Perinatal hypnosis - not just hypnobirthing

(This is a copy of an article written for the Journal of the National Council for Hypnotherapy in 2025)

Sophie Fletcher has been a hypnotherapist for nearly 20 years and has been training hypnobirthing teachers since 2008, both privately and in the NHS.  She is the best-selling author of Mindful Hypnobirthing, Mindful Mamma and Mindful Menopause.  You can find out more at sophiefletcher.co.uk or on instagram @mindful_menopause

Perinatal hypnosis - not just hypnobirthing

For 20 years, hypnobirthing has been a great joy to me. We all know as hypnotherapists that the work we do changes lives, but there is something special about handing this knowledge to a mother who will pass it on to her child. Marie Mongan used to say, “We are changing the world, one birth at a time.”

Subsequent work by obstetricians such as Michel Odent gives glimpses into the reasoning behind this. It comes down to the capacity of oxytocin, the birth hormone, to optimise connection and empathy in human beings. When babies are born in their own time, it allows the potential for oxytocin to facilitate bonding and support neurological priming. This neurological priming is important for social, cognitive, and emotional development.

Reduced exposure to natural oxytocin at birth has been associated with potential difficulties in mother-infant attachment and emotional regulation later in life (Gu et al., 2021). It can also increase the risk of Postpartum Depression (PPD).

Interventions can disrupt the physiological process of birth and impact oxytocin. For example, take induction of labour (IOL). In the third trimester, maternal oxytocin increases, and exposure to oxytocin during this time sets the stage for a baby’s social and emotional development, creating an environment primed for attachment and healthy social behaviours. If a baby that, if left, would have been born at 42 weeks, is induced at 39, it misses out on three weeks of increased oxytocin levels.

A destructive debate about normal birth has been rattling around the birth world, becoming more divisive over the years. Some organisations have been pilloried in their pursuit of normal birth. The truth is that, in some NHS Trusts, over 50% of women are being induced. Twenty years ago, this figure was around 20%. The women haven’t changed or evolved out of being able to birth their babies; it’s the system that has changed.

Iatrogenic harm is when harm is caused by the intervention itself, and we know without question that intervention is causing an unprecedented number of birth injuries—both physical and psychological—which have lifetime consequences. Sadly, the majority of these are avoidable.

What does hypnobirthing have to do with all of this?

Put simply hypnobirthing can help parents to step out a fear state and assess the implications of certain interventions based on their own values and the research available making decisions confidently.  It builds trust in their body and the normal physiological processes of a mammalian birth. We know that fear increases pain and the risk of intervention so by lowering this and equipping parents with effective pain management tools we give both the mother and baby an opportunity for a birth that supports both immediate health and healthy long-term development.

Sadly, hypnobirthing has become a tick-box for many parents as it has exploded in popularity. Now many people teaching have no robust hypnosis training. Because of this it’s usually taught to a rigid framework because they are unable to adapt the work and the preparation to the needs of each individual client.

It’s also very focused on normal birth, which I think is important; however, there is no manoeuvrability if intervention is needed which often leaves women floundering if medical intervention is needed or they want to use the tools in a different way. 

So where does this leave hypnotherapists?

Interestingly, there is increasing research on the use of hypnosis in pregnancy and beyond. Its application can be far more comprehensive than it is currently being used for.

I prefer to refer to it as Perinatal Hypnotherapy  and break this down into two areas:

1. Birth hypnosis 
2. Pre- and post-natal support

Birth Hypnosis

This is a programme of preparation. I’ve found that six sessions are the minimum needed to prepare a client for different aspects of birth. I run these over three sessions of two hours, two sessions of three hours, or in a group setting over a day.

Most of my work is now private one-to-one. If I teach a group, I teach no more than three couples. I see people teaching classes of ten couples—that’s twenty people—and I don’t need to tell a hypnotherapist how ineffectual that environment is for processing fear!

Good hypnosis preparation should:

1. Give tools to explore options confidently. Many decisions are made from a place of fear; women are anxious about the unknown and are overwhelmed by information. I use BRAINS.
2. Educate them about their own physiology and positively reframe the capacity of their body to birth.
3. Shift deep-seated beliefs and fears about birth using a range of knowledge, tools, and tailor-made affirmations.
4. Address cue association in the birth environment.
5. Teach them simple but adaptable pain management tools.
6. Give them confidence in using self-hypnosis and imagery for different stages of birth or things that may arise.
7. Introduce their birth partner to some simple techniques.
8. Encourage them to research physical support such as massage and positioning. I can help with this in my practice as I’m a doula*, but it’s a good idea to do some further CPD in this if you are going to consider working in this area, as you can create powerful associations with massage, breathing, and physical movement.

Beyond Birth

Hyperemesis Gravidarum (Pregnancy Sickness)

In studies women using hypnotherapy significantly reduced the severity of nausea and frequency of vomiting compared to the control group. An evidenced protocol is two sessions of hypnotherapy, when in the second they were taught heterohypnosis. The first session involved guided imagery, imagining a safe environment by a stream with suggestions such as, “This stream flows in balance and feeds the living creatures in it.” The treatment involved practising self-hypnosis four times a day, with suggestions such as closing their eyes and imagining a stream where they would feel comfortable and peaceful.

For anyone intending to work with this, think about secondary gain with regards to sickness. Often, we hear external stimuli that validate the sickness, such as, “Oh, you’re really sick; that’s a sign that it’s a strong pregnancy.” This is particularly relevant in anxious clients or those who have experienced loss or fertility treatment. Before a scan or when they begin to show, this can affirm the pregnancy.

Anxiety and Depression in Pregnancy

Studies show that hypnotherapy can reduce anxiety and depression in pregnancy. We know that these conditions can affect brain development, especially in the amygdala and neocortex, which are responsible for emotional regulation and stress responses. Practising stress-reduction techniques can help support a baby’s brain development. Reducing anxiety, stress and depression in pregnancy also reduces the risk of PPD. It’s important to recognise the limitations of hypnotherapy—good support from a mental health MDT can also be important in pregnancy to reduce the risks of PPD. 

Tokophobia (Fear of Childbirth)

It’s one thing to learn some techniques for pain management for birth, but if you are phobic of birth, it can be very frightening to be pregnant. Six to twelve sessions of work, with a programme consisting of a mix of education, harnessing existing resources, and understanding what the actual fear is, can be transformative. Chunking down is essential, as a fear of childbirth is nearly always something very specific associated with childbirth. It can be fear of tearing, fear of the smell of anaesthesia, fear of needles, and so on.

Breech Baby

This is one of the most fascinating areas I’ve worked in. I have some extraordinary stories of using guided imagery where babies have turned in the session. It’s long been thought that fear can contribute to breech presentations, and this plays out in some of the work I’ve done. A study by Dr Lewis Mehl Madrona in 1994 with 200 women showed that 81% of women in the experimental group had a baby who turned spontaneously compared with only 26% in the control group.

Hypnotherapy audio tracks can also be used alongside an ECV (External Cephalic Version) to help relax the mother and potentially assist with turning the baby.

Breastfeeding

There are very limited studies on breastfeeding and hypnotherapy. Anecdotally, I’ve seen good results with imagery around increasing milk flow and with confidence in feeding. Numerous studies on relaxation for breastfeeding show increased quantity and quality of milk.

PTSD and Birth Trauma

Unfortunately, with the rise in interventions, we are seeing more and more women with birth trauma. One of the techniques that has worked very well for this is the Three Step Rewind. There are very limited studies on this, but the strength of anecdotal experience means that some NHS Trusts are incorporating this within their postnatal services.

Caesarean Birth

You can also run a tailored programme of birth for caesarean preparation. Introducing anchors, rapid relaxation techniques, and wound recovery. You can accompany this with recovery tracks. Though no research has been done on hypnosis and caesarean recovery, we do know from other studies the impact of hypnosis on surgical recovery.  

I run an RCM accredited hypnobirthing training course, which is a mix of self-guided and live online training. This includes access to extensive resources and ongoing support. My training dates for this year are March, September and November.  I offer a significant discount of 33% to NCH hypnotherapists.  I also have peri-menopause training running in March, May, and October.  Visit my website sophiefletcher.co.uk/training to find out more.