Visualize calm childbirth. . .

Hypnosis

Thursday, October 26, 2006

GABRIELLE GLASER

The Oregonian

Until she became pregnant with her son five years ago, Genoveva Bekleyen considered herself a "wimpy girl." She popped aspirin at the first sign of a headache or the first hint of cramps. Bekleyen never dreamed that she would consider anything but the most conventional of deliveries -- until she learned of a method of natural childbirth that promised to ease the fear and pain of labor.

Bekleyen, 34, enrolled in a course that used hypnosis to teach women a combination of relaxation, breathing and visualization to control the pain and anxiety of childbirth. For her, it worked.

A video taken just a few hours before she delivered shows Bekleyen walking calmly and quietly around her hospital room. Although she is in what is generally considered the most difficult stage of labor, active labor, Bekleyen's face betrays only concentration -- not agony.

"Come on, Max, you're almost here," she coos, calling her soon-to-be-born son by name. When she feels a contraction, she puts her hand over her swollen belly and summons, she recalls, images of a green meadow in her native Romania.

"No one could believe that was me -- no epidural, no screaming, no pain," said Bekleyen, of Portland. She is taking a refresher course for the birth of her second child, due later this year. "But it was -- and it changed the way I thought about everything. If I could do this, I could do anything."

Although it has been around for centuries, hypnosis has only recently entered the medical mainstream as a tool for stress, pain management, weight loss and kicking cigarettes. It has taken decades for hypnosis -- which, for many, conjures images of someone being lulled into a trance with a swinging gold watch -- to earn legitimacy.

HypnoBirthing got its start in the late 1980s, when Marie Mongan, a New Hampshire hypnotherapist, developed the technique.

When labor starts, some women become so fearful of the next contraction that their worries trigger the fight-or-flight reflex. Grantly Dick-Read, an English obstetrician and pioneer of natural childbirth, called this the fear-tension-pain cycle. In his 1933 book, "Childbirth Without Fear," Dick-Read wrote that fear diverts blood to the large muscle groups needed for fleeing. If this occurs during labor, the uterus is deprived of blood flow, causing more cramping -- and more pain.

If women could remain calm, Dick-Read said, they would experience less pain -- and a shorter, more peaceful labor.

Building on the theory, Mongan began using hypnosis to prepare women for labor. Her book, "HypnoBirthing: The Mongan Method" (HCI, $19.95, 326 pages), is now in its third printing.

"When a woman eliminates fear, her body can work like it's supposed to," said Sharon Burt, a Portland HypnoBirthing instructor. "The more relaxed their bodies are, the more naturally the birth process will happen."

Burt teaches a five-week course at a small Southeast Portland office called HypnoBirthing Northwest. It includes materials and a CD for exercises the mother and her companion can practice until the baby is born.

"Birthing is a positive experience, and we want the mother to feel that way," said Burt, a mother and grandmother who said she was "knocked out" for the births of her two children in the 1960s.

The method even uses new language to describe childbirth. Contractions are "surges." Pain is "sensation," and pushing is "birth breathing." Its popularity is spreading due, in part, to the Internet; instructors are now trained in 22 countries.

"In our culture, we have a fear of the pain of labor, and the process isn't necessarily something we look forward to," said Deirdre Brown, a family practice physician in Portland who is expecting her first child. "This approach is helping me to reframe the whole process," she said.

Brown attends Burt's course with her husband, JD, who will guide her in relaxation during labor. The Browns, along with Bekleyen, her husband, Taner Bekleyen, and two other couples, lean back into couches as they listen to Burt's calming cues. Burt, a petite blonde, has a voice so soft and soothing, she sounds as if she is reading a bedtime story.

"Feel all the tension drain out of the bottoms of your feet," Burt tells the group.

When Bekleyen first spoke about HypnoBirthing to her friends, they scoffed. She lived in San Diego at the time and was surrounded by a decidedly un-earthy crowd. "Look, I wear makeup. People were shocked when I said I was going to do this."

But she did -- and succeeded, despite the protestations of even her family. "My mom said, 'Why are you doing what we did in the countryside 100 years ago? We live in the modern world now.' "

The courses, she said, showed her a different way to think about herself. Single at the time of her son's peaceful birth, she realized she was "capable and strong," Bekleyen said.

Tamara Medley, an obstetrician-gynecologist in Grants Pass, said she also appreciated the technique for that reason. Medley, a mother of three, took a course in labor hypnosis during her last pregnancy. It taught her some useful relaxation methods, she said.

"At night, when you're pregnant, so many of us lie in bed and wonder, 'How am I going to do all of this?' The tapes from the class really help give you ways to think positively about yourself, your pregnancy and the baby," she said.

But they do not always eliminate the pain of delivery, she said. "For most women, childbirth is painful," Medley said. "Sometimes women who've been to HypnoBirthing classes feel confused by what they experience during active labor -- especially if they've been told that their contractions aren't supposed to hurt. They think something is wrong if they start feeling pain. They get scared."

"I wish HypnoBirthing said, 'It's normal to experience pain, but you're still going to be OK,' " Medley said.

Reva Wittenberg, a public health coordinator in Olympia, took HypnoBirthing classes in preparation for her older daughter's birth two years ago. She said the pain she experienced took her by surprise.

Videos of women using the technique show them so relaxed during active labor, they appear to be in a deep slumber. "That was so not me," said Wittenberg, 33. "I am not one of those ladies who just dreams through birthing."

Once her fast, intense labor started, all plans to relax "went out the window," Wittenberg said. They were replaced by what she called "major expletives."

Still, her HypnoBirthing instructor was not discouraged by the news, she said. "She told me, 'You have no idea how much it helped you, early on.' And she was right -- it was helpful for me to remind myself that my body was strong and healthy."

"I'd still recommend it," Wittenberg said. "The more tools you have going in, the better. If labor were so easy, would it be such a big deal?"

Gabrielle Glaser: 503-221-8271; gabrielleglaser@news.oregonian.com