The power of the mind...

[porcelina]

I just had an appointment with the midwife yesterday (one of many at my birth center). She started in with the argument that the mind is a very powerful thing. If you believe and visualize that you will have a fast and easy birth, then you can influence your experience. If you believe you will have a difficult birth and/or are mired in fear, you can have a negative experience.

I have such a hard time with this way of thinking. I had such a difficult first birth given the occiput posterior position my DS was in. From what I have gleamed from this forum, many women with this presentation also had very difficult experiences. Furthermore, there are cases in which the pelvis is malpositioned, or baby malpositioned in some other way, and it really does make for difficult labor. Somehow I feel like you are setting yourself up for failure if all you do is try to convince yourself that you will have a fast and easy labor. Sure, maybe in some cases, it will help, but in an equal number of cases, I think you will just feel like a failure and more traumatized if it didn't turn out the way you "visualized."

This is similar to the argument that birth doesn't have to be painful. Sure, for some women, whose babies are positioned just right, and for whom conditions are all in their favor, I buy that birth can be non-painful or even orgasmic. But, I think there are also many cases where birthing just downright hurts. If you believe that you can do it without pain, and then have pain, you will, once again, feel like a failure.

Doesn't it make sense to try to prepare for both pain and non-pain, easy and difficult, fast and long? Techniques to let go of the pain, relax, etc.?

[echospiritwarrior]

I have had two very fast births very much the way I visualized. In fact, while pg with #2 I told the MW that assists mine that I wouldn't mind to have a slightly longer labor so that I could enjoy it a little more (having a first baby within 2 hours of realizing I might be in labor and 10 minutes after MW arrived wasn't exactly my idea of calm) and that MW told me to be careful what I asked for. #2 was born in about the same amount of time, but I was much calmer since I had mentally prepared myself that things could happen crazy fast again.

Both times I kept my desired experience in the foreground but I did make mental preparations for "whatever" since nothing in live is guaranteed. Were I to have had an eight or twelve or even twenty-four hour labor I do not think I would be disappointed but I also doubt it would have been the crazy "DH-get-up-ctx-right-on-top-of-one-another-roller-coaster-no-time-for-help" experiences I feel I have experienced. I wouldn't have been "disappointed" unless I had to go for surgical birth (and even then I keep that in mind as a SMALL possibility and would seek help in coping with my feelings).

I think it's good to have a plan and to visualize but also realize that anything goes.

[*MamaJen*]

It's pretty interesting if you look at the role of stress hormones like cortisol on the amount of pain you feel. I think that if a woman goes into birth feeling terrified of the pain that she expects is coming, she will likely perceive more pain. If you go into birth feeling safe, calm and relaxed, you will likely perceive less pain.
That's true in a lot of situations, not just birth. If you psych yourself up to think that something is going to really hurt, then it probably will. If you choose the perception that it won't be that bad and you can totally handle it, you likely can. I mean, obviously that wouldn't work for, like, a really catastrophic injury, but for milder kinds of pain, I think it holds true.
For sure, some childbirths just suck. The baby might be badly positioned or something. There's no shame in having a really difficult labor. You can also tell yourself, if the pain gets to X unbearable point, I will go in for an epidural. As long as the pain is manageable, I will labor calmly and without fear.
I think a good rule of thumb would be to go into it calm, and be prepared for an arduous labor, but not expecting it. Kind of the same way you would feel if you were about to run a marathon.

[CI Mama]

I share this struggle with you. I had a difficult labor & delivery with my DD and am still sorting out whether a failure of "visualization" had something to do with my experience (and eventual c-section). I used positive mantras and chanting as a way of handling pain and fear through much of my labor, but "thinking positive" was not enough to prevent my c-section. On the other hand, those strategies served me well in terms of staying present and mindful each step of the way, so in a way I did get the experience I wanted.

I agree that it's not helpful to approach anything in life from a state of paralyzing fear. Fear closes us up, whereas an open mind can respond to all kinds of experiences and is flexible in responding to changing information & circumstances. So I would say that if visualization or some other mental technique helps you stay open, then it's a helpful technique.

But I also know that for me, something that seems positive can also become a trap. My mind is not completely within my control. It takes a lot of wisdom for me not to turn a positive process of visualization into a form of magical thinking (and later, a stick with which to beat myself up when things don't turn out the way I think they ought to have). If your midwife's "argument" about the power of the mind is stressing you out, then maybe that perspective is not helpful to you!

Women who experience pain in labor or who have difficult experiences are not weak-minded. There is real wisdom in knowing how to prepare for the birth that you want to have and in knowing when to surrender to the birth that you are having.

[rparker]

Originally Posted by *MamaJen*

It's pretty interesting if you look at the role of stress hormones like cortisol on the amount of pain you feel. I think that if a woman goes into birth feeling terrified of the pain that she expects is coming, she will likely perceive more pain. If you go into birth feeling safe, calm and relaxed, you will likely perceive less pain.

I think that this mindset would be even more important in the case of a difficult birth/poorly positioned baby. If you go into labor calm and unafraid I think that you're likely to experience less pain in a bad situation than if you were tense and afraid before the first contraction. A positive mindset isn't a guarantee that birth will be fast, easy, or pain-free, but a negative mindset will set you up for pain even under the most auspicious circumstances.

I also don't think that having a positive outlook is setting yourself up for disappointment and/or feeling like a failure if your birth ends up being more difficult than what is statistically normal. If you are calm and relaxed and still experiencing painful contractions that can serve as a cue that something isn't quite right and needs to change for birth to progress. It still sucks and isn't the same kind of experience other women with the same mindset but more optimal conditions will have, but that doesn't mean that it's "wrong" or "failing"... it just means that you have to work harder to achieve the same end result. If anything I think that if you go into birth calm and unafraid and still end up having to cope with a difficult labor you should feel proud and like more of a success than if your birth experience had been super easy and/or orgasmic.

If you know that the pain isn't the result of fear/stress you can realistically view it as your body having done what it needed to do to try to birth your baby in the safest way possible. Pain is demonized but it has a very real and necessary physiological function: it's the body's way of alerting us when something is wrong. It is "natural" for childbirth to sometimes go wrong. Pain can be the first clue to the mother and her birth attendants that outside intervention may be fully warranted in order to save the baby or mother's life. You wouldn't feel like a failure if you touched a hot stove and it hurt, right? Sometimes pain saves us from real injury. It's unfortunate that modern obstetrics has made the majority of women so mistrustful of their bodies that pain is viewed as the norm and every birth is seen as something that the mother needs to be rescued from

[dianakaye]

I've only birthed once, and I wasn't as prepared as I would have liked. DS was posterior, labor was over 24 hours and pushing was 2 hours.

Next time I plan to hope for the best and prepare for the "worst". I think you should spend most of your time visualizing a nice, easy birth, but there is nothing wrong with being prepared.

Think of it this way- if you prepare for an easy birth and are surprised with a hard one, what will be the consequences? If you prepare for a hard birth and get an easy one, what will be the consequences?

Again, I'm going to spend a lot of my time visualizing a great labor and delivery, but that won't stop me from having a back up plan in case I don't get what I want!

[prothyraia]

I think the key is to expect a 'good' birth (whatever that means to you) and also manage not be too attached to that expectation. It's a really tricky attitude to manage, but I think it's the healthiest.

This is the best way I can explain it: I have a job that has the potential to be really ugly, or pretty relaxing and almost boring. When I head off to work, I expect to have a relatively calm day. Most of the time, that's the case. Every once in awhile, my expectation turns out to be wrong and I have an awful, stressful, draining day; that's life, and I don't feel like I failed, or was wrong, or should be embarrassed because it took me by surprise.

Now, I could go off to work expecting an awful day, and in that case I would almost certainly have one most every day (or at least be stressed out waiting for the @#$% to hit the fan). And that's not helpful.

A positive attitude/expectation opens up the possibility that you will have a pleasant experience, but it's not enough in and of itself to make it happen. Nothing is!

[JessicaS]

Originally Posted by prothyraia

I think the key is to expect a 'good' birth (whatever that means to you) and also manage not be too attached to that expectation. It's a really tricky attitude to manage, but I think it's the healthiest.

This is the best way I can explain it: I have a job that has the potential to be really ugly, or pretty relaxing and almost boring. When I head off to work, I expect to have a relatively calm day. Most of the time, that's the case. Every once in awhile, my expectation turns out to be wrong and I have an awful, stressful, draining day; that's life, and I don't feel like I failed, or was wrong, or should be embarrassed because it took me by surprise.

Now, I could go off to work expecting an awful day, and in that case I would almost certainly have one most every day (or at least be stressed out waiting for the @#$% to hit the fan). And that's not helpful.

A positive attitude/expectation opens up the possibility that you will have a pleasant experience, but it's not enough in and of itself to make it happen. Nothing is!

I agree pretty much.

Of course relaxation techniques help a great deal but it isn't a guarantee against any complications.

[cappuccinosmom]

I can only go on my experience.

I have had two births that were very much alike, almost freakily so. Same gestation, same situation with unpleasant doctors, hospital births, etc. IOW, emotionally pretty high stress with a lot of people putting pressure on me and trying to scare me into doing things there way. Both were also short, intense labors.

One of them was intense but not painful in the way you normally think of pain. Hard work, etc. But I was not hurting.

The one after that hurt like heck, even after I'd had the confidence-building successful and "easy" birth previous.

I don't think that pain was all in my head, or even all in my hormones.

[jenrett]

I've never given birth, but I have done a lot of other difficult physical tasks that I think we can learn something from.

I don't think that pain is 100% in your head, but I do believe that it is 90% in your head, and that your mind has more control over your body than most people think it does. The best example of this that I have, personally, is my first Ironman (2.4 mile swim, 112 mile bike, 26.2 mile run). I spent 9-10 months preparing for the Ironman, and I had a goal. The entire time, when I thought about the race, I visualized myself finishing each leg of the triathlon at a certain time. When race day came, I finished the swim EXACTLY on time. I was 7 minutes late off the bike, and I finished the entire race 22 minutes behind schedule. That's only 3% behind my projected finish time.

What does this have to do with birth? Everything. I believe that the OP's midwife is correct in that your mind has incredible control over your body. Yes, there are times when things happen that are out of our control - we have a posterior baby, baby gets stuck, in a bad position, etc. However, for the vast majority of women and babies, birth is normal, and if we spend our time visualizing a fast (if we want it), easy birth, we will have a fast, easy birth. If we spend our time in fear because it's going to hurt, and we have bad images about what's going to happen, then, more than likely, you are going to have a bad experience.

I have no proof for this, though people have done studies in sports science on visualization and success. Winners know they're going to win before the race starts...that type of thing.

But, I also agree, that if you feel like visualization doesn't work for you, don't do it. In my opinion, it's your loss, but you need to do whatever you need to do to prepare yourself the best for your birth.

Good luck!

[47chromosomes]

My midwife's first baby had a nuchal hand, and she said she spent her second pregnancy "talking" to her baby about the importance of having hands down during birth. Indeed her second child was born with hands directly down to her sides, and they remained that way whenever the baby was asleep for the first weeks of life. I DO think there are very powerful connections between birth and the power of visualization. That said...

My second birth was a posterior, acynclitic baby at home. The baby was in a poor position for the last weeks of my pregnancy, and you can bet I was "talking" to our baby about better positioning. I was visualizing it. I was crawling all around the house on my hands and knees, and reading everything I could about how babies find their way to a good position in labor. That, and making frantic trips to the chiropractor. I was doing everything right. And, that birth sucked. He NEVER settled in to a correct position by himself. We (meaning my amazing midwives) had to eventually (after 22 hours) break my water and with one hand inside and one hand palpating my belly, put him in a correct position. Of course he almost immediately crowned after that! It was especially difficult in light of my easy first birth, which incidentally I went in to with both the belief that vaginal birth was indeed possible for me, but with the knowledge in the back of my mind that my mom had c-sections for a weirdly shaped pelvis, which incidentally I also have inherited. I knew I would be better off with a supportive birth team, no epidural, and the freedom to birth in any position I like, but it was still in the back of my mind. Anyway, no power of the mind influenced the ease of that birth.

I think there is a fine line between visualizing and believing in your ability for an easy labor and also pondering the what-ifs, if you are the kind of person who needs to do that. I am that person, and I did not ponder what-ifs with my second baby. I assumed his birth would be even easier than the first, so after that crazy labor that was double the length (active labor was more like quadrupled the length), I felt traumatized for having gone through it. Traumatized by my home birth!

After processing and accepting what happened, it has become a positive experience to me in retrospect. But this time, I am preparing to surrender to whatever birth I have. I do hold close the idea that an easy labor is totally possible for me (because it IS--weird shaped pelvic opening and all), and I am "talking" to this baby about what position will help him or her come into this world in peace and ease. I am also considering how I will emotionally cope if things are not perfect. That was my fault last time--I had not visualized how I would cope in the event things were less than perfect. I think that, in and of itself, would help any labor happen more easily and peacefully, which is what I REALLY want. I want to receive this baby with peace and gratitude--no matter how it all goes down.

[at_the_hip]

You would probably benefit from reading "Birthing From Within". I really like their stance on pain, and our expectations of it in labor/birth. Not everyone will agree (when does everyone? lol), but I can say that half of my births were relatively easy although very long (with anterior babies) and the other half were extremely painful but shorter due to direct posterior position and births (baby didn't turn). While all of the births had good outcomes, they were not equal.

I have to be prepared that either could happen despite my desire for a less painful birth! I believe it was/is the shape of my pelvis and/or accident I had as a teenager that may cause this to be an issue...but while some births are 'easy' and 'intense but painless'...often if there is malposition involved or some other issue (stress can always play a part), the amount of pain and type of it can be very different and difficult. This can be traumatizing even without a bad outcome of any kind, and I think we need to be realistic to some degree that it is a possibility.

In the book BFW it also talks about how the women who often cope best with labor are those who face it with a 'healthy' amount of fear...enough to prepare their minds/hearts for what is to come, rather than dismissing it altogether and being surprised and unprepared for a difficult labor.

In any case mama, you and baby can work together to do what needs to be done. Sometimes this can be hard! Blessings to you for your labor & birth.

[Otterella]

I'm convinced I shaved HOURS off my labor by concentrating on visualizing the opening of my cervix through every contraction. But visualization isn't everything. I had discussions with my midwife beforehand about visualizing the closing of my cervix after the birth of the placenta to avoid PPH. This was at first very difficult for me, and I bled pretty badly. She reached up and pulled out gobs of clotted blood that was preventing my uterus from shrinking down and my cervix from closing. After that was cleared, I was easily able to visualize the process of closing down. So it works as a feedback loop. I do think there are some things that no amount of visualization are going to get you through, like repositioning a malpositioned baby, but by paying attention to the feedback your body is giving you from your visualizations, you can address problem physically by changing position or whatever you need to do.

[limette]

Originally Posted by prothyraia

I think the key is to expect a 'good' birth (whatever that means to you) and also manage not be too attached to that expectation. It's a really tricky attitude to manage, but I think it's the healthiest.

This is the best way I can explain it: I have a job that has the potential to be really ugly, or pretty relaxing and almost boring. When I head off to work, I expect to have a relatively calm day. Most of the time, that's the case. Every once in awhile, my expectation turns out to be wrong and I have an awful, stressful, draining day; that's life, and I don't feel like I failed, or was wrong, or should be embarrassed because it took me by surprise.

Now, I could go off to work expecting an awful day, and in that case I would almost certainly have one most every day (or at least be stressed out waiting for the @#$% to hit the fan). And that's not helpful.

A positive attitude/expectation opens up the possibility that you will have a pleasant experience, but it's not enough in and of itself to make it happen. Nothing is!

This is how I went in with both of my births. I expected/visualized/wished it to go the way I planned but had ideas on how to handle it if it didn't.

For the first this totally went out the window. It was horrible from the get go and I ended up transferring to the hospital, getting every drug possible (after being dosed with pitocin without consent) and c-section.

Birth number 2 was equally painful except I had a doula to keep me focused. I'm sure my vbac would have been another c-section if she hadn't been there.

Both were posterior babies.

[savithny]

I think mindset about labor is like skill at card games.

If you're a good Poker, or Bridge, or Euchre player you are more likely to win than if you're a bad one, right?

But the hand you're dealt is up to chance, you have no control over it, and some hands just cannot be winning ones.

So you practice, and study strategy, so you're prepare to make the best of the cards you're dealt. Some hands will be winners no matter who plays them. Some hands, skill is going to make the difference between winning and losing. And some hands, all you can do is mitigate your losses.

And there's no shame in losing when you're dealt a crap hand, as long as you know you were ready for it and did your best.

[St. Margaret]

Originally Posted by savithny

I think mindset about labor is like skill at card games.

If you're a good Poker, or Bridge, or Euchre player you are more likely to win than if you're a bad one, right?

But the hand you're dealt is up to chance, you have no control over it, and some hands just cannot be winning ones.

So you practice, and study strategy, so you're prepare to make the best of the cards you're dealt. Some hands will be winners no matter who plays them. Some hands, skill is going to make the difference between winning and losing. And some hands, all you can do is mitigate your losses.

And there's no shame in losing when you're dealt a crap hand, as long as you know you were ready for it and did your best.

Nice metaphor! Exactly.

I do believe that visualization can help prepare you, and can even help baby be in the right position. This is not to say that people with back labor did something wrong, but that it *can* *help*.

I did Hypnobabies so I was big on the visualizing a calm normal birth, and it worked wonders for me. But I did "cheat" and read Birthing from Within, too, and spent some time building that into my mind, too-- that I could be a warrior if I had to be. It all worked to help me feel strong and ready, and encouraged me to do the things I needed to do, like drinking my RRL tea and sitting in good positions ahead of time... so that was my experience. But if I end up with bad positioning or some emergency that necessitates a section, I'll be a strong woman and own it and roll with it. I was glad to have taken a class where we practiced a whole range of techniques so I could help overcome real pain, and I used some of that in transition a bit, as I worked my way down into hypnosis. I also found it VERY useful for the real discomfort of post birth pains.

[GuildJenn]

I'll be contrarian here.

I think a really good book to read on the topic is Barbara Ehrenreich's Bright Sided: How the Relentless Promotion of Positive Thinking has Undermined America. She takes a look at the research into the relationship of cancer and positive thinking has been really misrepresented, but how difficult it is for people to talk about it because they're treated as if then anything bad that happens to them after they express their doubts is their fault. (She is a breast cancer survivor herself.)

Anyways - it may well be that positive thinking has an impact on pain and stress. That makes sense: If you for example didn't know that you were giving birth and thought you were dying, it would probably have a big impact on how you managed that experience, the duration of the pain, etc.

But in terms of how a labour goes down it is just so much more complex than that.

I'm kind of an example. In both my labours, my early labour was close to painless (I'd say scarily so actually).

With my first child I went to the hospital about an hour after my first twinge of pain, and I was past 7 cm. With my second, I was having what I thought were mild Braxton-Hicks until I was bored enough to time them and found they were about 3 minutes apart - the admitting OB didn't think I was in labour at all until she did an exam and discovered I was at 8 cm.

I never really had a chance to visualize anything during that time. I can't even say I know what early labour is like. I had visualized listening to my music and using a birthing ball and stuff but - not.

From there each labour was really different. With my daughter (my first) I was actually almost high on excitement and "woman power" and pretty much not scared or anything - until I had been pushing for over an hour, at which point I did find it horrible and everything went downhill for the next three hours until she came out almost dead (and subsequently died). Until the very end of that labour I had no idea that anything was wrong. A negative outcome never even entered my mind, beyond "avoid a c-section."

This outcome was so far from my thoughts you can have no idea. I had imagined us doing everything for her whole life - I was so over the moon to have made it to the third trimester. Even when they told me she would at the very least have "learning difficulties" I was still so in deep denial that I completely misunderstood what they were talking about. And then of course, she ended up being resuscitated and eventually dying.

With my second, I assumed from the start that he would die. I didn't really want to but I pictured his baby funeral, checked on whether the plot next to my daughter's grave would be available, and planned for a worse birth. From the moment I walked into the hospital I was sure the vaginal delivery would be either impossible (c-section) or labourious. I had such visceral memories of where my daughter 'stuck' that even though she eventually did make it past that spot, I couldn't imagine a baby getting further down the canal.

It shocked the heck out of me when after one long nausea-creating transition pain, it took 4 contractions to push him out. He was such an easy, quick birth. We barely had time to let anyone know I was in labour. I'd say even I barely had time to figure out I was in labour (except for that one contraction which was - killer.)

So - yeah no, I don't believe much in it. I think if it gives people comfort, great. If it makes people feel guilty or bad, ugh. And if it allows birth professionals to essentially blame the victim for their experiences well then, that's not right. And sadly I have heard stories where women were berated for not being positive enough during labour.

[porcelina]

Wow, GuildJenn, what an intense and excruciating experience you have had. We lost a niece at 3 months and I know the grief must continue to be overwhelming.

Thank you so much all of you for your very thoughtful and insightful responses. So many of you have amazing points and experiences that really help me put things into perspective. It is so helpful to have these deep discussions with all of you.

[Quinalla]

For me, what worked was to go in thinking positively, but also prepared in case I did have a less-than-ideally positioned baby or one of the many complications that do happen, albeit rarely. The whole "Hope for the best, but prepare for the worst." attitude. I think the mind/attitude is more powerful than people give it credit for a lot of times, but I don't think the mind is all powerful. Physical facts will have a significant impact as well to be sure! So for me, I made sure I knew that there were things that could happen that really were unavoidable and I knew a lot of things that could be mitigated/avoided by various techniques and of course things that some doctors think of as routine that really don't help or sometimes hurt things. I made sure I had a complete picture, but I also made sure to try and focus on positive stories, thoughts, etc. as birth grew closer.

[Veritaserum]

Originally Posted by porcelina

Doesn't it make sense to try to prepare for both pain and non-pain, easy and difficult, fast and long? Techniques to let go of the pain, relax, etc.?

Maybe it does for you. If so, do that! For me, I couldn't imagine wanting to give birth naturally if I had to accept that it would be difficult and painful. The only way I could choose unmedicated childbirth was if I had ways to reduce (or possibly eliminate) pain. For that reason, hypnosis was a great fit for me. If you haven't read Birthing from Within by Pam England, you might want to. I've found it to be a good fit for women who prefer to prepare with a "birth hurts, but I'm strong" approach. I chucked it across the room because it was absolutely the wrong approach for me.

Hypnobabies isn't just positive thinking. I learned hypno-anesthesia techniques, which are also used by people who can't use pain medication for dental work and minor surgical procedures. I felt more confident because I didn't have to rely on "positive thinking" and "relaxing the right way". I certainly did stay positive about birth and did my best to relax, but I credit my comfort to the endorphins coursing through my veins.

I've given birth five times. Some of those births were easier than others. I used hypnosis with my last four (epidural with my first). My third baby's birth was the most difficult, due to complications. I do not feel like failure because her birth was painful. I recognize that I was dealt a difficult hand for that birth and I did the best job possible under the circumstances. I'm still very, very glad that I had my hypnosis training because it allowed me to stay calm and lucid during a very stressful time. I was also glad that my fourth and fifth babies' births were comfortable!

Originally Posted by prothyraia

A positive attitude/expectation opens up the possibility that you will have a pleasant experience, but it's not enough in and of itself to make it happen. Nothing is!

Originally Posted by savithny

And there's no shame in losing when you're dealt a crap hand, as long as you know you were ready for it and did your best.

I think the card game analogy is a good one.