Research shows that relaxation during labor and birth allows for a dramatic reduction in the stress reaction. When subjected to stress (of any kind) or fear, be it real or anticipated, body changes take place that trigger a defense mechanism and institutes the fight or flight mechanism. The fight or flight mechanism is started by the autonomic (or involuntary) nervous system and includes body changes such as an increase in respirations and mild/moderate rapid heart rate. With this stress response, females have a strong tendency to take flight or flee. Obviously this is not practical during labor/birth.
Most of us teach about the Fear-Tension-Pain Cycle as first described by Dr. Grantly Dick-Read in the late 1950s. Fear (due to lack of education and practical knowledge), leads to tension in the body – tension in the muscles of the body uses oxygen that would have normally been made available to the fetus and the uterus. This, in turn, decreases the efficiency of the uterine contractions and thus slows or in some cases, stops the labor process. Tense striated muscles contribute to an increased in lactic acid build up that impinges on pain receptors, magnifies pain perception and increases fatigue. Fatigue decreases the pain threshold, further increasing pain perception and reduces the laboring mother’s ability to conserve energy for the expulsive efforts needed during the second stage of labor.
Conscious relaxation and practicing coping techniques may be some of the first items removed from childbirth education curriculums when timing in the class becomes an issue. However, initiating a relaxation response to contractions or pain stimuli can decrease metabolism, slow down the heart rate, calm breathing, reduce blood pressure and relax muscles – all of which has a positive effect on the baby, mother and labor.
From Dick-Read to Lamaze to Bradley, nearly all methods of childbirth education have some aspect of relaxation built into the curriculum. More and more information about the benefits of relaxation and stress reduction is available on the internet. However, practicing relaxation techniques under the careful guidance of a childbirth educator increases the success of using the techniques not only during labor but as life skills. Lamaze brought to the forefront psychoprophylaxsis or preventing the mind from dwelling on the intensity of contractions through guided imagery, focusing on breathing techniques and focusing on specific objects called focal points. Mindfulness is not unlike psychoprophylaxsis.
Along with progressive relaxation and touch relaxation, the use of mindfulness or Mindfulness-Based Stress Reduction (MBSR) can enhance relaxation. MBSR can be defined as bringing one’s complete attention to the present moment; paying attention in a careful and nonjudgemental way so that each of the senses can be addressed. Concentration is at its highest level for awareness. In our driven and hurried world, we all too often reach a point where we say “where has the day (week, weekend, month, etc) gone?” We are just too busy to, as the saying goes, stop and smell the roses. Researchers say that MBSR along with relaxation can increase brain function and enhance our immune system in addition to helping to cope with stress.
When incorporating MSBR with relaxation, first select a comfortable area in which to practice. In a childbirth education classroom, make sure that the temperature is moderate, the environment is quiet, lights are dim and there might be relaxation music or white noise playing faintly in the background. Have participants get into comfortable positions either sitting or lying down, well supported by pillows or even bean bag chairs. As educators, we are often unsure of the participants feelings about guided imagery to different locations such as a beach, so for the first experience, it may be beneficial to focus on having them get their breathing under control.
Begin by having all participants do a relaxation assessment of their body muscles – from the top of their head, to their face and jaws, to the neck, shoulders, right upper arm, right lower arm, right hand. Then have them take a large breath in and out, and relax from their left upper arm, left lower arm, and left hand. Further focus on relaxing their belly and pelvis muscles. After taking another large breath in and out, have them relax their right hip, right upper leg, right lower leg, and allow the stress to run out of their right foot like sand. Take another large breath in and out and focus on the left hip, left upper leg, left lower leg and allow all of that stress to run out of their left foot.
Have them envision a bright candle light near their belly button. Tell them to examine the light for the shape and different colors. With their eyes closed and the focus on the light, have them monitor their other four senses – what do they hear? (pause for a few minutes) What do they smell? (pause for a few minutes) What are they touching? (pause for a few minutes) What does their mouth taste like?
After experiencing this scenario, gently bring them back to the present, to the classroom, and have them slowly open their eyes. Have them share their initial thoughts and feelings. Gently bring the lights up and allow them to continue to share the experience.
With routine practice and the knowledge that the breathing is a safe refuge in times of stress, positioning, breath awareness and the relaxation body scanning can become a part of their prenatal life routine and hopefully future routine as well.
To learn more:
The National Center for Complementary and Alternative Medicine or NCCAM provides great insight into the research being done on MSBR. http://nccam.nih.gov/health/meditation/overview.htm
The Kentucky Inventory of Mindfulness Skills, which is for educational purposes only, can help a person identify areas of mindfulness that need improvement. http://personality-testing.info/tests/KIMS.php
Duncan, L. and Bardacke, N. Mindfulness-based childbirth and parenting education: Promoting family mindfulness during the perinatal period. Journal of Child and Family Studies. 2010 April; 19(2) 190-202.
Hughes, et al. Mindfulness approaches to childbirth and parenting. British Journal of Midwifery October 2009, Vol 17, No 10. http://www.oxfordmindfulness.org/wp-content/uploads/Hughes-et-al-Mindfulness-Childbirth-Final-published-article.pdf
Vieten, C and Astin J. Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: results of a pilot study. Archives of Women’s Mental Health (2008) 11:67-74. http://media.wisdompractices.org/uploads/files/mmp.pdf