It’s time now to get to grips with the amazing and life-changing hypnobirthing tool kit. In this chapter I will take you through the two breathing techniques (game changers, the pair of them), some visualisations, light-touch massage, guided relaxations, positive affirmations and the art of creating shortcuts to relaxation. Enjoy.
Breathing is the single most important thing you can do in labour. If you take nothing else from this book, take this!
A good breathing technique helps you in many ways; firstly, it ensures you are bringing oxygen into your body which, as you know, your muscles need to be able to work effectively. You wouldn’t try to exercise whilst holding your breath. Same goes for labour and birth. Secondly, by remaining committed to a breathing technique you are ensuring that you remain relaxed and avoid panic breathing/hyperventilating. Finally, by focusing on your breath through each surge, you are redirecting your focus away from the sensation you are experiencing, which makes each surge more manageable. Instead of being swept up in the waves and feeling out of control, by sticking with your breath you are remaining calm and grounded. The counting that goes alongside the breathing technique or the visualisations can be hugely helpful in keeping you on track.
In this chapter you will learn two very simple and easy breathing techniques. These alone will transform your labour for the better and I don’t say that lightly! I recommend practising them as much as possible so that they become second nature. The first breathing technique, which I call ‘up breathing’, is a lovely calming breath and you can use it throughout the day to bring some relaxation into your life. Certainly a few rounds of this breath before bed will help you get to sleep. The other breathing technique, which I call ‘down breathing’, is a great one to use when going for a poo. So, the toilet is the perfect place to practise this one! To help, at the back of this book you’ll find a practice schedule which you can use if you wish. How much you practise is, of course, up to you, but the more practice you put in, the more effective all of these tools and techniques will be.
To keep things super simple, up breathing is for the ‘up stage’ of labour, where the muscles draw up and the cervix opens. Down breathing is for the ‘down stage’ of labour, where the muscles begin to move downwards, gently pushing the baby out.
The first thing I want to reassure you about is that you will know when you’ve entered the down stage and it’s time to change your breathing style, because you will feel your body beginning to push and you will feel your baby moving down the birth canal; it’s an unmissable sensation. It doesn’t matter if you’re a first-time mum-to-be, trust me; you will know. It’s a bit like doing a poo. How do you know when you need to go? You don’t wait until the poo is halfway out before going to the toilet (at least, I hope you don’t!). You usually experience a feeling of pressure beforehand and you just know.
The second thing I want you to know is that there is no need to worry about what might happen if you forget to switch and continue to use your up breathing throughout the down stage of labour. The answer is absolutely nothing bad will happen. If you’re happy breathing in for four and breathing out for eight throughout your entire labour and birth, then that is absolutely fine; the most important thing is that you keep breathing! As long as you are bringing in oxygen and breathing out rather than tensing and holding your breath, you are doing an amazing job and it will be profoundly more comfortable.
However, what you might notice is that when your body starts to push it will become more difficult to continue with the up breathing. It’s hard to inhale slowly and feel your chest rise and expand as your uterus muscles push downwards in the opposite direction. You might notice that you start to make a mooing sound as you exhale, as your body simultaneously and involuntarily pushes downwards powerfully. Again, this is totally fine and indeed very normal – it might just indicate that it’s time to switch to down breathing, which will be a lot easier to do at this point.
This is the most important one to master as it’s the one you’ll most likely use for the longest amount of time. Nobody can tell you how long your labour will last (sorry!), but a general rule of thumb is that the first stage, the ‘up stage’, where the uterus muscles draw up and the cervix softens and opens to fully dilated, is longer than the second stage, the ‘down stage’, in which the uterus muscles change direction and push the baby down the birth canal and out into the big wide world. This stage can last anything from a few minutes to a couple hours, whereas the first stage is likely to last several hours (although, of course, not always).
The good news is that up breathing is very easy to do and also feels really nice, so it’s a breath you will hopefully enjoy practising.
It’s also worth noting that this breathing technique is not a hypnobirthing-specific one. It is used to help people suffering from insomnia and anxiety, and is also used in mindfulness practice. It’s effective because it slows the heart rate and helps you to relax; it really is a skill for life.
So, let’s give it a go!
Make sure you’re sitting comfortably. In a moment I want you to close your eyes to block out what’s going on around you. Then I want you to inhale deeply through your nose, filling your lungs, whilst slowly counting to four. Then I want you to slowly exhale through your mouth, allowing the air to slowly pass through your lips, whilst counting to eight.
At first you may find it tricky exhaling for eight counts, especially when pregnant, since the baby inhibits your lungs from filling to their full capacity. However, it will get easier through practice, and when you’re in labour and your baby moves further down into your pelvis, you will find you are better able to breathe. If you’re really struggling, try exhaling for a count of six instead. Just make sure your exhale is longer than your inhale; this will feel calming and relaxing. This breathing technique is the opposite of panic breathing or hyperventilating, where someone inhales faster and faster and their exhale becomes shorter and shorter and almost non-existent. We are aiming for the opposite effect.
Let’s try now . . .
Breathing in, 2, 3, 4 and breathing out, 2, 3, 4, 5, 6, 7, 8.
Now I want you to do the same again, but this time doing four repetitions of the breath. So in for four and out for eight, four times over. If you have someone with you, ask them to count for you.
Ideally, you’re now feeling nice and relaxed. It’s normal to feel a little light-headed. In fact, the more you do this breath, the more you’ll feel like you are floating on a little cloud. It’s a bit like natural gas and air, and most people really enjoy this feeling.
The reason I asked you to do the up breathing four times over is significant. Four repetitions of the up breathing technique takes about forty-eight seconds. This is how long a surge or contraction generally lasts when you are in established labour. Imagine a surge (contraction) slowly building to a peak of intensity, before easing off and releasing until you feel nothing at all; if you do four repetitions, the surge will either have passed completely, or at the very least be on the release – you will have got over the peak.
Thinking of surges in this way, breaking it down, really helps to make labour more manageable. Lots of women hear stories of labours lasting hours and have this idea that, once labour starts, it’s one long contraction until the moment of birth. The reality is that you will experience a surge, lasting about forty-five seconds to a minute, then a little break of a few minutes and then another surge. This is the pattern that established labour generally follows; three surges in a ten-minute period, each surge lasting about forty-five seconds. This pattern may well last many hours but broken down in this way and dealt with surge-by-surge makes it a lot easier to handle.
Milli Hill once calculated that during a regular labour, a woman only experiences any sensation at all for approximately 23 per cent of the time.3 The other 77 per cent of the time, she experiences nothing at all. So even if your labour is ten hours in total, you will only be experiencing the sensations of labour for just over two hours.
I love the affirmation ‘every surge brings me closer to my baby’. There are no wasted surges. Deal with each one as it comes; close your eyes, begin to inhale, count to four, then slowly exhale and count to eight. Do this four times over and by the time you finish, the surge will have passed and you know you are another step closer to meeting your baby.
Another favourite affirmation of mine is ‘inhale peace and exhale tension’. I imagine my body expanding and filling with peace as I inhale for four and then, as I exhale for eight, I image all tension releasing as my whole body softens and relaxes. I hope you will enjoy practising this breathing technique and use it not just for birth but for life, in times of stress. It’s a very simple but incredible powerful tool you have. Best of all, you have it with you always and it’s completely free. You never need to remember to pack it! You carry your breath with you wherever you go, so don’t forget to use it.
At some point your uterus muscles will start to push downwards and you will feel the change in direction, and then the mounting pressure as your baby descends. This is the time to switch your breathing technique.
This stage is less about relaxation (although it’s always important to be relaxed) but is more active; you are birthing your baby! I use the analogy of blowing out a candle; you wouldn’t slowly exhale as the flame would just waver and not go out. You would direct your breath with purpose. You would use your breath with intent. This is what happens with down breathing; you use your breath with focus and intent. As you exhale through your mouth, you channel your breath downwards to help your muscles push your baby down and out.
There is no counting involved when it comes to the down stage of labour. You simply take a quick, big breath in through the nose, filling your lungs and then as you exhale through your mouth, you channel that out breath down through your body. And then you repeat. And you do this until the surge has passed at which point you can return to your normal breathing.
I appreciate most people find the up breathing easier to master; you inhale for a count of four through your nose and you exhale for a count of eight through your mouth – easy peasy! Down breathing without the counting, on the other hand, is a little trickier to get your head around. To help you, I have a few tips and tricks.
As you practise down breathing, rest your hands just above your hips, at the bottom of your ribs. As you inhale you will feel little movement but as you exhale, if you’re exhaling with focus and intent, channelling your breath downwards, you should feel your muscles respond and almost push downwards with your breath. Try it a few times. If you feel your muscles move downwards with your breath, you know you’ve cracked it. During the down stage of labour your muscles will be pushing downwards powerfully with each surge and by using this breath you are ensuring that you are working with your uterus muscles rather than against them. You are helping to make everything more effective. You are not pushing, you are using your breath to help your muscles. It’s your muscles that will be doing all the hard work.
When it comes to practice, down breathing is not one that is going to help you drift off to sleep peacefully, which is why I always recommend doing your practice in a particular place, or should I say when doing a particular ‘activity’.
Yes – on the toilet when going for a poo! It’s the perfect time and place to practise your down breathing. I always suggest women stick a little sticky note on the back of their toilet door at home and simply write ‘down breathing’ on it as a little reminder. Then when you go to the toilet, let’s say once a day, you’re ensuring regular practice. Not only that, but you’re beginning to condition yourself to associate the down breathing technique with relaxing and softening, and with something being expelled from the body. Yes, it’s a poo, rather than a baby, but that sensation of mounting pressure does feel pretty similar to that at the beginning of the down stage of labour. You might even find the down breathing helps you go for a poo – more breathing, less straining! Either way, the more you practise, the more it will be second nature to you on the big day.
You might also find it helpful when watching positive birth videos on YouTube to listen in extra carefully towards the end, just before the baby is born. Try and tune in to see if you can hear the woman in the video using her breath in the down stage of labour. This might give you a good idea of how down breathing is used in practice.
Finally, it’s common to worry about how you will know when you have entered this down stage, but you really will just know. You will feel your body begin to push downwards and it’s an unmistakable sensation. Lots of women I’ve taught have said that at this point they naturally switched to down breathing because it felt more comfortable to do – it wasn’t a conscious decision.
Some people will really love the counting technique for breathing and will come to rely on their birth partner to count for them, coaching them through each surge. If this works for you, then that’s brilliant. Practise with your birth partner – it’s a great way for them to be involved. Other people might prefer the room to be quiet or to listen to music or relaxation readings.
If you don’t find the counting relaxing or you don’t have someone to count for you, then another way to pace your breathing is to use a visualisation. It’s a good idea to use an upward visualisation to accompany your up breathing. For example, you might like to imagine a hot air balloon: as you inhale, the balloon fills with air, inflating until it’s a big round balloon. Then, as you slowly exhale, imagine the hot air balloon gently rising up into the sky and drifting off into the distance.
You might prefer to imagine the sun rising over the horizon as you inhale, then, as you exhale slowly, picture it moving upwards to its midday position above your head. Imagine feeling the warmth of the sun as it rises upwards.
Alternatively, you might like to imagine a party balloon inflating and expanding as you inhale, and then, as you exhale, feel all the air releasing as the balloon shrinks quickly in size. Choose a colour for your balloon as this will help you with your visualisation.
For down breathing, people tend to use opening visualisations. For example, as you exhale you could imagine all the layers of a rose bud unfolding and opening.
Some women will use visualisations with which they are already familiar – from yoga classes for example. A common one is the ‘golden thread’ visualization: as you exhale you picture a golden thread running from your lips and extending out towards the horizon. If you break your breath you break the thread, an image that might help you remain committed to that longer exhale.
Some women during the down stage of labour will visualise their baby moving down the birth canal and focus on the fact they will be meeting their baby very, very soon. Perhaps they will consider what their baby’s face might look like, whether they are a boy or a girl, or perhaps they will imagine the moment they introduce their baby to siblings or other family members. It’s nice to allow yourself to be distracted by these happy thoughts.
It’s a really a case of whatever works for you and helps you to maintain the in-for-four and out-for-eight rhythm of the breath.
Whatever you choose is fine. Just take some time each day to practise the breathing whilst using a visualisation. Doing a few repetitions each evening before you go to bed is ideal as it will help you relax into sleep, but do also practise whenever you think of it during the day.
At first you will probably find that you still count silently in your head whilst breathing and trying to follow the visualisation. After a bit of practice, you will get used to the rhythm of the breath and what four and eight counts feels like, and will be able to pace yourself, focusing on your visualisation without counting. Practice really is key. Even if you plan on having your birth partner count for you, it’s a good idea to also have a backup visualisation you can use if your birth partner is having to talk to a midwife or doctor, or if you pop out of the room to go to the toilet. You can never have too many tools at your disposal.
In psychology there’s something called positive reprogramming, which means rewiring your brain and changing the way you think. The aim of positive reinforcement is essentially the same. However, I think the latter sounds friendlier and less like you’re a piece of computer software that’s about to be plugged in and rebooted!
Positive reinforcement is simply the act of consciously seeking out positive thoughts over and over again until you change on a neurological level the patterns in your brain (the reprogramming element). Numerous studies have shown that using positive affirmations regularly (listening to or reading positive statements) or engaging in cognitive behavioural therapy (CBT) is effective and changes the way your brain lights up and processes information in your subconscious mind. Amazing stuff.
When it comes to birth, lots of women – and men – feel terrified. No doubt a lot of that fear is down to the media, what we see on TV and the horror stories we hear. However, through positive reinforcement it’s possible to replace our negative associations with birth with more positive ones, and, as a result, feel more positive and confident when thinking about birth.
Easy ways that you can start using positive reinforcement to change your mindset include:
• Listening to positive affirmations on MP3
• Creating or buying a set of positive affirmation cards to place around your home so that you see and absorb positive statements daily
• Watching positive birth videos
• Reading positive birth stories
• Looking at positive birth photography
Here are some positive affirmations to get you started. Repeat them to yourself as often as possible. There are also loads more great resources at the back of the book, so make sure to check them out too.
I make decisions that feel right for me and my baby
I love and respect my pregnant body
Giving birth is the most wonderful and empowering experience
I feel calm, relaxed and at ease
My body knows how to nourish and grow my baby
I trust my body is perfectly designed to birth my baby
I will birth my baby comfortably, calmly and confidently
Where my mind leads my body follows
Relaxing my mind relaxes my muscles
The birth of my baby will be beautiful
My baby knows when and how to be born
My baby will come when my baby is ready
My baby is the perfect size for my body
As labour progresses I become more deeply relaxed
I listen to my body and do what it needs me to do
I inhale peace and exhale tension
My birth partner is by my side and on my side
Every surge brings me closer to meeting my baby
My surges cannot be stronger than me because they are me
I am a strong and capable woman
All the strength I need is within me
Birth is a safe and wonderful experience
I trust in the instinctive nature of birth
My baby will be born gently, calmly and safely
My job is simply to relax and allow my body to birth my baby
Giving birth is powerful but so am I
I look forward to holding my baby in my arms
I welcome my baby with love and confidence
As important as it is to absorb positivity and build new positive associations with birth, it’s equally important to protect yourself from negativity, which only undermines your efforts. Avoid TV shows that you know show dramatic – and traumatic – portrayals of birth, don’t be sucked in by clickbait on the internet which you know will lead only to scary or worrying stories, avoid TV dramas or novels that could trigger fear and have the confidence to ask those who feel it appropriate to share their birth trauma with you at this time to please refrain from doing so – or at least wait until you have had your baby! Try not to absorb someone else’s negative experience in the name of being polite, as it will only impact your own.
When I’m teaching I often use the analogy of a filing cabinet. Your brain is full of files and the ones at the front are the easiest to reach and pull out. In pregnancy you want to fill your brain with positive files. These could be positive birth stories, positive birth images, positive affirmations, so that when you’re in labour your subconscious mind draws upon the content in these files and you feel reassured. What you don’t want is for your cabinet – or subconscious – to be full of negative files, because when you’re in labour these are the files your subconscious will draw upon and they will make you feel frightened, which will negatively impact the progression of your labour.
So, go out there and fill that cabinet with positive files and positivity and don’t allow yourself to store any new negativity. You’ve probably had a lifetime of creating negative associations about birth. Now is the time to start building positive ones.
You may sometimes become aware that your mind has drifted and you’re thinking of something that concerns you or makes you feel worried or anxious. It may be something you heard in passing, something that apparently happened to a friend of a friend, something you saw on TV or even your own previous experience of giving birth. If this happens, consciously steer your mind back to something positive: read a positive story, watch a positive video, scroll a birth photography account, listen to your positive affirmations. The more you do this, the sooner it will happen that, when you think of birth, or someone mentions birth, immediately a positive thought is triggered.
Positive reinforcement takes some commitment, but the impact is profound and, as with a lot of these techniques, the benefits are felt immediately. By listening to positive affirmations or reading positive affirmation cards you will begin to feel less anxious and more confident about birth right away.
It is not typically part of our culture to practise relaxation. Most people, if asked, will say they do something to relax – be that running, reading a book, going for a drink or watching telly. We frequently substitute a less enjoyable activity (work, for instance) with a more enjoyable activity (a hobby, for example) and count this as an example of us ‘relaxing’. But really, we’re merely engaging in a different type of activity. We rarely actually switch off and take time out to truly relax.
We all love to distract ourselves from the day’s worries and demands by engaging in something more fun. That’s not a bad thing at all and it does make you feel good, but it’s not relaxation practice.
In labour we want to be thoroughly relaxed – in mind and body. We know there is a mind-body connection, so if we can achieve a sense of calm in our minds, it makes sense that our bodies will also be relaxed, making birth so much easier.
In hypnobirthing we have various ways of achieving this relaxation. A lot of it might be new to you, but through practice it can become second nature, and, over time, you will find it easier and easier to tap into the relaxed state you are able to create. It’s a valuable skill to have for life generally, not just in pregnancy, because regular relaxation offers so many mental and physical health benefits. In some schools, mindfulness and relaxation exercises are being taught to young children as part of the curriculum. Hopefully, the next generation will grow up knowing how to properly relax and able to recognise the benefits of such practice. Even if it’s not something you’ve done before, it’s relatively easy (with a little practice) to achieve a state of deep relaxation using some simple tools. And that’s what we’re going to look at in this chapter.
These can also be called guided meditations and are essentially mindfulness exercises. They are about being present in the moment, allowing your mind to be guided by the voice of your birth partner or a recording, and achieving a state of relaxation. This is not about being hypnotised or being out of control. During a guided relaxation you are very much in control.
I’ve provided pregnancy-specific scripts for you to use at the back of this book (see pages 219–227). They are designed to help you feel confident about your upcoming birth, and can be read by your birth partner. I’ve also included links for free MP3s, which you can download, in the Resources section at the back of this book. With the MP3s, all you need to do is find a quiet space, pop your headphones in and play them. Allow your eyes to close when prompted to do so and simply listen to my voice as it guides you through the relaxation exercise.
Although the MP3s can be very effective, it’s a good idea to try doing some guided relaxation practice with your birth partner. Their voice is even better as it’s already familiar to you and a source of reassurance and comfort. Doing the practice together also helps your birth partner to feel involved. If you want to give this a go, use the scripts at the back of the book. I recommend playing some gentle background music whilst your birth partner reads the script. It might also be a good idea to light a candle, spritz the room with a scented room spray, dim the lights – and add anything else you plan on doing when giving birth. Essentially practise setting the scene! Then ensure you are comfortable (sitting or lying down), close your eyes and allow yourself to be guided through the relaxation by your birth partner’s voice.
It may feel funny the first couple of times you do this, but, with practice, it will become routine and hopefully you will find you actually enjoy taking five minutes out of your day to do this exercise together.
An anchor in hypnotherapy is simply something that you strongly associate with a happy memory. It can be a smell or a particular sound (a piece of music for example), a visual, a taste (a particular food) or a familiar touch.
Another term for setting anchors is ‘conditioning’. There was a famous study done in the 1890s/early 1900s known as ‘Pavlov’s Dogs’, which was all about this concept. A scientist, Pavlov, used a metronome to produce a clicking noise and would then feed his dogs. After some time, he discovered that when the dogs heard the metronome they would salivate in anticipation of the food. The food no longer needed to be present to trigger this reaction; the dogs were conditioned to associate the sound of the metronome with their food. In this way Pavlov proved that animals – including humans – could be conditioned, through repeated and reinforced association, to respond to set triggers.
When it comes to doing your hypnobirthing practice you are essentially doing the same thing: conditioning yourself to relax in response to certain triggers – be that audio, touch, etc. You are building positive associations now in pregnancy between these triggers and a sense of deep relaxation. Then, when in labour, your body will respond in kind to these triggers. The more you practise, the more powerful and effective the triggers will be.
You’ll notice that the first guided relaxation script (at the back of this book) is very simple and your birth partner only needs to read it through and that is all. The following two scripts have a little more going on: the first includes some arm stroking and the second an arm drop – these are two ways that we can set anchors that trigger relaxation for Mum during birth.
With arm stroking, your birth partner will simply need to stroke your arm slowly, starting at the knuckles, over the hand and up the arm towards the elbow, whilst reading the script. It can be a very light stroke, almost tickly, or a firmer stroke; it comes down to personal preference. By doing this each time the script is read, you will begin to associate the arm stroking with the lovely, deep relaxation you are hopefully experiencing. Then, when in labour, your birth partner may not have time to read the whole script, but they can use the arm-stroking element. This will be a trigger for you and help to ease you into that lovely, familiar, relaxed state. Hypnotherapists call this ‘setting an anchor’. In this case, the touch is the anchor and you associate it with the deep relaxation you have experienced when practising at home, feeling safe and comfortable. I like to think of it as creating a shortcut to relaxation.
It’s worth knowing this works for anything else too! If you prefer having your hair stroked, you could ask your birth partner to do this instead. It’s not that the arm has any special powers, but more that you build an association, through practice, between an action (arm stroking) and a feeling (relaxation). You can then use the action as a standalone to trigger that same feeling in labour.
The second script includes an arm drop. When prompted to do so within the script, your birth partner needs to gently take hold of your wrist and raise your arm a little above your lap. If it’s properly relaxed your arm should feel heavy to lift. Then, when prompted to do so within the script, your birth partner will release their hold on your wrist and allow your arm to drop into your lap. If you have remained relaxed your arm should be limp and heavy, falling without resistance. If your arm hovers and appears to defy gravity this would suggest you are holding onto some tension in your body and are partially lifting the weight of your arm yourself. By repeating this arm drop three times, you will be encouraged to really let go and release all tension.
Of course, a limp, relaxed arm is not directly going to make birth easier, but if your arm is limp and relaxed, the chances are that your entire body is also free of tension. The more relaxed the muscles are throughout your body, the more comfortable your labour will be, and the easier it will be for the baby to descend and be born, because there is no resistance or internal struggle. On the other hand, if you are holding onto tension in your arm, your core is likely to also be tense and drawing up. This will make the descent of baby more difficult as the muscles draw up and hold your baby in.
As with the arm stroking, the more you practise, the more effective this exercise will be. The more familiar it is, the faster your body will respond, recognising that when your birth partner takes your wrist to raise your arm you are to hand over the weight of your arm to your birth partner and let go of any tension. It can work powerfully at the right time and, as with the arm stroking, can be used as a standalone trigger for relaxation, as well as being used within the context of the relaxation script.
A lot of our behaviour is conditioned without us even being consciously aware of it. As humans we are very receptive to patterns and routine, so aim to incorporate your relaxation practice within your normal daily routine and it will be soon become second nature. For example, you could aim to set aside some time each evening before bed to practise relaxation. Before bed is a particularly good time to practise because you should feel nice and relaxed and well ready for sleep by the time you’ve finished the exercises. The practice also offers immediate benefits so it shouldn’t feel like an arduous chore; rather, I hope it’s something you’ll look forward to doing each evening because it’s enjoyable and feels good and will soon become as routine as brushing your teeth.
If you take a moment just now to reflect, you can probably identify a number of things in your own life that you already do which trigger a certain response. These triggers could be sounds or smells, or they might help us feel awake or help us go to sleep, or make us feel happy or sad, energised or hungry. For example, for me, putting on my slippers immediately signals that I’m at home and relaxing rather than going out and being busy. For others it might be soaking in a bath, a certain scented candle, a foot rub. If there is something you regularly do at home to relax, use that as part of your birth preparation. It will be powerful because you’ve already been doing it for years. You don’t need to build a new association if one already exists. You just need to find ways of incorporating into your birth what you already do at home to relax.
Always remember that the end goal is to be relaxed in mind and body. How you get there is less important. The important thing is that you get there! Try out some of the suggestions in this book, try some of the things you already do, and cumulatively you will find you have a toolbox full of things you can use in labour.
The word ‘massage’ here is slightly misleading as this technique is more about the light touch than massage in the traditional sense. This is not deep-tissue massage and there’s no working of the thumbs deep into the muscle. Instead, your birth partner will use the backs of their fingertips to lightly stroke your back, trailing their fingers slowly and lightly against your skin.
So, birth partners – you should always start with both hands at the base of the spine, just above the coccyx. You then move your hands up the spine, backs of the fingertips in light contact with the skin, before branching out as if you are drawing the lower layers of a palm tree’s leaves. Begin again at the bottom, this time going up a little further and then again, branching out and letting the backs of your fingertips trail lightly down Mum’s side. Start again at the bottom, going a little higher this time before branching out, around and down. Continue until you are reaching the base of Mum’s neck before branching out across the tops of Mum’s shoulders (see the illustration overleaf). Then begin the exercise again at the bottom and repeat it over and over. Always keep the touch light and move slowly and gently. Visualise drawing a palm tree on Mum’s back as you go.
It may feel repetitive or as if you’re not doing much at all, but hopefully Mum will be experiencing a lovely tingly feeling spreading out throughout her body – this is the oxytocin. By stimulating the nerve endings of the spine you’re encouraging the production of not only oxytocin but also endorphins. Endorphins are the body’s natural pain relief and are believed to be many times stronger than morphine. Endorphins stick around in the body and make you feel good, so the more of these the better.
Light-touch massage works in a similar way to a TENS machine (Transcutaneous Electrical Nerve Stimulation). A TENS machine has four sticky pads that are placed on your lower back, and these are attached by wires to a small, handheld device. A rhythmic electrical pulse is then emitted and you can control the strength of it – turning it up or down. The device usually comes with a boost button that you press when experiencing a surge. When you press the boost button the rhythm changes and a different sensation radiates throughout your back. It takes some getting used to initially, but after a short while you almost won’t notice it. The way it works in terms of pain relief is that the electric pulse stimulates the nerves into producing endorphins, just as light-touch massage does.
You can buy a TENS machine especially for labour and birth from pharmacies, or you can hire them from various places. Your midwife should be able to advise. You want one suitable for pregnancy because there are other types available for those suffering from back pain that work in the same way but might not be suitable for use in pregnancy.
Light-touch massage is a personal favourite of mine and it’s something birth partners can do between surges to help Mum to relax and produce more of the good, happy hormones. The TENS machine is also useful for this and it can be used at home in early labour, as well as when labour is more established. The only place you can’t use a TENS machine is in a birth pool, for obvious reasons! Other benefits of the TENS machine is that nothing passes to baby, like a drug might, and if you don’t like it you don’t have to wait for it to leave your system, but can simply switch it off. Whether you choose to use light-touch massage or a TENS machine, or a bit of both, is totally down to personal preference.
By now you should start to feel like you have a good toolkit coming together ready for birth. I always recommend giving each exercise a fair try, even if at first it seems a little funny or ineffective. These may well be new skills you are learning and not something you have ever done before, so it could take a little time to get to grips with them or warm to them. However, if you have tried something a number of times and it’s really not aiding your relaxation then let that one go and focus on the techniques that do work for you. As long as you have a few tools you can rely on to help you relax, that’s great. Never lose sight of the main aim of the game: to be relaxed. How you get there doesn’t really matter. You might use an arm drop, you might not. You might use something entirely different. You might choose to customise your toolkit with techniques you already employ to help you relax. What matters is that you get there. I hope that at least some of these techniques will help you achieve that wonderful state of relaxation.
The breathing techniques, along with the counting or visualisations, are certainly the most important to master and should be used during each surge. The light-touch massage, guided relaxations, arm-stroking and arm-drop techniques can be used between surges to help you deepen your relaxation and let go of any tension acquired during the surge.
When it comes to practising, I have included a practice schedule at the back of the book for you to use if you wish. I would recommend setting aside time each day to practise. It doesn’t have to be a lot of time! Maybe ten or fifteen minutes. You don’t need to practise every single technique every single evening. I’d recommend starting your practice with a few repetitions of the up breathing to slow things down and get you in the mood and then doing one of the guided relaxations or the light-touch massage. Then pop your MP3s on or play some relaxing music of your choice as you drift off to sleep. If you do this each evening, you will be very well prepared.
Home water birth – Antonia, second-time Mum
This was my second home birth, with our first son being born on the sofa two years previously. Although my first labour was technically ‘good’ with no complications, I certainly felt it was traumatic and struggled to cope with the intensity at times. I realised looking back that I hadn’t really believed in my ability to birth him, so when push came to shove (quite literally) I panicked and ended up leaving the birth pool and pushing for him coached by others. I remembered feeling totally out of control and, although proud we’d managed to have him at home, a bit traumatised by the whole thing. In fact, the first thought I had when they placed Solly into my arms was ‘I am never doing that again!’
This is why, when Sam and I found out we were expecting our second child, I knew so much I wanted to conquer this fear and make my next birth something I could be really proud of. With some practice and positive thinking I was truly able to change my mindset about labour, and started to (dare I say it) look forward to the challenge!
On the day of my labour I woke up at 1.30am with what felt like the start of contractions. I immediately went into a minor default panic but knew that if I could just stay in bed and conserve my energy I would be helping myself out massively. I started listening to my relaxation track for hypnobirthing and breathed through all the feelings I was having until they started to come with some frequency. When we finally called the midwife in the morning I felt calm and relaxed. By 8am I was in established labour. Sam and I were in the lounge together, candles burning, music playing and very much in our own space.
When things started to hot up, and I got into the pool, Sam helped me remember my breathing. This helped massively: him knowing what I needed made me feel like we were in it together. Also, for Sam, I think it made him feel much more included than in my first labour when he perhaps felt like more of a spectator.
I remember so many of the affirmations going through my head when I felt overwhelmed and them really calming me down. In particular, I found comfort in the fact that I was not alone and that women all over the world were doing this with me. Instead of in my first labour when all I wanted was for the surges to stop, I almost welcomed them as I knew they were bringing me closer to my baby.
Finally, and most miraculously for me, was the fact that I got to believe in myself and my ability to trust my body and birth my baby naturally. My midwife was amazing and in those final surges simply stood back and allowed me to birth him. I literally couldn’t believe what I was feeling: my baby coming to me naturally without any need to be told to push. The reflex was so strong and within a couple of big surges he came floating up between my legs to meet me.
To say it was amazing was an understatement. This birth was such a gift and has left me on a high I don’t think I’ll ever come down from. For anyone who is nervous or may not trust in their ability, I could not recommend hypnobirthing enough. If only all women had access to it, the way we think and feel about labour and birth would be different. I am forever grateful for my chance to own my birth instead of being overwhelmed by it. There really is no greater gift!