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Clinical Autogenic Training in Pregnancy
Dr Alice Greene MRCGP, DCH, Dip Obst, Dip AP
AT has been used for many years both in the treatment of primary infertility (1) and in pregnancy and childbirth. It has been shown
to bring significant benefits during the ante-natal period, labour itself, and also post-natally. Documented clinical trials show
that using AT can reduce the pains of labour and helps speed up the first and second stages. Based on all the research findings(2),
the use of AT for birth preparation appears highly commendable. Ante-natal Regular practice helps abolish or significantly reduce many of the complaints of pregnancy including nausea, vomiting, constipation, breathlessness, irritability, tension and anxiety, indigestion, physical discomfort and insomnia. Fear and anxiety also respond very well. And, by reducing tension and stress, and normalising blood pressure and heart rate, AT helps prevent the onset of toxaemia of pregnancy. Labour The deep relaxation of AT allows the physiology of the body to do its job naturally and well. This reduces fatigue and exhaustion, and helps keep blood pressure, breathing and heart rate at optimal levels. Pain and irritability are minimised by reducing stress, tension and muscle spasm. AT has also been shown to shorten the time of cervical dilatation by 3-4 hours, to increase the strength and effectiveness of contractions and reduce their number by one fifth, so that labour is approximately one third shorter. Using the exercises in a specific way to coincide with the timing of the contractions can bring about considerable pain relief. Post-natal Here AT can certainly help rapid recovery from the physical and emotional stresses of labour and delivery. It has also been shown to boost milk production (3) and reduce post-natal depression. Another positive benefit is to help insomnia, and getting back to sleep after night feeds. Research The work of Professor Prill (4) (on the use of AT helping mothers in labour) in the Department of Obstetrics at the University of Warzburg was particularly impressive. One of his several studies involving 1,000 women, showed very convincing advantages of using AT over no treatment for the reduction and length of labour pain. AT-trained mothers had 30% shorter labour (for both first and subsequent babies), 20% fewer contractions, and a subjectively less distressing birth experience. Another study of 302 women who had used AT during their pregnancies found about 70% of them said they had experienced 'notable pain relief'. Professor Prill, in agreement with observations reported by other authors, concluded that 'Autogenic Training helps significantly in facilitating, economising and accelerating the physiological processes of natural delivery' (5) Much of the work done today is still based on Prill's research. In a Japanese pilot study in 1977 (6) the authors commented that even a very small number of AT exercises may a) shorten the 1st and 2nd stages of labour, b) decrease or prevent asphyxia in the newborn, c) reduce plasma cortisol levels during labour and delivery. A variation on traditional AT was tested against a Lamaze (7) trained group in Italy in 1979 (8). Both groups tested similarly for many birth outcomes, but the AT-trained women reported less anxiety prior to, and less pain during, labour. Also, the expulsion time was shorter, thus replicating Prill's observations. Learning Autogenic Training The best time to learn AT is in the first six months of pregnancy if possible. Because of the potential risks of altering placental blood flow, the fifth standard exercise (abdominal warmth) is omitted. As pregnancy advances, a variation on the training postures ensures good body support and comfort. Fathers-to-be are highly recommended to learn AT, both for themselves, and to become a calm support for their partner.
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