Midwife Information

As I am a qualified nurse I am passionate about working with hospitals, midwives and other staff for the best care for women and couples in pregnancy, birth and beyond.
I speak very highly of Midwives in all areas and encourage couples to not replace NHS classes with PureBirth classes but to compliment them.

I am quite often the person the couple will call with concerns and I always without exception forward a client to their midwife.

I believe that the support and care I offer in my classes or my role as a birth companion help the couple to feel confident and relaxed about birth and therefore a calmer and happier birth experience for everyone.

I am happy to visit units or clinics to talk about my classes or if you have any questions.

I hope in the meantime the information below may help you to assist your couples if you don’t know a lot about HypnoBirthing and any further questions don’t hesitate to call me.

Assisting Women during Birth using HypnoBirthing®--The Mongan Method

Thank you for your interest in learning more about assisting mothers in birthing their babies safely, peacefully and comfortably with HypnoBirthing®. We hope that the information presented here will be useful!

Fear, stress and tension have long been known to be associated with increased levels of pain as reported by patients. Grantly Dick-Read, MD, described the “Fear-Tension-Pain Syndrome” in the 1920s, and since that time obstetrical care providers have noted that education and stress management strategies have been effective in decreasing the level of pain reported by women in labor.

Hypnosis has been used effectively in the management of pain for over a century, but fell out of favor with the advent of safer, more effective analgesia/anesthesia. Over the years, several studies have been undertaken to research the efficacy of hypnosis in childbirth. A meta-analysis of these studies, “Hypnosis for Pain Relief in Labour and Childbirth: A Systematic Review,” appeared in the British Journal of Anesthesia in 2004. The article states

This report represents the most comprehensive review of the literature to date on the use of hypnosis for analgesia during childbirth. The meta-analysis shows that hypnosis reduces analgesia requirements in labour. Apart from the analgesia and anaesthetic effects possible in receptive subjects, there are three other possible reasons why analgesic consumption during childbirth might be reduced when using hypnosis. First, teaching self-hypnosis facilitates patient autonomy and a sense of control. Secondly, the majority of parturients are likely to be able to use hypnosis for relaxation, thus reducing apprehension that in turn may reduce analgesic requirements. Finally, the possible reduction in the need for pharmacological augmentation of labour when hypnosis is used for childbirth, may minimize the incidence of uterine hyperstimulation and the need for epidural analgesia.1

Obstetrical patients using self-hypnosis have been shown to have lower scores for pain associated with childbirth, shorter duration of both first and second stage labor, increased number of spontaneous births, decreased use of analgesia, anesthesia and labor augmentation and infants with higher average Apgar scores.

HypnoBirthing® teaches women to relax quickly and completely with uterine contractions, and to use visualization to help facilitate cervical effacement, dilation, and fetal descent. Women and their birthing companions are taught that fear and tension lead to increased levels of catecholamines, which ultimately causes increased pain during labor. The positive effects of visualization are thought to be similar to those achieved by athletes using mental imagery to prepare for competition. Rather than using multiple types of breathing and imagery to distract the laboring woman from her discomfort, HypnoBirthing® allows a woman to become deeply focused upon the birthing process.

When in labor, a woman using this method is not asleep or unconscious, and is receptive to suggestions made by her birthing companion and others. For this reason, references to pain, medications and procedures are best kept to a minimum. Women using HypnoBirthing® will ask for analgesia or anesthesia if they need it.

HypnoBirthing® encourages the laboring woman to allow passive descent in second stage and to “breathe the baby down” with release of air as she “feels the urge.” The HypnoBirthing method discourages Valsalva pushing, and beginning to push before the woman has the involuntary urge to do so. Recent studies have shown few risks and some benefits in allowing the mother to “labor down” in second stage, allowing passive descent, as opposed to “pushing” as soon as cervical dilation is complete. With passive descent, there are fewer fetal heart rate decelerations and less fetal acidosis. Maternal benefits include a shorter period of “pushing” and less fatigue. Unless specifically instructed otherwise, women begin bearing down spontaneously when the fetal presenting part is well down in the birth canal; they will generally wait until the contraction peaks and then give a series of “mini-pushes” with air release.

HypnoBirthing® stresses that the goal is a gentle and safe birth for the baby. Staying relaxed and focused upon her baby and the birthing process enables the birthing woman to remain calm and more comfortable. Her companion(s) will help her to maintain this calm focus with music, dim lights, soft touch, and speaking words of encouragement. They will also help her to remain well nourished and hydrated and assist her in moving about. The companions will advocate for the mother and baby if interventions are suggested and help the woman to make informed decisions.

We find that, no matter what turn the labor and birth may take, most couples are very satisfied with their birthing experience. Because they are calm and relaxed, they will feel empowered to make good decisions if interventions become advisable.

Bibliography

1. Cyna AM, McAuliffe GL, Andrew MI. Hypnosis for Pain Relief in Labour and Childbirth: A Systematic Review. Br J Anaesth. 2004 Oct;93(4):505-11. Epub 2004 Jul 26;

2. Fraser WD, Marcoux S, Krauss I, Douglas J, Goulet C, Boulvain M. Multicenter, randomized, controlled trial of delayed pushing for nulliparous women in the second stage of labor with continuous epidural analgesia. The PEOPLE (Pushing Early or Pushing Late with Epidural) Study Group. Am J Obstet Gynecol. 2000 May;182(5):1165-72.

3. Hansen SL, Clark SL, Foster JC. Active pushing versus passive fetal descent in the second stage of labor: a randomized controlled trial. Obstet Gynecol 2002 Jan;99(1):29-34

4. Harmon TM, Hynan MT, Tyre TE . Improved obstetric outcomes using hypnotic analgesia and skill mastery combined with childbirth education. J Consult Clin Psychol. 1990 Oct;58(5):525-30.

5. Jenkins MW, Pritchard MH. Hypnosis: practical applications and theoretical considerations in normal labour. Br J Obstet Gynaecol. 1993 Mar;100(3):221-6.
6. Martin AA, Schauble PG, Rai SH, Curry RW Jr. The effects of hypnosis on the labor processes and birth outcomes of pregnant adolescents. J Fam Pract. 2001 May;50(5):441-3.

7. Mayberry LJ, Hammer R, Kelly C, True-Driver B, De A. Use of delayed pushing with epidural anesthesia: findings from a randomized, controlled trial. J Perinatol. 1999 Jan;19(1):26-30.

8. Roberts JE. The "push" for evidence: management of the second stage. J Midwifery Womens Health 2002 Jan-Feb;47(1):2-15

Tips for Assisting HypnoBirthing® Births

When you first meet the couple, ask if there are specific visualizations or relaxation techniques that hope to use. They will ahve a HyponoBirthing plan along with their birthing preferences (birth plan.) which will help you to know what kinds of techniques the couple are using as everyone is different.

Many women prefer to omit routine cervical checks. They may also ask that there be no mention of pain, and decline to respond to use of the pain scale. If that is the case, please note that in the chart so that other care providers will be aware of those choices.

Enter the room quietly and speak softly. If the woman appears to be deeply relaxed, speak with the birthing companion(s) rather than directly with the mum. The companions will gently alert the woman that you are there to check the baby, measure blood pressure, etc.

If at all possible, monitor the baby only intermittently, and in whatever position the mum is in at the time.

HypnoBirthing® advocates the use of gentle, vernacular language regarding birth. For instance, the word “surge” replaces “contraction,” which often has negative connotations. We use the terms “thinning” and “opening” instead of “dilation” and “effacement.” Please refer to the attached list for more suggestions. Phrasing suggestions in positive terms is helpful. For instance, remind the mum to “breathe and relax, just let go” rather than saying “it would hurt a lot less if you’d just relax.”

Slow breathing is encouraged during each surge. Slow breathing is a very slow belly breath in and slow breath out to give the uterus space and is also helpful for a mother who is tense.

In the event that the woman becomes uncomfortable or frightened, remind the birthing companion to help her to become more deeply relaxed between surges, change positions, etc.

If the birth slows or stalls, suggest that the laboring woman use the opportunity to rest and relax. If the surges do not resume in a reasonable amount of time, suggest that the companion help her to use natural methods to increase uterine activity and use the visualizations they have learn't (especially releasing fears and limiting thoughts.)

Women using HypnoBirthing® may not experience the signs often associated with transition.

During the birthing phase, allow her companion when possible to encourage her, and avoid coaching her to “push.” She has been taught to bear down as her body feels the need, and to exhale instead of holding her breath and only to push if absolutely neccessary.

The Power of Words

Medical words used to describe pregnancy and birth often have negative connotations to birthing women. To embrace the concept of gentle, normal birth, HypnoBirthing® advises couples to think and speak in the kinder, softer word substitutes that appear on the list that follows:

Uterine surge or wave not Contraction
Birth companion not Coach
Birth/birthing not Deliver/ Delivery
Pressure/sensation/tightening not Pain or Contractions
Birth path not Birth Canal
Birth breathing/breathing down not "Pushing"
Special circumstances not Complications
Thinning/opening not Effacing/dilating
Near completion/nearly complete not Transition
Practice labour not False Labour