within you.
How can I turn the ow into wow?
Begin to change how you see birth, start to see it as a powerful experience, a welcome experience. Hypnosis is brilliant as accessing your deep-rooted fears around pain of birth and changing them into a positive expectation. You can read more about hypnosis for birth here. It also gives you techniques that help activate the part of your brain which can change and reduce those sensations during birth. If you do experience pain, sometimes certain interventions or anxieties can arise which case tension and pain, hypnosis is great at being able to turn them off or down. Read this amazing article by Dr John Butler who had a hernia operation using self-hypnosis.
Here are some tips
- First tackle your fears of pain, these may be creating unnecessary anxiety. Perhaps this may be learning about the physiology, reading books that explore birth in a very positive way. Try ‘Ina May’s Guide to Childbirth’ or read my new book coming out in March ‘Mindful Hypnobirthing’ where I explore our physiology and psychology around birth, fear, expectation and pain in much more depth.
- Do a class that teaches you techniques for relaxation, self-hypnosis or mindfulness.
- Learn techniques such as massage, which are wonderful for relaxing your muscles during labour
- Stop listening to people telling you about painful births, talk to people who are likely to say ‘you know what, it was ok, in fact it was better than ok’.
- Stop watching dramatic TV shows about birth, these create expectation
- Think about creating a birth environment that will relax and calm your rather then make you anxious and frightened.
Say these affirmations every day, to yourself and then out loud as you get more comfortable. Affirmations are a very simple way of beginning to change your unconscious belief around pain, expectation and birth.
- As my body expands and grows I welcome each tweak and niggle as a sign of my baby growing and my body creating the perfect environment for pregnancy
- When labour starts I relax and let go, excited that I will soon be holding my baby in my arms
- As the contractions rise and fall in my body, I embrace that sensation resting comfortably between each one
- As I rest between each one, I feel a sense of deep relaxation and closeness with my baby and my partner
- I am comfortably aware of the sensations of labour as they get stronger and longer bringing my baby to me
- I see my contractions positively and with each tightening I follow my breath
- As I focus and follow on my breath my body relaxes into each contraction