Several months ago I was approached by a friend whose wife was considering signing up for hypnobirthing classes. Because he knew I was a cognitive hypnotherapist and because their financial resources were limited, he wanted to know whether or not the added expense was worth it and/or if it was something I offered.

As to whether or not I offered ‘hypnobirthing’ classes, the answer was no. At the time, I hadn’t heard the term but was aware that teaching women self-hypnosis techniques to help reduce associated anxiety and reduce pain was well within the purview of hypnotherapy. To ensure I wasn’t misleading him though, I suggested he give me a couple of days to look into the subject and afterwards we could discuss options.

Fundamentally, the term hypnobirthing is a relativity new way (1989) of packaging ideas first introduced in the early 1890s, then again in the 1920s, the 1940s and the 1960s regarding natural childbirth*. Today, hypnobirthing classes broadly align to what one would find on a NHS antenatal class with a couple of key differences. Hypnobirthing classes are typically more holistic in nature and offer women an additional support option by providing a sense of extended family. Additionally, and importantly, hypnobirthing classes include relaxation and/or self-hypnosis training.

While this was all very interesting information, my goal was to find out if they ‘worked’, so I continued my search.

Digging into the subject, I was unable to locate research papers which compared the outcomes of women who attended hypnobirthing classes against those who, for example, attended NHS antenatal classes. That said, I was able to source research which compared the outcomes of women taught self-hypnosis and/or relaxation techniques against women who had not. In some cases the women were taught these techniques as part of a research study, in other instances they were included in their standard antenatal course. In some cases women received hours of advanced training while other received their training during labour.

The difference I wish to highlight is subtle but important. While there may be evidence that particular hypnobirthing classes ‘work’, I was unable to locate it. What I was able to locate, is research suggesting specific techniques, regardless of the educational setting in which they were taught, yielded positive outcomes. That’s good news because it gives women greater options as to whom to approach for training.

Okay, so let’s quickly review what these positive outcomes are. According to the research literature, women who utilised self-hypnosis/relaxation benefited in a variety of ways. A review of ten studies conducted between 1986 and 2006, and involving 749 women, overwhelmingly found those who received self-hypnosis training had a more positive childbirth experience compared to those who had received “standard care”. These benefits included:

• Decreased used of analgesia including epidural injections for pain relief.

• Greater sense of deep relaxation throughout the childbirth process.

• Feeling “well after delivery” or describing labour as “pleasant”.

• Labour length reduced to just over half the average length.

• Greater increase in “spontaneous vaginal birth” and lower cesarean rates.

• Less postpartum exhaustion.

• Feeling confident and in control throughout the childbirth process.

• Less pain compared to previous births.

• Decreased hospital stays.

Of the ten studies included in this meta review, only one, involving 82 women and measuring the use of analgesia, found no statistically significant benefit. That’s good news, because when 90% of your reviewed studies indicate there is a strong correlation between utilising these techniques and achieving a enhanced childbirth experience it suggests most women will benefit from self-hypnosis training, even if only to a small degree.

While the larger meta review did not specifically detail the techniques used, I was able to locate one paper which cited three techniques: eye-fixation, visualisation and positive suggestions.

Eye-fixation (think of the term spacing out) is simply a technique anyone can use to quickly put themselves in a trance by fixing one’s focal point upon a single object such as a candle flame, a distinct point on the wall or ceiling, or some other handy object. We tend to do this naturally when we daydream in the garden or when our focus in narrowed while driving in the rain.

Visualisation (you’ll see this described as “guided visualisation” on many hypnobirthing course websites) is more commonly referred to as daydreaming. The difference here is, unlike daydreaming about what you want to say to your boss, this visualisation is designed to elicit feelings of calm and tranquility, thereby enabling the women to achieve a deep sense of peace and physical relaxation. As part of these visualisations, women may be taught to focus on their breathing and/or mentally dissociate from their bodies to manage pain throughout their labour.

Lastly, positive suggestions are used to speak to the unconscious mind. The suggestions, which will draw attention to the natural process of childbirth and the capabilities and strength of woman, would normally be embedded within the visualisation and my also incorporate focused breathing.

For research purposes and for the majority of group hypnobirthing classes, each woman will receive the same visualisation and positive suggestions. For the former it’s about ensuring a standard measurable approach, and the latter, time and money. Ideally, the visualisation and positive suggestions would be tailored to the woman. This is because, while a tropical beach settings might seam ideal for example, it would likely be distressing and counter productive had she experienced a significant negative emotional event on a beach.

So with research papers in hand and numerous websites reviewed, I went back to my friend and said…

• I was unable to find any research evidence showing hypnobirthing classes or standardised hypnobirthing curriculum enhances a woman’s childbirth experience.

• I was able to find research evidence which showed self-hypnosis techniques, likely taught as part of a hypnobirthing class, do enhance the childbirth experience. These techniques include visualisation, positive suggestions and focused breathing. That said, it was difficult to determine exactly what techniques were taught as part of the various hypnobirthing class websites I reviewed.

• There are a host of other bespoke techniques which could be used to enhance a women’s childbirth experience, but are unlikely to be offered as part of hypnobirthing class. These techniques include things like the Emotional Freedom Technique (EFT) or any number of Neuro-Linguistic Programming (NLP) techniques such as spinning or physical, olfactory or auditory anchoring.

• If your wife is only interested in learning some self-hypnosis techniques or resolving any anxiety she is experience about the upcoming birth, it would be a pleasure to work with her. Alternatively I could recommend a couple of local female cognitive hypnotherapist, if she would find that more amenable.

• Hypnobirthing classes are not just about self-hypnosis training. They provide information on pregnancy, childbirth and child care. In addition, many provide women with an additional support option outside of the NHS. If your wife is interested in signing for a hypnobirthing class I would recommend both of you contact at least two or three before you part with any money.

• Lastly, the choice is really down to your wife.  You just need to be as supportive as you can while she comes to her own decision.

Note:

*If you are interested in more information on hypnobirthing as well as it’s history, I would suggest obtaining a re-printed copy of Dr. Grantly Dick-Read’s 1942 book Childbirth without Fear, Maria Morgan’s 1989 book HypnoBirthing: A Celebration of Life and/or The Good Birth Companion: A Practical Guide to Having the Best Labour and Birth by Nicole Croft and Yehudi Gardon published in 2011.

References

1. Downe, S., et al., Self-hypnosis for intrapartum pain management in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness., BJOG An International Journal of Obstetrics and Gynaecology, 2015.  [Click here for PDF]

2. Cyna, A. M., McAuliffe, G. L. and Andrew, M. I., Hypnosis for pain relief in labour and childbirth: a systematic review, British Journal of Anaesthesia, Volume 93, No. 4, pages 505 – 511, 2004.  [Click here for PDF]

3. Cyna, A. M., Andrew M. I., and McAuliffe G. L., Antenatal Self-hypnosis for Labour and Childbirth: A Pilot Study, Anaesth and Intensive Care, Volume 34, No. 4, pages 464 – 469, August 2006.  [Click here for PDF]

4. Semple, Amy and Newburn, Mary, Research overview: Self-hypnosis for labour and birth, NCT’s journal on preparing parents for birth and early parenthood, pages 16 – 20, December 2011.  [Click here for PDF]

5. Werner, A. ,Uldbjerg, N., Zachariae, R., Rosen, G., and Nohr, EA., Self-hypnosis for coping with labour pain: a randomised controlled trial, BJOG An International Journal of Obstetrics and Gynaecology, 2012.  [Click here for PDF]

6. Varner, Corry A., Comparison of the Bradley Method and HypnoBirthing Childbirth Education Classes, The Journal of Perinatal Education, Volume 24, No. 2, 2015.  [Click here for PDF]