Prevention of Post Natal Depression - A talk for Midwives

Post on 14-Dec-2014

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An illuminating presentation originally promoted to Dr Miriam Stoppard at a Midwifery Study Day as to how emotional and physical preparation through pregnancy can help prevent PND.

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Relaxation & Control Hypnotherapy aiding Mental Health

Post Natal Depression and Post Traumatic Stress Disorder

Post Natal Depression

• 10-15% of post partum (after birth) women develop Post Natal Depression

• Family relationships (partners, other children etc) suffer with the effects of Post Natal Depression. It effects the entire family

• Breastfeeding is difficult • Bonding with the baby is compromised

• Other far reaching effects

Agenda• What causes Post Natal Depression? • What promotes Mental Wellbeing?• Clinical Evidence of Hypnosis to help cure Post Natal

Depression• How does Hypnosis work? • Breathing • Hypnosis for Childbirth • Fear-Tension-Pain Syndrome • Relaxation • Promoting Mental Wellbeing • Birth Secrets Classes, Book and CD range

What causes Post Natal Depression (PND)?

• We don’t really know!• Some likely causes:

– Feeling of being “out of control” during childbirth– Have had depression or PND before– Do not have supportive partner – Premature or sick baby – Loss of own mother as a child – Various stresses and anxieties

What promotes Mental Wellbeing?

What promotes Mental Wellbeing?

• It may be different things for every person • Mental wellbeing will only be achieved if you

have all your basic human needs met• Maslow’s Hierarchy of Needs is a good place to

start searching for what gives us mental wellbeing

Maslow’s Hierarchy of Needs

Our Basic Human Needs• The need to give & receive attention (friends, family,

social network)• Taking need of the mind-body connection (breath, sleep,

food, exercise etc)• The need for purpose (goals, work, parents)• Connection to something bigger than one self (religion,

clubs, a cause/purpose)• The need for creativity & stimulation (learning new skills)• The need to feel understood & connected (intimacy,

partnership)• The need to feel a sense of control

How do we deal with normal challenges in life?

• Having a sense of control • Sense of knowing/knowledge • Confidence in your own ability (body/mind)• Fear of unknown is removed • Informed decisions • Information gathered from others –

history/research

• Tools to help you with the process

Having a Baby

• If we feel the need to prepare for a ‘normal challenge in life’ why do we not prepare for labour, childbirth and parenting to the same degree?

• Antenatal classes give information on ‘signs of labour’, ‘pain management’ and ‘medical intervention’ but they fail to prepare us for the day of labour or parenting.

• Birth Secrets courses and hypnosis is a wonderful tool in preparing you for labour, birth and parenting.

Many clinical trials have been conducted using hypnosis during pregnancy to eliminate Post Natal Depression by reducing medical

intervention during labour

We will take a look at them now

Clinical Evidence • P. McCarthy (1998) ‘Hypnosis in

Obstetrics’ (1998), Australian Journal of clinical and Experimental Hypnosis, 26, 35-42– Demonstrated a “virtual absence of

postpartum depression” using hypnosis in 600 women compared with 10-15% average

Clinical Evidence • M.W. Jenkins, M.H. Pritchard (1993), ‘Hypnosis:

Practical Applications and Theoretical Considerations in Normal Labour’, British Journal of Obstetrics and Gynaecology, 100 (3), March, 221-6 – Mean length of 1st Stage of labour in primigravid (first

time labour) women was 6.4 hours after hypnosis and 9.3 hours in the control group.

– 2nd Stage of labour 37 min and 50 min respectively– Use of analgesic agents was significantly reduced in

hypnotised group compared with control group

Clinical Evidence • Harmon et al, 1990, also reported lower depression

scores in the hypnotically treated group.

• Martin A.A, 2001, Pregnant Adolescents, the reduction of complications, surgery and hospital stay show direct medical benefit to mother and child and suggest the potential for corresponding cost-saving benefit.

• Hao TY, 1997, showed a significant shorter time of the first and second stage of labour in the study group (suggestion therapy) than in the control group.– Also indicated the conversation between nurse and

mother to be played significant role in the outcome

How does Hypnosis work?

Hypnosis/HypnotherapyHypnosis is a powerful, natural and safe state of

directed awareness.

It is a state of profound relaxation that you allow yourself to enter. You are in complete control.

In this state of relaxation you are able to imagine and visualise a comfortable & enjoyable

birthing experience.

The Law• Your body is inherently obedient to commands • We generally follow the first instruction• We interpret words literally • Once one person does something that

seemed impossible before then it gives others permission to do the same (4 minute mile!)

• Your body does not know the difference between imagination and reality (just think of how a fantasy can make physical changes to your body)

The Law• Your body is inherently obedient to commands • We generally follow the first instruction• We interpret words literally • Once one person does something that

seemed impossible before then it gives others permission to do the same (4 minute mile!)

• Your body does not know the difference between imagination and reality (just think of how a fantasy can make physical changes to your body)

If these laws are true then …• We can begin to use different language to

have a better experience of childbirth• We can use our imaginations to:

– Remove fear of childbirth – Gain confidence in body and babies ability to birth

naturally with less medical intervention– Rehearse the day of labour in our minds, imaging

the day going well

• Gain more information of how the female body works during labour

How does fear effect birth?

Dr. Grantly Dick-Read

Dr. Grantly Dick-Read – 20th century English obstetrician (London 1913)

“My theories are drawn from observation at the bedside of labouring mothers, not in a

laboratory”.

Dr. Grantly Dick-Read

• Discovered the Fear-Tension-Pain Syndrome• “Fear is the cause of tension within the body”• Scientists discovered in mid-seventies that a

source of natural analgesic was within the body • Endorphins – neuropeptides in the brain and

pituitary gland (80 times stronger than morphine)• Endorphins produce a tranquil, amnesiac

condition

Fear Response• Adrenaline effects birth in a negative way• Muscles tighten and blood supply is reduced in

the uterus as it moves to the arms and legs gearing you for fight or flight response

• Adrenaline blocks the release of Endorphins (the bodies natural pain killers)

• Endorphins – 80 times more effective than Morphine, you want those available during birth!

• Fear constricts muscles, not expands and dilates them!

Relaxation and Uterus Function

• Increased blood supply/oxygen to Uterus • Muscles of Uterus are able to function effectively • Each contraction works in harmony with your

body and feels comfortable • Each contraction is effectively dilating your

cervix

• Relaxation aids in dilation of cervix

What do we cover in the Birth Secrets Classes?

• Breathing • Visualisation • Language • Body position • Knowledge of how the body works• Give parents a sense of control & confidence• Release fear about childbirth• Bonding with baby • Light Touch massage • Birth Plan

Promoting Mental Wellbeing with Hypnosis

• Education of bodies natural function

• Confidence in body• Language• Knowledge • Encouragement • Relaxation • Breathing • Body Position• Visualisation

• Support • Confidence • Advice • Realise the miracle of

birth• Excitement • Preparation • Positive Birth Stories• Role of the Birth Partner

Promoting Mental Wellbeing

Feeling prepared for Childbirth reduces the rate of post natal

depression to “virtually absent”!

Quote from Dr. Michel Odent

World renowned advocate of gentle birthing.

“One cannot help a physiological process. The point is not to hinder it.”

If we hope to create a non-violent world

where respect and kindness replace fear and hatred …

We must begin with how we treat each other

at the beginning of life

For that is where our deepest patterns are set.

From these roots grow fear and alienation

or love and trustSuzanne Arms - Immaculate Deception

Thank you

Happy Birthing!