Pregnancy and Childbirth
Pregnancy, Birth, and Midwifery
By Gayle Peterson, Ph.D.
To begin to address women's needs in a meaningful
way, we must encourage a yielding relationship to the childbirth process.
Pain in labor is a reality. And the expectation
of pain as well as some means for coping with it, goes a long way
toward healthy birth outcomes.
The birth of a baby is the birth of a family. A myriad
of births take place at once: women become mothers, husbands become fathers,
daughters become sisters and sons become big brothers. One birth ripples
through generations, creating subtle shifts and rearrangements in the
Unfortunately, we rarely regard pregnancy and birth as
formative phases in family making. Nor do we realize that as a woman enters
motherhood, she feels new, pressures some of which derive from her
own experience of having been mothered and some of which are engendered
by family and societal beliefs and mandates. Moreover, hardly ever are
the coping styles promoted in the marketplace applicable to the stress
To begin to address women's needs in a meaningful way,
we must encourage a yielding relationship to the childbirth process. We
must emphasize the sensation of following - one's baby, wherever that
may lead. Above all, we must foster trust and cooperation in labor, rather
than a desire to take control of the process.
Body-centered hypnosis does just that it facilitates prenatal
bonding, noninterventive birthing, and healthy postpartum adjustments
as well. When integrated into prenatal preparations, it creates a bridge
between the unconscious bodily processes of pregnancy and childbirth and
the emotional and psychological growth required during this sensitive
time in a woman's life cycle.
OVERCOMING ANXIETY THROUGH HYPNOSIS
Reduced maternal anxiety is the psychological factor
most significant in normalizing pregnancy, labor, and birth outcomes.
High-anxiety states, which affect oxygenation and the flow of nutrients
to the fetus, have been correlated with abnormal decreases in fetal movement.(1) Anxiety has also been associated
with uterine dysfunction in labor,(2,3,4)
other debilitating labor patterns,(5)
as well as prematurity(6) and miscarriage. As anxiety
levels drop, these conditions improve.
To effectively transform maternal anxieties several researchers
and practitioners now recommend the use of hypnosis. Some point to the
need for hypnosis in contemporary obstetrics, primarily to address the
psychological needs of the mother.(7)
Others use hypnosis to address the needs of the family as they prepare
for labor.(8) Still others recommend hypnotherapy
to reverse the potentially debilitating emotional factors that can arise
Over the past 17 years, I have developed a body-centered
hypnosis to help women prepare for childbirth. Using techniques that engage
portions of the brain, I create a hypnotic experience of birth, including
the sensory patterning of labor. I link the pregnant woman's experiential
input with hypnotic suggestions for labor and birth that are based on
her personal history. I also link the hypnotic experience of childbirth
to the woman's individual needs, weaving suggestions for conflict resolution
via Ericksonian storytelling(10)
into a guided journey through labor. Overall, I strive to create a subjective
experience of having already mastered the birth process.
Women who have engaged in this form of hypnosis report
that phrases and images from the hypnotic experience reemerge during labor.
Many laboring women even feel that they are "reliving" the birth.
My belief is that the sensation aroused by the hypnotic birth journey
becomes encoded in the nervous system through the brain's memory tracings,
and that the suggestions for coping with labor and birth become activated
by the physiological processes themselves.
Whereas some forms of hypnotherapy involve dissociation
from bodily experience, body-centered hypnosis deepens a woman's bodily
sensation, taking her into a focused experience of physiological processes.
Body-centered hypnotic suggestions are communicated, through a variety
of images and sensations, to the visual, auditory, and somasthetic cortices
of the brain. Here, I believe, the images and sensations that carry sufficient
emotional impact trigger the release of acetylcholine (a neurotransmitter
involved in the formation of memories) through the hippocampus and into
long-term memory storage. Later, the physical processes of the developing
pregnancy and labor activate these hypnotic messages. If anxieties have
been addressed successfully in hypnosis, then maternal anxiety lessens
and labor is more likely to progress smoothly.
Hence, body-centered hypnosis mediates a woman's fears
about childbirth and motherhood through bodily sensation and physical
memory, and the effects are observable. Provided that pain has been adequately
addressed, the flow of oxytocin during labor tends to be sustained and
the ejectory reflex remains largely unimpeded. In addition, some birthing
women retain a conscious awareness of the hypnotic messages given. Others
do not; yet, upon recall they will repeat a phrase or two, demonstrating
that the messages have become an intrinsic part of their birthing experience.
One woman reported the following recollection soon after her second birth:
"And so 'straight down and out he came' (a phrase from her hypnosis
session, used to help counteract the effect of her previous posterior
birth) in a two-hour labor."
Pain in labor is a reality. And the expectation of pain,
as well as some means for coping with it, goes a long way toward healthy
birth outcomes. The hippocampus plays a major role in this respect, for
it mediates between the expectation of an experience and its actuality.
One researcher notes that when differences between expectations and realities
remain minor, the hippocampus "inhibits the reticular activating
system," but as soon as major differences emerge, the hippocampus
stimulates the reticular activating system "to alert the entire cortex
to these discrepancies" and, in the process, precipitates higher
levels of tension in the central nervous system.(11)
Another researcher suggests that women who experience cognitive dissonance
between what they expect and what they undergo have more birth complications
than women who experience no such dissonance.(12)
Uterine inertia, or the cessation of contractions, is
one such complication; another is the occurrence of strong, unrelenting
contractions that produce no cervical dilation in both instances, the
involuntary processes of the uterus go haywire due to the firing of conflicting
messages from the limbic system (a.k.a. the emotional center of the brain.
Accompanying the message for labor to proceed comes a new message elicited
by the woman's response to unexpected pain or fearfor labor to turn
off. When both "fight" and "flight" polarities of
the limbic system are activated in this way, labor can easily become dysfunctional.
When the expectation of pain is addressed in advance, however, the limbic
system is better prepared to create a self-regulating feedback loop that
will facilitate the progression of labor.(13)
Body-centered hypnosis reaches into this self-regulating
limbic activity, helping women cope with the likelihood of pain in labor.
Sensations evoked by the use of vivid imagery, meaningful metaphors, and
the repetition of certain phrases all produce memory tracings in the braintracings
that are further developed by listening to an audiotape of the hypnosis
session. Stimulated by the hypnotic messages, pregnant women thus reexperience
the sensations evoked during hypnosis, all the while reactivating limbic
pathways that feed into the autonomic nervous system. The hypnosis is
rendered even more effective when pregnant women identify their unique
coping styles and utilize active coping techniques before labor begins.(14)
This body-centered approach to pain management not only
decreases anxiety levels during the upcoming birth, but profoundly affects
subsequent births as well. In contrast, most other forms of hypnosis used
for childbirth focus on "transcending" the pain or blocking
it out, offering few long-range benefits The laboring woman v hose experience
of pain is denied or rendered inaccessible often has more difficulty resolving
her birthing anxieties the next I time around.
The experiential quality of body-centered hypnosis is
equally promising, and a far cry from methods that invite pregnant women
to merely relax and absorb suggestions. The more actively women participate
in the hypnosis process, the more it becomes an intimate part of everyday
life. The more engaged they are in the experience of bodily sensations,
the more motivated they will be to create positive suggestions, and the
better prepared they will be to bring forth new life.
Some of the techniques used in body-centered hypnosis
- Linking. Connecting one naturally occurring
phenomenon with another increases the likelihood that the right hemisphere
of the brain will take in suggestions. Linkages are most effective when
used in conjunction with a truism or some other form of reasoning that
engages the left hemisphere's analytic tendencies. For example, in the
message "As you stand up, gravity will help the baby come right
down," standing up is linked to the baby's head coming down, and
the truism about gravity; reinforces the linkage.
- Incorporation. Here, a naturally occurring stimulus
is utilized to ensure activation of suggestions in a different environmentfor
example. "Your child's voice and eyes will remind you of that confidence."
The use of environmental stimuli occurring in the hypnotic environment
can further activate a suggestion.
- Metaphor. This figure of speech bridges conscious
and unconscious processes by engaging the right hemisphere directly.
The left hemisphere, perceiving a "just pretend" message,
simply rests. One striking metaphor is the rosebud, sealed tightly until
the right time, when something changes inside and the petals opensoftly,
graduallyto the sky. Metaphors enlarge the context for embedded
commands and other hypnotic techniques, helping them impact more deeply
on the nervous system.
- Reframing. An undesirable experience in a first
birth can become a resource for a second birth once the left hemisphere's
image of the event has been altered The right hemisphere is then accorded
a newerand less threateningexperience of the event. For
example, a woman who has had a cesarean at 5 centimeters dilation might
be given the suggestion that she was "halfway there"
halfway toward her desired goal of a vaginal birth. Reframing her first
birth in this way will help her view it not as a past failure and thus
a potential source of anxiety, but as part of an ongoing movement toward
her desired goal.
- Synesthesia. Mixing together visual, auditory,
and somasthetic impressions helps transport suggestions directly to
the unconscious. For example, the rising and falling of the practitioner's
voice can set the stage for the rising and falling sensation of contractions,
leaving nothing for the left hemisphere to guard against. The synesthetic
qualityin this instance, a change in tonalityimpacts immediately
on the unconscious, touching into the limbic system and creating pathways
of emotional memory.
Through these techniques and others as well, body-centered
hypnosis is able to support the contemporary woman's entry into motherhood,
helping her meet calmly whatever comes her way in labor. In the event
of a complication, it helps ease her anxiety so that she can better cope
with a difficult situation. When used routinely in prenatal care, this
form of hypnosis can free today's women to focus on the tasks at hand:
gestation, childbirth, and ultimately, postpartum adjustment.
The best part is that everyone benefits. Women who are
supported in transforming areas of distress into wellsprings of resourcefulness
learn to make the delicate adjustments needed in giving birth, in creating
family, andwith each subsequent birthin creating family anew.
1. H. Moroshima and H. Pedersen, "Maternal Psychological
Stress and the Fetus," American Journal of Obstetrics and Gynecology,
131 (1978): 286.
2. R. L. Gorsuch and M. K. Key, "Abnormality of
Pregnancy As a Function of Anxiety and Life Stress, Psychosomatic Medicine,
36 (1974): 352-362.
3. M. MacDonald, M. Gunther, and A. Christakes, "Relations between
Maternal Anxiety and Obstetrical Complications," Psychosomatic
Medicine, 25 (19v3): 74 77
4. G. Levenson and S. Shnider,. "Catecholomines: The Effects of
Maternal Fear and Its Treatment on Uterine Dysfunction and Circulation,"
Birth and Family Journal, 6 no 3 (1979): 167-174
5. S. E. Lederman, B. A. Lederman, and 3 Work, "The
Relationship of Maternal Anxiety, Plasma Catecholomines, and Plasma Cortisol
to Progress in Labor.," American Journal of Obstetrics and Gynecology,
132 (1978): 495.
6. L. M. Gunther, "Psychopathology and Stress in
the Life Experience of Mothers and Premature Infants American Journal
of Obstetrics and Gynecology, 131 (1963): 286
7. G. Di Bernando, "The Role of Hypnosis in
Present-Day Obstetrics," Minerva Medicine, 66, no 6
(1975): 276 - 280.
8. N. Poncelet, "An Ericksoman Approach to Childbirth,"
in J. Zeig, ed., Ericksonian Psychotherapy, vol 2 (New York: Brunner-Mazel,
9. L. E. Mehl, S. Donovan, and G. H. Peterson,
"The Role of Hypnotherapy m Facilitating Normal Birth,"
in P. Freyburgh and L. Vanessa-Vogel, eds. Prenatal and Perinatal
Psychology and Medicine, (Park Ridge, NJ: Parthenon, 1988).
10. J. Zeig, Ericksonian Approaches to Hypnosis
in Psychotherapy (New York: Bnunner-Mazel, 1982).
11. Charles Hampden-Tumer, Maps of the Mind (New
York: Macmillan, l981), p. 84.
12. Randi Ettner, Cesarean Birth: Risk and Culture
(Berkeley, CA: Mindbody Press, 1985), ch.13.
13. Gayle Peterson, "Body-Centered Hypnosis for
Childbirth" (unpublished dissertation).
14. For a discussion of visual, auditory, and kinesthetic
coping styles in labor, see Gayle Peterson, An
Easier Childbirth: A Mother' s Workbook for Health and Emotional Well-Being
during Pregnancy and Delivery (Los Angeles: Jeremy Tarchare
Gayle Peterson, MSSW, LCSW, PhD is a family therapist specializing
in prenatal and family development. She trains professionals in her
prenatal counseling model and is the author of An
Easier Childbirth, Birthing
Normally and her latest book, Making
Healthy Families. Her articles on family relationships appear
in professional journals and she is an oft-quoted expert in popular
magazines such as Woman's Day, Mothering and Parenting.
She also serves on the advisory board for Fit Pregnancy Magazine.
Dr. Gayle Peterson has written family columns for ParentsPlace.com, igrandparents.com, the Bay Area's Parents Press newspaper and the Sierra Foothill's Family Post. She has also hosted a live radio show, "Ask Dr. Gayle" on www.ivillage.com, answering questions on family relationships and parenting. Dr. Peterson has appeared on numerous radio and television interviews including Canadian broadcast as a family and communications expert in the twelve part documentary "Baby's Best Chance". She is former clinical director of the Holistic Health Program at John F. Kennedy University in Northern California and adjunct faculty at the California Institute for Integral Studies in San Francisco. A national public speaker on women's issues and family development, Gayle Peterson practices psychotherapy in Oakland, California and Nevada City, California. She also offers an online certification training program in Prenatal Counseling and Birth Hypnosis. Gayle and is a wife, mother of two adult children and a proud grandmother of three lively boys and one sparkling granddaughter.
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