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