Mindfulness in Pregnancy and Childbirth
For most of us fortunate enough to be parents, the birth of a baby is an amazing beginning of a new soul entering the world and of our becoming a parent – probably the most intense change in our life, whereby we take on one of the most important, enriching, but stressful jobs in the world – caring for and nurturing the future generation.
Practicing mindfulness during pregnancy and childbirth can bring great benefits, which will extend beyond the birth into the sometimes stressful, always profound and mostly joyful weeks and months of learning to care for our child. Mindfulness can be a source of strength and pleasure in our years as a family.
The benefits of a mindful pregnancy and labour
Studies have shown how mindfulness can decrease depression and anxiety in pregnancy and childbirth and increase positive emotions. It can therefore help enormously in the birth preparation and in nourishing mindful relationships with our partner, family and most importantly, ourself. Encouraging evidence suggests that mindfulness is successful in both reducing vulnerability in high-risk groups and as a universal intervention, by focusing on three main areas; managing pain during pregnancy and labour; reducing risk of perinatal depression; and increasing ‘availability’ of attention for the infant. With the rise in the practise of mindfulness it is interesting to take a look at these three areas:
When the body hurts – a mindful approach to physical pain
Research has shown that mindfulness helps sufferers of chronic pain, including many who have found no pain relief through medication and the pain in pregnancy and childbirth presents similar problems.
- Pain during pregnancy – similar to sufferers with more chronic conditions, paracetamol is the only recommended safe pharmacological pain relief in pregnancy. In a study of women suffering from pelvic girdle pain (PGP) it was found that paracetamol was generally ineffective and the women’s feelings of being unable to
cope and of losing control were very similar to those who suffer chronic pain. The idea of pain relief raised expectations, which led to chronic disappointment and an increased sense of helplessness when it failed to remove the pain. However, mindfulness does not aim to remove, reduce or ‘wall off’ the pain, but instead it aims to change our relationship to the pain sensations, so that the experience of the pain is less all-absorbing and therefore less likely to set off negative emotions which increases the pain. Due to the close links between physical and emotional pain, when we can disassociate the physical sensations from the thoughts about them, we can recognise potential freedom. Mindfulness practise helps us to become aware of, and to relate differently to, the negative thoughts surrounding intense physical sensations, when we stop feeling overwhelmed by the pain and become less fearful of losing control. - Pain during labour – practising mindfulness during childbirth can give enormous benefits. Studies have shown that first-time mothers who fear childbirth are more likely to have longer labours and women can often feel overwhelmed by pain, by fear of not coping and of losing control, yet there are other women who somehow
manage their pain without ‘pain relief’. These women have more positive, empowering experiences of giving birth than those who resist their labour pains,
with reports of ‘going with the flow’, ‘being present’, being ‘in the zone’ and ‘working with pain’ and this seems to confirm that there is naturally a vast individual difference in reactions to labour. This would support the practise of mindfulness, in that it helps us to develop a sense of being in touch with the ‘present’ moment and to be non-judgmental of bodily sensations without needing to react against them with tension and anxiety. A mindfulness programme could fundamentally change perceptions, allowing women to be more willing to experience the intense pain of labour, but also not feeling judgmental of themselves or a failure if they choose pain relief to help them. Although it could be argued that nothing can prepare for the pains of childbirth, it has been shown that women have used coping strategies during labour, which they have learnt in previous experiences and this would suggest that mindfulness can be learnt in pregnancy to help deal with ongoing pain and discomfort, which would then be used for positive pain management in childbirth. This could often halt the snowball effect of interventions, which would result in a more positive experience for women and their partners, greater job satisfaction for midwives and fewer expensive labour interventions! Mindful Birthing (Amazon book)
Mindful Hypnobirthing (Ebay book)
When the mind hurts – a mindful approach to mental pain
Depression can be one of the most common complications in the perinatal period, with risk factors for postpartum depression (PPD) being both psychological and social, including lack of social support, marital conflict, stressful life events and history of adversity and abuse. It is vitally important to find a means of preventing perinatal depression in order to prevent further future consequences such as:
- Further marital problems and reduced social support
- Poor adherence to perinatal care
- Increased use of alcohol and other substances
- Increased risk of pre-term labour
- Low birth weight
- Reduced biological and behavioural outcomes for baby that continues through early childhood
- Reduced parenting skills
- Increased risk of future depression – after PPD the risk of further episodes of depression recurring is doubled.
The most common method of dealing with depression is antidepressant medication (ADM), however during pregnancy most women prefer not to use ADM, because of the risks involved and in fact, even when ADM has been used, the results have been mostly ineffective.
So could mindfulness prove more effective? We need an approach that is specifically designed for those at risk, but who are not showing symptoms and Mindfulness-based cognitive therapy (MBCT) can offer exactly that. Mindfulness practise can half the risk of future relapse for those who have had three or more episodes of depression, but who are not currently showing symptoms. There are more details about how MBCT can help here
Studies are still ongoing, but it is already clear that many women find it helpful and it is thought that MBCT could have similar preventative effects for perinatal women at risk as for the general population – preventing perinatal depressive relapse and recurrence.
When the mind is in auto-pilot – a mindful approach to parenting
Mindfulness practise can help us recognise when we are preoccupied and running on auto-pilot – an arguably more important effect than reducing pain and depression. We can often become stressed in our everyday lives, leading to a chronic sense of dissatisfaction with how our lives are going. Mindfulness allows us to recognise these stresses more clearly and helps us to improve our skills in dealing with them.
We can feel more able to concentrate, more engaged in life, less preoccupied and simply notice more of the beauties and pleasures of moment-to-moment life. This is vital for the parent-child interaction, which relies on the parent’s awareness of the child’s behaviour,
and lays down an important foundation for the child’s later social, emotional, and cognitive abilities. If we are more preoccupied with our own concerns, then we are not available to notice the little signals that our babies are pre-programmed to make and allow them to thrive, which form the basis of secure attachment and their future cognitive development.
How to use mindfulness in pregnancy and childbirth
- Mindful meditation can help everything – it generates a deep level of calming, mental rest for the mother and baby, during pregnancy and the birth. When practised daily it teaches us how to avoid reacting badly to stressful situations, creating an inner silence and confidence. It is the safest and most effective method
(non-pharmacologically), to reduce anxiety and stress – restoring and strengthening the immune system of both the mother and baby. Meditation decreases the production of stress hormones (cortisol) and produces endorphins (the pleasure hormone), which via the placenta, reassures the unborn child about the safety of its environment, calming the baby and helping with childbirth – all due to the pain relieving effect of endorphin. The effect increases exponentially, therefore the earlier in pregnancy that meditation is practised, the higher the endorphin levels will be at birth. Meditation also lowers blood pressure and heart rate, reducing the risk of pre-eclampsia, placental abruption, miscarriage and pre-term labour. After the birth, meditation can increase breast-milk, which is essential to the baby’s early development – ensuring it suffers less colic, has fewer allergies and infections, has a higher tolerance for discomfort and develops skills for self-soothing. - Prepares the mind – preparation educates us to make the right decision when
necessary. It is important that all expectant parents attend the various childbirth and breastfeeding courses available – the more informed we are, the more empowered and relaxed we can be during labour. It is the fear of the unknown which increases pain and causes more fear, thus creating more painful deliveries. Instead of focusing on the ‘perfect birth’, try to learn about the various, different labour outcomes and decide in advance how you would deal with the diverse possibilities. - Slow down – pregnancy can be a great opportunity to focus on creating mental space and making ourself emotionally healthy. Practise being mindful of the inner preparation as well as the external details of planning. Try to give some time for the mother to relax and connect with herself, her partner and the baby. The last part of pregnancy can be exhausting and extremely uncomfortable and we should pay attention to the lack of energy by changing exercise routines and using the quiet time to hydrate and rest. This will lower the risks of pre-term contractions, reduce swelling and allow the baby to feel safe and calm, ready for entering the world after an energised birth.
‘Smile, breathe and go slowly’ Thich NHat Hanh
- Try to have a good night’s sleep – it’s sometimes a huge challenge during late pregnancy and in early parenthood to achieve good, restful sleep. Scheduling regular naps in pregnancy will hopefully help to carry that forward after the baby is born. If sleep isn’t easy to achieve we can try various exercises detailed on our Mindfulness meditation to overcome insomnia and improve sleep page. Whilst practising the mindful breathing exercise we can imagine wrapping the baby in a blanket of our breath, nourishing it with each inhalation and hugging the baby with each exhalation. If we’re trying for a nap, even if we don’t fall asleep, we will have spent some time consciously relaxing and calming our body.
- Try not to get too hung up over plans – each pregnancy and childbirth is unique and whilst we can have an idea of a birth plan, in reality it’s important to remember we can’t plan childbirth: we can’t plan the timing: how a woman tolerates the pain; the length of labour; the size and direction of the baby’s head; the efficacy of the contractions; or how the baby copes with labour. It may be beyond our control how and when we deliver, but what we can control is how we
deal with the unexpected and how we feel about it if it happens, and mindful meditation during the pregnancy, will help us deal with any situation that occurs. The most paramount plan of course is always to have a healthy baby delivered in the best and safest way possible, but ignoring or burying our emotional response to the change in plans can make it more difficult to bond with the new arrival. Instead, we should give ourself a moment to experience whatever we’re feeling, acknowledge those emotions, breathe and then let go. - Train like an Olympian – we wouldn’t enter a marathon without months of training and equally, keeping fit through pregnancy is vital. Exercise will help reduce backache, prevent diabetes, increase energy, reduce stress and improve our mood. It increases muscle strength, tone and endurance, improves sleep and helps in the physical demands of labour. If we recognise each contraction as a workout,
putting maximum effort into the mental and physical energy expenditure, the rest in between can then provide a respite to mentally recharge, breathe, rest mentally and physically, create space and build up reserves to start the next contraction, whilst the birthing partner is offering love, support and encouragement, which will aid the successful delivery. - Acknowledge and accept the pain – although it is a physical discomfort, it is also an experience of the mind, and anticipation of the pain will cause more unnecessary mental suffering. Using mindful meditation, to harness the mental and physical stamina needed, allows us to recognise the labour pains as intense physical sensations, which arrive, peak and leave again and then we can become aware that the pain is just part of the miraculous journey for our baby. Pain is always best managed in the security of a familiar environment and it’s therefore better and more comfortable to remain at home as long as possible. Asking for pain relief is not a failure, even if a natural birth was originally planned and neither is having an unplanned Caesarian when the end result is a healthy baby! Be flexible.
- Set the scene – a dark, quiet environment is ideal for most women during labour and little things can mean a lot – a favourite pillow, pair of socks etc. Aromatherapy,
specially lavender, is very soothing and personal touches from home can bring love into the room, as well as music – even if having a C-section. Remember it’s a birthday party, so have fun! - Stop working by the hour – there is a long journey ahead and there’s no need to watch the clock! Be ‘present’ in the moment, breathe and forget about any concept of time or deadlines. Gravity, time and contractions will work together to bring the baby down until the urge to push is felt.
- Be a supportive partner – watching the birth is one of life’s greatest, enriching
moments and a supportive partner is an important, relaxing and calming resource for the mother. This is why it is better for the partners to attend all the classes and appointments etc where possible. It is an important time to bond with our partner and baby and the stronger the relationship before the birth, the more positive the support will be in labour. - Allow the mindful practise to adapt with the baby – inevitably what was a 2-hour daily yoga and meditation practise in pregnancy could end up as 10 minutes of meditation whilst baby naps, 10 minutes of stretching whilst holding it and 10 minutes of breath awareness whilst nursing or feeding. It could be a while before we can return to the regular routine, but just taking time for moments of practise everyday will make a vast difference to our energy level, our patience, and ability to engage positively and mindfully with the child and others.
- Remember the big picture – the most important aim is to bring a healthy baby into the world. Birth plans don’t really matter; ending up with a C-section is fine; choosing an epidural instead of a drug-free delivery is not a problem; as long we remember to be an intensely proud new parent. The Mindful mother (Amazon book)
How to have a mindful labour – with or without pain-relief
Childbirth classes educate us about the birth process, but generally do not teach skills for coping with the anxiety of childbirth, which can sometimes increase the fears of first-time mothers. However, mindfulness can teach us how to cope with the pain and fear during labour and help us understand that the painful contractions come and go, moment by moment and in between there are moments of calm and ease. It teaches us to stay anchored in the ‘present’ moment and stop worrying about the past or future.
Mindfulness meditation practises, such as yoga, mindful breathing, sitting meditation and walking meditation can all help, allowing us to discover unrecognised inner resources of strength and resilience. It helps us to understand that although giving birth can be difficult, it is physical process we can manage, moment by moment.
During the labour, as mentioned previously, it is best to remain at home as long as possible during early labour and continue daily life. Maybe even take a walk and when a contraction comes we should practise mindful breathing exercises Notice the air as we inhale, the breeze on our cheek and the birds singing. Mindfulness meditation can help enormously to take us through labour and delivery.
Mindful birthing does not deny the pain – instead it provides techniques for dealing with the pain moment by moment – and it needs to be practised regularly before labour. It teaches us to pay attention to our breathing and focus on the sensations in our body, keeping us in the ‘present’ and then when we don’t have the labour we expect, it can cause anxiety and stress, but mindfulness can help us get through and deal with the experience calmly.
During the intense, later stages of labour, mindfulness meditation helps us to notice and even enjoy, the time between contractions, instead of merely concentrating on the pain and staying in the contraction in our minds through the rest period, which can totally wear us out!
Practising for a mindful birth may mean we are hoping for an unmedicated birth, but this is not a requirement – mindful birthing is for all types of birth. Conversely, training the mind to be in the ‘present’ moment allows us to work with the process, actually supporting the natural physiology and dealing with the various deliveries.
‘Mindfulness may not give you the birth experience you want, but it helps you fall in love with the birth experience you get’ Nancy Bardacke
Staying mindful after childbirth
Mindfulness techniques are not just for labour – they should also become part of our daily life afterwards. Mindfulness can be extremely useful in the more frustrating moments of dealing with children, like dealing calmly and staying balanced in the middle of a child’s tantrum. It helps us handle stress better and become more resilient. Just as in those rest periods between contractions, we can develop the ability to find quiet breaks in our work. Mindfulness is about being more ‘present’ with your child, being mindful even during the most mundane tasks, but we shouldn’t be critical of ourself when we slip up – that defeats the object!
Amongst all the sleepless nights, crying babies and endless nappy-changes, we will discover moments of wonder, joy and peace, with those moments of frustration and anxiety becoming more infrequent and disappearing fast.
Discovering mindfulness can help us cope with the various stresses of parenthood and fully appreciate the many precious moments.
‘Childbirth is the only blind date where you know you will meet the love of your life’
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