Is hypnobirthing supported by science?

 I know this is a really important question, particularly to people who have studied science and may be a bit sceptical about hypnosis, mindfulness and complementary therapies.  Many people I work with are researchers, or work in healthcare, like to know the facts!

Before I get into what the research is telling us, I want to give you a bit of context to this area of scientific study. The first thing to say is that the amount of research that has been done on hypnobirthing is quite small. Medical research is expensive and is often funded by large pharmaceutical companies. Getting funding for research on complementary therapies is particularly difficult as there is little financial upside for companies to fund this work.

Hypnobirthing involves a range of different tools and techniques and provides information to educate, alleviate fear and boost confidence. This introduces a complexity to running trials.  

A research trial will typically test a group that receive a treatment and compare it to a control group who haven’t received a treatment. Now, that is relatively easy for a new drug but when testing hypnobirthing, your control group may still attend antenatal classes, read books and browse the internet. Some of them may even be using some of the techniques taught by hypnobirthing teachers. All this can make it more difficult to measure the effectiveness of hypnobirthing.

Understandably hypnobirthing research often involves research assistants reading scripts to women or participants simply listening to audio tracks as this helps standardise the treatment. However, this can be a very different experience to attending a face-to-face session from a hypnobirthing teacher or a hypnotherapist.

Having a good rapport with a therapist can be a key factor in the success of any talking therapies. It is often difficult to build rapport if somebody is sticking to a defined script fearful that any deviation will invalidate the research.

An alternative approach is to compare women who have done courses to women who haven’t. This also presents challenges to those looking to interpret the results. You could argue that women looking to do hypnobirthing could be more worried and fearful in the first place which could affect the results of a study that compares them to women who have not sought additional support.

There are also differences between hypnobirthing methods and the quality of teaching can vary by practitioner. Personally, I believe practitioners that sell hypnobirthing as pain free birth or for natural birth only, will set some of their clients up to fail because they do not provide appropriate support should medical interventions be required. This could have a huge impact on the findings of a study.

In the real-world, hypnotherapists and some hypnobirthing teachers will tailor techniques to suit an individual. In trials it is important to standardise the programme, or the skill of a practitioner becomes another factor that could make the findings difficult to interpret.

I know from my work that changing techniques to suit clients can make all the difference to the success of hypnobirthing, for example, using an ocean-based wave metaphor to manage contractions may be great for one person but if a client has a fear of the sea, then it could cause them distress.

All these factors can make the design of research into hypnobirthing and the interpretation of results difficult.

That said, studies carried out in recent years are starting to provide evidence that supports the experience of the millions of women across the world who have used hypnobirthing techniques to birth their babies.

The first paper I want to talk about was published in 2016 by an international collaboration of researchers from Australia and the UK. It is a Cochrane review which is the gold standard in medical research. It summarises, reviews and interprets the results of nine medical research trials on hypnobirthing.  The research found that hypnosis may reduce the overall use of pain medication.

This was a groundbreaking finding that backs up what women have been telling us for years; that the techniques women learn in hypnobirthing can be used instead of or alongside medical pain relief.

Unfortunately, given many of the issues I have talked about earlier, the researchers were unable to find enough evidence to demonstrate that hypnosis improves satisfaction with pain relief or a sense of coping with labour.

Lets move forward to 2019 to a paper from two Iranian researchers, Susan and Sima Azizmohammadi. Their paper reviewed the use of hypnotherapy for pain management during childbirth. Their findings suggest that hypnosis may be a safe and effective way to reduce pain during childbirth, with some women even experiencing complete pain relief. Although again they call for more research to determine its overall effectiveness.

This is hugely encouraging that the evidence base is growing to support hypnosis as an effective way to reduce pain during childbirth.

Next, we have a couple of papers from 2023. The first is a systematic review of seven studies from Stephanie Catsaros and Jaqueline Wendland, two researchers from the Université Paris Cité. They found positive effects of hypnosis in alleviating anxiety, depression, and fear of birth, empowering women with a higher sense of confidence and improving the overall emotional experience.

Two of the studies they reviewed also indicated encouraging outcomes in postnatal wellbeing. The authors concluded that hypnosis has positive effects on physical aspects of labour, the empowerment and the increase in confidence associated with hypnosis seem to bring a significant contribution to a more positive subjective experience of pregnancy and childbirth, and on women's overall wellbeing in the perinatal period.

Finally, a Tiril Uldal and her team at the University of South-Eastern Norway carried out a qualitative study, published in 2023, which involved explores the experiences of women who used hypnobirthing techniques to prepare for childbirth by conducting detailed standardised interviews over Zoom. The women reported that hypnobirthing classes helped them develop a positive view of childbirth and gave them coping mechanisms to manage pain during labour.

This is just a flavour of some of the research out there which is helping to build the evidence base for the use of hypnobirthing. There are also studies that focus in on the use of hypnosis to treat hyperemesis gravidarum (nausea and vomiting in pregnancy). A 2022 study by Seyda Ozgunay and her team at Beykent University in Istanbul, for example, concluded that the use of hypnotherapy and anti-sickness medications with patients diagnosed with hyperemesis gravidarum experienced significantly reduced severity of nausea and frequency of vomiting compared to those who only received the anti-sickness medication. Also, hospital stay was found to be shorter for those that received hypnotherapy.

Returning to the question, ‘Is Hypnobirthing supported by science?’ I would say there is now good scientific research that supports the use of hypnobirthing. The evidence is strongest when it comes to reducing the need for pain medication during labour. But there is also good evidence that hypnobirthing:

• helps reduce pain during childbirth and has positive effects on physical aspects of labour,
• helps improve the overall emotional experience,
• helps alleviate anxiety, depression, and fear towards birth,
• helps make women feel more empowered and confidence,
• helps improve women's overall wellbeing in the perinatal period,
• helps women develop a positive view of childbirth,
• helps give women coping mechanisms to manage pain during labour,
• and treat sickness in pregnancy.

If you have any questions about hypnobirthing register for my free hypnobirthing session on 9 April, 7pm (UTC) or listen to Hypnobirthing: Twenty questions wherever you get your podcasts.

Here are the links to the research discussed in this post:

Azizmohammadi, S., & Azizmohammadi, S. (2019). Hypnotherapy in management of delivery pain: a review. Eur J Transl Myol, 29(3), 8365.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6767938/

Catsaros, S., & Wendland, J. (2023). Psychological impact of hypnosis for pregnancy and childbirth: A systematic review. Complementary Therapies in Clinical Practice, 50, 101713.

https://www.sciencedirect.com/science/article/abs/pii/S1744388122001815?via%3Dihub

Middleton, P., Cyna, A. M., Matthewson, M., Jones, L., & Cochrane Pregnancy and Childbirth Group. (2016). Hypnosis for pain management during labour and childbirth. Cochrane Database Syst Rev, 2016(5),

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7120324/#CD009356-bbs2-0038

Ozgunay, S. E., Dincgez, B., Karasu, D., Ozgen, G., Taymur, I., Eminoglu, S., & Ceylan, I. (2022). Adjuvant Hypnotherapy for Hyperemesis Gravidarum: A Randomized Pilot Study. Int J Clin Exp Hypn, 70(3), 277-285.

https://pubmed.ncbi.nlm.nih.gov/35867532/#:~:text=Those%20in%20the%20control%20group,treatment%2Das%2Dusual%20alone.

Uldal, T., Østmoen, M. S., Dahl, B., & Røseth, I. (2023). Women’s experiences with hypnobirth – A qualitative study. Sexual & Reproductive Healthcare, 37, 100890.

https://www.sciencedirect.com/science/article/pii/S1877575623000800