Times Article Feb 26th 2005

Body&Soul

Smooth delivery
by Emma Mahony
After two traumatic experiences, one mother learnt how to switch off labour pains and enjoy the birth of her third baby

To an outsider, it appeared as if Kate Lloyd-Birt had had fairly typical hospital births in Milton Keynes for her first two children but, on the inside, she felt “traumatised” by the “awful, awful” experiences.

It didn’t help that both pregnancies were complicated by symphysis pubis dysfunction (SPD), which meant that whenever she walked the two large bones at the front of her pelvis grated together. Because of the hormonal softening of ligaments as the body prepares for birth, SPD occurs in 1 in 35 women, and Lloyd-Birt, 33, suffered in all three of her pregnancies.

As she reached full term with her first two babies, the hospital offered her an induction to alleviate the painful symptoms, which kick-started contractions “so strongly that I asked to be taken up to the labour ward for an epidural” (anesthesia to numb the lower half of the body). She worked her way through all the pain relief, including gas and air, and pethidine. Tom, now 4, was delivered by forceps after a 26-hour labour, and Harry, 1, with ventouse (a suction device on the baby’s head), after 18 hours’ labour.

Soon after the births, she was separated after from both babies because of complications and had to spend time in hospital.

When she fell pregnant with her third baby, seven months after Harry’s arrival, she talked to her obstetrician about a Caesarean rather than repeating the ordeal. Her obstetrician advised against it; giving birth naturally is believed by some doctors to be better for the baby’s health. So Lloyd-Birt looked for an alternative. It came in the form of Alison Day, a colleague at the manufacturing company where Lloyd-Birt worked as an office manager, who introduced her to the American concept of Hypnobirthing. Still relatively new in this country, few practitioners in the NHS have even heard of it. Day claimed to have enjoyed an easy eight-hour first birth at home and described it to Lloyd-Birt as “fantastic”.

After visiting the Hypnobirthing website, Lloyd-Birt enrolled with her husband, Richard, who had also “hated the previous two experiences”, on a course, a 45-minute drive away in Northampton, which lasted for four weeks, each weekly session lasting three hours.

There were six other couples on the course “and all were taught first and foremost that hypnosis was not about standing up on stage and turning into a chicken”, says Lloyd-Birt. Because the other mothers present were first-timers, she questioned the instructor, Jenny Mullan, rigorously, who, in turn, used Lloyd-Birt’s previous experiences to demonstrate how the body can tense up during labour.

Partners were engaged to help the women go into a deeply relaxed state, using words from a script delivered in a calm voice as they went under, and counting them down from five in a more lively voice to bring them out. Couples were encouraged to practise the steps three times a week for half an hour.

As well as learning breathing techniques, they were also shown diagrams of how the muscles in the uterus worked and were taught visualisation exercises. The mothers-to-be were also given relaxation tapes to listen to, which can be played during labour to trigger calm. Lloyd-Birt used the tapes to relax and fall asleep to every night.

When she went into labour two months before her due date, she was taken to hospital. Although she was given steroid injections to prevent the contractions, they appeared not to be working and the doctors thought that the baby was going to be premature.

As a last resort, she decided to try the visualisation techniques she had been taught by Mullan to stop the birth coming early. “Instead of the cervix opening up like a flower, I imagined it staying closed and pulling back up, and I used my breathing to hold the pain of the contractions,” she says.

“The midwives couldn’t believe how strong the contractions were on the monitors, and how I wasn’t in any pain or dilating.” The contractions abated and after five days she was allowed home and stayed there until she reached full term.

When labour started spontaneously two months later at 4am, instead of rushing to hospital, Lloyd-Birt chose to have a bath and relax while listening to the tapes. “I wasn’t even sure if I was in labour; I thought it might be a tummy upset.” At 7am she got up, dressed the children for nursery and made everyone breakfast, with her contractions coming every seven minutes. She agreed to go to hospital only because Richard insisted. But she stopped for breakfast en route and arrived in the delivery ward with toast and hot chocolate from McDonald’s.

“We were both so relaxed that the midwives assumed we were at the paperwork stage,” Lloyd-Birt says. “It was only when I was examined that we realised there wouldn’t be time to fill up a pool for the waterbirth I had planned.” The midwife told her that she was fully dilated and able to push when she felt like it.

However, there was one small complication; the baby was over to the left-hand side, so, remembering “the Polar Bear position” from her classes, Lloyd-Birt knelt on all fours to push back on her heels. The midwife stood back and watched as the baby moved into the correct position.

Then, lying on the bed and breathing through the pain, without any need for analgesics, Lloyd-Birt continued to use her visualisation techniques to birth the baby.“The midwife was brilliant; she just let us get on with it, and everything happened the way it was supposed to.” Georgia was born within an hour, and came into the world alert and ready to breastfeed.

“Immediately after the birth, a paediatrician came into the room and couldn’t believe how quiet and calm the baby was,” says Lloyd-Birt, adding that she felt fantastic. “I wasn’t in the least bit tired. I could have done it all over again.”

She claims that Hypnobirthing made the difference. “Without it,” she says, “I would definitely have opted for pain relief again and and probably had the same experience as my first two labours. But I can honestly say that having prepared, and knowing more about how my body worked, meant that I didn’t experience any pain. It was quite amazing.”

Stand and Deliver (And Other Brilliant Ways to Give Birth), by Emma Mahony (HarperCollins, £7.99), is available from Times Books First at £6.79, plus 99p p&p. Call 0870 1608080, or visit www.timesonline.co.uk/booksfirstbuy

What is it?

HYPNOBIRTHING is based on the belief that severe discomfort to the mother and distress to the baby is not a natural accompaniment to labour. Advocates say that when a mother is properly prepared, through education and learning simple but specialised relaxation and breathing techniques, she can experience a normal birth. Hypnobirthing requires the participation of mother and birth companion.

SUITABLE FOR all mothers-to-be, whether they want to give birth in hospital or at home. It is beneficial to women who are terrified of childbirth, or who have experienced a bad birth.

COST Between £200 for a four-week group session and up to about £450 for individual tuition.

CONTACT The official UK website: http://www.hypnobirthing.co.uk/ For Jenny Mullan’s classes, visit http://www.betterbirth.co.uk/.

WHAT’S THE EVIDENCE? DR TOBY MURCOTT

Can Hypnobirthing make birth easier?

Hypnobirthing appears to have worked well for Kate Lloyd-Birt as she did not feel the need for pain relief during labour and found the birth a rewarding experience. A more appropriate question is, will Hypnobirthing work for everyone? Hypnosis has been used to alleviate pain for years and there is evidence that it can help with a number of painful conditions. A systematic review of 18 separate studies, conducted in 2000 at the Mount Sinai School of Medicine in New York, concluded that hypnosis was effective at reducing pain. And a review from the influential Cochrane Collaboration, an organisation that provides information on the effects of healthcare, said hypnosis may be useful for pain relief during labour but that more research was needed.

What about postponing early labour?

It’s impossible to say as there is no way of knowing whether Lloyd-Birt’s baby would have arrived early without her visualisation techniques. She had received steroid injections, which appeared not to work but may have had an effect. Likewise, it’s impossible to tell whether her baby would have moved across had she not used “the Polar Bear position”. However, both these observations suggest that this birth was a very different experience from her previous two; she appeared more confident this time around.

What about confidence?

There is much more to childbirth than pain. Confidence is a crucial element of a natural, or as she prefers, active birth, according to Carol Bates, the education and professional development adviser for the Royal College of Midwives. An experienced midwife herself, she says that it’s possible to tell whether a mother is confident and sees herself as an active participant or whether she lacks confidence and sees herself as a more passive patient. A good midwife, Bates says, will support an active mother, following her lead and intervening only if a problem arises. Lloyd-Birt appears to have been an active mother and it’s possible to speculate, but impossible to prove, that Hypnobirthing played a part in that.

Is Hypnobirthing a path to natural childbirth?

Carol Bates is concerned about the term “natural”; historically, “natural” birth led to high death rates. Active childbirth, she says, is different. Mothers who are knowledgeable and confident can go through the normal process of childbirth with minimal distress. The Royal College of Midwives does not advocate any particular technique but is campaigning for normal childbirth and a change in the way that birth is perceived. For further information, log on to www.rcmnormalbirth.net

Toby Murcott’s new book, The Whole Story: Alternative Medicine on Trial? (Macmillan, £16.99), is available from Times Books First at £13.59, plus p&p. Call 0870 1608080, or visit www.timesonline.co.uk/booksfirstbuy

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Read more about Hypnobirthing

Hypnobirthing by Jenny Mullan Practitioner Training is accredited by RCM

Richard and Judy

Richard and Judy with Marie Mongan and Jenny Mullan

Hypnobirthing was featured in a story about painless childbirth on the “Richard and Judy” TV show on 8th July 2004.

They interviewed Jenny Mullan. Also featured were Marie Cooksey and Steve Bowerman, a couple who recently used Hypnobirthing for the birth of their first child.

What is Hypnobirthing?

Hypnobirthing is a complete birth education programme, that teaches simple but specific self hypnosis, relaxation and breathing techniques for a better birth.

Hypnobirthing is much more than just self hypnosis or hypnotherapy for childbirth.

Frequently Asked Questions about Hypnobirthing

There are some questions that just come up time and time again. This page is designed to answer some of the more common ones.

What is Hypnobirthing?
Who is Hypnobirthing suitable for?
Will I be ‘out of it’ if I use Hypnobirthing?
I’m scared of hypnosis and hypnotherapy. Is Hypnobirthing safe?