For thousands of years, both men and women considered agonizing pain to be an inevitable part of childbirth. Suffering during labor and delivery was accepted as part of the price that all women must pay for original sin. Pain relief was considered a violation of God's will and a disruption of the natural order. In fact, women who attempted to use anesthesia or other means of pain relief were treated as heretics. For example, in 1591, a woman in Edinburgh, Scotland, requested pain relief while giving birth to twins. She was convicted of acts "contrary to divine law and in contempt of the Crown" and ultimately burned at the stake.

Fortunately, times have changed. Punitive suffering need not be part of modern childbirth. Virtually all midwives and health-care practitioners strive for relaxed, successful birth experiences, whether or not they use hypnosis with their patients. While the word hypnosis continues to conjure up images of entertainers who make willing subjects quack like ducks or perform other embarrassing acts, it is also used by thousands of medical doctors, midwives, psychiatrists, and psychologists.

Though the practice has not always been defined as hypnosis, the induction of a trance state is part of human nature. Mothers instinctively rock their babies back and forth and pat them on the back to sooth them and induce an almost hypnotic state of calm. Even though mothers have depended on such techniques to comfort their babies for eons, the actual practice of hypnosis was not formalized until about 250 years ago.

Modern hypnotherapy started in the mid-eighteenth century when Viennese physician Friederich Anton Mesmer (1734-1815) set forth his theory of "animal magnetism." Mesmer hypothesized that the body contained a magnetic fluid that ebbed and flowed in accordance with an internal tide that responded to the tides of the oceans and the gravitational pull of the planets. He believed that illnesses were caused by imbalances of the body's tides and that a more harmonious distribution of magnetic fluid could cure disease. To patients afflicted with illness or disease, Mesmer offered a simple cure. He had them drink a potion that contained iron, and he created an "artificial" tide by attaching magnets to their bodies and transferring his fluid magnetism to them. This focus on magnets resulted in the term "animal magnetism."

Mesmer believed that the "magnetic fluid" could be transferred from one person to another, or, more precisely, from himself to his patients. Mesmer's healing rituals involved a dramatic display of hand waving and moving magnets in front of his patients while offering soothing words to calm them. He brought his patients into a state of focused attention; even today we say a person is "mesmerized" when he or she is entranced or in a state of deep concentration.

Mesmer's version of hypnosis became very popular for a time, but then his colleagues in Austria labeled him a charlatan. Still confident of his technique, Mesmer moved to Paris in the 1780s and was considered a miracle healer for a number of years. At the peak of his popularity, Mesmer held mass healings in which he filled large oak tubs with "magnetized" water, iron filings, and broken glass. As many as twenty people held metal rods that protruded from the sides of the tub. By touching the metal rods, people believed that the energy of the water flowed into their bodies and stimulated the circulation of the magnetic fluid within them.

While many people were impressed with Mesmer's abilities, others were less sure of them. One of the final straws came in 1784 when Mesmer suggested that women need not suffer pain during childbirth. That same year, a royal commission of Louis XVI, headed by Benjamin Franklin who was visiting overseas, determined that all that took place during one of Mesmer's healings was an "excitement of the imagination." Mesmer himself acknowledged that animal magnetism "must in the first place be transmitted through feeling." He recognized the importance of emotion in his healings, and he had an impressive, imposing air similar to that of a modern-day faith healer. He also was able to make pointed suggestions, often telling his patients in great detail what was going to happen to them. In essence, Mesmer's colleagues played down his success and attributed it to the placebo effect, in which a person's expectations trigger a response.

Despite the scientific establishment's rejection of mesmerism, other healers were intrigued by the practice. One of the best known was a Hindu-Portuguese priest, Abbe José de Faria, who began to look at the practice in more analytical terms. In 1819 he concluded that the cause of the trance state (which he called "lucid sleep") was caused not by magnetism but by concentration by the subject. Faria had his clients relax, lean back, empty their minds, and concentrate on falling asleep, which most promptly did. He could then induce them to feel illusions of heat and cold and to experience various tastes and smells.

Faria had his patients stare at a stationary object, a hypnotic technique now called fixed-gaze hypnosis. He found that after his patients stared at the object and reached a point of heightened concentration, they were in a highly suggestible mood. At that point he commanded them to stop feeling their symptoms. In this way he produced near miraculous healings.

During this period, medical experts were gaining a greater appreciation for the mechanics of hypnosis. In the mid-nineteenth century, Dr. James Braid, a well-known surgeon from Manchester, England, coined the word hypnosis, after Hypnos, the Greek God of sleep. Rather than referring to what transpired in a trance as animal magnetism, he referred to it as "nervous sleep" brought on by hypnotic suggestion. Braid was also the first to attribute the success of hypnosis to psychological rather than physical variables.

Like his colleagues, Braid had been very skeptical of mesmerism and animal magnetism, but he was intrigued with the practice after watching a mesmerist from France in 1841. Braid then began to experiment with hypnosis, and he eventually refined his technique, then used it to perform pain-free surgery after inducing a trance in the patient by staring at his subjects with a focused, authoritative gaze. Braid used hypnosis routinely in his medical practice during the 1840s and 1850s. He knew from experience that he was able to bring on a relaxed, sleeplike state in his patients, but he did not know why he was able to do so. Braid appreciated that the mind and body were intertwined, but he did not understand how the two interacted.

Another major breakthrough came when word spread of the work of Dr. James Esdaile, a British doctor working in India who used hypnosis as anesthesia when he performed as many as two thousand major operations, including at least nineteen amputations. Dr. Esdaile either passed his hands over the affected body part or simply pointed his finger at the patient until he or she entered a trance.

Hypnosis remained in vogue in some circles into the late nineteenth century. At that time, a respected French doctor, Dr. Hypolite Bernheim, founded the Nancy (France) School of Hypnotism. One of Dr. Bernheim's students was the well-known Viennese therapist Dr. Sigmund Freud who was intrigued by the practice of hypnosis. Freud used hypnosis to help patients explore how their feelings about past experiences might contribute to their current emotional problems. As his practice developed, Freud turned from hypnosis to other techniques, such as free association and dream interpretation, which became the cornerstones of psychoanalysis, but Freud readily acknowledged that many of his ideas about the human psyche began with his interest in hypnosis.

Medical practices tend to rise and fall in popularity, and psychoanalysis and other practices overshadowed hypnosis in the early part of the twentieth century. Hypnosis fell out of favor until the 1950s when Dr. Milton Erickson began experimenting with it for the treatment of both mental and physical ailments. Dr. Erickson is probably the best-known hypnotist of the twentieth century; his research on the practice has influenced thousand of hypnotists, psychotherapists, and hypnotherapists. Dr. Erickson's work demonstrated that hypnosis could be used to help people internalize new ways of thinking and behaving without being aware that they were learning.

Dr. Erickson's work legitimized hypnosis in the eyes of the medical community. In 1955, the British Medical Association approved hypnotherapy as a valid medical treatment and an effective form of pain control during childbirth. The association stated, "In suitable subjects, it [hypnosis] is an effective method of relieving pain in childbirth without altering the normal course of labour." The American Medical Association followed suit in 1958, concluding, "The use of hypnosis has a recognized place in the medical armamentarium and is a useful technique in the treatment of certain illnesses, when employed by qualified medical personnel."

Today, the therapy is so widely accepted that the American Society of Clinical Hypnosis, a professional association of physicians, psychologists, and dentists, boasts more than four thousand members. Hypnosis is now mainstream. It is even recognized by many health-maintenance organizations.

When it comes to the use of hypnosis in childbirth in the United States, no one has contributed more than Dr. Joseph B. DeLee, an obstetrician who took the radical stand of openly arguing that a woman need not suffer in childbirth. He realized in the 1930s, when hypnosis was out of vogue, that with hypnosis some women could relax profoundly during labor and delivery. Dr. DeLee advocated hypnosis as being the "only anesthetic without danger" and told the profession: "I am irked when I see my colleagues neglect to avail themselves of this harmless and potent remedy."

In the past fifty years, thousands of studies have validated the experience of Dr. DeLee and measured the efficacy of hypnosis. Today most people accept the mind-body connection and do not find it extraordinary to believe that the way a person thinks can alter the response of his or her body's systems, including the autonomic or involuntary body systems (such as temperature and blood pressure). Many modern health-care practitioners may find this result unremarkable, but at the time this was considered an unbelievable, incredible, and unexplainable claim.

Now you, too, can capture the power of the mind-body connection and use it for a more joyful, pain-free childbirth. But first you have to practice the techniques outlined in this book, ideally with the help of a trained hypnotherapist. The next chapter will help explain the mechanics of childbirth and describe how hypnosis can be used as an alternative to anesthesia.