My emergency C-section felt special
The birth of her daughter was anything but ‘normal’, yet hypnobirthing kept Chloe Lambert calm, even as everything went wrong
On a cold, cloudy Saturday morning last December, my daughter was born. All things considered, it wasn’t the most fun of evenings – ending, as dawn broke after three days in hospital, in an emergency caesarean section. Holding my sleeping baby in my arms, her tiny chest rising and falling against mine, I was wheeled out of the theatre, exhausted, bruised, but so happy I thought my heart would burst. We stopped for a moment next to a room that looked familiar. It was the midwife-led suite, where my husband and I had hoped to have a natural birth, avoiding interventions such as an epidural if possible and managing the pain using gas and air, along with hypnobirthing – visualisation techniques we had learned to reduce fear and anxiety during labour.
We looked down at my current state – anaesthetised from the waist down, catheterised, and a 10cm wound across my stomach – and in our delirious daze, couldn’t help but share a grim laugh. So much for that idea! Last month, it was noticed that the Royal College of Midwives had quietly dropped the campaign for “normal births”, which had run since 2005, with Professor Cathy Warwick, the former chief executive, conceding that it had made some women who needed interventions – such as an epidural or C-section – feel like failures.
Unfortunately, she’s right, as shown by the many women who’ve been prompted to share their unhappy birth stories by the ensuing debate. I know several who went through long, painful and traumatising labours because they felt pressure to go without an epidural (or were denied it when they did ask). And though things have improved, there are still remnants of a rather unsisterly stigma around C-sections – a week after my daughter was born, a family friend gazed down at her and said: “They’re so docile, caesarean babies. She probably doesn’t even know she’s been born.” She was well meaning but in my fragile state, it stung.
My birth was anything but “normal” – and nothing like what we’d planned – but rather than a failure, it was a positive experience I look back on with pride. That was largely down to the fantastic care we received at Kings College NHS Hospital, but also, I believe, because we did hypnobirthing. You’d think that our classes would have been long forgotten in the circumstances, but we discovered that the techniques can help in all kinds of deliveries. They’re possibly even more useful when things don’t go to plan – and frankly, that seems to be pretty often.
Thirty years ago, 10 per cent of births were carried out by caesarean section; today, one in four pregnant women will give birth this way. This is partly due to the procedure becoming safer – and so, more likely to be recommended when complications arise – but is also thought to be a result of obesity and women having children later in life.
Hypnobirthing teaches you visualisations and breathing techniques to reduce fear and anxiety – a sort of sports psychology for labour. Demand is soaring, and increasing numbers of NHS trusts are training midwives in it and offering classes; privately, a course typically costs from £200 to £400 per couple.
Evidence has shown that feeling frightened and anxious during childbirth can prolong labour and increase the need for pain relief. According to proponents of hypnobirthing, if a mother is in a calm state of mind, she produces hormones that act as natural painkillers, and help make labour swifter and more comfortable.
The name gives it an unfortunate air of pseudoscience, and I received a fair amount of ribbing from friends and colleagues when I announced I wanted to give it a try. However, hypnobirthing is not hypnosis, but rather mindfulness, building confidence and positive thinking.
The evidence for hypnobirthing is mixed; some studies, including one by Wolverhampton NHS Trust, have found women who practise it are less likely to require analgesia, interventions or caesarean sections. A three-year study of 680 women from three hospitals in the North West, however, found that hypnobirthing made only a minor difference to the use of pain relief during labour, although it did have a significant impact on anxiety and fear about childbirth.
During the two-day course I
attended with my husband Felipe, there was an in-depth discussion about the practicalities of birth and the choices available to us. There were about a dozen couples there, and many, like us, had chosen to do hypnobirthing as an alternative to NCT classes.
Along with a detailed run-through of how labour works, our trainer Katharine Graves taught us simple visualisations to practise during pregnancy and in the different stages of labour. I was relieved to find the classes free of happy clappy-ness and instead a very practical focus on instilling the benefits of relaxation. If nothing else, it was a fantastic sleep aid – listening to the CD we were given in bed at night, we were both out like a light.
There was certainly a focus on natural birth – perhaps an unrealistic one – but we were also reminded to expect the unexpected and encouraged to make informed, autonomous decisions. So when the unexpected happened, hypnobirthing meant we were better equipped to cope.
I had had a very smooth, happy pregnancy and was considered “low-risk”, but during a routine check-up at 39 weeks, my bump was found to be measuring slightly small – a sign the baby’s growth might be tailing off. I was referred to hospital for a scan, and doctors there recommended that I be induced.
I couldn’t hide my disappointment. I’d spent months imagining my birth would begin at home, with lots of warm baths and comedy DVDS (laughter gets the oxytocin going, supposedly). Instead, I was admitted to hospital and spent a sleepless first night on a noisy induction bay.
However, throughout the entire process – various, uncomfortable induction procedures, including having my waters broken, two days of on and off contractions and then the shock of an unplanned C-section after the baby began to show signs of distress – I kept going back to the visualisations I had learned.
I know that in many ways we were lucky. Although the caesarean section was not planned, it was performed early in labour, we were able to have time to mentally prepare for it, and the operation was uncomplicated and over in 20 minutes.
We asked to have our favourite music playing during the operation, and to have the baby placed on my chest, skin to skin, as soon as possible. Throughout, Felipe was right next to me, helping me to breathe calmly. Small things that helped it all feel gentle, special and a bit more “normal”.
“You might think hypnobirthing would be redundant in women who have an epidural or a caesarean section, but it’s still very useful, in helping to stay calm throughout the procedure and the run up to it,” says Pat O’brien, senior lecturer in obstetrics and gynaecology at University College London Hospitals and a spokesperson for the Royal College of Obstetricians and Gynaecologists. “Who knows whether it can have physiological effects, too. But we do know that adrenalin reduces contractions so, theoretically, the more relaxed a woman is, the less adrenalin, and the more effective the contractions will be.”
Colchester NHS Trust was one of the first to start offering hypnobirthing classes free to all parents, and Teri Gavin-jones, a specialist midwife and trainer, now travels around the country teaching the principles to midwives and even doctors.
“When we first started offering it we felt it would only suit a certain percentage of women, but then we realised relaxation techniques are for all births,” she says. “It’s good antenatally – if a woman is relaxed it helps to lower her blood pressure and heart rate, which impacts on the environment the baby is growing in. And in all our classes, we remind women that the relaxation techniques can be used in theatre as well as the birthing room.
“Of course, if a caesarean section is needed we will proceed with all drugs needed to anaesthetise the woman, but if she can maintain her breathing and minimise adrenalin that means more oxygen is going to the baby and again it’s a better environment for the baby. Mothers tell me they felt involved in the birth and welcomed their child happily.”
I had wanted a natural birth, and still believe it is the ideal scenario if it’s possible. It took six weeks to recover from the operation – not easy with a newborn baby to care for. But above all, I was simply grateful to modern medicine for bringing our daughter to us safely. It was only when she was carried into my arms, and she looked right into my eyes with a strange longing, that I let it all out, sobbing and wailing at the pure relief and the rush of love. It had been a long, dark night, but there she was – a girl! – and I felt I’d known her all my life; that everything was just as it should be.
‘The name gives it an unfortunate air of pseudoscience, but it’s not hypnosis’