Hypnobirthing
by Debra Rose Wilson, PhD MSN RN IBCLC AHN-BC CHT, and Debbie Finken, MSc PhD
Abstract: Hypnosis has been used for
treatment of sleep, pain, and numerous
other disorders for thousands of years.
While still considered fringe by many
today, hypnosis has been considered
mainstream by many, even in the United
States. Many cultural practices include
hypnosis as part of a holistic approach to
treatment. Hypnosis for childbirth is not
a new concept and hypnobirthing practice
is increasing. Certification as a practitio-
ner of hypnosis can be a viable option for
many childbirth educators.
Keywords: evidence-based, hypnosis, hypnobirthing, history, certification
Introduction
A woman contemplates the experience of labor begin-
ning when pregnancy is confirmed and more as she draws
closer to the end of her pregnancy. Portrayal in media and
society often presents labor as difficult, painful, something to
be feared. The reality of the labor experience is different for
each woman, but there is a commonality of concern about
expectations of labor. The medical method is the one most
often chosen by obstetricians as an intervention in the labor
process (analgesics, labor inducing drugs, epidurals), with the
assumption that labor and birth are a medical condition and
that the woman’s role is reduced to passive experience (Kukla
& Wayne, 2016). Hypnobirthing changes this dynamic. Hyp-
nosis as a method of inducing a subjective experience where
alterations occur in perception, lived experience, behavior,
beliefs, thinking, sensation, or emotion (Elkins, Barabasz,
Council, & Spiegel, 2015). Hypnosis is a technique used by
therapists to help clients relax and focus, and is based on
suggestion (APA, 2017). Hypnotherapy is commonly used to
treat conditions such as pain control, anxiety, irritable bowel
syndrome, and for helping clients to quit smoking (APA,
2017; National Center for Complementary and Integrative
24  |  International Journal of Childbirth Education  |  Volume 32  Number 4  October 2017
Health, 2015). It is often used as an adjunct to other forms of
counseling and therapies (Society for Clinical & Experimen-
tal Hypnosis, 2017).
Hypnosis is very much like how it feels when daydream-
ing; an experience that is familiar to the average person
when comfortable and content. The method of hypnosis
involves hypnotic induction through body awareness (relax-
ation of muscle groups), internal breath focus, guided imag-
ery provided by an attendant, or self-hypnosis to facilitate a
calm and altered state of consciousness (Lynn, Lawrence, &
Kirsch, 2015). Hypnobirthing takes this method of hypnosis
and applies it to the labor and delivery process. The pro-
cess involves reduction of intrapartum pain and discomfort
through alteration of response and perception of negative
beliefs and fear through concentration and relaxation (Steel,
Frawley, Sibbritt, Broom, & Adams, 2016).
Hypnobirthing is not a fad and it is not new. Elements
of hypnobirthing have been around formally for almost a
century, when Dr. Grantly Dick-Read, an English obstetri-
cian, focused on reduction of fear and tension through
relaxation, and hypnosis has been an American Medical
Association approved part of scope of practice for physicians
in the United States since 1958 (Sakula, 2004). The origins
of the method, the technique, evidence/how it works, and
training will be discussed further below.
Origins of Hypnosis and Hypnobirthing
Egyptians used verbal incantations and rhythmic chants
to facilitate a natural anesthetic state of mind over two thou-
sand years ago (Hammond, 2013). Evidence has also been
found of ceremonies that used hypnotic methods over a
thousand years ago in Chinese, African, and pre-Columbian
cultures (MacHovec, 1975).
While hypnotic, or trancelike states were in continuous
use in many cultures throughout history, it was not formally
explored until Franz Anton Mesmer. Modern hypnosis can
trace its roots back to this 18th century physician Mesmer,
who attributed hypnotic trance states to a form of “animal
magnetism” (Stewart, 2005). Mesmer originally called this
process animal magnetism because of his assumption that
all living things had a magnetic fluid, or common magnetic
continued on next page
Hypnobirthing

iStock.com/ZoneCreative
continued from previous page

force (Hammond, 2013). The technique for mesmerism

required a session in a dimly lit room with music in the back-
ground and a light touching over the patient’s body starting
at the head and going down to the feet (Hammond, 2013).
This mesmerism technique often lasted hours with only ten
percent of the patients unresponsive to the technique (Mor-
gan & Hilgard, 1973).
The term “hypnosis,” from the Greek hypnos, was
first coined by James Braid, a Scottish surgeon in the 19th
century, as he thought the process of mesmerism was similar
to sleep. Braid also is known for taking a more modern, sci-
entific approach to hypnosis (Elkins, 2016). The amount and
quality of research beginning in the 20th century, along with
extensive experience in clinical settings, has given hypnosis
mainstream credibility as a therapeutic tool (Elkins, 2016;
Elkins, Barbasz, Council, & Spiegel, 2015).
Braid adapted the concept as he realized that hypnosis was
not a state of sleep, but actually a concentrated attention and
Evidence of Efficacy
Evidence-based birthing practices have shown that a
prolonged absorption (Tellegen & Atkinson, 1974). In 2014, the
minimalist approach is the most beneficial form of birth-
American Psychological Association, long aware of the impor-
ing for the mother (Wildner, 2008). Use of hypnosis during
tance of hypnotherapy as an essential element of clinical appli-
antenatal and intrapartum periods demonstrate a reduction
cation and research, provided a formal definition of hypnosis: “A
in medical intervention. Sometimes referred to as hypnother-
state of consciousness involving focused attention and reduced
apy for labor, this method involves a mind-body technique
peripheral awareness characterized by an enhanced capacity for
in which the birthing process is reframed as safe, easy, and
response to suggestion.” (Elkins, et al., 2015, p. 383).
satisfying (Beebe, 2014). There are some healthcare providers
As mentioned earlier, Dr. Grantly Dick-Read was an
who are resistant to the application of hypnotherapy during
early proponent of a more relaxed method of childbirth
labor either because of lack of knowledge or rejection of ev-
in the early 1930s. In 1959, Marie Mongan gave birth to
idence-based information (Beebe, 2014). Hypnotherapy has
her third and fourth children in a relaxed and self-sedated
shown efficacy in for smoking cessation, anxiety, depression,
manner after she came across the works of Dr. Dick-Read.
and pain management, and cross-over to its use in childbirth
Mongan, who coined the term “hypnobirthing,” was asked
has been evaluated as equally effective as hypnotherapy for
by her pregnant daughter to duplicate the method she used
these other treatments.
in her own childbirth experience which involved self-hyp-
With the advances of brain scanning technology, there
nosis (Mullan, 2008). Mongan had previously experienced
has been a resurgence in hypnosis research. While using hyp-
the typical method of childbearing in the 1950s which
nosis for pain brain mechanisms involved in the modulation
included lying flat on a surgical bed while anesthetized
of pain involve cortical (thinking) as well as subcortical areas
with chloroform and serving as more of a participant than
(Vanhaudenhuyse, Laureys, & Faymonville, 2014). It can be
the one in charge of her own birth experience. By the time
seen on scans that susceptibility to hypnosis is associated
Mongan gave birth to her third child, she chose to follow Dr.
with the brain/executive control capabilities associated with
Dick-Read’s method of relaxed childbirth. Mongan’s method
being able to focus, particularly in the right prefrontal cortex
provided a foundation for women to explore a level of relax-
(Cojan, , Piguet , & Vuilleumier, 2015). In a fMRI study of
ation that relied on natural birthing instincts and hypnosis in
hypnosis and pain there was found to be reduced activity
which breathing techniques and creative visualization aid the
in the dorsal anterior cingulate cortex, reduced connections
mother in feeling greater control of her birthing experience
between conscious awareness and pain sensation coming in
(Mullan, 2008). Since the inception of Mongan’s hypnobirth-
to the brain, focused attention, and enhanced emotional and
ing method, countless women have chosen to use hypnosis
as a primary method for labor and delivery.
continued on next page

Volume 32  Number 4  October 2017  |  International Journal of Childbirth Education  |  25

Hypnobirthing
continued from previous page
somatic control. Also found was a lack of self-consciousness
which typically characterizes hypnosis (Jiang, White, Grei-
cius, Waelde, & Spiegel, 2016).
Montgomery et al., (2014) found hypnosis as effective
in controlling fatigue in patients with breast cancer who are
undergoing radiotherapy. Under hypnosis researchers see
modulations of core brain networks which are involved in
higher-order thinking. Landry, Lifshitz, and Raz (2017) in
their meta-analysis found that hypnosis relates to increased
activity in higher-order visual areas. The visualization during
hypnosis seems to be significant to its effect.
Another meta-analysis demonstrated that hypnosis was
safe for patients with irritable bowel syndrome resistant to
medical treatment (Schaefert, Klose, Moser, & Häuser, 2014).
Since hypnosis is not invasive, has no side effects, and ben-
efits are applicable to many life situations, it does need more
research and practice in today’s world (Wilson & Dillard,
2012). Doulas and nurses often get extra training in guided
imagery and hypnosis to assist laboring women.
How It Works
There are a few common myths or misperceptions about
hypnosis. Probably the two most common are beliefs that
undergoing hypnosis will make the subject submissive and
under the complete control of the hypnotist, and that the
person will lose consciousness and memory (American Soci-
ety of Clinical Hypnosis, 2015). Most who practice therapeu-
tic hypnosis do not assert any power over their clients, rather
empowering them to choose and control the process.
Hypnobirthing is relatively simple. Hypnotherapists
often start the preparation for childbirth early in pregnancy,
but it is still effective if started during the third trimester. It
does take some practice. The intention of preparation is to
reframe the knowledge of the birth process. Instead of the
focus as a painful, difficult, and dangerous experience, the
reframe provides a substitution of terms to change the wom-
an’s perception of the experience. Instead, the focus is on
awareness of the natural instinct of a woman’s body toward
the innate ability to give birth (Mongan in Beebe, 2005).
The induction of hypnosis often starts with closed or lowered
eyes and breath focus (Wilson & Dillard, 2012). Through
hypnotic suggestion, the laboring woman will focus on areas
of her body where muscle tension may occur. Positive af-
firmations are given to assist in relaxation and to provide a
feeling of safety during the birthing process (Beebe, 2005).
26  |  International Journal of Childbirth Education  |  Volume 32  Number 4  October 2017
Training and Certification
Many countries, states, and provinces offer certification
courses in hypnosis and hypnotherapy with legislation by
state in regard to expectations of certification with a general
range of 100 hours to over 300 hours depending on the level
of training and practice one needs for certification (Southwest
Institute of Healing Arts, 2017). Most hypnotherapy certifica-
tion requires a license to practice in the health care field, but
not all. Many are psychologists, nurses, physical therapists,
medical doctors, massage therapists, and social workers.
It is wise to look for training courses that have a philoso-
phy of safety and evidence-based practice. Hypnosis certifi-
cation often includes a network of interprofessional groups
which increase understanding and professional cohesion
between physicians, nurses, educators, and doulas (James,
2009). Check with your state regulatory agency to determine
state level expectations toward certification or licensing.
Some states may provide information about certification
under the mental health practice umbrella.
Find ways to incorporate hypnosis into childbirth educa-
tion as a viable option for families. Look for local training
opportunities that can count toward licensure for your own
practice. Hypnosis during labor has the potential to reduce
the use of drugs and fear through practice and education.
Shorter labors might be because of less resistance and less
emotion with contractions. This low-risk approach can
provide a more calm and peaceful birth environment, with
lower blood pressure, and more effective regular heart rate.
Hypnosis is a viable option for childbirth and an exciting
new tool to add to the tool box of those who help women
give birth.
References
American Psychological Association (2017). Hypnosis. Retrieved from
http://www.apa.org/topics/hypnosis/
American Society of Clinical Hypnosis. (2015). Myths about hypnosis.
Retrieved from http://www.asch.net/Public/GeneralInfoonHypnosis/Myths-
AboutHypnosis.aspx
Beebe, K. R. (2014). Hypnotherapy for labor and birth. Nursing for Women’s
Health, 18(1), 48-59. Doi: 10.1111/1751-486X.12093
Cojan, Y., Piguet , C., & Vuilleumier, P. (2015). What makes your brain sug-
gestible? Hypnotizability is associated with differential brain activity during
attention outside hypnosis. NeuroImage, 117, 367-374.
Elkins, G. (2015). Handbook of medical and psychological hypnosis:
Foundations, applications, and professiona lissues. New York: Springer
Publishing.
Elkins, G. R., Barabasz, A. F., Council, J. R., & Spiegel, D. (2015). Ad-
vancing research and practice: The revised APA division 30 definition
of hypnosis. American Journal of Clinical Hypnosis, 57(4), 378-385. Doi:
10.1080/00029157.2015.1011465
continued on next page
Reducing Stress in Infants: Kangaroo Care
Hypnobirthing
Gabriels,
and safetyK.,
garoo
ofBrouwer,
hypnosis A.
care: Experiences
in J., Maat,
adult J., & bowel
irritable
and needsMedicine,
van den
of parents
Hoogen, Systematic
syndrome.
in neonatal
A. (2015). Kan-
review
and meta-analysis. Psychosomatic 76(5), 389-398.intensive care: A
continued
continuedfrom
from previous
previous page
page systematic review ‘parents’ experience of kangaroo care. Pediatric Neonatal
Society for
Nursing, 1(1),Clinical & Experimental
8. Retrieved Hypnosis. (2017). Treatment. Retrieved
from http://dx.doi.org/10.16966/2470-0983.102
from http://www.sceh.us/treatment
Gianaros, P., & O’Connor, M. (2011). Neuroimaging methods in human
References
Hammond, D. C. (2013). A review of the history of hypnosis through the
late 19th century. American Journal of Clinical Hypnosis, 56(2), 174-191.
Southwest
stress Institute
science. In R. J.ofContrada
Healing Arts.
& A.(2017). Programs/Course.
Baum (Eds.), The handbookRetrieved
of stress
from https://swiha.edu/
science. biology, psychology, and health (pp. 543-563). New York, NY: Springer
Barnett, C. R., Leiderman, P. H., Grobstein, R., & Klaus, M. (1970). Neo-
James, U. (2009).ThePractical usesside
of clinical hypnosisdeprivation.
in enhancingPediatrics,
fertility, Publishing Company, LLC.
natal separation: maternal of interactional Steel, A., Frawley, J., Sibbritt, D., Broom, A., & Adams, J. (2016). The
healthy
45(2), pregnancy and childbirth. Complementary Therapies in Clinical
197. characteristics
Gottesman, M.of(1999).
womenEnabling
who useparents
hypnotherapy
to “read”fortheir
intrapartum pain of
baby. Journal
Practice, 15(4), 239-241. management:
Pediatric HealthPreliminary
Care, 13(3, insights from a nationally-representative
Part 1), 148-151. sample
doi:http://dx.doi.org/10.1016/
Bauer, K., Uhrig, C., Sperling, P., Pasel, K., Wieland, C., & Versmold, H. of Australian women. Complementary Therapies in Medicine, 25, 67-70.
S0891-5245(99)90080-9
T.Jiang, H.,Body
(1997). White, M. P., Greicius,
temperatures and M. D., Waelde,
oxygen L. C., during
consumption & Spiegel, D.
skin-to-skin
(2016). Brain
(kangaroo) careactivity andpreterm
in stable functional connectivity
infants weighingassociated with grams.
less than 1500 hypnosis.The Stewart,
Klaus, M.J.H.,
H. Kennell,
(2005). Hypnosis in contemporary
J. H., Plumb, medicine.
N., & Zuehlke, Mayo
S. (1970). Clinic
Human
CerebralofCortex,
Journal 27(8),
Pediatrics, 4083-4093.
130(2), 240-244. doi:http://dx.doi.org/10.1016/S0022- Proceedings,
maternal 80(4), 511–524.
behavior at the first contact with her young. Pediatrics, 46(2), 187.
3476(97)70349-4
Khianman, B., Pattanittum, P., Thinkhamrop, J., & Lumbiganon, P. (2012). Tellegen, A. & Atkinson,
Ludington-Hoe, G. (1974).
S. M. (2011). ThirtyOpenness to absorbing
years of kangaroo care and self-altering
science and
Relaxation B.,
Bohnhorst, therapy forT.,
Heyne, preventing
Peter, C. and
S., &treating preterm
Poets, C. labour.
F. (2001). Cochrane
Skin-to-skin experiences
practice. (“absorption”),
Neonatal Network, a30(5),
trait related
357-362.todoi:10.1891/0730-0832.30.5.357
hypnotic susceptibility. Journal
Database ofcare,
(kangaroo) Systematic Reviews,
respiratory control, andDoi:10.1002/14651858.CD007426.
2012(8). thermoregulation. The Journal of of Abnormal Psychology, 83, 268–277.
pub2
Pediatrics, 138(2), 193-197. doi:http://dx.doi.org/10.1067/mpd.2001.110978 Ludington-Hoe, S. M., & Hosseini, R. B. (2005). Skin-to-skin contact anal-
Vanhaudenhuyse,
gesia A., Laureys,
for preterm infant S., &AACN
heel stick. Faymonville, M. E. (2014).
Clinical Issues, Neurophysi-
16(3), 373-387.
Kukla, R.K.,
Bystrova, & Wayne,
Widström,K. (Winter 2016). Pregnancy,
A. M., Matthiesen, birth, and medicine.
A. S., Ransjö-Arvidson, A. B., ology of hypnosis. Neurophysiology, 44(4), 343-353.
E. N. Zalta (Ed.).B.,
Welles-Nyström, TheWassberg,
Stanford Encyclopedia of Philosophy.
C., … Uvnäs-Moberg, Retrieved
K. (2003). from
Skin- McCain, G. C., Ludington-Hoe, S. M., Swinth, J. Y., & Hadeed, A. J.
https://plato.stanford.edu/entries/ethics-pregnancy/ Wildner,Heart
(2005). K. (2008). Origins and
rate variability impactofofabirthing
responses pretermbeliefs. International
infant to Kangaroo
to-skin contact may reduce negative consequences of “the stress of being
Journal
care. of Childbirth
Journal Education,
of Obstetric, 23(1), 17-19.
Gynecologic, and Neonatal Nursing, 34(6), 689-694.
born”:
Landry,A M.,
study on temperature
Lifshitz, M., & Raz,inA.newborn infants,
(2017). Brain subjected
correlates of to differentA
hypnosis:
ward routines in St.and
Petersburg. 320-326. doi:10.1177/0884217505281857
systematic review Acta Paediatrica,
meta-analytic exploration.92(3),
Neuroscience & DOI:
Biobehav- Wilson, D. R. & Dillard, D. M. (2012). Use of hypnosis in the childbearing
10.1111/j.1651-2227.2003.tb00553.x
ioral Reviews (In Press). year. International
Uvnäs-Moberg, K. Journal
(1998). ofOxytocin
Childbirth Education,
may mediate 27(3), 31-36. of
the benefits Peer reviewed
posi-
article.
tive interactions and emotions. Psychoneuroendocrinology, 23(8), 819-835.
Cohen,
Lynn, S.S.,J.,Kessler,
Lawrence,R. C.,
J., &
& Gordon,
Kirsch, I.L.(2015).
U. (1997). Strategies
Hypnosis, for measuring
suggestion, and sug-
stress in studies of psychiatric and American
physical disorders. doi:http://dx.doi.org/10.1016/S0306-4530(98)00056-0
gestibility: An integrative model. Journal of In S. Cohen,
Clinical R. C.57(3),
Hypnosis,
Kessler,
314-329. & Doi:
L. U.10.1080/00029157.2014.976783
Gordon (Eds.), Measuring stress: A guide for health and social White, C., Simon, M., & Bryan, A. (2002). Using evidence to educate
scientists (pp. 3-26). New York: Oxford University Press. birthing center nursing staff: About infant states, cues, and behaviors. The
MacHovec, F. J. (1975). Hypnosis before Mesmer. American Journal of Clini- Dr. Debra
American RoseofWilson
Journal is a nurse,
Maternal/Child a hypnotherapist
Nursing, 27(5), 294-298. for more
Cong, X., Ludington-Hoe,
cal Hypnosis, 17, 215. S. M., & Walsh, S. (2011). Randomized crossover
trial of Kangaroo Care to reduce biobehavioral pain responses in pre- than 30 years, and is the 2017 – 2018 American Holistic Nurse of
Montgomery,
term infants: AG. H., study.
pilot David,Biological
D., Kangas, M., Green,
Research S., Sucala,
for Nursing, 13(2),M., Bovbjerg,
204-216. the Year; this national award is given by the American Holistic
D. H., Hallquist, M. N., & Schnur, J. B. (2014). Randomized controlled
doi:10.1177/1099800410385839
trial of a cognitive-behavioral therapy plus hypnosis intervention to control
Nurses’ Association. She has been the editor of the International
Meredith Baker-Rush is a speech-language pathologist with clini-
Contrada,
fatigue in R. J. (2011).
patients. Stress,
Clinical adaptation,
Oncology, 32(6),and health. In R. J. Contrada &
557-563. Journal of Childbirth Education since 2011, and is faculty at
A. Baum (Eds.), The handbook of stress sciences (pp. 1-9). New York: Springer cal experience of working in a neonatal intensive care unit and is
Morgan, A.Company,
H. & Hilgard, both Walden University and Austin Peay State University.
Publishing LLC. E. R. (1973). Age differences in susceptibility to completing her doctorate in health psychology. She has personal
hypnosis. International Journal of Clinical & Experimental Hypnosis, 21, 78-85.
Feld, R., & Eidelman, A. (2003). Skin-to-skin contact (Kangaroo Care) accel- and professional experience with Kangaroo Care and continues
Mullan,
erates J. (2008).and
autonomic Hypnobirthing: The maturation
neurobehavioral art to a peaceful birth: infants.
in preterm WomenDevel-
birth- Dr. Debbie Finken is a professor of psychology at Metropolitan
to support stress reduction techniques across the life span.
ing underMedicine
opmental self-hypnosis is a growing
and Child Neurology,trend. Hypnobirthing[R]
45(4), practitioner
274-281. DOI: 10.1111/j.1469- State University of Denver and a psychology writer. She holds a
and UK trainer Jenny Mullan explains the practice. Midwives Magazine, 38.
8749.2003.tb00343.x doctorate in clinical and health psychology. She is working on an
National R.,
Feldman, Center for Complementary
Gordon, I., Schneiderman, andI.,Integrative
Weisman,Health(2015). Hypno-
O., & Zagoory-Sha- anthology of positive psychology for publication in 2018, and is
sis. Retrieved
ron, O. (2010).from https://nccih.nih.gov/health/hypnosis
Natural variations in maternal and paternal care are associ- also working on a social and scientific exploration of the experi-
ated withA.systematic
Sakula, changesoninLondon
(2004). Plaques oxytocin following
houses parent–infant contact.
of medico-historical interest.
1133-1141. ence of death for publication in 2019.
Psychoneuroendocrinology, 35(8),
Journal of Medical Biography, 12(3), 140. doi:http://dx.doi.org/10.1016/j.
psyneuen.2010.01.013
Schaefert, R, Klose, P., Moser, G., & Häuser, W. (2014). Efficacy, tolerability,

VBAC Education Project

ICEA
ICEA isis proud
proud toto announce
announce the
the joint
joint collaboration
collaboration between VBAC.com and
ICAN
ICAN forfor the
the VBAC
VBAC Education
Education Project.
Project. The VBAC Education Project is a
FREE
FREE evidence-based
evidence-based educational
educational project
project with modules for both parents &
professionals.
professionals.

For more
For more information,
information, please visit www.icea.org.

Volume 31
Volume 2017  | | International Journal of Childbirth
32  Number 44  October 2016 Childbirth Education 
Education | | 27
17
Copyright of International Journal of Childbirth Education is the property of International
Childbirth Education Association and its content may not be copied or emailed to multiple
sites or posted to a listserv without the copyright holder's express written permission.
However, users may print, download, or email articles for individual use.