Can you have a pain-free birth?

Experts want midwives and doctors to ensure new mothers get the maximum opportunity to have skin-to-skin contact right from the start.

Experts want midwives and doctors to ensure new mothers get the maximum opportunity to have skin-to-skin contact right from the start.

Published Jun 14, 2013

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London - Ask a woman to describe the single most painful experience of her life and most mothers won’t hesitate to say “childbirth”. But Verity Lovelock would disagree. In fact, the trainee architect insists that giving birth to her son Nathanael 20 months ago wasn’t just pain-free - it was enjoyable.

You read that right. In words that will have most mothers gasping with incredulity at best - and feeling murderous at worst - Verity describes her eight-hour labour as little more than “slightly uncomfortable”.

“I honestly didn’t find my labour a painful experience,” she insists. “The stronger my contractions got the less they were a problem, because it was a productive feeling. Every one was a step closer to my baby. As soon as it was over I thought ‘when can I do it again?’”

You don’t have to have given birth yourself to know that a drug-free labour is generally accepted to be at the very top of the pain scale.

But Verity is one of a growing band of mothers who feel we’re bombarded by too many negative messages about childbirth.

And this ‘birth doesn’t have to hurt’ brigade could be about to gain a new - and rather special - Royal recruit.

It’s been reported that the Duchess of Cambridge is learning to “hypnobirth” - where a mum-to-be uses self-hypnosis in order to mentally programme herself to relax during birth. It’s increasingly popular among women aiming for a pain and drug-free labour.

Kate is said to want as natural a birth as possible and has apparently been reading up on the subject and listening to hypnobirthing CDs.

Hypnobirthing was an approach Verity, 28, embraced when she was preparing for her son’s arrival.

Having been diagnosed with MS - a degenerative neurological disease that affects muscle movement, balance and vision - in her early 20s, she too was keen for a natural labour, with minimal medical interference.

Verity, who is married to Tom, 33, a business analyst, and lives in Portsmouth, explains: “I’ve had enough ill health in recent years and wanted it to be as positive an experience as possible.”

While some women sign up to classes, and others listen to CDs, Verity used a chapter of a hypnobirthing book to learn visualisation techniques - focusing on images she found calming - to help her cope with labour.

Unfortunately for Verity, her waters broke three weeks before her due date. When after a week her contractions had still failed to start, she agreed to a hospital induction because of the risk of infection for her baby.

Induced births are often more painful because the artificial hormones used to stimulate labour bring on strong contractions. But Verity says that she never felt in pain or scared.

“I just concentrated really hard and talked to my little boy,” she says. “It was intense but, by the end, I was totally euphoric between contractions. I don’t remember pushing - suddenly he was just there.”

Afterwards, Verity settled straight into life as mother to Nathanael, but believes there is one downside to experiencing a pain-free birth: ‘It’s really hard - people either assume you’re a smug hippy, or tell you that you’re just really lucky.

“I’m neither,” she insists. “I worked really hard to have the labour I wanted because I had all the odds stacked against me.”

The idea that labour can be pain-free is not a new-fangled theory.

In fact, it’s based on a 71-year-old manual called Childbirth Without Fear, written by Grantly Dick-Read, an obstetrician who began his career when Queen Victoria was on the throne.

According to him, women are capable of giving birth without discomfort, and the pain of labour is caused by fear. His work inspired the hypnobirthing movement that started in the Eighties and his teachings are still at the heart of it. The aim of hypnobirthing is to reduce or eradicate the fear and tension that cause a woman to suffer agony.

It’s a view that those who (unlike Mr Dick-Read) have actually been through a gruelling labour may well violently disagree with.

But Verity believes many of his theories make sense.

“The crux of it is that your body is designed to give birth - it’s only your mind that holds you back,” she says. “So when I was in labour I didn’t let myself think of the experience as painful or scary, even for a minute.”

But can it really be a case of mind over matter? Maternity expert Nicole Page Croft, author of The Good Birth Companion, believes that most women who say their birth is pain-free do experience discomfort - they just perceive it differently.

“Instead of thinking of this as the excruciating pain you’d experience if you broke your leg, we should view it as the pains that an elite sportswoman would expect to experience during training,” she says. “If you accept it as part of the package, it’s easier to focus on the goal instead.”

Sarah Abay, a 37-year-old art teacher from South London, is another mother who used hypnobirthing. After a surprisingly enjoyable home birth with her daughter Molly, five, she fell pregnant with twin boys Barnaby and Gabriel, now two.

Against the advice of her specialist - having twins is considered a high-risk pregnancy - she insisted on another home birth, and the boys were born in her dining room after a drug-free labour that lasted just four hours.

She says: ‘I had meditation music playing and spent my time using breathing techniques. It was hard work, but I didn’t experience any pain at all and I didn’t lose faith.

“Barnaby was born at 7.15pm, followed by Gabriel at 8.14pm. When I called my mom at 9pm, she nearly fell off her seat. She couldn’t believe they had come out so quickly. By then I was so energised I’d even had a shower and the boys had been weighed.”

Sarah, whose husband Chris, 36, is a personal trainer, believes birth has become over-complicated by modern medicine: “The female body is amazing. Giving birth is primal, it’s what women are designed to do,” she says.

“It made complete sense to me that given half a chance I could do it with very little intervention or pain.”

It’s an attitude that chimes with Grantly Dick-Read’s outlook.

His belief was that “there was no law of nature that could justify the pain of childbirth” and some research supports the idea that expecting a painful labour is a self-fulfilling prophecy. A recent Norwegian study found women with a fear of childbirth spent one hour and 32 minutes longer in labour than those with no such fear. They were also more likely to need a forceps or ventouse delivery, or an emergency C-section.

Sarah Ockwell-Smith is a mother of four and trained psychologist who has worked as a hypnobirthing teacher and doula - a professional birth partner. She’s also the author of BabyCalm: A Guide For Calmer Babies And Happier Parents.

She explains how fear impacts on labour: “Oxytocin is the hormone that kick-starts your uterus to contract and your cervix to dilate, helping the baby to move down,” she says. “It also makes you feel high, but it’s inhibited by adrenalin, which you produce when you’re afraid. Your body doesn’t want you to feel drugged if you’re in danger, so it stops oxytocin production so that you can run away and be safe.”

Contrary to Dick-Read’s theory, she says the pain that results from fear isn’t just in a woman’s mind. “It’s a very real physical pain,” she adds. “But it’s not a pain that needs to accompany labour. It’s a side-effect of adrenalin, which triggers a ‘fight or flight’ response in your brain, diverting blood to your legs and respiratory system and away from less essential areas - such as your uterus.

“The drop in bloodflow leads to a build-up of lactic acid - as it would in any muscle - and a hideous cramp that lasts however many hours labour lasts. Which, without oxytocin, is even longer.”

Once adrenalin kicks in, she says the process is hard to reverse.

So if the science makes sense, why aren’t more women shouting from the rooftops about popping babies out as easily as champagne corks?

Sarah Ockwell-Smith believes one of the reasons is women giving birth in hospital: “Oxytocin is a very shy hormone; it’s best produced when you are in a warm, quiet, dark environment, not a brightly lit room with lots of people around,” she says.

Even talking to a woman in labour can hamper the process.

“It switches on her neo-cortex, the part of the brain that deals with analytical, rational thought,” Sarah says. “But that’s the part we really want switched off in birth. Instead, we want her to use the primal part of her brain that enables her body to behave instinctively.”

Natalie Meddings, an antenatal yoga teacher in South-west London and founder of tellmeagoodbirth story.com - where women share positive labour experiences - agrees that modern women have forgotten the instinctive nature of birth.

She says: “The most fundamental lesson when it comes to birth is that the body does it without you, it’s an involuntary process.”

But consultant obstetrician Malcolm Dickson says that while hypnobirthing does help many women, expectant moms should keep in mind some limitations.

Self-hypnosis won’t work for every woman, and it can’t prevent complications occurring during labour.

He adds: “While stress, fear and anxiety undeniably exacerbate pain, some women, no matter how calm they are, will still find contractions agonising, simply because the sensation of the cervix stretching can be innately painful. Hypnobirthing won’t prevent a woman tearing as she pushes her baby out either.

“There’s also a risk that a woman will feel disappointment, even a failure, if she sets her heart on a pain-free birth and finds it’s not possible. It’s best to keep an open mind.”

And, when it comes to giving birth, it seems modern, educated middle-class women are their own worst enemy. As a generation used to being in control of our lives and jobs, we find it difficult to let go and accept birth is a process that cannot be ‘managed’ like a work project.

Sarah Ockwell-Smith agrees - from personal and professional experience. Her first two children were born in hospital after epidurals, but after discovering hypnobirthing she went on to have two 11lb babies with barely any pain at all.

“Birth is built up to be such a big deal. When I was expecting my first baby I was a classic middle-class mother, going to yoga and NCT classes. I spent a fortune preparing for birth and read every book there was. But despite being massively prepared and educated I had the most hideous experience.

“In contrast, I’ve worked with 19-year-olds who haven’t read anything who have amazing births, because they don’t know any different. We forget it’s a natural process that can be amazing. I actually found the high I experienced in my last two labours addictive.”

Mom-of-two Jade Elmer says she also had very different experiences. The former account manager turned teaching assistant from Basingstoke says when she was in labour with her son Toby, six, her instinct was to try and control the process - not only through copious research but micro-managing the labour itself.

“I was pleased whenever the midwife came in and wanted to examine me, because I wanted to know what was happening,” she recalls. The result was a three-day labour that culminated in so much pain she felt as if her “body was being torn in two.”

When she fell pregnant with Lyra, now two, she was determined not to repeat the experience.

“My aunt changed my mindset,” she says. “She had a home birth and when I fell pregnant with Lyra, I decided it was worth trying to have the same enjoyable experience she had.

“She lent me her hypnobirthing CD and I had it on repeat during labour and found it really helped me to relax and focus.’

This time, Jade, 24, who lives with long-term partner Darren Head, 26, a sales consultant, says she found the birth actively enjoyable.

“The contractions weren’t painful, just intensely uncomfortable surges,” she says. “I didn’t even push at the end, and as Lyra was born I just felt a massive high.”

Although Jade and Sarah have no immediate plans to grow their families, Verity is excited to be expecting again in June. If pain-free birth really is addictive, perhaps her husband should start preparing himself for a bigger family than they’d planned. - Daily Mail

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