TAKING THE PAIN OUT OF LABOR AND DOING IT NATURALLY.

Byline: Mariko Thompson Staff Writer

When Tanya Fox became pregnant four years ago, she wanted to give birth without an epidural - a painkiller injected into the base of the spine. But she feared that she wouldn't have the fortitude to stick with that decision if the labor pains became too intense.

To prepare for childbirth, the Westlake Village resident enrolled in a class called HypnoBirthing, which uses self-hypnosis to induce relaxation. When the first contractions hit, Fox immediately used a progressive relaxation exercise from head to toe.

``I never asked for the epidural,'' says Fox, who gave birth to a boy and is now pregnant with her second child. ``I never needed it. The class gave me the added confidence that I needed.''

Seeking to ease the pain of labor without medical intervention, many pregnant women turn to relaxation techniques that have proven useful in the labor and delivery room. Relaxation tools such as self-hypnosis and yoga are taking their place alongside old standbys the Lamaze and Bradley methods for expectant moms.

Where once doctors dismissed the usefulness of Lamaze and Bradley, most now encourage pregnant women to take birthing classes. The more women know about childbirth and the more calm they are during labor, the better the births tend to go, says Dr. Ken Murray, a family doctor in North Hollywood.

``It makes an unbelievable difference,'' Murray says. ``It's night and day.''

Most American women have heard horror stories about childbirth and have been conditioned to fear the pain. Understanding the childbirth process and using relaxation techniques makes women feel more in control, says Louise Matheus, a registered nurse and department administrator for labor and delivery at Kaiser Permanente in Woodland Hills.

``Fear in any circumstance causes tenseness,'' Matheus says. ``If you decrease the fear, it can cut hours off labor.''

More than breathing

Through TV and movies, Lamaze has come to be associated with noisy breathing. But breathing techniques are just one part of the Lamaze philosophy, which is centered on natural childbirth. In Lamaze classes, parents learn about the importance of movement and different birthing positions. Lamaze encourages walking, which uses gravity to help bring the baby down. Educators go over positions that are conducive to birthing, which include squatting.

``The worst possible position is lying on your back,'' says Ellen Steinberg, a Tarzana-based Lamaze instructor and lactation consultant.

Then, of course, there's the vaunted breathing techniques, along with visualization exercises and massage.

Steinberg notes that the childbirth-preparation classes at most hospitals teach a generic version of Lamaze. Few are run by instructors with Lamaze International certification. These days, most certified Lamaze International instructors teach classes in their homes, she says.

Besides Lamaze, the Bradley Method is another popular form of natural childbirth where the expecting mother's partner serves as birthing coach.

Hypnotize yourself

When pregnant women come to hypnotherapist Teresa Van-Zeller, they're either frightened of childbirth, wanting to do natural childbirth, or both. Developed by Marie Mongen, HypnoBirthing teaches self-hypnosis techniques for pain management and relaxation. While most people view hypnosis as a parlor trick, almost everyone has experienced it, says Van-Zeller of Woodland Hills.

When you drive the car home without thinking about where you're going, that's a state of hypnosis.

With HypnoBirthing, Van-Zeller has her clients determine whether they respond to visuals, sound or touch. If the guided-imagery exercise has the class imagining themselves at the beach, one woman might envision the sand and the water, another might hear the waves crashing and the cry of sea gulls, and yet another might feel the warm sand between her toes. Tapping into the natural response deepens the hypnosis experience, she says.

In HypnoBirthing, contractions are called ``surges,'' a term less associated with pain. Through the power of suggestion, the perception of pain becomes altered. The women learn to ride through the surges and focus on enjoying the time between them, Van-Zeller says.

``The mind is a powerful thing,'' she says. ``Any kind of pain is exacerbated by the fear of pain. Hypnosis is stress reduction and deep relaxation.''

The yoga solution

In prenatal yoga, Katie Wise focuses on strength-building, meditation and endurance. An instructor at Pregnagym in West Hills, Wise has her expecting moms do poses that work the lower body, performing stretches to open the pelvis and squatting poses that strengthen the quadriceps. In meditation, they focus on deep breathing into the belly to calm the mind.

They also learn to push through the pain by doing ``keep up'' exercises. These are simple movements, like doing small circles with arms outstretched, that last for five to nine minutes. Soon the muscles are screaming with fatigue.

``It's excellent training,'' says Wise, who also is a labor doula or coach. ``They come up against their edge and feel exhaustion, frustration and even a little pain. They get used to the idea that not all pain is a warning. They see the mind is wrong - and they can keep going. It's a mini-simulation of labor.''

Do it your way

Of all the relaxation methods, Lamaze continues to be the most common at Kaiser Permanente, says registered nurse Matheus. But anything from listening to a favorite CD to sitting on a birthing ball to taking a warm shower helps the body relax, she says. Aromatherapy has become increasingly popular, too. (Wise makes a blend of rose, ylang ylang and clary sage oils. She also recommends jasmine, peppermint and lavender.)

Whatever method they choose, women shouldn't be made to feel guilty if they opt for an epidural or if they experience pain, Wise says. Very few women experience pain-free births. For the majority of moms-to-be, the question is how to deal with the pain, she says.

``There's no right or wrong way to birth,'' Wise says. ``The more tools you have, the better. The tools that help the most include some flexibility and room for the unexpected.''

Mariko Thompson, [phone]

mariko.thompson(at)dailynews.com

FOR MORE INFORMATION

Lamaze International, [phone] or www.lamaze.org. Ellen Steinberg, a certified Lamaze educator and lactation consultant in Tarzana, can be reached at [phone].

The Bradley Method, [phone] or www.bradleybirth.com.

HypnoBirthing, www.hypnobirthing.com. Teresa Van-Zeller, a certified HypnoBirthing instructor in Woodland Hills, can be reached at [phone] or by e-mail at Hypno2000t(at)aol.com.

Prenatal yoga at Pregnagym at West Hills Hospital, [phone].

CAPTION(S):

5 photos, box

Photo:

(1 -- cover -- color) Just Relax

Expectant moms use varied techniquex for a drug-free delivery

Shane Michael Kidder/Photo Illustration

Tina Burch/Staff Photographer

(2 -- 3) Above, Miguel Ochoa and Xochitl Flores rub her belly during a lesson in relaxation techniques in the Lamaze Preparation class at Kaiser Permanente in Woodland Hills. Above left, Tarzana resident Tammy Frizian's husband Sam gives her a back massage - another technique aimed at relaxation and pain relief - during the class.

(4) Frank and Susan Bernardo of Granada Hills follow along in the Kaiser class, where the emphasis is on giving couples more control through knowledge of the birthing process.

(5) Rotem, left, and Azi Nissim of Woodland Hills, foreground, get close during the Kaiser Lamaze class.

Evan Yee/Staff Photographer

Box:

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