Hypnobirthing, Pregnancy & Maternal Mortality in the US: the Scoop- by Dr. Eeks

About a year ago, I received a call from an anxious woman who said, “I’m going into labor next week and one of the speakers in my ZENBand broke. Please, can you send me a new set of speakers ASAP, as I want to wear the band while in labor!”

My first thought was, “Why would you wear a ZENBand during birth?” I was puzzled, because I never associated ZENBands with birth. To me, it was a tool for reducing stress and anxiety. Then again, birth can be anxious…

The woman on the phone went on to explain that she practiced hypnobirthing, a term I wasn’t familiar with at the time. She said she used the ZENBand during her hypnobirthing sessions and needed to wear it while she was in labor. I didn’t want to keep her on the phone, so I jotted down “hypnobirthing” as a reminder to research it later. Of course, I sent her out an extra pair of speakers that afternoon.

That phone call was my introduction to hypnobirthing.  Through research and conversations with hypnobirthing practitioners, I learned that hypnobirthing was founded by Marie Mongan, a certified hypnotherapist, hypno-anesthesiologist, and instructor of hypnotherapy.  She is the mother of four children, and the inspiration behind hypnobirthing comes from her own birthing experiences. The crux of the hypnobirthing philosophy is, “the belief that every woman has within her the power to call upon natural maternal instinct to birth her babies in joy and comfort, in a manner that most mirrors nature.”  Practitioners told me that hypnobirthing helps pregnant women view birth in a positive way, rather than a fearful or negative way, by using visualization exercises, self-hypnosis and relaxation skills.

I became intrigued by hypnobirthing, because I live in the United States, and though we don’t talk about it much, the US has the highest maternal mortality rate of all developed nations. The US is the wealthiest country, yet our maternal mortality rate is higher than many poor countries. When it comes to lowest maternal mortality rates, the US ranks 46 out of 184 countries.  Our rate is twice as high as Canada, and US women are four times as likely to die in pregnancy or childbirth as women in Greece or Poland.  Worse yet, our rate isn’t getting better with time. It’s getting worse. A 2016 analysis showed that the maternal mortality rate increased by 27% in 48 states, especially among African American women. The fact that the US claims to have the most sophisticated health system in the world yet the highest maternal mortality rate of all developed nations isn’t just ironic, it’s flat-out embarrassing.

The suspected causes are varied. Poor women have a higher maternal mortality rate than rich women, which could be due to lack of insurance and/or access to quality care. Some doctors have mentioned clinical complications from obesity, such as cardiovascular problems and diabetes. Others blame the “medicalization” of a natural process for the increased rate. Developed countries that rely more on their midwives, like the UK, have better rates. Others are simply in the dark and puzzled by the high rate.  I don’t think hypnobirthing can reverse our dismal maternal mortality rate, but I am interested in any method or practice that seemingly makes birth easier, more natural and less fearful.

Currently hypnobirthing is more popular abroad, especially in the UK. It seemed to gain in popularity after Princess Kate expressed interest in hypnobirthing during her pregnancy. The UK also has a much more established midwifery program than the US, and usually midwives are more aware of alternative birthing/prenatal practices than medical doctors who follow strict standards of care and perpetually fear lawsuits. Home births and water births are also more popular in the UK, and several NHS trusts have even incorporated hypnobirthing training as a standard prenatal class. I think hypnobirthing will become more popular in the US as more and more people continue to become interested in natural wellness, mindfulness and alternative approaches to health.

I chatted with Dr. Marion Lacombe, a board-certified obstetrician and gynecologist in Florida who owns and operates Essence Ob/Gyn.  First, I must say that I talk to a lot of doctors daily, and this woman stands out- not only for her knowledge but for her ability to think outside the box. Dr. Lacombe told me that she first heard of hypnobirthing from two of her pregnant patients who did exceptionally well during labor. One didn’t even request any medication. Dr. Lacombe asked the patients what seemed to make the process easier, and they both mentioned hypnobirthing. She then researched hypnobirthing on her own, attended classes and began recommending it to her patients. Her patients that practice hypnobirthing have “less difficulty” and “more normal” births. Now she requires her patients to take hypnobirthing classes. Dr. Lacombe also stressed the need for women to practice “and become obsessed” with what they learn in the hypnobirthing classes in order for it to be maximally effective during birth. As long as the woman’s health status allows for it, Dr. Lacombe tries to keep birth as natural and anxiety-free as possible.  I ended our chat by telling her that if I ever get pregnant, I’d like her to be my doctor.

The scientific body of evidence for hypnobirthing isn’t robust, but there are some noteworthy studies. I will mention randomized controlled trials (RCTs), since they are the “gold standard” of evidence.   A large randomized controlled trial was conducted in the UK and included 680 pregnant women divided into two groups. One group used hypnobirthing and the other group used routine care. Results showed that there was not a statistically significant difference between groups in regard to pain or requesting pain medication ( Odds Ratio = .89).  However, the group that used hypnobirthing had significantly lower levels of fear and anxiety. A much smaller RCT published in the Journal of Maternal and Child Health had a similar outcome: women using hypnobirthing had a significantly lower level of anxiety associated with pregnancy than women who did not.  Another small RCT out of Colorado involving 38 pregnant women showed that the women who practiced hypnobirthing perceived a greater ability to cope after their training than the women who did not use hypnobirthing. However, after birth, the hypnobirthing group perceived poorer intra-labor coping skills than the non-hypnobirthing group.

The anecdotal evidence for hypnobirthing is very strong. I get a lot of orders for ZENBands from women pregnant with their second and third child who swear by the technique. Hypnobirthing moms with blogs praise the technique in their posts. Furthermore, many hypnobirthing instructors have powerful personal testimonies on their websites from very happy clients. My opinion is, why not? First and foremost, hypnobirthing is safe. It’s not snake oil – It’s a tried and structured way to prepare your mind for birth in order to make the experience more positive, natural and less anxiety-provoking.  Anxiety in general is on the rise, and that includes prenatal anxiety. Prenatal anxiety and stress are linked to negative birth outcomes. If hypnobirthing can help a woman alleviate some of that anxiety and stress, it’s definitely worth trying.










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