The Headspace Guide To A Mindful Pregnancy

by Andy Puddicombe

  WEIGHT GAIN

  However well you eat, and however much exercise you do, there is one thing that’s unavoidable and that’s the gaining of more weight than you’ve ever imagined before. Well, that’s obvious, I hear you say. But, for a lot of women, this doesn’t make it any easier to accept. Indeed, at some point during the third trimester, if not sooner, someone will think it’s perfectly fine to come up and say, ‘Look at you … you’re huge!’ It seems pregnancy gives others the impression that they have the right to comment on your body. Maybe even touch it, too. Some may say not to worry about the extra weight – ‘Relax, go with the flow, don’t worry about it’ – but that’s easier said than done.

  With all the extra pounds, it is not uncommon for some women to become body dysmorphic, hating what is happening to them. This one thing alone can be a major source of stress, especially if you happen to be a fierce dieter or the athletic type who has always been loath to gain even a few pounds. It can be hard to accept the extra 15–30lb. And if you are someone who has struggled with weight in the past, the idea of adding to your body mass can be very depressing.

  Whatever your shape and size, you will most likely pick clothes out of the wardrobe and realise they don’t fit any more; or you’ll be desperate to un-stretch the third trimester stretch marks; or you’ll think things like, Will I ever lose this baby weight? or Will my partner continue to find me attractive?

  As ever with mindfulness, all this requires a shift in perspective, looking at it through the lens of impermanence and acceptance. With mindful eating and mindful exercise, weight gain can be significantly reduced, while still leaving plenty of good nutrients for the baby to grow at a healthy rate. With that in mind, view the extra pounds as a reminder of that little bundle of joy growing inside you. And remember, weight gain is necessary for a healthy pregnancy: it is a good thing. It won’t last for ever and, if you’re anything like most mothers, you will almost certainly look back at some stage in life and wish you could do it all again.

  If you could only see it through the eyes of nature, you would never lose a single moment worrying about weight gain in pregnancy. It is a necessary and beautiful thing. Mindfulness will help you see this, allowing you to let go of the anxiety, the fear, the shame, the guilt, and instead be empowered by this miraculous event.

  CHAPTER ELEVEN

  MOVING THROUGH THE PAIN

  Before we enter the delivery room, or home birthing pool, or whatever your plans may be, I’d like to dedicate some time to that which is usually spoken about only in hushed tones: the sheer pain of childbirth. As a friend of mine said to his wife shortly beforehand … ‘Darling, this might smart a little.’ (And yes, he was appropriately reprimanded afterwards.)

  But right upfront I’d like to reassure you that not only is every delivery different, but mindfulness will ease the way for both you and your baby. I remember almost falling off my chair as we sat in the recovery room just hours after the birth and my wife asked me, in all seriousness, if we could have another one! How can you even think about it, after that? I thought. Sure, there was a heady mix of hormones and pain relief in the air, but still, the very fact she could contemplate such a thing so soon after, is testament to the resiliency of both body and mind.

  As a man writing a book about pregnancy, I fully appreciate that I have no true reference points when attempting to comprehend what this experience feels like. But based on the pain I felt as my wife squeezed off my fingertips, it must have been excruciating at certain moments.

  Of course it is not just men who are in the dark about this, for until a woman has given birth, she is armed only with hearsay, the experience of others. So it is no surprise that so much fear and anxiety exist around the event.

  Naturally, we each have a different pain threshold – the sensation of pain is such a subjective thing – so not even the most seasoned midwife can pinpoint what the experience will be like on a scale that perhaps starts somewhere around ‘quite painful’ and ends at something like ‘unimaginable’. Neither can they say what the most painful part will be. As a relatively small woman, my wife fully anticipated the crowning of the head to be the worst moment, but reflecting back on the experience afterwards, she said that the delivery itself was no more painful than some of the mountain-bike races she’s taken part in. ‘But the contractions …’ she said, ‘wow, they were something else!’

  Of course, hindsight is one thing, and we all tend to be pretty good at that. But the mind is less adept with foresight, especially after absorbing so many wince-worthy tales from mums who’ve already been there. Ask your partner to consider that for a second: imagine if someone says that if we walk down a certain road, we’re certain to meet a force that is going to hurt like hell; in fact, it might be the worst pain we’ve ever felt. How many of us men would keep walking down that road? Yet women have no choice but to keep walking, relatively blind. Consequently, and especially from the start of the third trimester, worry plays a big role in trying to figure out what lies ahead.

  One of the little-known benefits of mindfulness is its ability to aid pain relief. It’s why Headspace is currently being used in clinical trials with the NHS to investigate the impact of mindfulness as an intervention for pelvic pain. Indeed, published data from studies in the US would seem to suggest that in some cases mindfulness can be even more effective than morphine!

  In the same way that athletes learn mindfulness before going into competition because they know it’s going to help them focus, be less distracted and more able to cope with pain, so expectant mothers can become mentally stronger ahead of childbirth. Alongside all the physical preparation, the more you meditate and train the mind, the more confident and proficient you will be when the due date arrives. And by the way, this doesn’t only apply to labour and childbirth; it offers a remedy for those who experience back or pelvic pain during pregnancy, or any other kind of physical pain caused by injury or disability. Whatever the reason we’re experiencing sickness, aches or pains, we can fundamentally shift our perspective through the practice of mindfulness.

  There is good reason why paramedics arriving at the scene of an accident encourage patients to take deep breaths, to relax as much as possible, because the more stressed out we become, the more tense the body gets, and the more acute the pain feels. By learning to focus our attention on the sensation, rather than getting caught up in the idea of pain, we disengage from the thought surrounding it – namely, the alarm, the panic, the stress – and, therefore, reduce the level of perceived pain. In bringing awareness into the equation, we effectively get to reframe how we appraise the sensation in a whole new, less reactionary context. Getting away from the emotionally charged ‘story’ and instead getting into the body is how we find relief.

  ‘SCRATCHING NOT ALLOWED’

  As part of my monastic training, I inevitably spent a lot of time sitting on my backside, often meditating for many, many hours a day. When one meditates for such extreme lengths of time, there tends to be a bit of discomfort along the way, either through sitting in one position for most of the day, or due to the residual tension and stress being released in the body. It was rare for that discomfort not to escalate when meditating at that intensity, so we had to find ways to work with the resulting aches and pains. Interestingly, when it comes to physical sensations, instead of zooming out to see a bigger picture, (as we do with thought) we zoom in – it’s more of an investigative mind, homing in with a gentle curiosity that examines it in more detail.

  But before we got to look at pain, we first had to sit with an itch.

  A rule in one particular monastery – one of many rules – was that we were not allowed to scratch an itch. At first that sounded a little crazy, until we looked at the idea and motivation behind it. As we sat there, during those endless hours, it didn’t matter if we felt the slightest prickliness on the arm or a little tickle behind the ear, we weren’t allowed to scratch. Even if a mosquito landed on your head, or a spider was crawling up
your arm, there was no scratching. Full stop. And when told you can’t scratch an itch, guess what the mind does? It finds the itchiest itch it can possibly find and urges you to scratch it like crazy!

  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.

  MEDITATION VERSUS MEDICATION

  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.

  CHAPTER TWELVE

  LABOUR AND CHILDBIRTH

  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.