When Harry Kane tweeted that he was proud of his wife after she gave birth to their second daughter along with a picture of the new addition to his family, he may have expected only goodwill in return. “So proud of @KateGoodlandx for having the most amazing water birth with no pain relief at all,” he said.
But Kane was immediately criticised for what some saw as an implicit criticism of mothers who use pain relief during childbirth. Broadcaster Julia Hartley-Brewer asked: “There’s a reason why women get pain relief during labour: because it bloody hurts,” while others said they found the tweet “depressing”.
While Kane sought to assure critics that he believed “any women can give birth however they would like”, he added that he and he wife had “both learnt a lot from hypnobirthing” – opening a debate about a technique that has become increasingly common in birthing centres around the country.
The practice – which has grown in popularity in recent years, with a host of companies offering courses and advice – is a method of pain management involving visualisation, relaxation and deep-breathing techniques during labour.
“This is the biggest revolution in birthing in history,” said Katharine Graves, founder of KG Hypnobirthing antenatal programme and the Hypnobirthing Association. “It still has connotations of tree-hugging hippies but people are beginning to realise there is another way. Our country is one of the most advanced in the world in this area, but we still have a way to go.”
NHS statistics reveal a shift towards childbirth with little or no pain relief. In 2016-17 around 60% of women had an anaesthetic or painkiller, compared to 68.6% in 2006-07. According to NHS Digital, the shift has come as a result of guidelines from Nice (the National Institute for Health and Care Excellence) which warn that epidurals can lead to “a longer second stage of labour and an increased chance of vaginal instrumental birth”.
In February, the World Health Organisation issued new recommendations to “reduce unnecessary medical interventions”, which it stated had been on the increase over the last 20 years. It added: “Childbirth is a normal physiological process that can be accomplished without complications for the majority of women and babies.”
“The popularity of hypnobirthing is growing and there is certainly an increasing interest among people who want to do things a bit differently,” says Milli Hill, author of the Positive Birth Book. “Women aren’t stupid, they know what is going on in birth rooms across the country and that women are often coming out of those experiences feeling annihilated, so they are asking for the techniques they can use to make it a more positive experience.”
Lia Brigante, quality and standards advisor at the Royal College of Midwives, said there was evidence that women felt more relaxed and more in control when using hypnobirthing. “For many women it works and supports and enables them to manage their pain in labour quite effectively,” she said.
The National Childbirth Trust (NCT) meanwhile, which has been repeatedly criticised for pressuring women into natural birth, said women who had attended hypnobirthing classes had reported quicker labours, less need for pain relief and less need for intervention, but added that women “shouldn’t ever feel pushed into giving birth a certain way or judged about their decisions”.
But not everyone is evangelical about the practice. While many on discussion threads on the parenting site Mumsnet swear by hypnobirthing, others are fiercely critical. One woman who did a course before each of her children wrote: “Frankly it was the most painful thing I have ever experienced until I got an epidural. Not a single technique made a single bit of difference.” Another woman described how, after doing hypnobirthing training, she had “blindly persisted” with a difficult birth and ended up with emergency surgery and had been left with PTSD and a feeling of failure.
Dr Virginia Beckett of the Royal College of Obstetricians and Gynaecologists said the presentation of a drug-free birth as an unmatchable ideal was dangerous. “Over the time I’ve been an obstetrician I’ve seen a significant issue and association with post-natal depression caused by women feeling a sense of failure if they haven’t achieved birth without pain relief and that’s potentially very damaging,” she said. “Everyone’s experience of labour is different, it’s not just about how good you are at dealing with pain.”
Linda Geddes, author of Bumpology, described how she had been on a hypnobirthing course and had written in her birthing plan that she did not want an epidural. She had one midway through a 42-hour labour. “I’m in favour of personal choice, the more tools at a woman’s disposal the better,” she said. “But there is a risk that if women are fed the line that childbirth doesn’t have to be painful they may not do their research on the other options. And, if they do need help, they might feel they have failed in some way. It doesn’t matter how you give birth, what matters is giving birth.”