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The Nocebo and Placebo Effect and how they Affect Birthing People

Updated: Jul 16

The human body's health is directly impacted by the thoughts that are held by the person. You are essentially what your beliefs are. If you believe you will be young and beautiful, you will be. If you believe you will become old and decrepit, you will. Our thoughts and actions become the basis of our health.


Equally as important are the messages that we hear from others regarding ourselves. When we hear positive feedback from others about our appearance or achievements, we strive to do better or look better. When we hear negative comments consistently, we become disengaged with who we are and apathetic to achievement and appearance.


Our beliefs ultimately shape who we are and what our realities become.


Most people have heard of the placebo effect- which is the body's ability to regain health when the mind believes that the placebo treatment provided will heal it. The mind's ability to heal the body is an essential part of all healing. Indeed, health outcomes improve when the mind believes that the treatment provided (whether medical or a placebo) will be effective. The Placebo Effect is well documented because many drugs and health treatments are tested against placebos to verify their efficacy and determine whether or not they are as effective as the mind's ability to heal the body. The placebo effect proves that the mind has an incredible ability to impact positive health outcomes.


The same is true in birth. When it is believed that a positive birthing outcome will be achieved then the likelihood of complications reduces. Furthermore, when you have a care provider who supports you and reaffirms positive birthing outcomes and reassures you, this contributes to your underlying belief and can increase the positive impacts of the placebo effect. Your likelihood of a positive birthing outcome increases when you have the support of those who care for you.


The nocebo effect is the opposite of the placebo effect and is equally if not more powerful as it is still the mind that is generating the beliefs about the outcomes. Essentially, the nocebo effect is when the mind believes that a negative outcome will occur as a result of a treatment. Regardless of the effectiveness of the treatment, if it is believed that the treatment will cause more harm than good, the likelihood of a negative health outcome increases.


The nocebo effect can be exacerbated by care providers as well when they go over possible negative outcomes resulting from any given treatment. When the person receiving the treatment believes that negative side effects will result from the treatment, and their healthcare provider has reiterated the risks of taking on the treatment, therefore reaffirming the belief held, the health outcomes usually go awry as well.


How does this relate to birth?


In many countries, birth has become a highly medicalized event. Caesarean births have been normalized and many birthing people question their own ability to birth without having this major abdominal surgery. Additionally, a hospital setting and medical interventions are seen as necessary for a natural vaginal birth. As a result, many pregnant people doubt whether or not they will be able to give birth without active medical management. The media has contributed to this distrust of the pregnant body by portraying birth as a scary, painful experience and perpetuating the belief that birth is something to be feared.


Birth is unpredictable.


Often, birth is seen as something that needs to be managed or controlled in order to ensure safe outcomes. But what happens to the pregnant person's mindset when they are consistently inundated by social and medical cues indicating that birth is unsafe? Trust in the body's innate abilities and wisdom are lost and the nocebo effect can prevail.


When care providers suggest that extra ultrasounds are needed or it is dangerous to carry a pregnancy past a certain amount of weeks, this can indicate to the pregnant person that their body is no longer safe for their baby and that they can no longer trust the their pregnancy or the natural physiological process of birth. When the media shows portrayals of birth as a painful or freightening, this can lead the birthing person to feel unsafe in their body and not trust in the natural physiological process of birth. Ultimately, it can lead to poor health outcomes for both the pregnant or birthing person and baby when fear becomes the baseline for pregnancy and birth.

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