You know that feeling you get when you're entirely absorbed in a creative work or experience, when the place where you physically are in in the world starts to fade away?
A movie theater becomes a ship's deck or the surface of the moon.
The pages of a book transform into a faraway rainforest.
A single painting is suddenly a lush garden.
If you don't personally experience that kind of immersion, perhaps you've had a time when you've felt utterly present. Maybe it was during a "once in a lifetime" moment: a looking-over-the-rim-of-the-Grand-Canyon, just-achieved-a-huge-goal, Kelly-Clarkson-might-sing-about-it time. Maybe it was just when you were taking a walk or washing dishes and you realized you weren't thinking of the past or the future. You were simply right there, right then.
The ability to visualize or to remain present isn't just helpful or fun in our everyday lives. These abilities can actually become a part of the "toolbox" of comfort techniques that help you to work toward your best possible birth.
Now, I know what you're thinking: "Rhiley, there are no thoughts I can think or words you can say that will make labor into a tropical island. Or that will make me feel present always." And I'm in total agreement with you! In discussing these tools, I as a doula in no way think that visualization/presence will be perfectly successful for everyone or be a sort of "teleportation" out of the experience of labor.
Nevertheless, there are several ways we can use visualization and/or presence that can potentially help you to have your most positive labor and birth experience possible:
View labor as a journey. To some people, it can be helpful to think of labor itself as a long journey from one "place" to another. Find imagery that is powerful to your personal experience: think of a time when you achieved a difficult physical or mental goal and of all the steps you had to take along the way. Some of my personal favorite ways to think of labor as a journey are as climbing/hiking a mountain, sailing a ship to an island, or taking a long bike ride with hills and valleys along the way. With help from your doula and/or support person(s), apply this imagery to the process of labor/birth. Work to integrate it as a comfort technique, whether through printed out pictures, phrases to say during labor, guided visualizations, and/or physical items to take with you to your birthing location.
Think in terms of letting go and empowering yourself. During the experience of labor/birth, our bodies can sometimes tense up, as we're experiencing feelings, pain, and/or sensations we may not have felt before. Using imagery and/or self talk that promotes letting go or empowering yourself can be comforting (e.g.- I am like a river where everything flows, I am a flower opening up, I am strong, I am doing this, etc.)
Reframe contractions. Some people like to think of contractions as "waves" or "surges" running through their body. This reframing can potentially help you settle into a mindset of working with the process of labor, rather than fighting it. At the very least, it can sound a lot nicer to hear "walk into the waves" or "go with the surge", rather than "you're having a contraction".
Concern yourself with the now, not the next. In labor/birth, it can be easy to fall into a mindset where you're constantly worried about how the experience will go or what will happen along the way. Nearly every birth I have attended as a doula has involved a moment where the laboring/birthing person wonders out loud: "Will this ever end?" Cultivating a mindset for yourself and with those who support you of presence can be beneficial to help you move past your "breaking moment". Work together to focus not on the next contraction or when you'll start pushing, but rather on what you're doing in the current moment, and on knowing that you'll get where you need to go whenever you get there.
Surround yourself with people who are present. When reflecting on who all you would like to attend your labor and birth, it can be helpful to think of whether the people who are supporting you are generally present. Sometimes during labor/birth, support persons can settle into patterns that aren't optimal to supporting the experience of the laboring/birthing person, such as:
Thinking on the past in a non-constructive way (e.g. "I remember when I/someone I know gave birth...", "You were a lot more relaxed an hour ago", "You've never had a high pain tolerance")
Actively worrying for the future (e.g. "If the contractions are this bad for you now, how will you feel later?", "What if you have to get a c-section?", "I hope your next nurse is as good as this one")
Unexpected escapism (e.g. using cellphone, watching TV, talking with other visitors, or "zoning out" rather than engaging with the experience of the laboring/birthing person who wants them to be engaged)
Do I anticipate any or all of these strategies will work for every birthing person? Certainly not. Scientifically speaking, the jury is still sort of out on whether visualizations and presence are evidence-based methods to reduce pain or perception of pain in labor. According to a comprehensive 2018 review from Cochrane on relaxation techniques for pain-management in labor, "Relaxation... may have a role with reducing pain, and increasing satisfaction with pain relief, although the quality of evidence varies between very low to low... Further randomised controlled trials of relaxation modalities for pain management in labour are needed."
While we wait to see what research continues to discover, in the interim, there are no risks to utilizing visualization and presence as comfort techniques if we so choose. These strategies can influence our approach not only labor and birth, but also life itself. I mean, basically any experience is improved by being on the metaphorical beach, right?