If you're nervous about giving birth, hypnotherapist Maggie Howell has some suggestions about how to get you to see things differently

For so many women, birth has become an event to be feared. We read one horror story after another, women you meet are desperate to tell you their story in such graphic detail and even the antenatal classes are filled with so much 'what can go wrong' information. The media is full of scare stories that can influence a pregnant woman's mind before her baby is even the size of a pea.

How does fear affect the birth?

Bear with me here, but imagine a woman going into labour in the jungle. Suppose she saw or even thought she saw a tiger lurking in the shadows. What do you think would happen? Would she have a conscious choice on what happens next?

She may think she could control the situation, but her body would already have made the decision. Simply believing there is danger in her birth space would instantly stimulate a healthy 'fight or flight' mechanism. Labour contractions would slow down or stop and would not resume until she felt safe.

The fear would activate the nervous system to produce adrenalin, giving her the power to prepare to fight or run away. Her cervix would tighten to prevent her baby from being born in an unsafe environment and the increased level of adrenalin would neutralise the oxytocin (the hormone responsible for stimulating the uterus to contract) and endorphins (painkilling hormone), naturally slowing her body down or even stopping the birth.

Experiencing fear during labour also increases the heart rate, creates shallow, fast breathing (so reducing oxygen in the body for mum and baby), raises blood pressure and directs blood from the uterus (and the baby) to the limbs, preparing them for action. All this 'fight or flight' preparation uses a great deal of energy and staying in this state for prolonged periods of time is extremely draining for a woman in labour.

You may be asking, 'So what does a woman giving birth in a jungle have to do with me?' This is essentially about fear, fear of pain, fear of dying, fear of tearing, fear of losing control. A woman's nervous system does not know the difference between real or imagined danger and so will respond in the same way to both. Have you ever felt the rush of adrenalin and fear when watching a horror movie? Is the threat real or imagined?

If you go into the birth feeling frightened your system will respond accordingly. This subsequently makes contractions more painful, in the same way that if you tense up when you are in pain, the pain becomes far greater. While there is fear or anxiety in childbirth, a woman's body will not be allowed to flow easily through the natural progression of labour.

In addition, the minute you introduce artificial hormones from induction or augmentation, the body stops producing the right amount of natural hormones, including the wonderfully powerful endorphins or natural painkillers.

How does being relaxed and calm make a difference?

By being relaxed during labour, a woman's body responds in a very different way to the fear scenario described above. When she is relaxed, her breathing is even and rhythmical, ensuring a high level of oxygen is entering her body. This oxygen goes through to her baby, ensuring that it remains calm and stable. Increased oxygen stimulates the production of oxytocin (the hormone responsible for contraction) and endorphins.

Her blood pressure remains at a healthy level, and as her body is soft and relaxed she conserves her energy, with all excess energy being channelled through to the muscles that are really working hard, namely her uterus. As the uterus has no resistance or tension from surrounding muscles, the contractions are more effective and more comfortable.

As the labour progresses unhindered by artificial hormones, other natural hormones kick in which allow the cells of the birth canal to relax, soften and stretch, so making the babies descent easier and more comfortable.

How does Hypnosis work?

Hypnosis is a natural state, which we all experience many times a day. It is a time when your conscious (analytical, rational) mind takes a step back and your subconscious (feelings, memories, emotions) come to the forefront. For example, when you are daydreaming or reading a book and realising you have read the same line over and over again.

With intended hypnosis, you purposefully take yourself into a daydream-like state using music, soothing images or guided visualisation. Once the critical and analytical part of your mind relaxes, you become more receptive to positive suggestions and affirmations. As the mind does not know the difference between imagination and reality, the more times you give yourself positive suggestions, the more real they become.

Does hypnotherapy offer a pain-free birth?

Is it possible to have a pain free birth? Some women do say that their experience was pain-free. However, hypnotherapy does not guarantee that a woman will have a pain-free experience. It would be incorrect and quite detrimental to lead women into believing that birth will be pain-free. You should be prepared to feel really powerful sensations and hand control over to your birthing body.

By preparing for these powerful sensations by building trust in your body's ability and reducing the fear, tension and anxiety around birth, hypnotherapy helps you feel more in control and far more able to cope with, and accept, the sensations that you are feeling.

What hypnotherapy options are available to me?

• One-to-one hypnotherapy sessions
• Group hypnotherapy sessions
• Audio hypnotherapy, using CDs

Hypnotherapy sessions

If you would like to see a hypnotherapist we recommend that you see a qualified clinical hypnotherapist. Many general practitioners can refer you to a clinical hypnotherapist registered with the NHS, or you can see who is in your area by going to The Hypnotherapy Association website

I suggest you speak to a few hypnotherapists over the phone then decide who you wish to meet. Most will give a free consultation for around 30 minutes to allow you to see them and help you to decide for yourself if you want to work with them.

There are group hypnotherapy sessions available from Natal Hypnotherapy where you will:

• Learn the principles of hypnosis
• Find out what hypnosis is and what it is not
• Experience being hypnotised
• Discover how to enter deep relaxation in seconds
• Learn how to safely and easily take yourself in and out of hypnosis
• Learn how to write successful programmes to make the changes you want
• Learn how to use more successful language with yourself and others
• Have fun and meet others who have benefited from hypnosis

Teaching is limited to groups of no more than 15 so that your progress through the course can be monitored on an individual level. For further information, visit www.natalhypnotherapy.co.uk

Audio hypnotherapy

Self-hypnosis CDs guide you into a deeply-relaxed state using breathing techniques, guided imagery and visualisation. Once you are in a relaxing daydream-like state, the CD continues with a detailed visualisation of giving birth from a physiological perspective so you can practice how you would like to feel and respond to the sensations and changes during labour.

The CD also includes triggers such as 'each new face you meet, reminds you of the confidence you have in your body, each contraction encourages you to relax, the sights and sounds around you float past and allow you to remain wonderfully calm.' This way you are using things that may otherwise have caused you some anxiety and turning them into something positive and useful.

By listening to the CD over and over again before labour your body and mind become more and more familiar with the processes of a calm, relaxed birth, so increasing your confidence and reducing a lot of anxiety.

As your mind does not know the difference between imagination and reality, once you go into the labour for real, all the suggestions just kick in as the body recognises the sensations and triggers and says 'Oh yes, we have done this before, this is a sign for me to relax and stay calm.'

Maggie Howell, d.Hyp, c.Hyp, LHA, UKHypReg, is the founder of Natal Hypnotherapy, a qualified British clinical hypnotherapist and trained Doula.