Pregnancy & Birth
Hypnobirthing: The Evidence Is About Fear, Not About Pain
The largest trial ever run on hypnosis for childbirth followed 1,222 first-time mothers in Denmark. The women who learned self-hypnosis rated their birth experience more positively afterwards. The same trial found no difference in epidural use, and none on any measure of pain. Same women, both results. Which of the two you are shopping for should decide what you buy.
The short answer, before the detail.Hypnosis has a real, modest, repeated signal for how women feel about giving birth — less anxiety beforehand, less fear than they expected, a more positive memory afterwards. It has no reliable evidence for anything clinical: not pain, not epidurals, not caesareans, not the length of your labour, not your baby’s condition at birth.
Use it alongside your maternity care, never instead of it. It does not replace your midwife or your doctor, and it rules nothing out — including changing your mind about pain relief at any point. Every decision about pain relief in labour belongs to you and your care team.
Written by Ernest McLeodClinical hypnotherapist. An Adelaide practice, seeing clients across Australia by video. Fourteen years in practice. About Ernest →
I earn a commission when someone buys a session through this site. On this topic you should know that before you read another word, and then judge whether what follows reads like someone protecting a sale.
What hypnosis for birth has actually been shown to do
Start with the best study in the field. Werner and colleagues randomised 1,222 healthy first-time mothers in Denmark to three one-hour lessons in self-hypnosis with recordings, to three lessons in relaxation and mindfulness, or to usual care. Six weeks after the birth, on a scale where a lower score means a more positive experience, the hypnosis group scored 42.9 against 47.2 and 47.5, p = 0.01. Their conclusion: “a brief course in self-hypnosis improved the women’s childbirth experience.”
The UK’s SHIP trial points the same way from another angle. 680 first-time mothers, two 90-minute group sessions at about 32 and 35 weeks plus a daily CD. It missed its primary outcome, and 27 of its 29 secondary outcomes showed nothing. The two that moved were both about fear — anxiety mean difference −0.72 (95% CI −1.16 to −0.28), P = 0.001; fear −0.62 (−1.08 to −0.16), P = 0.009, comparing actual against anticipated levels.
Hold that loosely. Two significant results out of 29 comparisons is close to what chance alone produces, and the trialists said only that the question “needs further investigation”. Promising, not proven.
A 2025 German trial of an online hypnosis birth course, 221 women, is almost a diagram of the argument. Stress fell (p = 0.019), expectations of birth improved (p = 0.002), and so did fear (p = 0.007) and self-efficacy (p = 0.047). Then, verbatim: “However, we found no significant group differences in the experience of pain (p = 0.08).” The psychological outcomes moved. The pain did not.
That is the most consistent signal in the field, and it is still the weaker kind of evidence: secondary outcomes, single trials, smaller studies. The Cochrane review below did not assess fear of childbirth or antenatal anxiety at all, so there is no graded estimate for the one claim this page makes. A 2023 review describes “a more positive subjective experience of pregnancy and childbirth”. Wanting that is reasonable in its own right.
What the most recent Cochrane review (2016) found
Madden and colleagues published Hypnosis for pain management during labour and childbirth on 19 May 2016, with a literature search dated 30 September 2015. Nine trials, 2,954 women, across Australia, Denmark, the UK and the USA; eight of the nine tested antenatal training. It is still the current version — and it is a decade old, so read it as the most recent Cochrane review rather than as the latest evidence.
Its one positive result: less pharmacological pain relief overall, average risk ratio 0.73 (95% CI 0.57 to 0.94), 2,916 women, eight studies. That is the number the category is built on, and it carries two caveats that are not optional. The review’s own Summary of Findings table rates it very low certainty. And the review states the result “did not reach statistical significance if the quasi-randomised trials were removed from the analysis”.
There is more. The effect came entirely from training given in the first or second trimester. For third-trimester training it was RR 0.89 (0.75 to 1.04) across 2,354 women — not significant. Nearly every commercial course sold is a third-trimester course.
On everything else the review is flat. Epidural use, RR 0.81 (0.51 to 1.27); the plain-language summary says hypnosis “does not seem to reduce the use of epidurals”. Satisfaction with pain relief, RR 1.06 (0.94 to 1.20), one study, 264 women. Sense of coping with labour, mean difference 0.22 (−0.14 to 0.58), one study, 420 women — on both, “not enough evidence currently exists”. Spontaneous vaginal birth, RR 1.12 (0.96 to 1.32): “women using hypnosis are no more likely to have a normal vaginal birth”.
The three biggest trials were all null — including the Australian one
The Australian trial ran from 2005 to 2010 at the largest tertiary maternity centre in South Australia. 448 women past 34 weeks were randomised to antenatal hypnosis sessions with CDs, to the same CDs alone, or to nothing extra. Use of pain medicine: 81.2 per cent, 76.9 per cent and 76.2 per cent — RR 1.07 (0.95 to 1.20) and RR 1.01 (0.89 to 1.15). Median pain scores were identical in all three arms. The conclusion: it “does not reduce the use of pharmacological analgesia during labour and childbirth”.
SHIP missed epidural use, 27.9 against 30.3 per cent, odds ratio 0.89 (0.64 to 1.24). Werner’s 1,222 women split 31.2, 29.8 and 30.0 per cent, with “no statistically significant differences … for any of the self-reported pain measures”. And a 2024 systematic review in Midwifery — six trials, 2,937 women, newer than Cochrane — found epidural RR 0.79 (0.39 to 1.61) and reported “no effect on the use of pharmacological analgesia”.
One pooled result goes the other way. A 2024 meta-analysis put pain intensity at standardised mean difference −1.45 (−2.34 to −0.55), with I² of 91 per cent — severe heterogeneity, so the estimate is not reliable. The same review found hypnosis could not reduce epidural use, and credited its caesarean and fear benefits to mindfulness.
Outcome by outcome, with nothing left out
| Outcome | Verdict | The numbers |
|---|---|---|
| Pain in labour | No effect shown | Cochrane could not pool the data. Werner, 1,222 women: no difference on any pain measure. The Australian trial: identical medians. One 2024 pooled estimate is positive but has I² = 91%. |
| Pain medicine overall | Weak, contested | RR 0.73 (0.57–0.94), very low certainty; loses significance without the quasi-randomised trials; third-trimester subgroup RR 0.89 (0.75–1.04). Midwifery 2024: no effect. |
| Epidural | No effect | RR 0.81 (0.51–1.27). SHIP OR 0.89. Werner 31.2% v 30.0%. Midwifery 2024 RR 0.79 (0.39–1.61). |
| Length of labour | No effect | MD −93.78 minutes, 95% CI −233.43 to +45.87 — the interval crosses zero. Not significant. |
| Mode of delivery | No effect | Spontaneous vaginal birth RR 1.12 (0.96–1.32); caesarean RR 0.90 (0.60–1.34); assisted birth RR 0.80 (0.63–1.03); induction RR 0.98 (0.77–1.25). |
| The baby | Nothing shown either way | Apgar under 7 at five minutes RR 1.02 (0.28–3.71); special care admission RR 1.06 (0.86–1.30). Far too imprecise to support any claim about your baby. |
| Satisfaction with pain relief | Evidence absent | RR 1.06 (0.94–1.20), one study, 264 women. Cochrane: “not enough evidence currently exists”. |
| Sense of coping | Evidence absent | MD 0.22 (−0.14 to 0.58), one study, 420 women. Flagged by Cochrane as a research gap. |
| Birth experience | Supported, modestly | Pooled MD −4.40 (−7.22 to −1.58), 1,126 women — essentially one trial. Werner: 42.9 v 47.2 v 47.5, p = 0.01. |
| Anxiety and fear of birth | Strongest signal, not Cochrane-graded | SHIP: anxiety −0.72 (−1.16 to −0.28); fear −0.62 (−1.08 to −0.16) — both secondary outcomes in a null trial. |
The courses in the trials are not the courses you can buy
HypnoBirthing® is a trademarked programme — the Mongan Method, founded by Marie Mongan and run by the HypnoBirthing® Institute as a five-session course. Hypnobirthing Australia™ is a separate Australian organisation, directed by Melissa Spilsted, whose flagship is the Positive Birth Program. Different brands, different materials.
None of the nine trials in the Cochrane review tested either of them. Every intervention was purpose-built for the study: three sessions and CDs in Australia, two group sessions and a CD in SHIP, three one-hour lessons in Denmark. All shorter and far cheaper than a 12-hour branded course. That cuts both ways, and I want to be fair about it — the trial evidence cannot be transferred to a branded course, and the null results cannot be said to condemn one either.
The accurate statement is that no branded hypnobirthing course has been tested in a randomised trial. Which means “clinically proven” and “evidence-based” are not available to anyone selling one. Costs, checked September 2026: self-paced online courses generally A$150 to A$260; live courses with a certified practitioner typically A$500 to A$1,000 per couple for about 12 hours. Practitioners set their own prices.
One 2026 Australian study did look at the branded product, matching 1,322 pairs of women retrospectively. Those who used HypnoBirthing were less likely to have had an epidural (odds ratio 0.50 in first-time mothers) or a caesarean (0.69, corrected by a published corrigendum). Use of water immersion also rose — and that is the tell. Women who choose, pay for and finish a birth course differ in motivation and often in their model of care.
The authors wrote that HypnoBirthing is “associated with” those outcomes, which is correct and careful. Randomised trials totalling roughly 2,900 women, which can answer the causal question, found no such effect. When observational data and randomised data disagree, the randomised data wins.
Which brings me to the percentage reductions in caesareans, inductions and epidurals displayed on Australian hypnobirthing marketing. I traced them to an uncontrolled before-and-after count of births at one hospital, with no sample size, no control group, no significance testing and no peer review. I will not repeat the figures. The same brand’s research page also cites a superseded 2006 version of Cochrane, and a 2016 Australian trial whose intervention contained no hypnosis at all.
About the physiology, since you will be told about it
Fear–tension–pain, and the idea that relaxation lets endorphins replace the stress hormones that cause pain, is the model hypnobirthing is built on. It is not a verified mechanism and should never be handed to you as established physiology. Where it has been measured, it went the other way: a study of 349 women given self-hypnosis training with recordings found that antenatal hypnosis training “may increase the release of cortisol during childbirth”. Nobody, including me, can tell you this lowers your stress hormones.
What this does not do
It does not make birth safer, for you or for your baby. It does not shorten labour. It does not reduce your chance of an induction, an assisted birth or a caesarean, and it does not help you avoid an epidural. It does not produce a pain-free birth — “surges” and “pressure” reframe the sensation, they do not remove it. A woman promised a painless birth who does not get one has been set up for self-blame at the worst possible moment.
In 2023, four in every five women in Australia had some form of pain relief medicine during labour. Choosing it is not a failure of preparation, and nothing sold here should make you hesitate to ask for it.
RANZCOG’s patient information on pain relief in labour does not mention hypnosis. Neither does healthdirect’s list of options, nor the Australian Pregnancy Care Guidelines. That is not a verdict that it fails — it reflects that the evidence has not reached the standard those bodies use. Some Australian hospitals and private maternity services do run classes.
And severe fear of childbirth is not something to self-treat with a recording. No trial has ever recruited women with diagnosed tokophobia, so hypnosis has no standing as a treatment for it. That conversation belongs with your midwife, GP or obstetrician.
If fear of birth is what brought you here
People who will talk this through with you, free.
Pregnancy, Birth and Baby — 1800 882 436, 7am to midnight (AET), seven days a week. Funded by the Australian Government, staffed by maternal child health nurses. The right number for “should I be doing this?”
PANDA, Perinatal Anxiety & Depression Australia — National Helpline 1300 726 306, for anxiety, fear and low mood in pregnancy and after birth.
Gidget Foundation Australia — 1300 851 758, perinatal mental health support. Gidget states it is not able to provide crisis support, so if things are urgent use the numbers below.
healthdirect — 1800 022 222, 24-hour health advice. In an emergency, 000.
What is on this site, and the honest case for it
There are 17 sessions in the pregnancy and childbirth catalogue, each US$18.95, about A$27. The ones that match what the evidence supports are the ones about how you feel: Fear of Giving Birth, Fear of Pregnancy, Positive Pregnancy, Childbirth Rehearsal Hypnosis, Connect with Your Unborn Baby and Prepare For Caesarean. Self-help recordings about anxiety and confidence — not a birth plan, not a course, not treatment.
Is a recording a fair substitute for a person? On clinical pain generally, format matters less than you would think: Yim and Derbyshire found self-hypnosis at −0.24, therapist-delivered at −0.35 and recordings played in person at −0.33, with a subgroup difference of p = 0.94. Montgomery tested live against audiotape in 2002 and found none either. Small subgroups, and that is clinical pain rather than childbirth, so I will not pretend it transfers.
What does transfer is this: the Australian trial included an arm that got the CDs alone, with no live teaching, and it produced the same result as the arm with a hypnotherapist in the room. Which was, in that trial, no result at all.
So the pitch here is a narrow one. At about A$27, for someone frightened of giving birth who wants something to listen to at eleven at night, this is a low-stakes thing to own, aimed at the one outcome the research supports. For the wider picture, read does hypnosis work? first. If the fear you are carrying is bigger than birth itself, the anxiety sessions and the numbers above are better places to start than this page.
Common questions
Does hypnobirthing work?
It depends what you want from it. For anxiety, fear of birth, and how positively women remember the birth afterwards, there is a modest and fairly consistent signal. For pain, epidural use, length of labour, mode of delivery or anything about the baby, there is no reliable effect. The three largest randomised trials, including an Australian one, were all null on their main outcome.
Will hypnobirthing help me avoid an epidural?
No, on the evidence available. The most recent Cochrane review (2016) found a risk ratio of 0.81, confidence interval 0.51 to 1.27, and says plainly that hypnosis does not seem to reduce the use of epidurals. Trials of 680 and 1,222 first-time mothers found the same, and so did a 2024 review of 2,937 women. Anyone promising otherwise is ahead of the data.
Is a branded HypnoBirthing course worth the money?
Your call, but make it knowing no branded course has been tested in a randomised trial. The trials used short, purpose-built training written for the research, not HypnoBirthing® (the Mongan Method) or the Hypnobirthing Australia™ Positive Birth Program. In Australia, self-paced online courses run about A$150 to A$260 and live 12-hour courses about A$500 to A$1,000 per couple, checked September 2026.
Can I use this if I am booked for a caesarean or an induction?
Yes, and there is a session aimed at exactly that. Nothing about hypnosis requires a particular kind of birth, and nothing here should be read as suggesting one kind is better than another. What these recordings are for is feeling calmer and less frightened beforehand. Your birth plan is a conversation for you and your maternity team, not for a recording.
Is hypnosis safe in pregnancy?
A 2018 review of adverse events recorded in hypnosis clinical trials found serious adverse events attributable to hypnosis reported at zero per cent, and other adverse events at 0.47 per cent. The real risks on this topic are different: expecting a pain-free birth and being let down, or letting a recording stand in for maternity care. Never listen while driving, and tell your midwife what you are using.
I am terrified of giving birth. What should I do first?
Tell your midwife, GP or obstetrician. Severe fear of childbirth is common and is taken seriously, and no trial has tested hypnosis in women with diagnosed tokophobia, so it has no standing as a treatment for it. Pregnancy, Birth and Baby on 1800 882 436 and PANDA on 1300 726 306 will talk it through at no cost. A recording can sit alongside that. It cannot replace it.
Free and confidential, open now. Tap to call.
Where these numbers come from
- Werner A, Uldbjerg N, Zachariae R, et al. Antenatal hypnosis training and childbirth experience: a randomized controlled trial. Birth. 2013;40(4):272-80. doi:10.1111/birt.12071
- Werner A, Uldbjerg N, Zachariae R, et al. Self-hypnosis for coping with labour pain: a randomised controlled trial. BJOG. 2013;120(3):346-53. doi:10.1111/1471-0528.12087
- Downe S, Finlayson K, Melvin C, et al. Self-hypnosis for intrapartum pain management in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness. BJOG. 2015;122(9):1226-34. doi:10.1111/1471-0528.13433
- Motz L, Brückner RM, Schmidt B. Improving birth preparation with the hypnosis online course “The Peaceful Birth”: a randomized controlled study. Front Psychol. 2025;16:1508790. doi:10.3389/fpsyg.2025.1508790
- Madden K, Middleton P, Cyna AM, et al. Hypnosis for pain management during labour and childbirth. Cochrane Database Syst Rev. 2016;(5):CD009356. doi:10.1002/14651858.CD009356.pub3
- Catsaros S, Wendland J. Psychological impact of hypnosis for pregnancy and childbirth: a systematic review. Complement Ther Clin Pract. 2023;50:101713. doi:10.1016/j.ctcp.2022.101713
- Cyna AM, Crowther CA, Robinson JS, et al. Hypnosis Antenatal Training for Childbirth: a randomised controlled trial. BJOG. 2013;120(10):1248-59. doi:10.1111/1471-0528.12320
- Lai MYK, Wong MM, Kearney L, et al. The effect of antenatal hypnosis training on pharmacological analgesia use during labour and birth: a systematic review and meta-analysis. Midwifery. 2024;137:104113. doi:10.1016/j.midw.2024.104113
- Wang R, Lu J, Chow KM. Effectiveness of mind-body interventions in labour pain management during normal delivery: a systematic review and meta-analysis. Int J Nurs Stud. 2024;158:104858. doi:10.1016/j.ijnurstu.2024.104858
- HypnoBirthing International. HypnoBirthing – The Mongan Method [Internet]. HypnoBirthing Institute; [cited 2026 Sep 24]. hypnobirthing.com
- Hypnobirthing Australia. Positive Birth Program [Internet]. Hypnobirthing Australia; [cited 2026 Sep 24]. hypnobirthingaustralia.com.au
- Hypnobirthing Australia. Positive Birth Program online course [Internet]. Hypnobirthing Australia; [cited 2026 Sep 24]. hypnobirthingaustralia.online
- Lee N, Kearney L, Jenkinson B, et al. The association between women’s use of HypnoBirthing and maternal labour analgesia use and mode of birth: a retrospective propensity score matched study. Women Birth. 2026;39(3):102215. doi:10.1016/j.wombi.2026.102215
- Lee N, Kearney L, Jenkinson B, et al. Corrigendum to “The association between women’s use of HypnoBirthing and maternal labour analgesia use and mode of birth: a retrospective propensity score matched study” [Women Birth 39(3) (2026) 102215]. Women Birth. 2026;39(4):102217. doi:10.1016/j.wombi.2026.102217
- Hypnobirthing Australia. Hospitals [Internet]. Hypnobirthing Australia; [cited 2026 Sep 24]. hypnobirthingaustralia.com.au
- Hypnobirthing Australia. Research, statistics and scientific studies [Internet]. Hypnobirthing Australia; [cited 2026 Sep 24]. hypnobirthingaustralia.com.au
- Smith CA, Collins CT, Cyna AM, et al. Complementary and alternative therapies for pain management in labour. Cochrane Database Syst Rev. 2006;(4):CD003521. doi:10.1002/14651858.CD003521.pub2
- Levett KM, Smith CA, Bensoussan A, et al. Complementary therapies for labour and birth study: a randomised controlled trial of antenatal integrative medicine for pain management in labour. BMJ Open. 2016;6(7):e010691. doi:10.1136/bmjopen-2015-010691
- Werner A, Wu C, Zachariae R, et al. Effects of antenatal hypnosis on maternal salivary cortisol during childbirth and six weeks postpartum – a randomized controlled trial. PLoS One. 2020;15(5):e0230704. doi:10.1371/journal.pone.0230704
- healthdirect. Pain relief during labour [Internet]. Canberra: Healthdirect Australia; [cited 2026 Sep 24]. healthdirect.gov.au
- Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Pain relief in labour and childbirth [patient information]. Melbourne: RANZCOG; 2016. ranzcog.edu.au
- Yim TH, Derbyshire SWG. A systematic review of hypnosis for clinical pain relief. Eur J Pain. 2026;30(8):e70369. doi:10.1002/ejp.70369
- Montgomery GH, David D, Winkel G, et al. The effectiveness of adjunctive hypnosis with surgical patients: a meta-analysis. Anesth Analg. 2002;94(6):1639-45. doi:10.1097/00000539-200206000-00052
- Bollinger JW. The rate of adverse events related to hypnosis during clinical trials. Am J Clin Hypn. 2018;60(4):357-66. doi:10.1080/00029157.2017.1315927
- Australian Pregnancy Care Guidelines (LEAPP) v9.1.
- Australian practitioner course fees, checked September 2026.
Every other page ranking for this word is selling a course on the strength of numbers that do not hold. I would rather sell you one A$27 recording for the one thing the research supports, and have you hear the rest from your midwife.
The three sessions on this page
Every one is an instant MP3 from the publisher at US$18.95, about A$27, with ninety days to change your mind. I earn a commission; it changes neither what you pay nor what I list.
Fear of Giving Birth
Fear of giving birth — which is the outcome the evidence actually supports.
Childbirth Rehearsal Hypnosis
A rehearsal session, for familiarity rather than for pain.
Positive Pregnancy
For the pregnancy rather than the birth.
These are self-help audio sessions, not medical treatment, a diagnosis, or a substitute for maternity care. No therapeutic outcome is claimed for any session sold on this site, and nothing here is a claim about pain, labour, mode of birth or the health of a baby. Hypnosis does not replace midwifery or obstetric care, and every decision about pain relief in labour is one for you and your care team. Tell your midwife or doctor about anything you are using. If you have severe fear of childbirth, low mood or anxiety in pregnancy, speak to your midwife or GP, or call PANDA on 1300 726 306. Never listen while driving or operating machinery, and do not stop prescribed medication without your doctor’s approval.