Hypnobirthing: Is Pain-Free Birth Acheivable?
On a rainy June night, six couples strained to get a better view of a home video of a woman, legs spread, giving birth.
The room was hushed -- the couples' rapt silence matching that of the soon-to-be mom as she labored in almost eerie stillness. Aside from her steady breathing, the scene was quiet, as though someone had taken a sitcom birthing scene and pressed mute.
This is both the seductive promise and allure of hypnobirthing, the method of self-hypnosis that had brought the couples to Brooklyn that night. In the current climate of record cesarean section rates and regular epidural use, it was possible, their instructor told them, to have natural birth with no drugs, no screaming and seemingly little pain. Hypnosis, with its focus on inner attention and concentration, offers an alternative.
Obstetrical hypnosis has long existed in many forms, but the best-known version these days is the trademarked "HypnoBirthing" or "The Mongan Method." Now taught in more than 30 countries, the technique was developed by Marie Mongan, a former college dean from New Hampshire who claims to have used self-hypnosis to deliver all four of her children without anesthesia and without pain, some 60 years ago.
In subsequent years, Mongan went on to study hypnosis and wrote several books, including "HypnoBirthing: The Mongan Method," which has become the central tome of Mongan's technique. By eliminating fear and tension, it claims, physical suffering does not have to be part of the birthing experience.
"We do not promise a pain-free or painless birth. We say easier, shorter, more comfortable," Mongan said. "But there are many, many who do birth painlessly. I was one of them. I never felt a smidgen of pain."
Pain-free versus not pain-free is a tension that pervades much of the hypnobirthing rhetoric -- tempering women's hopes so they do not expect a pain-free birth, while at the same time tantalizing them with tales of women who rave about calm, even physically pleasant experiences.
"I had an amazing birth," one testimonial on the HypnoBirthing website states. "I would do it again today."
Central to a woman's ability to enjoy a similarly gentle birth, Mongan said, is completion of the five-week class cycle, which women typically start in the second trimester or early in the third.
According to a HypnoBirthing Institute survey, more than 12,000 mothers completed the class in the last two years worldwide. Mongan said that the program has "grown and grown," largely via word of mouth, estimating that she sells upwards of 2,500 copies of her book per month. And celebrities, like Jessica Alba, have brought attention to the method, publicly supporting it.
Prices for the class range between $150 to $600, depending on location. Though teachers can vary their approach, the core syllabus is meant to stay largely the same.
After a lengthy introduction to the method, students begin to practice a series of hypnotic relaxation and visualization exercises and work on breathing techniques. Over the weeks, they practice time distortion, making 10 minutes seem like five, and five like one. They practice hypnotic anesthesia, making certain parts of their body go numb. And they learn to replace words common to labor like "contraction" -- which Mongan said elicits fear -- with terminology deemed more empowering, like "surges." Rather than pushing, they are told to "breathe down the baby."
At home, students practice with a CD dubbed "Rainbow Relaxation," in which they are led through a series of relaxing commands. Your lower body becomes totally lose and limp, Mongan coaxes them, as music chimes lightly in the background. Picture yourself on a bed of strawberry colored mist.
"I can't describe it," said Cindi Braby, author of the blog A Utah Mom's Life, who used hypnobirthing with all five of her babies. "With my first child especially, I was in pretty deep," she said. "I was aware of what was going on around me, but I was having really, really low levels of pain the whole time."
Such relaxation takes work, and daily practice is recommended. Women are encouraged to read the book several times throughout their pregnancy so that when it comes time to labor, they are adept at moving themselves into a state of deep relaxation relying on the techniques they learned and the help of their birth companion.
"There's a learning curve," explained Yael Quittner, a certified HypnoBirthing practitioner and the teacher of the Brooklyn class.
"An incredibly laid back person might have an easier time relaxing than a career person who works an 80 hour week and is in charge of hundreds of employees," she continued. "But I do find, ironically, that type-A people tend to be incredibly good at HypnoBirthing, because they are succeeders. They are going to be successful no matter what."
Hypnosis expert Carol Ginandes, Ph.D, a health psychologist affiliated with Harvard Medical School, explained that positive expectation is central to that success, adding that anyone with direct personal exposure to hypnosis -- whether via smoking cessation or just a gimmicky stage act -- will have internalized expectations. Openness to the process is essential, she said.
Ginandes also cautioned that the "alert awake hypnotic trance" that can accompany successful hypnosis means it is possible that "suggestions presented to [a person] may be taken in at a deep level of mind." In other words, unanticipated physical or psychological developments may emerge.
"As a totally hypothetical example, imagine a scripted protocol that routinely instructs the client to imagine herself wading into the warm ocean all the way up to her neck, in an effort to elicit relaxation," Ginandes wrote in an email to HuffPost. "Now suppose, unbeknownst to the practitioner, this individual has suffered a near-drowning experience as a child. A strongly-worded direct suggestion about the ocean could precipitate a panic response or a post-traumatic re-evocation of an old trauma."
This, Ginandes said, is a potential issue with a "one-size-fits-all" approach to hypnosis, like The Mongan Method. She says that many lay hypnotists, meaning people who are not state licensed health care providers or affiliated with The American Society of Clinical Hypnosis, are experienced, well-intentioned and can have good results. But some may not.
To become a practitioner of The Mongan Method, instructors have to complete a four-day program, which includes a 16-hour introduction to hypnosis for childbirth or birthing basics, depending on the student's background. It also includes a 16-hour certification program and additional reading.
In the four years that she has taught HypnoBirthing, Quittner said she has had few bad experiences. She estimated that she has led at least 50 classes in that time, and has only had two couples who did not complete the program. Even students who did not necessarily have the results they dreamt of -- like the woman who had four previous C-sections, wanted a vaginal delivery, but ended up in surgery again -- were pleased with the overall sense of calm they maintained throughout.
"That mom called me after and said, 'I had a C-section, but my experience was totally different,'" Quittner explained. "She said, 'I was actually able to hear my doctor. I was calm. I had a positive experience.'"
One key consideration for women interested in pursuing the method is selecting a doctor or midwife who is accepting of it.
Dr. Laura Riley, medical director of labor and delivery at Massachusetts General Hospital and author of "You and Your Baby: Pregnancy," said that for many doctors who may not necessarily know a lot about the method, that means simply staying out of the way.
"You really have to advocate for your patient, especially in a big hospital," Riley said. "That means that we don't need a resident coming in and asking, 'Are you in pain?' because that's not a word we use. If things are going well, I tend to be really quiet and spend as little time in the room as possible, to not interfere."
Mary Murry, a certified nurse midwife and co-editor of the "Mayo Clinic Guide to a Healthy Pregnancy," said that in hospitals, it's the labor nurses who really need to be on board. They are the ones who spend the most time with women throughout the process.
Both Riley and Murry said they have seen an uptick in patients using the method in recent years, although neither believes it has crossed into the mainstream. Murry estimated that some 10 percent of the births she sees now involve some form of hynpobirthing; Riley said she has only seen 25 to 30 over the last 30 years. Both medical practitioners consider themselves to be fans of the process.
"I don't think there are any negatives to it," Murry said. "It doesn't require any pharmaceuticals, it gives the couple more autonomy and as long as people are open to changing the plan if complications arise, it helps women cope with their contractions."
Indeed, in spite of many of the sweeping claims of pain eradication that float around hypnobirthing, learning to calmly cope with contractions (or "surges," as they're sometimes known) is at the true heart of the technique. Which is why it appeals to women like Nadine Niznik, 32, a public relations professional in Manhattan who said she has no interest in greeting her birth with fear.
Niznik explained that the biggest thing she and her husband -- who initially saw the practice as "pretty out there" -- have learned is to really relax. She is able to better listen to herself, both tuning out external factors and tuning in to her body. She said she finds herself using the methods she learned in Quittner's Brooklyn sessions in other situations, like when she has been able to ignore the person fidgeting next to her on the subway, or when she has soothed her body after a long day at the office.
"I know birth is the most challenging thing I will do, and I expect pain," said the first-time mom, who is due any day. "But I have confidence that I can get through it. I don't have any fear."