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More women opting for hypnobirthing

26-May-2011 (Thu) Mind Your Body, The Straits Times

By Joan Chew

A shorter labour with no need for pain medication are among the benefits.

Mrs Audrey Ochman had a caesarean section for her first birth, a vaginal birth for her her second child and used hypnobirthing for her third delivery. -- ST PHOTOS: DESMOND FOO, TED CHEN

Mrs Audrey Ochman 'totally hated' her first childbirth in an Australian hospital five years ago.

During her 12-hour labour, induced four days past her due date and ending in a caesarean section, she was put on pain-relief drugs, which she subsequently became allergic to.

She recalled: 'My body broke out in rashes less than a week after the childbirth and I twitched 24 hours a day. I couldn't sleep properly too.'

The Singaporean homemaker, 39, who is married to a Polish-Australian, does not even take paracetamol for fever as she is 'pro-natural', she said.

So she was happy to use hypnobirthing techniques rather than drugs to relieve her pain for her third childbirth last November.

Then, her husband touched her on the small of her back to cue her to go deeper into relaxation and she focused on a Buddhist chant to take her mind off the pain.

This lasted about two hours, shorter than both her first delivery and her second one, a vaginal delivery that took about five hours.

Like her, British teacher Jane Graham (inset), said using hypnobirthing for her second childbirth made her feel 'relaxed and very calm', even with no painkillers.

She felt more alert after her second delivery than her first one, and spent two hours cuddling her son as he slept.

Both women are among a growing group here who are learning breathing and visualisation techniques in the belief that it can help them achieve a relatively stress-free and successful labour.

Five doulas or birth coaches and midwives here are reporting between two and 12 times more couples at their classes in the last few years.

For example, Four Trimesters, which offers doula services, had three or four couples a month in its hypnobirthing antenatal classes, when these were started in 2005.

This has now ballooned to 24 couples a month.

Dr Lai Fon-Min, an obstetrician at Camden Medical Centre and a certified hypnotherapist, said six to seven in every 10 patients he sees plan to use hypnobirthing, up from only one to two just five years ago.

The spike in demand has prompted Thomson ParentCraft Centre, a parent coaching centre at Thomson Medical Centre, to roll out regular hypnobirthing classes since last September, said its assistant director (clinical), MrsWong Boh Boi.

At least 50 couples have attended the classes. Three years ago, at most 10 couples a year asked for such classes, she said.

Hypnobirthing practitioners said that the majority of their students are expatriates, but more Singapore women are beginning to take to the idea of a 'natural' birthing experience.

Ms Kiki Porter Wolff, a hypnobirthing practitioner at Thomson Medical Centre, said: 'Women want to be more relaxed and make birthing as natural as possible, instead of being a clinical experience under bright lights.'

Ms Lauren Akers, who owns Baby Bliss which offers labour support and childbirth classes, said many women are finding out about alternatives to conventional births by looking online and through word of mouth.

Hypnobirthing classes are drawing first-time mothers-to-be and women like Mrs Ochman, who had prior unpleasant experiences.

The use of hypnobirthing as a non-medical form of pain relief has been shown in studies to benefit women in labour. They have shorter labours, use no drugs for pain relief and expend less energy, said hypnobirthing practitioners.

In a small study of six Iranian women who had normal vaginal deliveries, published in the International Journal Of Clinical And Experimental Hypnosis in 2009, all said they felt strong and alert rather than tired during labour.

Ms Di Bustamante, the director of doula firm ParentLink, said research by The Hypnobirthing Institute in the United States found that first-time mothers who use hypnobirthing report a five-hour labour, down from 12 hours typically reported by other women.

Dr Benjamin Tham, an obstetrician at Thomson Medical Centre, said when a woman is relaxed, her pelvic muscles that hold up the womb during pregnancy relax too, letting the baby descend easily from the birth canal.

Since pain is subjective and the length of labour varies, even women who do not practise hypnobirthing may experience a relatively easy labour, he added.

Ms Deborah Fox, a midwife and childbirth educator at the department of obstetrics and gynaecology at National University Hospital (NUH), said that more than 80 per cent of the women who use hypnobirthing do not use drugs for pain relief. NUH gets about three to four hypnobirthing requests each month.

However, some women who use hypnobirthing in the early stages of labour may later choose to use conventional drugs like a numbing jab to the spine called an epidural to get them through the labour, said Dr Chang Tou Choong, who heads Thomson Medical Centre's foetal assessment unit.

The obstetricians interviewed said that they have no issue with patients using hypnobirthing, but it may not be suitable for all women.

For example, hypnobirthing would not work for a woman who does not want to be hypnotised and who 'may not be able to reach a relaxed enough state to use hypnosis for pain relief effectively', Dr Lai said.

Dr Chang said very ill patients who have high blood pressure or pre-eclampsia, known as pregnancy-induced hypertension, should use an epidural, which is 'medically beneficial in controlling the blood pressure during labour'.

Ms Fox said hypnobirthing is just one of several methods which help women avoid an epidural. Other methods include massage, water immersion and yoga breathing.

But whatever pain-relief techniques a woman chooses, Dr Lai advised that she keep an open mind and be 'well prepared for alternatives should she find difficulty coping'.

Breathe deeply, relax and visualise

In the early 20th century, without proper health-care facilities or pain-relief drugs, hypnosis was one of the few ways available to relieve labour pains, said DrLai Fon-Min, an obstetrician at Camden Medical Centre and a certified hypnotherapist.

Today, hypnobirthing combines deep breathing, relaxation and visualisation techniques to help women stay calm and take their minds off their fear and pain.

Thomson Medical Centre's hypnobirthing practitioner, Ms Kiki Porter Wolff, said: 'We teach the subconscious mind to allow the body to relax with the help of triggers, such as a touch on a part of the body, a familiar piece of music or the husband's voice. We teach the body not to think of pain and bypass the conscious mind.'

Ms Ginny Phang, who runs Four Trimesters, teaches mothers-to-be, over four weeks, breathing and relaxation techniques, the different positions they can adopt during labour and a visualisation technique for dealing with different scenarios of childbirth.

The latter involves viewing the womb as a house and the cervix as a door. During labour, the woman's breathing must work in tandem with the womb to open up the cervix to let the baby out, Ms Phang said.

Ms Lauren Akers, a hypnobirthing practitioner, teaches her clients different types of breathing.

Calm breathing requires a woman to inhale and exhale through the nose and abdomen. During contractions, she has to take longer and slower breaths and go with the flow of her body, instead of tensing up and fighting against the contractions.

When the cervix is fully dilated, women tend to hold their breath in their chests as they push their babies out, said Ms Akers. They are trained instead to 'breathe the baby down', she added.

Hypnobirthing requires effort as women have to practise the techniques diligently before the 'big day', practitioners said.

They encourage couples to attend classes together, so that husbands can help their wives during labour. These classes are held in private or in groups, at a fee of at least $500.

For more information on hypnobirthing, attend the Natural Birth Workshop at NUHS Tower Block Auditorium, June 12, 9am to 6pm. Visit www.parentlink.org for more details or call Di on 9451-7702 by the end of this month.

Other labour-pain relief options


    What: Medication injected every four to six hours.

    How it works: It inhibits pain signals sent from the central nervous system to the brain.

    Side effects on mother: Nausea, vomiting, dizziness, drowsiness, difficulty in passing urine, dry mouth, hallucinations and low blood pressure.

    Side effects on baby: It can cross the placenta to the baby and may cause breathing difficulties, especially if given within three hours before birth.


    What: A 50 to 70 per cent concentration of nitrous oxide mixed with oxygen.

    How it works: It is inhaled and reaches the brain via the bloodstream within 15 seconds.

    Side effects on mother: Nausea, vomiting, drowsiness and disorientation.

    Side effects on baby: Minimal


    What: A morphine jab that numbs below waist.

    How it works: It is injected into the epidural space, an area located around the spinal cord.

    Side effects on mother: Itch, nausea, vomiting.

    Side effects on baby: It can cross the placenta and delay breast-feeding.

Sources: Dr Chang Tou Choong, head of Thomson Medical Centre's (TMC) foetal assessment unit, and Dr Benjamin Tham, an obstetrician at TMC.