The Headspace Guide To … A Mindful Pregnancy (16 page)

Try it. Next time you have an itch, whether that’s during your meditation or while you go about your day, be utterly still and bring your full attention to the sensation. Without reacting, gently begin to enquire: how does it feel? Words like ‘itchy’, ‘frustrating’, ‘annoying,’ etc. are not really sensations – they are our reactions to the sensation. So look again: how does it
feel
? Where do you feel it? Is it just one spot, or a wider area? Does it stay in one place or dance around? Is it a sharp sensation, or a dull sensation? Continue to look at the sensation, without thinking about it, instead gently enquiring in this way.

And when you do this, what happens? My guess is that the itch will begin to fade or even disappear. Sure, it might return, but every time you look at it with your full attention, with awareness, it subsides.

I’m not for one minute trying to compare an itch with childbirth, nor am I suggesting that you pause midway through delivery to ‘gently examine’ the sensation. The point is to simply describe the mechanism taking place and show how the reactive mind can actually intensify pain. Our thoughts can feed a pain in the same way they can feed an itch. But when we train the mind, again and again, the exercise above becomes second nature, and we learn to build space between us and the sensation. It is no longer part of our doing – it is part of our being.

This approach is similar to the exercise we did for nausea and fatigue earlier in the book. Remember the fingertip exercise? We’re doing the same here: gradually learning to step back and not react to our mind’s labelling of a sensation, choosing instead to stay in the present moment and observe it. That’s what mindfulness allows us to do – to create space, and thereby perspective. The result is a shift in which we paradoxically witness the pain more clearly, yet experience it less intensely. Think about that: by bringing it into sharper focus, we actually diminish it.

This is not about numbing pain. I’m not promising a mental epidural here. And it’s not that you won’t necessarily experience something as painful, but you can shift your perspective,
decrease
your sensitivity to the feeling and, at times, be liberated from it altogether.

In recent years, neuroscientists have become particularly interested in the use of mindfulness as a medical intervention. Nowhere has the appetite been greater than in the science and research of pain management. Chronic pain affects over 1.5 billion people worldwide – that’s 20 per cent of the entire human race. In the UK alone, it costs the NHS over £1 billion per year. So, with clinical trials showing that mindfulness can reduce pain, it’s no surprise that scientists are so excited. One leading researcher, Dr Fadel Zeidan, from the Department of Neurobiology and Anatomy at the Wake Forest School, North Carolina, has spent many years examining the efficacy of meditation as pain relief. In the first study of its kind in 2011, the published results provided ‘strong confirmatory evidence for an influence of mindfulness practice on pain processing’.

Using a thermal device (that’s a small laser to you and me) on the right calf muscle, heat was delivered to the skin of each of the participants in Dr Zeidan’s study. As they lay in an MRI scanner, a temperature ranging between 35 and 49 degrees Celsius was applied. Participants who had never meditated before had to grade the sensation from ‘unpleasant’ to ‘unimaginable’, and their responses were monitored both before and after an hour of meditation. The resulting brain activity produced data that showed how meditation ‘likely modulates pain through several (brain) mechanisms’. As Dr Zeidan commented afterwards: ‘We found a big effect – about a 40 per cent reduction in pain intensity. Meditation produced a greater reduction in pain than even morphine or other pain-relieving drugs, which typically reduce pain ratings by 25 per cent.’

It’s a fascinating finding, but I’ll emphasise now that you should always discuss pain management – medicinal and non-medicinal options – with your doctor/midwife before deciding what will work best for you. There are often feelings of shame and guilt around the use of pain relief in childbirth, as though it somehow takes away the naturalness of it all. Indeed, in some circles, it’s almost as if there are stars and stripes to be earned if one manages to give birth without resorting to drugs! But the only thing that really matters is delivering a healthy baby, while looking after your own health and wellbeing in the process. For many mothers, if not most, this will involve some medication of some kind.

Take Lucinda, for example. It was her intention to go through childbirth without using any medication at all, having practised a mindful pregnancy. For the first thirty-six hours, she managed to cope, but then she reached the point where she was close to passing out and creating a potentially distressing environment for the baby. At that point, she let go and allowed them to give her an epidural. That is an important part of pain management: the need to remain flexible in an unpredictable situation, without getting too attached to the outcome or goal.

Besides, when we speak about meditation versus medication, we’re not saying it’s a case of either/or. It’s more about understanding the potential of mindfulness as an intervention for pain, whether on its own or in combination with medication.

The study concluded that meditation likely alters pain by reframing our evaluation of it, adding: ‘… the constellation of interactions between expectations, emotions, and cognitive appraisals … can be regulated by the ability to non-judgementally sustain focus on the present moment.’

In an essay that Dr Zeidan wrote on ‘The Neurobiology of Mindfulness Meditation’, he helps shed light on why our responses are altered. ‘As the meditator becomes more skilled at attending to sensory and emotional experiences, without interpretation or elaboration, a decoupling between brain mechanisms … develops.’ In other words, our appraisal of sensory experiences starts to alter; our retrained mind adopts a different perspective.

Pregnancy and childbirth are difficult enough without adding the weight of an inner dialogue which continually reinforces the idea of pain and discomfort. Every single time we identify with the sensation and make it our own – ‘This hurts
me
’, ‘
I
don’t like this’ or ‘Why is this happening to
me
?’ – we magnify the pain, and open the doorway to a whole world of suffering, an endless loop of inner chatter. But every time we see the sensation from a place of calm, a place of clarity, stepping back and witnessing it as something separate from ourselves, we provide the conditions for it to transform. It is the difference between
witnessing
pain and
becoming
pain. I’ve put together a meditation exercise specifically for pain management at the end of this book (see
here
–
here
). It really will help to make all the difference.

This is it – this is everything you’ve prepared for, physically and mentally. The time we go from counting down the days, to counting down the minutes between contractions. The one day you will forever remember and celebrate with your child. If ever there was a time to be present, to cherish the here and now, then surely this is it. Yet, from a mindful pregnancy perspective, this is simply another moment unfolding before us. Sure, it’s a big one, a momentous one, but it is none the less another moment. You have been present for so many of them in the past nine months: receiving the news, the first scan, the first kick; and so it will continue long after the birth with baby’s first glance, first smile and first tentative steps. It is, quite simply, one moment after the next.

I’m pretty sure most parents-to-be visualise this day, when they finally get to meet, touch and hold the tiny person responsible for this incredible, magical mystery ride. I’m also sure that most couples, by this stage, just want it all over with. Whether it is the fear of childbirth or the excitement of meeting the baby for the first time, there is an overwhelming sense of wanting the security, comfort and knowledge that everything has gone well.

You could be heading into the delivery room or enjoying the more familiar environment of a home birth, which is becoming increasingly common. It really doesn’t matter where you are, as long as you’re in the present moment. So, if you can, put down all the stories of good and bad outcomes, forget about the videos, diagrams and statistics you may have seen in recent weeks, as none of it will bring you anywhere close to the experience of childbirth itself. Rather, simply set out with the intention to be present with your birth partner, whoever you are sharing the experience with, supporting one another with a mutual appreciation and healthy respect.

If you are part of a couple, I would encourage the partner to be engaged with a mindful pregnancy as much as possible. Our obstetrician, Dr Amersi, brings babies into the world every day of her life, and instantly knows whether the parents have followed the principles of mindfulness:

With the mindful couple, there is an immediate calm, a certain vibe that says we’re-going-to-enjoy-this; they show up as a team, on the same page, sharing the same positive energy. The mindfulness demonstrated throughout all appointments and antenatal classes translates into labour and delivery, and it is quite something. But the non-mindful pregnancy – whether that’s as a couple or with a single mother – also translates into the delivery room. As soon as I walk in, the anxiety is palpable and the restlessness evident; there’s a different vibe – a this-is-how-it-must-be energy that feels almost defensive against Mother Nature, as if they are determined to hold on to their expectations.

The resistance that Dr Amersi refers to is the tight grip of attachment – attachment to outcome, to hope, to control. But, as mindfulness reminds us with each new moment, we do not control nature, we are part of nature; we
are
nature. As soon as we try to dictate the expression of nature, or project our own self-created idea of how things should be, we set in motion a level of expectation that can only ever lead to disappointment. When we let go, this attachment is no longer there – only the present moment remains.

The last thing we need to be taking into childbirth is every ‘what if’ imaginable, whether that’s what we’ve heard from others, or via the beloved internet. This is not a time for details. Place those details into the very capable hands of the midwife or obstetrician who has no doubt steered countless women through this experience. Sure,
we
might not know what is going to happen, but the doctor is more than familiar with the obstacles, pitfalls and dangers that may crop up, so let them worry about those things.
Your
job is simply to be present, along with your birth partner, supporting one another, every step of the way.

Now is also the opportunity to turn the attention to the baby, because if anyone is about to be thrust into the giant unknown, after nine months of being safely cocooned, mostly asleep in the womb, it is your son or daughter. No matter whether they arrive by natural delivery or C-section, it is going to be quite an affront to the senses. The more motivated we can be by this idea – of doing everything we can with the baby’s best interests at heart – the less we will get caught up in our own stuff and the more emotionally available we can be for one another as a family unit. After all, this moment is one of the key focal points of a mindful pregnancy: the time to create a calm, soothing environment in which to welcome the baby into the world.

Traditionally, if we go back to the 1960s and 70s, it was customary for the father to stay outside the delivery room, pacing up and down the hospital corridor or, sometimes, sitting at the local pub waiting for a phone call. Thankfully, things have moved on since then. But the fact that this is a relatively recent trend helps to explain why some men still feel a little removed. For so long, the father wasn’t involved at all and yet now, he’s more often than not an integral participant.

The relationship with the birthing partner ideally needs to be nurtured from the very beginning with this day in mind. Their involvement from the get-go will determine the kind of support and synergy experienced at the finish line. Indeed, ‘Get the synergy right and the chances of postnatal depression diminish, too, because the woman feels supported, heard, understood, with a burden shared,’ says Dr Amersi.

In the doctor’s experience, partners are nearly always grateful and more proactive when acknowledged and given a big role, whether that’s helping to deliver the baby or being the first to announce the gender. ‘I’d always let them have their moment,’ she says, ‘and, after the skin-on-skin bonding between mother and baby, I think it equally important that the newborn feels the partner’s nurturing hands, too.’

From a mindfulness perspective, the partner plays an invaluable role, because it means the mother has a supportive hand to hold throughout the process; this presence and voice alone can help keep the mind in the present moment. When we consider that being more present often means simply
remembering to realise when we’ve been distracted
, having someone there to nudge us out of the inner chatter and gently bring us back to the here and now is an invaluable aid. More than that, if you have both been practising mindfulness over the course of the pregnancy, there will be an intuitive understanding from the partner who will know when to lean in, when to give you space, when to offer words of support, when to listen and, yes, even when to ask questions on your behalf. When such a symbiotic relationship finds its rhythm, it’s a bit like a dance between a couple who have been dancing in step all their lives.

As much as it’s difficult for the mother to keep in step, so it can sometimes be for the partner, too, especially if there is a strong emotional bond. I’m reminded of when I had cancer, a time which I swear was more difficult for my wife than for me. When it is happening to us as an individual, we are almost lost in it – we have let go somehow, knowing it is out of our control. But when we are looking on, we feel as though there might be something we can do, something we
should
be doing, to help ease the pain of the person we love. Obviously, childbirth and cancer are entirely different, but the principle remains the same: it’s hard to simply look on. Yet, while no one likes seeing the person they love suffer – that experience alone can trigger feelings of frustration, helplessness and fear – the last thing the mother needs is a partner wigging out at the side of the bed!