Hypnobirthing ensures pain-free childbirth for some
SINGAPORE: Ms Regina Lim gave birth to her daughter in circumstances starkly different from most other women's.
"Actually, childbirth is not painful," said the 34-year-old,
referring to her pain-free labour with Hannah and contrasting it with
her experience giving birth to her two older boys, where labour had
been induced.
Describing her daughter's birth at Mount Alvernia Hospital on
February 20, Ms Lim said: "It's almost like your body's trying to do a
split for you. If you just relax, it will gradually, over four or five
hours, get into the 'split' position." Labour had been "fun", added the
property analyst.
Ms Lim had practised hypnobirthing - a technique she credited with
helping ensure a pain-free birth - with the help of her doula, Ms Ginny
Phang. In ancient Greek, the word "doula" meant a woman of service.
Today, a doula is a professional who assists women during childbirth,
providing practical and emotional support.
Actress Nicole Kidman was reported to have had a doula at the birth of her daughter Sunday Rose last year.
Dr T C Chang, a consultant obstetrician and gynaecologist at
Thomson Medical Centre, told Weekend Today that hypnobirthing "can
reduce the need for pain relief." "Some patients will tell you ... they
didn't feel pain. Others will say the pain was reduced markedly",
obviating the use of pain relief during labour, according to Dr Chang,
who said that 15 to 20 per cent of his patients use doulas.
Hypnobirthing, which can comprise visual and auditory cues, is "a
mind-body technique to teach women to relax during labour," said Ms
Phang, who owns FourTrimesters, a firm that offers doula services.
According to another doula, Ms Kiki Porter Wolff, hypnobirthing "is
mind over matter, the mind controls how the body reacts. It won't get
rid of the pain per se but it reduces the pain to nothing but an
irritability."
Said Dr Chang: "They don't even use the word 'pain' ... they refer to every contraction as a 'surge'."
Ms Lim was part of a small but growing group of women who employ doulas, who number fewer than 20 in Singapore.
Ms Di Bustamante, the director of ParentLink, a company whose
services include doula and pregnancy-related services, said the firm
provides doula services for eight to 10 births a month, compared with
five or six such births per month, two years ago.
About half her clientele are expats and half are locals, she said.
The numbers involved are still tiny, however. Since 2007, for
example, KK Women's and Children's Hospital "has received two requests
for the assistance of a doula, during delivery", according to Ms Paulin
Koh, deputy director, nursing, at the hospital's delivery suite.
Ms Lim said: "In previous births, I had difficulty in getting what
I wanted because I was in labour and (not in a fit state to) argue with
doctors and nurses, and I wanted an advocate."
Ms Lim said her "advocate", the doula, Ms Phang, advised on matters
such as when to lie down and when to walk around, and when to go to the
hospital when labour had advanced. "When you're pushing the baby out,
someone will, invariably, in all the births, say something like 'Shut
up and push!' I will usually tell the nurse, 'you shut up'. Now I have
Ginny helping me to glare at her," she quipped.
Having the kind of birth they want - which often excludes pain relief - is important for clients of doulas. "
Some doctors don't even allow birth plans. We often have people
switching to us because they can't have a birth plan," said Ms Wolff,
who, besides being a doula, is also a trained nurse and midwife.
For Ms Lim, as with many people who opt for doulas, having a
natural, drug-free birth was crucial, especially after her unhappiness
over her second son, Rupert, having to be delivered via an emergency
Caesarean section six years ago.
"I felt that birthing, like eating or sleeping ... or having sex,
should be something that your body is designed to do. I wanted to have
a natural birth. I felt that this is the normal way to give birth," she
said, in contrast to "interventionist" societal norms regarding
childbirth.
In opting to give birth without drugs, Ms Lim is in a distinct
minority. With regard to the women who give birth at Singapore General
Hospital (SGH), for example, "over 90 per cent opt for pain relief",
according to Dr Tan Lay Kok, senior consultant at SGH's department of
obstetrics and gynaecology. The three forms of pain medication commonly
used are epidurals, pethidine injections and Entonox gas.
"In Singapore, all births are pretty much looked at as requiring
medical attention ... a medical event, not a normal physiological
event," said Ms Bustamante, a doula herself, stating views similar to
other doulas'. Citing the use of painkiller drugs as an example of a
medicalised approach, she added: "Some doctors want to release the
membranes, break the waters routinely, halfway through labour."
Asked separately by Weekend Today whether obstetricians in
Singapore were generally too interventionist in childbirth, Dr Tan of
SGH said: "Obstetricians have their patients' and their babies' best
interests at heart. It is in this context that any intervention is
discussed with the patient, taking into account both maternal and fetal
considerations, and assessing the pros and cons of the intervention."
Dr Tan added: "Labour is usually managed actively in hospitals, and
if the progress of labour is slow, the obstetrician may suggest
breaking the waters to help augment the uterine contractions."
Ms Bustamante also said: "Many doctors require that women give
birth on the bed on her back. This position is not conducive to an easy
birth. It fights gravity and can cause perineum tearing."
She added that "using a birth stool, squatting, (being on) all fours,
even standing are much better positions as this allows the pelvis to
open an additional 30 per cent".
Asked separately about which birthing position is best, Professor
Chong Yap Seng of National University Hospital (NUH), said that would
depend on the individual; it would be "the position that you feel most
able to push when you're in the second stage of labour".
"The training all over the world is like this: Most doctors are
trained with an active management mindset. Some of the policies may
seem a bit too cautious to laymen," he said, in reference to queries
about medical intervention in childbirth.
However, as doctors are privy to "very bad outcomes" that may occur
even with normal pregnancies, "we actually like to err on the side of
caution", said Prof Chong, senior consultant at NUH's department of
obstetrics and gynaecology.
Whichever birthing method women choose, there is perhaps one
universal constant in all new births. In 30 years of nursing, "I've
seen thousands of deliveries", said Ms Wolff, "newborn babies always
look like their fathers." She reckons it's a way for fathers to bond
with their new babies, even though their children's features will soon
shift and change.
- TODAY/sc