For years before pharmacological anesthesia came about, patients underwent surgical procedures while under hypnosis. In present day hospital settings, patients may feel overwhelmed by external situations, such as the stress of the hospital environment, and become more vulnerable and responsive to suggestions given by their doctor. So the doctor's suggestion can function as a hypnotic suggestion - if he says "this will hurt" - the patient actually feels increased pain; alternatively, if he says "relax it will be fine", the patient feels less pain.
As a woman who has birthed twice and having been involved in the birth community for some years, this is so true when it comes to birth. The birthing woman's senses are extremely heightened. She is focused inwards and yet at the same time suggestions/ comments from others, especially her care-provider (whom she usually holds in high regard) can affect her tremendously. If her husband or Birth Companion, says positive things to her such as "Relax, Trust your Body", this can have a soothing and calming effect on her mind AND her body. If on the other hand, her nurse or doctor asks "Do you feel any pain? Would you like an epidural?"---- this will also affect her, but in adverse way. She may not have felt any pain prior to this, but once the reference to pain and drugs is mentioned, she starts to believe that she is meant to feel pain, and then she actually WILL. She then takes on the role of "helpless patient" and may ultimately unwittingly give up control of making decisions in her birth to her care-providers.
So what can we do?
1) Choose your careprovider VERY carefully
This is a major decision you'll make that may determine your chances of having a gentle birth. Interview your doctor, and observe the way he/ she talks to you and treats you. Does he come from a very cautious viewpoint about birth? Is his philosophy - birth needs to be helped by medicine? Or is he happy to let nature take its course? Usually mothers are very instinctual and can tell if doctor is just stringing her along or if he really intends to honor her wishes for a gentle natural birth.
2) In your birth preference sheet, state that you would appreciate that labor ward staff to refrain from any references to pain or drugs in the birthing room, and communicate this to your care-provider
Depending on your doctor, he may or may not have control over this. If he is known to be a pro-natural doctor, the nurses and midwives may be used to his style of working and refraining from suggestions of medical help to his patients. Other times, its hit-and-miss - it will depend on which nurse or midwife is on duty on the day.
2) Do research about your intended place of birth well before your EDD.
Find out the attitudes of the staff in the labor ward. This will tell you alot about what their philosophy is - Do they rush to administer drugs to you to help labor along? Do they encourage natural means of managing labor? e.g. Do they encourage you to utilize hot showers, walking, changing positions, etc?
3) Hire a Doula
A Doula is a professional birth companion that supports the family emotionally and physically. Trained Doulas know the ins and outs of hospital policies and procedures and can provide the family with information for them to make informed decisions.
4) Father/ Birth Companion needs to protect mom's space
Birthing naturally in a hospital takes a lot of effort and preparation. The hospital is a huge system which has many policies and procedures in place to ensure things flow smoothly from a medical, legal as well as business aspect. The woman birthing without any intervention in the hospital is an EXCEPTION to the rule, not the norm. So it takes a lot of effort and preparation on her part. On birthing day, the father or Birth Companion needs to be vigilant about protecting mom's privacy and space. This certainly can be done - however, it takes assertiveness, firmness and a little bit of ingenuity :)