Health

Better Birthing
Doulas and HypnoBirthing techniques are helping moms
to be take a more natural, less painful route to having a baby.

BY VICTORIA PALMER

©Body & Soul Magazine, 2002


When Alexandra Gromley, age 32, was pregnant with her first child, she complained that her obstetrician treated her as though she were just another item on his to do list. And he wasn't doing anything to soothe her nerves about her impending labor. Gormley anticipated bright lights, cold stirrups and pain at the large Los Angeles hospital where she was scheduled to have her baby. She knew she could ask for an epidural anesthetic to ease her labor pains, but she didn't want to take drugs. There must be another way, she reasoned a way to rely more on her own body and less on medical interventions. After discussing her concerns with several new mothers, Gormley and her husband, Steve, decided to hire a doula, a professional birthing coach, to help with the birth.

Christine Napper, age 29, of Leroy, New York, was anxious about her labor, too. She worried that she might not be adequately prepared when it came time for her to give birth. Her physician, Lorne Campbell, M.D., recommended HypnoBirthing and coached Napper and her husband, David, in its techniques to eliminate her fears and reduce her pain.

In 2000, more than 4 million women gave birth in the United States, according to the National Center for Health Statistics. The majority of those women chose to have their babies in a traditional hospital setting with an obstetrician in attendance. Nonetheless, a growing number of pregnant women, like Gormley and Napper, are taking a more natural route. The American College of Nurse Midwives, with 7,000 members licensed to practice in all 50 states, reports that nurse midwives who focus on the needs of the pregnant woman and her family now attend at 10 percent of all births in the United States. In lieu of hospitals, women are opting to have their babies at birth centers, homelike facilities that are often equipped with comfortable bedrooms, bathrooms, kitchens and living rooms, and may be large enough to accommodate an entire family. Lamaze training, home births, water births, acupuncture for pain relief these are just a few of the innovations that are allowing women to regain a measure of control over their bodies and their birth experiences. Here Body & Soul takes a look at two options that are gaining in popularity: doulas and HypnoBirthing.

Doulas: Advocates for Moms to Be

In ancient Greece, the doula was the favorite female servant who helped in childbirth. Today doulas have evolved into professional birthing coaches who are trained to provide emotional, physical and informational support before, during and just after pregnancy. Generally, a family or couple meets with a doula in the last trimester to discuss birthing techniques such as breathing and positioning, and postnatal concerns such as breast feeding. She does not duplicate the services of doctors and nurses but rather collaborates with them in order to assure that the mother has a safe and satisfying birth experience. For example, if a doula detects a problem during labor, such as a baby in a breech (feet first) position, she alerts the appropriate medical staff.

Demand for doulas has been increasing, thanks to clinical studies showing that women with doulas have 50 percent fewer cesarean sections, a 25 percent reduction in length of labor, 40 percent less use of the labor inducing drug Pitocin and 60 percent fewer requests for epidurals. Fewer medical interventions also mean lower expenses, which is driving the creation of in house doula programs at hospitals. According to Jennifer Nunn, president of Doulas of North America one of the largest doula training, certification and membership organizations in the country the organization had fewer than 100 doula members when it started 10 years ago; now there are more than 4,000.

The Gormleys' doula, Los Angeles based Harinam Khalsa, proved invaluable throughout the birth. When labor began, Khalsa met the couple at the hospital. Doctors and nurses changed shifts, but the doula never left. As Gormleys labor pains intensified, Khalsa encouraged her to trust her body. Khalsa also made sure the mom to be was in control, intervening when a nurse "went ballistic" over Gormley's request to use the bathroom. "I was attached to all these monitors, and she didn't want me disrupting anything;' Gormley explains. To avoid problems, Khalsa accompanied her. When it was finally time to push, the doula stepped aside and let husband Steve act as birthing coach. Shortly afterward, their son Zachary was born. “My doula’s focus was always on me and my family," says a content Gormley. "My needs were more important than hospital procedure."

Linda Hamill, age 32, of Poughkeepsie, NewYork, wasn't so fortunate when she delivered her daughter Ashley in 1999. Doctors administered an epidural early, and while the drug's numbing effects reduced her pain, they also slowed her contractions. (Research suggests that in addition to slowing down labor, epidural medication may remain in the baby's system for up to six weeks after delivery; this may affect the baby's ability to "latch on" during breast feeding.) Eventually Hamill had to have a cesarean section. Afterward, healing was slow, and she could barely maneuver her own body, let alone care for Ashley. For her second pregnancy, Hamill and husband Jeff hired Jennifer Rush, a local doula. When contractions began at 4 A.M. one morning, Hamill was ready to head for the hospital. But Rush soon arrived, determined that labor was in the early stages and advised staying put. At one point, she suggested a bath. "For one hour," Hamill recalls, "Jennifer poured hot water over my shoulders. I was so relaxed I barely felt any discomfort. “At 8 A.M., the couple and Rush drove to the hospital. Already eight centimeters dilated, Hamill asked for an epidural; two hours later, her second daughter, Emily, was born. "Jennifer's voice helped me relax and focus;'says Hamill. "If I had known how close I was to the end, I'm sure I could' have gone without the drugs."

A doula's job is not to discourage medical interventions, but to help clarify the risks and benefits for a pregnant woman. "We live in a technological world,” says Donna Basilica, a doula in Boston. Epidurals and inducements are typical but not always necessary My job is to remind each woman that she is in control of the process. I tell her to relax and trust what is natural. After all, it's her birth, it's her baby, it's her body."

HypnoBirthing: Easing Fears and Pain

Comfort is not a word often attributed to childbirth, but as Marie Mongon writes in HypnoBirthing. A Celebration of Life, "When the mind accepts the belief that without complication, birthing proceeds naturally, no pain exists and no pain is experienced.' In other words, if a laboring mother's mind is free of fear, pain can be reduced or even eliminated. Mongan developed HypnoBirthing in 1989, based on the pioneering work of English obstetrician Grantly Dick Read. Dick Read postulated a fear tension pain feedback loop between a woman’s mind and body that produces oxygen deprivation in the uterus and painful, inefficient contractions. By relying on her natural instincts, he claimed, a woman might short circuit the loop and experience childbirth calmly, comfortably and safely. In five two and a half hour classes, certified Hypnotherapist (who often are doulas, midwives or nurses, too) teach women how to gain control over their minds, bodies and emotions. Participants, accompanied by their husband or partner, learn that the birthing muscles work better when the body is relaxed and practice visualization, self hypnosis and relaxation techniques to achieve deep relaxation. A pregnant woman might be instructed to imagine how she wants her labor to feel. if she wants the experience to be like snow falling gently on her fare, for example, her partner might stroke her arm while she visualizes this sensation. The stroking is intended as a reminder of what the mind is suggesting to the body. Then, during actual labor, the practice is replicated to help coax the mind into a fearless state, permitting the muscles in the uterus to relax and work without stress.

With the help of physician Lorne Campbell and her husband, Christine Napper learned to overcome her fears. "By the time I was in labor, I was confident” Napper says. "I was able to focus on my body but could still walk and enjoy the people around me"

Even the vocabulary used by HypnoBirthers redefines birth in a more pos itive way. According to Mongan, babies are birthed, not "delivered" like pizzas. The word "surge" replaces the word "contraction. “While contraction means tightening and shrinking, surge connotes the opposite the rush or flow of something. "I felt pressure during my surges, but no pain" says Napper, who gave birth to a daughter, Caitlin, after 18 hours of labor. "The best part was that my baby was alert. She wasn’t stressed at all ' "

Studies have shown that hypnosis during labor can reduce pain, complications and length of labor. Campbell has his own testament to the technique's success: "Since I started using HypnoBirthing with my patients last year,” he says, "only one patient has had a cesarean section."


How to find a specialist

Ask friends for referrals, or, if you don't know anyone who has used these natural childbirth techniques, contact one of the organizations listed below. Fees for doulas average $400, but may go up to $1,000, depending on location; fees for a series of HypnoBirthing classes range from $200 500. Some health insurers cover doulas and HypnoBirthing; check with your insurer regarding coverage.

Doulas of North America (DONA) P.O. Box 626, Jasper, IN 47546 (888) 788 3662; www.dona.org

Association of Labor Assistants and Childbirth Educators (ALACE) (trains labor assistants and provides client referrals) P.O. Box 390436, Cambridge, MA 02139 (617) 441 2500; www.alace.org

HypnoBirthing Institute (learn more about HypnoBirthing and where to find classes) PO. Box 810, Epsom, NH 03234 603 798 3286; www.hypnobirthing.com


VICTORIA PALMER IS A FREELANCE WRITER AND WRITING TEACHER IN NEW YORK CITY.


Inner Revelations In Berkeley, California offer classes for expectant mothers and their partners on HypnoBirthing.

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