Complementary Therapies in Clinical Practice 33 (2018) 77–84
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Complementary Therapies in Clinical Practice
journal homepage: www.elsevier.com/locate/ctcp
The effect of hypnobirthing training given in the antenatal period on birth
pain and fear
Filiz Yarici Atisa,∗, Gülay Rathfischb
a
Near East University, Near East Boulevard, 99138, Nicosia, TRNC, Mersin 10, Turkey
b
İstanbul University, Faculty of Florence Nıgtıngale Nursing, İstanbul, Turkey
1. Introduction
Preparing to have a baby is an experience that affects not only the
pregnancy and birth period but also the rest of one's life [1]. The par-
ents' preparation is vital for a healthy pregnancy and birth, [2]. Ac-
ceptance of the birth as a physiological process and the woman's con-
fidence in her body and her baby result in an easier natural birth [3].
Pregnancy and labour is the female body's natural, normal, and
healthy function. Unnecessary interventions effect birth and hormone
secretion. Oxytocin and endorphins are the most influential hormones.
Oxytocin is responsible for the delivery and helps the uterine contrac-
tions proceed. Endorphin is a natural painkiller secreted by the body.
Both the woman and baby at birth are under the influence of oxytocin
and endorphins. As childbirth progresses and the pain increases, en-
dorphins are released in increasing amounts. The result is a completely
natural reduction in pain perception. Women can progress through la-
bour with their instincts and focus more on events such as their in-
creasing labour pain [3–5].
Under the guidance of their instincts, most women actively parti-
cipate in childbirth. There is no particular intervention in labour that is
the most accepted definition in the literature [4]. In other words, nat-
ural births are those with as little interference as possible [5,6].
Hypnobirthing is focused on the development and liberation of
people's fears. It is based on deep relaxation for a comfortable child-
birth. It is an international application for healthy, peaceful, and con-
scious birth [1].
Hypnobirthing is more of a philosophy than a natural delivery
method. It has guided natural birth philosophy for some time [7]. Birth
via hypnosis that is known as the Mongan method is based on the push
technique. It involves training related to the birth process, relaxation
techniques, hypnosis, imaging, a light touch, and breathing [4].
Hypnobirthing was founded by Marie Mongan. It is based on the
theory that childbirth is natural and healthy [1,8–10]. According to
Mongan, women can give birth gently. She earned her hypnotherapy
counselling license in 1987. In time, she realised that alleviating the
pain of childbirth was possible through relaxation and hypnosis. She
developed a birth education programme by combining the advantages
∗
Corresponding author.
E-mail addresses: filiz_atis01@hotmail.com, filiz.yariciatis@neu.edu.tr (F.Y. Atis), gulumyil@yahoo.com (G. Rathfisch).
https://doi.org/10.1016/j.ctcp.2018.08.004
Received 2 June 2017; Received in revised form 20 July 2018; Accepted 7 August 2018
1744-3881/ © 2018 Elsevier Ltd. All rights reserved.
T
of natural delivery and hypnosis, which she termed hypnobirthing.
Mongan first applied this technique during the birth of her grand-
daughter Maura in 1990 [1]. Hypnobirthing enables women to adapt to
their natural childbirth instincts and involve their partner in the process
as well.
As a result of her research, Mongan focused on the “fear-tension-
pain” theory of English obstetrician Dr. Grantly Dick Read, the pioneer
of natural childbirth and author of Childbirth without Fear in 1933. Dr.
Read discussed reasons that caused birth pain, divided the mind and the
body into two poles, and reported that experts should investigate these
poles in order to understand and prevent pain. Superstitious beliefs,
levels of civilisation, and culture affect women's pain and cause anxiety
and fear during birth. The basic principle of hypnobirthing is that
childbirth is a normal, natural, and healthy phenomenon for women.
Hypnobirthing provides women with strong and comfortable guidance
that supports their innate birthing skills [1,4,10]. The hypnobirthing
mother, by embracing the innate birthing knowledge of her body,
learns to relax during the birth process by cooperating with her body
and baby [1]. The woman is able to rid herself of pain, fear, and ten-
sion. The first phase of childbirth is shorter, and the need for painkillers
decreases dramatically. The woman experiences a satisfying childbirth
experience consciously, attentively, and calmly with her baby and fa-
mily [1,8,9].
Hypnobirthing views childbirth as an extension of sexuality and the
realisation of family through the effective participation of both couples
[1,9]. Hypnobirthing involves cooperation. The philosophy of the
programme is not against the implementation of medical interventions.
It opposes the attitude of “performing the action and getting rid of it”
and unnecessary, routine, and arbitrary practises. Hypnobirthing en-
ables couples to complete the birthing process in a calm and comfor-
table manner even in cases when the pregnancy is risky or when the
birth is abnormal and requires surgical intervention [1].
Although the World Health Organisation (WHO) reports that cae-
sarean birth rates are between 10% and 15%, this rate increases every
year in Turkey [11]. According to the Turkish Demographic and Health
Survey's (TDHS) 2008 report, 36.7% of births in Turkey were caesarean
sections; this rate increased to 50.4% in 2013 [12,13]. The fear of birth