Demystifying Mindfulness for Childbirth Educators
Hypnosis is Not Mindfulness - Mindfulness is Not Hypnosis
In the last few years mindfulness has become a buzz word in the world of childbirth education - and rightly so as it’s changing birth experiences and changing birth outcomes - and GentleBirth leading the way.
I decided to write this piece with childbirth educators in mind, to take a deeper look at the cultivation of mindfulness as an important (but regularly missing) element of childbirth and parenting preparation. I also wanted to attempt to demystify the concept of mindfulness and propose that adding mindfulness cultivation to your classes can have significant health benefits for the parents you work with (as well as being beneficial to you as a birth professional). Hopefully this information will help you and your clients gain a better understanding of the differences between hypnotic birth preparation and the use of mindfulness for pregnancy, birth and beyond.
Meditation changes activity in the brain - even more so in pregnancy.
There is a growing interest in mindfulness and meditation in the sports world, business world and also in the birth and parenting world. Emerging studies have demonstrated that meditation can rewire how the brain responds to stress. Compelling evidence reporting less depression, more emotional resilience as well improved confidence and psychological flexibility is leading birth professionals around the world to explore this simple but powerful tool in more depth. All GentleBirth Instructors are required to complete a 6 week mindfulness course as part of their certification process and having an ongoing practice is very much encouraged.
What is Mindfulness?
We should start off by clarifying that mindfulness is not a ‘technique’ or a birth ‘method’. It is so much more than just “being in the moment” during labor. It becomes a way of life, that with practice can infuse every aspect of your life and change your relationship with your inner and outer world. Mindfulness is often defined as being present on purpose without judgment. When you are being mindful you are fully engaged in the present moment using your breath, physical sensations and even challenging emotions to create more emotional balance in your life. Mindfulness takes a welcoming rather than avoiding approach to labor.
Parents can practice mindful breathing….walking…..eating…..brushing their teeth….even sitting at a red light is an opportunity to be present and mindful rather than being on autopilot (mindless). Mindfulness means maintaining a moment-by-moment awareness of feelings, thoughts, physical sensations, and the world around us. Mindfulness also involves acceptance, meaning that we pay attention to our thoughts and feelings without judging them—without believing, for instance, that there’s a “right” or “wrong” way to think or feel in a given moment (that includes believing that there is a “right” or “wrong” way to give birth. Acceptance says “ok so this is not what I wanted but the fact is this is what it is - so what decisions can I make from here?” Acceptance helps parents see things as they are, taking a pause…..going back to the breath and then making a rational choice about how to be with it".
Mindfulness does not mean you are always in a state of calm “zen-ness” and labor can be tough work. We can be feeling angry and pay mindful attention to that experience - being angry is not “wrong”. Difficult emotions experienced in pregnancy, birth and parenting can be held in a way that is helpful rather than hurtful with an understanding of the human condition.
Mindfulness is paying attention to our experience in a way that allows us to respond rather than react. Responding is mindful….reacting is what we do on autopilot as a habit of thought. The breath is ‘home’….a place that is always available to us even when we feel things are out of our control. Mindfulness uses all five senses as well as our thoughts and emotions. Birth preparation courses that include mindfulness means parents are learning how to be mindful of sound, breath, movement, thoughts, emotions, and other things. These short periods of paying attention on purpose change the brain structure in positive ways within weeks.
Comparing Mindfulness and Hypnotic Childbirth
There are certainly some similarities between mindfulness practice and hypnotic childbirth classes but a number of differences that we’ll explore in this article.
In Hypnobirthing/Hypnobabies the goal is to help moms enter into the trance state of hypnosis so positive suggestions can be given for birth. Initially moms are guided into that state by narrowing their focus of attention and using a progressive relaxation with their class Instructor, followed by home practice with an Mp3 or scripts that the birth partner reads. As mom enters the trance state (if she can be hypnotized) that initial state of focus is encouraged to drift to the background.
In contrast, mindfulness training helps parents use their conscious awareness throughout – they stay in that focused state. As the conscious mind drifts to the concerns of the day once mom becomes aware that she is no longer focused she simply brings her attention gently back to her anchor (breath, sensation etc). It is the continued and repeated focused attention of mindfulness that brings about neurological changes in the brain. The same positive brain changes are not seen when the mind is daydreaming (Hypnobirthing/Hypnobabies). Being mindful is not about sitting crosslegged in an incense filled room it’s about being human, living in the moment and realizing that we have more options than we may think in any moment, no matter what is happening and we can always choose how we respond.
Comparing the Intention and Focus of Hypnosis and Mindfulness
Hypnobirthing/Hypnobabies has a specific future goal and intention (an unmedicated birth). It is focused on what you learned about birth through culture family and friends and a desire to change past ‘bad programming’ to reach the desired goal of an unmedicated birth (note there is no “good” or “bad” in mindfulness).
Mindfulness is focused on only the present moment and is accepting of where you are now. Parents have the opportunity to notice patterns of negative thinking that they can now choose to interrupt or simply notice without engaging with the thought or feeling (“I’ll be screaming for the epidural” “I won’t be able to breastfeed”). In the practice of mindfulness there is no need to change/heal any ‘bad programming’ parents just start from where they are in this moment.
A specific birth experience is not the goal – but a way of being that is accepting of all ways of giving birth without judgment.
Through mindfulness we become less attached to a particular birth experience and accept ‘what is’. When events out of mom’s control occur such as the need for medical intervention mindfulness really comes into it’s own. A mindful approach is about letting go of resistance or avoidance. Ironically the more we attempt to control what we think about, or our feelings results in more stress. So on top of the difficult feelings of induction etc mom now has to deal with the experience itself.
With mindfulness meditation parents are learning how to be both receptive – open, relaxed, alert; and active – with the intention to stay with experience (not to change it) as it arises and passes by. By training parents in the cultivation of mindfulness - their ability to direct their focus intentionally towards what is actually happening moment by moment, they develop more understanding, and compassionate insight as their pregnancy, birth and parenting experience unfolds.
Mindfulness does not involve creating any kind of trance state or hypnosis – there is no goal of changing your beliefs but being ok with whatever is happening in this moment right now in your mind, body and the world around you. It is what it is.
Comparing Approaches to Pain and Pain Management
Mindfulness changes mom’s relationship to the pain sensations so that the experience of the pain is less all-absorbing and less likely to trigger negative emotional responses that intensify pain (fear…feelings of being out of control). Physical pain is increased with emotional pain so by ‘uncoupling’ the sensations from accompanying emotions reduces pain perception. Mindfulness practice tells the fear centers of the brain (Amygdala) to ‘stand down’ and so reduces negative emotions that increase pain. But we are not trying to avoid pain.
The mindfulness ‘side effect’ of pain reduction occurs by turning down the ‘volume’ of pain sensations in the primary somatosensory cortex seen in MRI scans. Meditation increases activity in regions of the brain related to the processing of emotion and of cognitive control (the areas where the sensations of pain are actually interpreted). These brain areas regulate the sensations of pain and give it ‘meaning’ before it becomes part of your conscious awareness. Mindfulness does not promote the avoidance of pain (including painful emotions or physical sensations) or distract the mind from it. The goal of hypnotic childbirth programs is to change the sensations of labor. However many women will experience more than discomfort during birth as well as uncomfortable emotions in those first intense weeks of parenthood. Mindfulness requires acceptance of the present moment and the sensations - acceptance doesn’t mean we have to like what’s going on but we accept the reality that “it is what it is”. No trance state is required for mindfulness. When pain is present in labor mindfulness helps mums stay in the moment with those sensations and avoids pain catastrophizing which reduces the need for medication.
When a mom is expecting labour to be painfree or without discomfort and that is not her reality having additional tools in her emotional coping toolkit is essential for the mother’s psychological wellbeing.
Mindfulness helps moms to experience the intense sensations of birth without feeling judged or a failure if they choose pain relief to help them have a positive experience - this is an ongoing concern with childbirth preparation programs that only use hypnosis as their coping strategy.
Mindfulness is Not a Relaxation Technique or a Breathing Technique.
This is a very common misconception. Mindfulness helps parents to notice when they are experiencing emotions and feelings, to stop and watch how they feel in our mind and our body, and to react differently than we may have in the past especially when it comes to fear or anger. It allows parents to ‘pause’ between the emotion and choose a better response rather than a reaction. Like a train on a journey with all of the railcars connected…each thought in the 'train of thought’ leads to another….we can choose to get on the train and follow a particular memory/thought/plan or choose to get off the train at any point. With mindfulness we are teaching parents that they are NOT the train…but the landscape that the train is moving through. A recent RCT comparing relaxation techniques to mindfulness has shown brain changes in the fear center of the brain in those participants practicing mindfulness - not relaxation techniques.
Hypnosis is the opposite to mindful attention and focus and is the state that women are told to expect through hypnosis. The mind wanders – it’s been doing that for as long as we’ve been living. As parents cultivate the practice of mindfulness the mind will wander too but we are consciously bringing our attention back to the breath, sensation or emotion….not away from it to distracting colors or visualizations. Mindfulness retrains the brain not to chase after the dramatic stories and thoughts that pass through the mind from the moment we awake until we sleep each night….. “I can’t believe she said that.” ….what if I have to be induced?”
Although breathing techniques are taught as part of Hypnobirthing/Hypnobabies and most childbirth prep courses mindfulness is not in itself a breathing ‘technique’. In mindfulness training, breathing is used as an anchor – a safe place that you can retreat to anytime by simply taking your attention to your breathing and noticing it just the way it is – without changing it.
The chief executives of some of the largest most dynamic organizations in the world such as Google run mindfulness courses for all of their employees – not to induce relaxation but to increase productivity and creativity in their employees – to give them a mental edge in a digital world. Author and mindfulness expert John Kabat Zinn takes this approach to mindful breathing - “So see if you can just feel yourself breathing… . Sit in an elevated and erect position that embodies dignity to meet this moment in its fullness with alertness… . Let’s see if we can feel the breath, not think about the breath … moving in and out of the body as if we were approaching a shy animal sunning itself on a tree stump in a clearing in a forest. We want to approach it gently.”
Making mindfulness an integral part of birth preparation gives parents the tools to mindfully acknowledge that each moment will pass (especially difficult experiences in pregnancy, birth and parenting). It can provide birth professionals with an opportunity to promote parent and infant mental health and wellbeing through childbirth education – a goal we all wish to achieve.
As the demand for mindful birth preparation and parenting increases so will the opportunities for birth professionals to provide these kinds of classes to families in their communities. GentleBirth is available as both an App and workshop format and combines mindfulness, hypnotic childbirth, sports psychology and CBT.
To Recap:
Repeated studies have demonstrated that meditation can rewire how the brain responds to stress. Mindfulness increases emotional stability and psychological flexibility. About 30 percent of women who have struggled with depression in the past relapse during pregnancy. A 2014 study reported that pregnant women with histories of depression who participated in Mindfulness Based Cognitive Therapy had a relapse rate of just 18 percent.
Mindfulness takes advantage of the increased maternal neuroplasticity of the brain in pregnancy.
Mindfulness includes mindful awareness of more than the breath, it includes mindful awareness of thoughts, emotions, sensations, sounds, movements etc.
Acceptance based coping (instead of 'change’ coping strategies).
Beginners mind encourages compassion and loving kindness meditation and kindfulness.
Research is showing its potential for reducing labour pain, fear of childbirth and for enhancing attachment between parents and infants.
Parents who practice mindful parenting for a year were more satisfied with their parenting skills and their interactions with their children—though no new parenting practices beyond just being mindful had been taught to them.
Mindfulness training gives parents a mental edge as they become parents and cope with the new challenges that come along with having a newborn and can improve parent’s relationship with each other.
Mindfulness cultivation is not part of HypnoBirthing (Hypnobabies just began to add mindfulness to their curriculum in August 2015) but is a core part of the GentleBirth program combining hypnotic birth techniques, mindfulness training, sports psychology and mindset interventions.
All GentleBirth Instructors are required to complete a 6 week Mindfulness for Birth Professionals training as part of their certification. At the time of writing no other childbirth preparation class that includes mindfulness as part of their curriculum requires Instructors to take any training in mindfulness.
Learn more in my article for Lamaze Childbirth Educators
What questions do you have about teaching meditation/mindfulness skills?