HypnoBirthing® UK

[ronac]

I had my first child last March and found Hypnobirthing invaluable both before labor to relax and give me confidence and during the first and transition stage of contractions - even the stronger ones. But once the huge urge to push came it all seemed to go out of the window. I have practiced the J breathing for this stage but couldn't put it into practice vs the powerful surges.
Has anyone successfully used J breathing in this stage? Any tips? I am expecting again in July so would really appreciate some advice on this area.

[ockysmith]

Hi there,

I think to answer this question you have to have a very good grip of what happens physiologically just before and during the second stage, once you know that then you understand what needs to be done in order to facilitate a quick easy (and one where you don't push) second stage.

Humans weren't designed to forced push their babies out (as Western women do today) and a lot of myths surround this (including "the urge to push" and the fact that you have to progress to 10cm dilated in order to birth your baby). Actually - as a species - we are designed to spontaneously open (dilate and also perineum relaxation) and, without conscious help from ourselves, our baby is designed to be rapidly propelled down the birth path. This has been termed "The fetus ejection reflex" - FER - (originally by Niles Newton and latterly Michel Odent). The FER is however a bit like the holy grail of birth these days and rarely do women experience how birth should be as they inhibit the delicate chain of events leading up to it.

Basically for the FER to occur oxytocin needs to be flowing freely, the women shouldn't feel observed, she shouldn't be too cold, the light shouldn't be too bright, she shouldn't feel afraid and most importantly of all her neo-cortex ("the new brain" - the frontal part of a human's brain that differentiates us from other primates) should under no circumstances be stimulated (i.e: she should be functioning with her older primate brain) - the biggest cause of neo-cortex stimulating is language - the the first and biggest rule is "NO TALKING" (by anyone, saying anything) the second rule is that the woman shouldn't rationalise anything or try to control anything (through managed breathing etc..) - this article explains it very well:

http://www.wombecology.com/fetusejection.html

When all of the above is respected then oxytocin will flow freely and a small amount of adrenaline release (the only time we want it in birth!) will facilitate the spontaneous opening of the birth path, the relaxation of the perineum and the baby will be born quickly and easily, over an intact perineum without a great deal of warning (especially not "an urge to push"). I've experienced this twice now, both of my babies (both very large) were born without any assistance from myself (short of me being very very relaxed, I didn't practice any special breathing), without any urge to push and without any tears to my perineum (birth stories on here:
http://www.birthfriendly.co.uk/about.htm (you have to click for one).

The main aim of HypnoBirthing in my opinion is to ensure that the FER happens and is not inhibited, certainly by keeping women free of fear, relaxed and not stimulating their neo-cortex, plus respecting the birthing environment (dim light, warmth, nobody fussing over her - homebirth is perfect for this) - and it does this very well. Sometimes, however the focuss on J breathing springs the neo-cortex into life - thus inhibiting the FER, so I like to try and get my mums to experience an FER if at all possible and if it doesn't happen for whatever reason, then to move onto J-breathing.

J-breathing is very effective if it's done properly, but I think it's something that is quite often either mis-understood or just not practiced for long enough. I like comparing it to a squeezy tomatoe ketchup bottle. If you give it a shake, a hard squeeze etc..what happens? nothing, you get tired and agitated, but no ketchup. If you just wait for the ketchup to run down and collect around the opening and then give it a little nudge right at the end it comes out easily and you don't get tired and agitated. J-Breathing is much the same, the base of the J when you turn it gives that little nudge I find. The best time to practice is when you're sitting on the loo doing a poo - every day! for a couple of reasons, it's the closest feeling to a baby coming out of you, you'll remember to practice every day and lastly because when we are on the loo we are conditioned into relaxing our pelvic floor and "letting go" - so utilise that and practice there. It's particularly great if you're constipated, try "forced pushing" if you're constipated and then try J-breathing and giving it a little nudge and see which one makes the poo appear quicker (and with no pain) .

It might be worth you going back to your practitioner for a refresher session, or asking if you can sit in on the fourth class to go over J-Breathing again.

Edited to add I've just read you self -taught for your last baby, this really is the benefit of classes, the book is a great introduction, but you *really* do benefit from having somebody to guide you and show you how to use the techniques (as well as extra hypnosis in class and teaching your birth partner so they can help you on the day) - I've done both, self taught/read the book/listened to the CD and I've been to classes - there was no comparison in the births.

There have been many more practitioners trained in Scotland since your last post. Do look one up, it would be of great benefit to you if you really want to experience a HypnoBirth.

Sarah

[DebS]

Hi there
I too found myself pushing at the height of each surge (and loving it!) The feeling only briefly lasted at the peak of each surge and started at the beginning of the final stage as a little squeeze on my bladder (which felt perfect but I had to sit on a bath towel). Rather than an 'overwhelming urge' to push I felt it was as natural to me as breathing out after breathing in. I didn't go purple or hold my breath. As I was prepared to follow my birthing body I went with it - had a lovely natural waterbirth, no drugs, no gas and air and no tearing.
Good luck

[chelleh76]

Sarah: I just realised maybe I should have put my questions about birth breathing on here. Oh well.

To add to Ronac's question, kind of along the same line: I read the article on FER and how it is so important to have dim lighting, quiet environment etc. I am birthing in a hospital, which in some ways is accommodating, but generally pretty "old school", with monitors etc etc. It seems they'll go along with most things, provided the baby doesn't seem to be in any distress. For example, they'll let me be off the monitor for I think 40 mins in the hour and I'll be allowed to walk around the halls, have a shower or whatever. If the baby starts to struggle at any point though, then they'll "strap me in". I'm seeing my doctor on Thursday and I'm going to ask more questions about things such as "if I reach 10cm dilation, do you have a time limit that I must deliver within, or will you let my body do it's own thing?" (I've heard horror stories of mums reaching 10cm and then the chorus of nurses start chanting "PUSH!" and even induce if you don't deliver straight away!!) and also some questions about lighting, being disturbed by nurses etc. This brings me to my question for you guys:

Is it possible to achieve the holy grail of a "pain-free" or even "pain-reduced" birth, with J breathing etc, if you are in a hospital with nurses lurking about and bright lights? No matter what, I intend to implement the relaxation techniques I have learned through the program to help me remain calm, but am I having too high expectations of the outcome with the scenario I just mentioned?

[ockysmith]

[
You have to realise the aim of HypnoBirthing is *Not* pain free, it is easier, calmer, controlled birth. In answer to your question yes, I think J breathing in hospital is possible. I *don't* think it is possible to have a FER in hospital.

Have you put much thought into your place of birth? is there a medical reason you must be in hospital and accept (note, it is offered to you) routine continuous monitoring? Incidentally, the only thing that continuous monitoring has proven to be good at (statistically) is increasing caesarean rates, statistically it does nothing to improve the wellbeing of the baby (or mother), similarly vaginal examinations, you may want to consider whether you accept them or not. You might want to seriously consider your OPTIONS and write a good birth plan (another reason for attending classes!).

[chelleh76]

Hi again. I can see the benefits of home birth, however I just don't feel comfortable doing it myself. I am well aware of the policy-driven environment of a hospital, but I feel more comfortable having full medical assistance available if something were to go wrong. For example- what if emergency surgery on either the baby or myself is needed? I am not criticising those who choose to birth at home. I think they are very lucky they feel confident enough to do so and I'm sure it is a much more comfortable experience. There are definately many pros to homebirthing too.

I'm personally not worried about the monitoring- in other words, it's not my reason for wanting to be in a hospital. My reasons for hospital birth are as above. In regards to monitoring, my hospital allows me to be off the monitor if I present without any signs that the baby is in distress. I believe they like to monitor for 20 mins out of the hour. The rest of the time, I am free to walk, shower or whatever. I am going to ask if we can make the monitoring even less frequent if I appear to be doing well.

I saw my doctor today and she is actually quite supportive of my attempt at hypnobirthing. I asked her about dim lights for example and she said that wasn't a problem, in fact many women under her care ask for it. She did comment on the monitoring though, saying that since the use of monitoring, they have been able to reduce the rate of babies who have been born with problems such as brain damage and even still births if for example in previous times the baby had been struggling unbeknown to the doctor or mum. Obviously this conflicts with the studies you are referring to, so as with many topics on childbirth (let alone child-rearing), one remains unsure which studies to believe! I personally can see logic in both arguments.

I will get in contact with the Hypnobirthing lady again. Your points in this thread titled Birth Breathing about cost are good ones. I'll ask her the same questions, but here they are for you: I'm due in approximately 3 weeks, is it too late for me to get a lesson? She was talking about doing two one on one sessions with me. Is there any point with a hospital birth?

With regards to it not being a pain free birth, does it then reduce the pain or make it easier to deal with (eg distracting us from it)? I have a terrible time with pelvic exams, as I have a hyper-sensitive cervix. I had a dilation test done at 32 weeks, which was excruciatingly painful. Today at my exam, she conducted another one and I listened to my hypno stuff on my Ipod just before hand and practised some deep breathing and the experience was much better! I am wondering if this is kind of like what I'll experience? (the difference in pain tolerance when relaxed, not what actual childbirth is like!)

[ockysmith]

Are you in America? some of things you have said in your reply sound very American, if so you may be better on their website forum www.hypnobirthing.com

but I feel more comfortable having full medical assistance available if something were to go wrong.

I think this highlights the benefits of attending classes, for HypnoBirthing to be most succesful you need to go into labour free of fear, free or worry about the possibility of things going wrong, with ultimate trust in yourself and your baby. In classes we build on your confidence in natural birth and we carry out hypnotic "fear release" where you get the opportunity to work on any anxiety you have leaving you less than 100% confident in the fact that you can do it without medical help.


For example- what if emergency surgery on either the baby or myself is needed?

There is something called a "decision to incision" timing, this being the average time it takes from the moment it is decided an emergency caesarean is necessary to the moment the first cut is made with the scalpel, this is usually somewhere between 15 minutes and half an hour. A surgical team has to be assembled and scrubbed in and theatre needs to be prepped, this takes some time! being blue lighted to hospital in an ambulance is *quick*! and unless you live miles and miles from your nearest hospital you are actually likely to arrive with plenty of time to wait for them to finish prepping. Not to forget the fact that obstetric emergencies are often caused by what is known as a "cascade of intervention" due to medical procedures and at home it is rare emergencies are allowed to develop as you will be transferred in the minute the midwife (who provides one on one care at home as opposed to often sharing care with 1 or 2 more other women in hospital) has concerns. Please do consider it as a valid option. I felt like you first time around until I really researched the facts and found that emergency situations can be dealt with quite well at home! think about how long it took you to decide on your pram, cot, car seat etc...and think about how long you have spent researching your place of birth - one of the most important variables in terms of birthing outcome! if after your research you decide home is still best for you that's great, but make sure it's not a decision made out of fear or societal conditioning! (something also covered in classes!)

I am not criticising those who choose to birth at home. I think they are very lucky they feel confident enough to do so

This comment makes me so sad, all women should be confident and looking forward to a great birth, society has made us scared, untrusting and of the opinion that we *need* medical help to perform one of the most natural acts in the world. We spend a good 2.5hrs on this very topic in classes, discussing our beliefs and expectations of births and it is so important to "de-hypnotise" women of them.

In regards to monitoring, my hospital allows me to be off the monitor if I present without any signs that the baby is in distress. I believe they like to monitor for 20 mins out of the hour.

Do have a read of the guidelines on monitoring from the Roysl College of Obstetrics and Gynaecology (www.rcog.org.uk), they actually advise that for low risk women continuous electronic foetal monitoring is ill advised and that instead they should be intermittently monitored with a midwife listening in (doppler/sonicaid). The guidelines also state that a woman should be offered full support, no matter what her decision with regards to monitoring is. Your hospital appears to be ignoring this guidance for some reason (they should not be).


I saw my doctor today and she is actually quite supportive of my attempt at hypnobirthing.

Please don't see it as "an attempt", this is setting yourself up to fail, HypnoBirthing encompasses parts of something called NLP (neuro linguistic programming) in class and on CDs we give out, this re-frames the way we think through the use of language, so instead of saying "my attempt at HypnoBirthing" we would say "my calm and easy birth using HypnoBirthing".

I asked her about dim lights for example and she said that wasn't a problem, in fact many women under her care ask for it. She did comment on the monitoring though, saying that since the use of monitoring, they have been able to reduce the rate of babies who have been born with problems such as brain damage and even still births if for example in previous times the baby had been struggling unbeknown to the doctor or mum.

This is not true, statistically (see the RCOG guidelines again) continuous EFM (electronic foetal monitoring) is a very poor predictor of hypoxia damaged babies, in fact it does not reduce the amount of damaged infants, nor does it result in better Apgar scored, it does however result in increased Caesarean rates. Again in class we would help remove the fear instilled in women through negative comments like this. Here is a direct quote from the guidelines:


The expectation was that EFM would reduce hypoxia-induced intrapartum perinatal mortality (this means babies dying during labour from lack of oxygen). This has not occurred and the role of EFM in labour has been questioned. Furthermore, the three most recent reports from the Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI) have highlighted problems related to the use and interpretation of EFM.

and another quote:

• There are no differences in the rate of adverse neonatal outcome (umbilical artery acidosis (an indication of lack of oxygen) or Apgar score of less than seven at five minutes) or mode of delivery when intermittent EFM was compared with continuous EFM.

and another quote:

• From the available evidence, in healthy women who have had an uncomplicated pregnancy, continuous EFM increases maternal
intervention rates without any demonstrable improvement in perinatal outcome.



I will get in contact with the Hypnobirthing lady again. Your points in this thread titled Birth Breathing about cost are good ones. I'll ask her the same questions, but here they are for you: I'm due in approximately 3 weeks, is it too late for me to get a lesson?

No, it's never too late! I have taught women at 39wks before (the whole course!). Obviously the onus will be on you to practice - LOTS, but it's perfectly possible.

She was talking about doing two one on one sessions with me. Is there any point with a hospital birth?

Yes of course! in situations such as this we are permitted to teach the whole course over two days. Homebirth is the easiest place to relax in my opinion, but many women do have positive and easy HypnoBirths in hospital - just over 50% of my clients do! - again, I think you have to do a little more work (or your birth partner in particular) to control the environment and you have to have a good birth plan in place, but of course it's possible!

With regards to it not being a pain free birth, does it then reduce the pain or make it easier to deal with (eg distracting us from it)?


No, in HypnoBirthing we don't distract you from the pain, we work to eradicate something known as the "fear-tension-pain" cycle, put briefly if you are fearful you release adrenaline, adrenaline inhibitis something called oxytocin, the hormone responsible for contractions and progress in labour (and in any facet of love, such a bonding with your baby) and also something called Beta-Endorphins (your own anaesthesia stronger than morphine!) and at the same time oxygenated blood is drawn away from your uterus, leaving it full of lactic acid (what causes the pain in muscles cramps/stitches etc...), this leaves your uterus a big quivering jelly like mess meaning labour doesn't progress and you end up in intense pain. If you don't spark off this chain of events your body is left to function as it should, you flood yourself in these great feel good chemicals and birth becomes easier and far more comfortable. Many of my clients report "pain free" births, though it is obviously not true for all. In my own experiences I had an epidural for my first and second baby as I was in unbearable pain (full of fear and adrenaline), with my third and fourth babies (both weighing over eleven pounds with heads on the 100% centiles) I required no pain relief at all, for the last 5 to 10minutes I did experience a great deal of discomfort, but not enough to make me ask for pain relief, the rest of their labours I experienced just a sensation of tightness and pressure.


I have a terrible time with pelvic exams, as I have a hyper-sensitive cervix. I had a dilation test done at 32 weeks, which was excruciatingly painful. Today at my exam, she conducted another one and I listened to my hypno stuff on my Ipod just before hand and practised some deep breathing and the experience was much better! I am wondering if this is kind of like what I'll experience? (the difference in pain tolerance when relaxed, not what actual childbirth is like!)

Well, no because a vaginal exam is hardly natural is it?! and if you don't want one you can just refuse!!! nobody can examine you without your consent, if they did it would be legal assault. My birth plan stated I would accept examinations only in special circumstances where they may be some concern over myself or my baby.

Anyway, good luck with your decisions and your birth, remember it is "your body, your baby and your birth" and you (and your birth partner) are in control!

[kanamorita]

hmm.