In the previous post, I talked about how the year of 2012 has been the year of doing shit I never thought I would do. And signing up for a class called “hypnobirthing” would have been right at the top of the list had I even known such a thing existed pre-pregnancy. I mean, I once had an anxiety attack DURING a yoga class. And Therapist M has tried to talk me through some meditation exercises a couple of times, but they’ve only made me more anxious. I don’t seem like I’d be the type of person who could achieve deep relaxation during childbirth.
So why bother? As many of my friends say, there’s no prize for having a drug-free labor. But one of my own recent medical experiences revealed to me that unnecessary medical interventions can cause more problems than they solve. In my case, one unnecessary drug created a cascade of issues that resulted in an emotionally and physically traumatic ER trip and what would have been about $10,000 in medical bills, if not for our glorious health insurance. And although I’m all for doing whatever it takes if my baby’s life is at risk, giving birth doesn’t usually involve a medical emergency. I mean, people give birth to perfectly healthy babies in caves, taxis, on airplanes, in fields… yet all kinds of seemingly unnecessary medical “things” come standard during in a hospital birth.
Anyhow, hypnobirthing came highly recommended by our midwives. The idea is that there is a culture of fear surrounding birth and that this contributes to a stressful environment during labor. Movies, TV shows, and even birth horror stories from strangers on the street all make childbirth seem scary and painful. Then all the standard poking and prodding laboring women experience further diminishes any hope for relaxation. And all this stressful input causes our fight or flight response to kick in during labor, which causes the cervix to clamp down (making the pain of contractions a hell of a lot worse) and the whole birth process to stretch out into eternity. So hypnobirthing uses principles of hypnosis (essentially, meditation) to promote relaxation and a calm environment to prevent stress, thus encouraging the body to open up and give birth on its own.
All this intuitively makes sense to me. From an evolutionary perspective, it seems beneficial that our bodies would have a mechanism to stall labor in the event of a real or perceived life-threatening situation (like being chased by a rabid animal). And as J and I continue to practice hypnobirthing techniques, I do find myself able to be more and more relaxed each time. So whether or not hypnobirthing works for birthing, it has definitely helped minimize the take over of My Anxious Self in everyday life. But I’m still feeling skeptical. Will hypnobirthing actually help when shit hits the fan during labor? And here I’m looking for cold hard facts- do women who use hypnobirthing during labor have shorter, less painful, and simply easier labors then women who don’t use it?
So lately I’ve been delving into the research- is there actually compelling scientific evidence that hypnobirthing works? Perhaps not surprisingly, I haven’t found loads of peer-reviewed studies about hypnobirthing. Here I’ll present the first study that popped up in google scholar and review some others next time. If you have a compelling study to recommend, let me know!
This first study is out of Australia (1) and sounds extremely promising from the abstract… they claim to have found shorter labor times, less drug-taking, and fewer c-sections in hypnobirthing moms (based on surveys) compared to the general population. However, there are serious limitations to the study (most of which the author discloses herself). The sample size is small- around 80 for most of the stats. And instead of a proper control group (ideally, a similar subset of women who were not in the hypnobirthing program but took the same survey), they compare their results to stats from the general population. And one can think of all kinds of problems with this comparison. For example, the study suggests that hypnobirthing can play a role in minimizing c-sections: 22% of individuals in the study had c-sections compared to a general public rate of 38.4%. But what role does the actual hypnobirthing play here? Hypnobirthers are probably less likely to have a c-section even if the techniques themselves are useless. For example, a woman who already knows she’ll get a c-section (for whatever reason) probably wouldn’t bother signing up for a hypnobirthing class in the first place.
In general, this study contains a LOT of qualitative statements about the benefits of hypnobirthing but not a lot of numbers to back up the claims. And because there’s no control group, much of the information collected in the survey seems compelling but it’s hard to know what to make of it. For example, women were asked to address their discomfort level during labor and the author finds an average of 5.8 out of 10. This seems pretty good… except without a comparison to a non-hypnobirthing group, how can we know? And participants who opted for an epidural are excluded from this average. I imagine their pre-epidural discomfort would increase this average substantially.
In the end, I didn’t find any rigorous scientific evidence in this study that women who use hypnobirthing during labor have shorter, less painful, and simply easier labors than women who don’t use it.
But… that doesn’t mean it’s not out there. And I’m willing to give it a go, sample size = 1.
(1) Phillips-Moore, J. (2012). Birthing outcomes from an Australian Hypnobirthing Prgramme. British Journal of Midwifery, Vol. 20, Iss. 8, pp 558 – 564.