TRAINING FOR OBSTETRICAL ANALGESIA

The following passage is a report of a hypnotic childbirth preparation program lead by Erickson. The skills of the therapist, along with those of the patient, lead to this extraordinary result. At the next session some days later she stated that she had been interested primarily in thinking about her hypnotic delivery. After much discussion with her husband, during which he was primarily the listener, she had decided on an analgesia if it were possible. She explained that she wished to experience childbirth in the same fashion as she had, as a child, sensed the swallowing of a whole cherry or a lump of ice, feeling it pass comfortably and interestingly down the esophagus. In a similar manner she would like to feel labor contractions, to sense the passage of the baby down the birth canal, and to experience a sense of distension of the birth canal. All this she wished to experience without any sense of pain. When questioned about the possibility of an episiotomy, she explained that she wanted the sensation of the cutting without pain and that she wanted to feel in addition the suturing that would be done. When asked if she wished at any time to experience any feeling of pain merely as a measure of sampling it, she explained: Pain shouldn't have any part in having a baby. It's a wonderful thing, but everybody is taught to believe in pain. I want to have my baby the way I should. I don't want my attention distracted even a single minute by thoughts of pain. Accordingly, as a measure of meeting her wishes, she was taught to develop complete hypnotic anesthesia. (Usually the procedure is to proceed from numbness to analgesia to anesthesia.) Since in this instance an analgesia was the primary goal, anesthesia was induced extensively and then systematically transformed into an analgesia. (That a complete transformation of anesthesia to analgesia could be effected is doubtful, but the patient's wishes could be met in this manner, and whatever anesthesia remained would only supplement the effectiveness of the analgesia.) When she had been trained sufficiently to meet various clinical tests for analgesia, extensive training was given to her to effect the development of a profound somnambulistic posthypnotic trance with that degree and type of analgesia you have just learned, so that she could enter into labor without any further contact with the senior author. Additional instructions were that she would awaken at the completion of labor with a full and immediate memory of the entire experience. Then, when she returned to her room, she would fall into a restful, comfortable sleep of about two hours' duration, and thereafter she would have a most pleasant hospital stay, planning happily for the future. About seven weeks after the delivery she and her husband and baby daughter visited the senior author. They reported that, as she entered the hospital, she had developed a somnambulistic trance. During the labor and delivery her husband was present. She had talked freely with her husband and the obstetrician and had described to them her labor contractions with interest. She had recognized the performance of the episiotomy, the emergence of the head from the birth canal, the complete delivery of the baby, and the suturing of her episiotomy - all without pain. The expulsion of the placenta caused her to ask if there was a twin because she felt another one moving down. She was able to laugh at her error when informed it was the placenta. She counted the stitches in the repair of her episiotomy and inquired if the doctor had cheated by giving her a local anesthetic because, while she could feel the needle, it was in a numb, painless way that she associated with the numb feeling of her cheek after a local dental anesthetic. She was relieved when informed that there had been no local anesthetic. She was shown the baby, looked over it carefully, and asked permission to awaken. She had been instructed to be in full rapport with her husband and the obstetrician and to do things as needed to meet the situation. Hence, inexperienced in the situation, she carefully met the need of abiding by the situation by making sure it was in order to awaken. She again looked the baby over. Then, upon telling her husband that she had full memory of the entire experience and that everything had occurred exactly as she desired, she suddenly declared that she was sleepy. Before she left the delivery room, she was sound asleep, and slept for one and a half hours. Her stay in the hospital was most happy. Two years later she announced to the senior author she was having another baby, and asked that she be given a refresher course, just to make certain. One session of about three hours in the deep trance sufficed to meet her needs. Much of this time was used to secure an adequate account of her adjustments. They were found to be excellent in all regards.
Taken from Milton H. Erickson & Ernest L. Rossi, Hypnotherapy – An Exploratory Casebook, pag. 413, Irvington Publishers Inc.