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As in surgery, pain often plays a large part in complications of pregnancy and delivery. In our culture deliveries and surgical procedures are carried out in similar settings. Thus the fear associated with doctors, caps and gowns, scalpels, surgical orders, injections, intravenous fluids, and anesthesia attend both. This fear and our social programming tend to intensify the experience of pain. The process of giving birth need not be an excruciating ordeal. It can be taken matter of factly, as part of the experience of life, or it can actually be an ecstatic, joyful event. Indeed, if one observes animals giving birth, or women of certain tribes, who stop on the way to work, deliver, rinse off their babies and wrap them in a shawl, and continue to the marketplace, barely stopping to rest until the end of the day, one realizes just how natural, normal, and positive the birth experience can be. These people and the animals do not experience the fear of childbirth that we find in our society.

The fact that this fear is so endemic in our culture might, however come as less of a surprise if we examine some of the programming of the modern woman. She is constantly presented with photographs and stories of malformed babies and women who have died during pregnancy. Even the uterine contractions that occur during the birth process are called labor pains, leaving nothing to the imagination as to what one's experience ought to be. And in our vernacular, anyone who is distraught and complaining might be described as having a baby.

Few have not heard a gory tale of a baby's head getting stuck or of a woman's vaginal tissues tearing during delivery, requiring painful surgical repair, though it is rare for serious complications to occur with our present level of obstetrical skill. What is not passed on with this information is that in many cases the woman's fear causes such tension in the vaginal area that proper passage of the baby is not possible. A woman who is very frightened at the time of emergence of the infant's head is much more likely to give a panic-stricken push rather than heed her physician's instruction to allow it to come slowly and smoothly. The resulting tear is then the focus of the story you hear from her, and the blame is placed on herself, the doctor, the baby, or the process of birth itself. But often tension, expectation, and mental imagery is at fault.

A few years ago it would have been almost medical heresy to discuss what is today commonly accepted as natural childbirth. Numerous different methods are available, including the well known Lamaze and Leboyer techniques. All of them focus on the elimination of fear and the substitution of positive conditioning, a positive environment, and positive expectations. My approach to a delivery has been based on similar principles. First, I teach methods of deep relaxation.

After the relaxation, positive image visualization is used to help the unconscious to realize that pregnancy and delivery are normal functions of the body, and that uterine contraction involve no more discomfort than the contractions of the biceps or any other muscles of the body. The delivery is visualized as proceeding slowly and calmly. An understanding is developed that panicky feelings can actually hinder its progress and cause the very problems that the woman wishes to avoid. Suggestions similar to those given for use prior to surgery are used, along with visualizations of a comfortable birth and relaxed rest period following that. I also make clear the fact that the less fear present in the mother at birth, the more unlikely the child is to be in any distress when born, and the fewer complications for both.

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