HypnoBirthing

1. Introduction

Version followed: HypnoBirthing® – The Mongan Method as published by the HypnoBirthing® Institute: the five-unit parent course on hypnobirthing.com and the course description co-authored by Mongan in Swencionis, Rendell, Dolce, Massry & Mongan 2012 (five weekly 2.5-hour sessions), with Marie F. Mongan's textbook HypnoBirthing: The Mongan Method (4th edition, Health Communications, 2015; the textbook for the classes per the Institute's shop) for technique names. The book itself is drawn on only through short excerpts on Bookmate (edition not shown) plus its catalogue contents list; technique details otherwise come from course pages, summaries, a nursing textbook and theses (each tagged). Generic UK "hypnobirthing" classes (NHS midwife-led, other brands) differ in detail and are named where used. [source: HypnoBirthing Institute course page and book page; Swencionis, Rendell, Dolce, Massry & Mongan 2012; Bookmate excerpts; Wake County catalogue record of Mongan 2015]

Scope of this guide. HypnoBirthing is antenatal education with self-hypnosis. It is used alongside routine maternity care (midwife and/or obstetrician), never instead of it. This guide gives no obstetric, medication or pain-relief advice: every decision about labour, induction, monitoring, pain relief, position for birth, breech presentation or caesarean belongs to the client and her maternity team. A psychotherapist's role is (a) screening and treating fear, anxiety and trauma that affect the pregnancy and birth, and (b) teaching or reinforcing the self-hypnosis, relaxation, breathing and imagery skills within their competence. The organisation (verified). The method is run by the HypnoBirthing® Institute, whose official site also calls it "HypnoBirthing International"; it was founded by Marie Mongan in 1989 (the Fernandez Hospital leaflet's date of 2000 conflicts with this; the Institute's own date is followed), lists an address in Pembroke, New Hampshire, USA, reports educators in 46 countries, and after Mongan's death in 2019 is led by President Dr Vivian Keeler, Vice President Anthea Thomas (also director in Australia) and CEO Maura Geddes, Mongan's daughter. [source: HypnoBirthing Institute, "The Official HypnoBirthing Institute"; HypnoBirthing Australia page] Who teaches it. "HypnoBirthing" is a registered name taught by Certified HypnoBirthing Childbirth Educators. Their training is a 4-day programme: Introduction to Hypnosis for Birthing (1.5 days; covers inductions, deepening, judging trance depth, post-hypnotic suggestion, alerting and the "dangers of unqualified therapy"), Birthing Basics (physiology, home study; credit for midwives and doulas) and an Educator Certification Workshop (2.5 days), with a case study of one couple through the 5-session programme, a "Gold Seal" on certification and annual recertification. The Institute states its materials are for personal use and may not be used by unaffiliated persons. [source: HypnoBirthing Institute, Educator Training course outline] So a therapist who is not certified can use clinical hypnosis for birth preparation within their competence but should not present it as the HypnoBirthing course or use its materials; a certified educator without clinical training should refer mental-health problems on [synthesis].

What it is. A childbirth-education programme created by hypnotherapist Marie F. Mongan (1933–2019) that combines information about birth physiology with daily self-hypnosis, relaxation, breathing, visualisation, affirmations and a trained birth companion. OpenStax's maternity nursing text calls it "more of a philosophy" than a single technique. [source: OpenStax/LibreTexts Maternal-Newborn Nursing 14.4; Wikipedia; Edmonds 2023]

How change is thought to happen. Mongan builds on Grantly Dick-Read's fear-tension-pain idea: fear produces muscular tension and a stress response, which (in her account) increases pain, slows labour and leads to interventions. HypnoBirthing aims to replace fear with "peaceful confidence" through (1) releasing specific fears, (2) rehearsed deep relaxation conditioned to cues (anchors, breathing, companion's touch and voice), (3) repeated positive imagery and affirmations, and (4) changed language around birth. Mongan's physiological claims (uterine blood flow, endorphins, cervix) are hers, presented here as the method's rationale, not established fact. [source: OpenStax/LibreTexts 14.4; Shortform preview; Blinkist summary]

2. Framework

Format. Five classes taught "over the course of 5 weeks", face to face or online, in groups or privately, attended by the pregnant woman and her birth companion, who takes an active role. The Mongan co-authored description gives five weekly 2.5-hour sessions that include videos of actual births. [source: HypnoBirthing Institute course page; Swencionis, Rendell, Dolce, Massry & Mongan 2012, p. 123; HypnoBirthing Australia] The Institute names six techniques: relaxation, breathing, visualisation, self-hypnosis/deepenings, affirmations and education; the 2012 paper names four basic ones: relaxation, breathing, visualisation and deepening. [source: HypnoBirthing Institute course page; Swencionis, Rendell, Dolce, Massry & Mongan 2012, p. 124] Course materials described by practitioners: the Mongan textbook, home-practice scripts, relaxation recordings ("Rainbow Relaxation"; the 2015 book's CD holds a relaxation track and a "birth rehearsal imagery" track), birth-preferences handouts, prompts for the companion, practice of positions, an extra hypnosis session for building confidence and releasing fears, and nutrition and toning handouts. [source: Embrace Birth; Fernandez; Hunterdon; Wake County catalogue; Edmonds 2023]

A shorter clinical alternative (different programme). The Australian HATCh trial (Cyna) taught self-hypnosis in three weekly one-hour group sessions (5–10 women) from 36 weeks, with an audio CD for home practice. Useful as a model if a therapist offers brief hypnosis preparation rather than the full course. [source: Cyna 2011 thesis]

Content by unit (verified). The Institute publishes the five unit titles; the 2012 paper co-authored by Mongan lists each unit's content. The table follows both; rows 0 and "Postnatal" are my additions [synthesis]. Other affiliates arrange topics slightly differently (e.g., HypnoBirthing Israel puts light touch massage and special breathing in session 2 and fear-release imagery in session 3). [source: HypnoBirthing Institute course page; Swencionis, Rendell, Dolce, Massry & Mongan 2012, pp. 123–125; HypnoBirthing Israel course content]

Labour phases as the book names them: onset of labour; thinning and opening; slow or resting labour; nearing completion; baby crowns and births; post-birth and "birth afterglow". These are descriptive labels for teaching; clinical assessment of labour is the midwife's. [source: Wake County catalogue of Mongan 2015]

Home practice. Daily rehearsal is central; the method relies on repetition so techniques become automatic. Parents are taught that at least 20 hours of home practice are needed to become competent, and are encouraged to practise daily. Tommy's notes practice ranges from several times a day to two or three times a week, and benefits depend on regular practice. [source: Swencionis, Rendell, Dolce, Massry & Mongan 2012, p. 124; Shortform; Blinkist; Tommy's]

Criteria for moving on [synthesis]. Move from relaxation skills to rehearsal imagery when the client can reach a calm state with her cue within a few minutes and reports it on a 0–10 scale; move to birth rehearsal when calm breathing is automatic and the companion can reliably trigger the anchor; consider the client ready when birth-related fear ratings have fallen, she has discussed her preferences with her midwife, and she has a plan for the birth not going as hoped. Do not move on while screening concerns (Section 4, Preparation) are unresolved.

3. Guiding principles

• Birth as a normal physiological process. Most pregnancies are low risk, says the method. In practice: speak about birth calmly and confidently, but leave all judgements of risk to the maternity team. [source: OpenStax/LibreTexts 14.4]
• Fear-tension-pain. Fear is treated as the main thing to change. In practice: assess and work on fear before teaching techniques. [source: OpenStax/LibreTexts 14.4; Mongan 2015 ch. 8–9 titles]
• Power of the mind and repetition. Thoughts and repeated images are held to shape bodily responses. In practice: give daily recorded practice and affirmations; review adherence each session. [source: Blinkist; Shortform]
• The art of doing nothing. The labouring woman stays loose and limp and lets her body work. In practice: train release of effort (limpness, slow out-breath), not striving. [source: OpenStax/LibreTexts 14.4; Mongan 2015 ch. 12 title]
• Let baby and body set the pace. Mongan holds that labour should not be "managed" and that interventions belong where medically indicated. In practice: this is Mongan's position; the therapist does not advise on induction or interventions and helps the client discuss her questions with her care providers. [source: OpenStax/LibreTexts 14.4; Mongan 2015 ch. 22–23 titles] [synthesis for therapist stance]
• Changed language. "Surge" or "wave" for contraction; "pressure" or "sensation" for pain; "membrane release" for waters breaking; "special circumstances" for complications. In practice: use the client's chosen words consistently in session and scripts. [source: Blinkist; OpenStax/LibreTexts 14.4; Tommy's]
• The birth companion is an active partner. In practice: train the companion in anchors, reading the rehearsal script, light touch, and prompts. [source: Blinkist; Shortform; Edmonds 2023]
• Prenatal bonding. The book devotes a chapter to "falling in love with your baby". In practice: include imagery of meeting and holding the baby. [source: Mongan 2015 ch. 11 title; Shortform] Content of that chapter [uncertain].
• Aware and in control. Hypnosis is described as a dreamy, deeply relaxed state in which the woman remains aware and in control. In practice: tell clients they can open their eyes, speak and respond at any time; the course teaches that a hypnotised person does not act against their will, and the Institute promises parents they stay "awake, alert, and fully in control". [source: DBTH NHS page; Swencionis, Rendell, Dolce, Massry & Mongan 2012, p. 124; HypnoBirthing Institute book page]
• Calm environment and not disturbing the woman in self-hypnosis. In practice: help the client write this into birth preferences and tell staff she is using it. [source: OpenStax/LibreTexts 14.4; Tommy's]
• Useful for every kind of birth. Course providers say skills apply to medicated and caesarean births; reported benefits include feeling good about the birth whatever the outcome. In practice: rehearse calm for changes of plan, not one ideal birth. [source: Hunterdon; OpenStax/LibreTexts 14.4]
• Adjunct, within competence. Hypnosis is an adjunct that adds to other care and analgesia, not a replacement; practise hypnosis only within your field of expertise. In practice: liaise with the midwife; refer obstetric questions back. [source: Cyna 2011 thesis]

4. Intervention inventory

The 2015 book groups its techniques as: relaxation (progressive relaxation, disappearing letters, light touch massage, anchors); breathing (calm, surge, birth breathing); visualisation (rainbow relaxation, the birth companion's reading, the opening blossom, blue satin ribbons, the arm-wrist relaxation test); ultra-deepening (glove relaxation, the depthometer, the sensory gate control valve, time distortion). Fear release, affirmations and language work sit alongside these. [source: Wake County catalogue of Mongan 2015] The course paper adds "instant" relaxation and says several inductions are taught, with each mother becoming proficient in the one or two she prefers. [source: Swencionis, Rendell, Dolce, Massry & Mongan 2012, p. 124] All example wording below is illustrative and in my own words; none is Mongan's script. Where a technique's content is not given in the sources (Institute pages, the 2012 paper, Bookmate excerpts, summaries), that is marked [uncertain] and any procedure given is generic clinical hypnosis [synthesis].

Preparation, screening and consent (before any hypnosis)

• Purpose: decide whether hypnosis-based birth preparation is safe for this client now and set it up as an adjunct to maternity care.
• Steps: (1) Confirm the client is booked with a midwife or obstetrician and agree to share, with consent, that she is preparing with self-hypnosis. (2) Take a perinatal mental-health history: current and past depression and anxiety, psychiatric admissions, psychosis or bipolar disorder (including postpartum episodes in her or close family), dissociative symptoms, substance use, prior traumatic birth, sexual abuse, pregnancy loss, intimate partner violence [synthesis]. (3) Rate fear of birth (0–10, plus her own words for the worst fear). (4) Explain hypnosis plainly: a focused, relaxed state she enters and leaves herself, in which she stays aware and in control; it does not make anyone do anything; it is not a guarantee of a particular birth. (5) Agree goals (e.g., calmer pregnancy, a practised way to stay calm in labour whatever happens). (6) Get written consent for hypnosis and, if you will record scripts, for the recordings.
• Screening the sources give: Earlier antenatal-hypnosis trials excluded women with prior psychiatric hospitalisation, depression in pregnancy, anxiety or major depressive disorder; case reports describe psychotic symptoms before labour and treatable postnatal anxiety with compulsive behaviour after hypnosis in labour; problems in non-obstetric hypnosis were linked to age regression by inexperienced practitioners and to use with people with psychosis. [source: Cyna 2011 thesis]
• Added cautions [synthesis]: do not use with current psychosis, or history of bipolar or postpartum psychosis without the perinatal psychiatry team's agreement; with severe dissociation, untreated PTSD or severe tokophobia, treat these first (trauma-focused therapy, perinatal mental-health service) and keep hypnosis to brief, present-focused, eyes-open relaxation; no age regression. Make sure she knows that hypnosis does not replace reporting symptoms (bleeding, fluid loss, reduced baby movements, unusual or constant pain, headache, feeling unwell) to her maternity unit.
• Example language (illustrative): "This is a skill you'll be practising, a way of switching on deep calm. You'll hear me the whole time, you can move, talk or open your eyes whenever you like, and everything to do with your care in labour stays between you and your midwife."
• Watch for: expectations of a pain-free or guaranteed birth; pressure from a partner to take the course; fear so high she cannot listen to birth information.

Fear release session

• Purpose: identify and lessen specific fears, negative emotions and past experiences linked to birth. The course teaches "releasing emotions, fears, and limiting thoughts" (Unit 3), with exercises meant to replace fear with confidence; affiliates add separate fear-release sessions, described as particularly helpful after prior birth trauma or abuse. [source: Swencionis, Rendell, Dolce, Massry & Mongan 2012, p. 124; HypnoBirthing Institute course page; HypnoBirthing Israel; OpenStax/LibreTexts 14.4; Embrace Birth] Mongan's own fear-release script is not drawn on here [uncertain]; steps below are a generic version [synthesis].
• Steps [synthesis]: (1) In ordinary conversation, list fears and rate each (0–10); separate realistic concerns needing information from the midwife from fears driven by stories or past events. (2) Address information gaps by encouraging specific questions to the midwife. (3) Induce relaxation (progressive relaxation below). (4) Present-focused imagery: invite her to notice where the fear sits in her body, give it a shape, and imagine setting it down or letting it drift away on each out-breath, replacing it with an image of calm and support. (5) Suggest that she can meet the birth with the calm she feels now. (6) Re-alert, debrief, re-rate fears.
• Trauma rule: stay with present feelings and future rehearsal. Do not regress her to past events or use hypnosis to "uncover" memories; treat any memory as her experience, not as facts to verify. If fears are tied to trauma with PTSD symptoms, offer or refer for a trauma-focused therapy with stabilisation first. [synthesis per brief]
• Example language (illustrative): "As you breathe out, let that heaviness in your chest settle onto the ground beside you. You don't need to carry it into the birth room. Notice what's there instead… perhaps more space, more ease."
• Watch for: tearfulness that settles is common; flashback signs, fixed stare, loss of contact, or panic mean stop, open eyes, ground (see Section 5).

Affirmations and language reframing

• Purpose: repeated positive self-suggestion and birth language that carries less threat. [source: OpenStax/LibreTexts 14.4; Blinkist; Tommy's; Edmonds 2023]
• Steps: (1) Explore which birth words trigger fear. (2) Agree alternatives (surge or wave; pressure or sensation; membrane release; special circumstances). (3) Write 5–10 short, present-tense affirmations in her words (suggested ones may be offered or she can create her own). (4) Pair them with relaxation practice daily, and on cards or recordings for labour. (5) Share chosen words with the companion and, through birth preferences, with staff.
• Example language (illustrative): affirmations such as "My body knows how to do this," "Each surge brings me closer to meeting my baby," "I can stay calm whatever the day brings."
• Watch for: affirmations that become rules ("I will not need help"), which can turn into guilt later; rephrase to flexible ones [synthesis].

Progressive relaxation

• Purpose: the foundational relaxation, taught as the first hypnotic induction and used to start other techniques; the course also teaches an "instant" relaxation for quick deepening (its procedure is not drawn on here [uncertain]; a fast countdown cue, as described in the steps below, is my approximation [synthesis]). [source: Swencionis, Rendell, Dolce, Massry & Mongan 2012, p. 124; Blinkist; Wake County catalogue]
• Steps (as summarised from the book): sitting comfortably, assign numbers to body zones from 5 (head and neck) down to 1 (calves and feet); breathe out and imagine the breath relaxing each zone in turn as it moves down; then count from 5 to 1, letting each number release its zone; with practice, counting faster brings relaxation faster. [source: Blinkist] Re-alert by counting up and suggesting she returns refreshed [synthesis].
• Example language (illustrative): "Five… your scalp and jaw soften. Four… shoulders drop, arms grow heavy. Three… your back and belly loosen around your baby. Two… hips and thighs let go. One… calves and feet, completely at rest."
• Watch for: slower breathing, softened face, heavy limbs; client's 0–10 calm rating rising; time to relax shortening across weeks.

Other inductions taught in the course

• Purpose: give her a choice of ways into hypnosis; the course teaches several inductions besides progressive relaxation, and each mother becomes proficient in the one or two she likes best. The educator training lists eye fixation/closure, Elman, Ericksonian and "Shanti" leads and an "eyelift conversion" lead, with direct and permissive approaches. [source: Swencionis, Rendell, Dolce, Massry & Mongan 2012, p. 124; HypnoBirthing Institute educator course outline] The course's own wording of these inductions is not drawn on here [uncertain].
• Steps [synthesis, generic clinical hypnosis, not the course script]: eye fixation: she fixes her gaze on a point slightly above eye level while breathing slowly; suggest the eyelids grow heavy and close when ready; continue with a deepener. Permissive style: offer choices ("you might notice… or perhaps…") rather than commands; useful for clients who dislike being directed. Always re-alert by counting up.
• Example language (illustrative): "Let your eyes rest on that spot… and whenever they feel ready to close, let them close, and let the calm spread."
• Watch for: strain or watering eyes (let them close sooner); clients with trauma histories may prefer eyes-open, permissive methods.

Disappearing letters

• Purpose: a deepening technique listed among the relaxation techniques. [source: Wake County catalogue] Its procedure is not given in the Institute's pages, the 2012 course paper and Bookmate excerpts [uncertain].
• Steps [synthesis, generic deepener, not Mongan's text]: once relaxed, she slowly imagines letters or numbers written in front of her, letting each fade before the next; when they no longer appear, she lets herself drift deeper.
• Example language (illustrative): "Picture the letter A… watch it soften and fade… let B begin to blur… and if the letters stop coming, just let them go."
• Watch for: frustration if images are faint; offer an auditory or counting alternative.

Light touch massage

• Purpose: the companion's very light stroking to bring comfort and relaxation and (in the method's account) endorphin release; listed as a relaxation technique. [source: Wake County catalogue; Edmonds 2023 ("endorphin massage")]
• Steps (from Mongan's book, as excerpted on Bookmate; edition not shown): (1) She sits or leans forward with her back accessible and relaxes [synthesis]. (2) First motion: the companion places the backs of the fingers of both hands together at the base of her tailbone and draws them up and out from the spine in a V-shape, working up the back to the base of the neck, then around the neck to the sides of the ears. (3) Second motion: again starting with the backs of the fingers at the base of the spine, the companion strokes upward in a sideways figure-of-eight pattern that crosses at the centre of the back. (4) The undersides of the arms and the elbows are also named as effective areas. [source: Bookmate excerpts of Mongan] Synchronising strokes with her slow out-breath, practising during home relaxation so the touch becomes a calm cue, and letting her set pressure and stop at any time are my additions [synthesis].
• Example language (illustrative, companion): "I'm going to stroke very lightly up your back with the backs of my fingers. Tell me if you want it slower, lighter or to stop."
• Watch for: touch aversion, especially after sexual trauma; offer voice-only anchors instead.

Anchors

• Purpose: a conditioned cue that brings back deep relaxation. [source: Blinkist; Wake County catalogue]
• Steps: while she is deeply relaxed, the companion presses gently on her shoulders and cues her to relax twice as deeply; repeated across practice so touch alone triggers release. [source: Blinkist] Add a verbal cue word chosen by her [synthesis].
• Example language (illustrative): "Each time you feel these hands on your shoulders, your whole body lets go twice as far."
• Watch for: the anchor working outside sessions (test it during daily practice); fading if not rehearsed.

Calm breathing

• Purpose: slow breathing used to begin relaxation and self-hypnosis and in the rests between surges (the first of the course's three breathing techniques). [source: Swencionis, Rendell, Dolce, Massry & Mongan 2012, p. 125; Shortform; Embrace Birth]
• Steps: seated with head and shoulders supported and soft lighting, she first brings herself into deep relaxation, then breathes in relaxation and sends it down through her body. [source: Bookmate excerpts of Mongan] The breath itself: slow, deep in-breath through the nose, then a soft release out through the mouth; practised daily until automatic. [source: Shortform] Mongan's specific counts were not found [uncertain]. Healthline describes a hypnobirthing breath of in for 4, out for 7, but does not attribute it to Mongan, so treat it as a generic option, not the Mongan count.
• Example language (illustrative): "Breathe in slowly through your nose, filling low into your belly… and let it soften out through your mouth, as if sighing."
• Watch for: dizziness or tingling suggests over-breathing; slow it down and make breaths smaller [synthesis].

Surge breathing

• Purpose: slow breathing used through each surge in the thinning-and-opening phase (the second of the course's three breathing techniques). [source: Swencionis, Rendell, Dolce, Massry & Mongan 2012, p. 125; Wake County catalogue; DBTH NHS] Mongan's exact counts are [uncertain].
• Steps (NHS midwife-led version, not the Mongan text): at the start of a surge, one long slow breath out through the mouth; then breathe in slowly through the nose to a count of three and out gently through the mouth to a count of five, repeating until the surge passes; relax shoulders and jaw throughout. [source: DBTH NHS page] Healthline describes a longer variant (in for 7, out for 7) without attributing it to Mongan. Practise daily with imagined surges [synthesis].
• Example language (illustrative, companion): "Long breath out… now in, two, three… and out, two, three, four, five… shoulders down, jaw soft."
• Watch for: breath-holding at the peak; she can lengthen the out-breath if counting feels hard.

Birth breathing

• Purpose: the third breathing technique, used with surges in the birthing phase: mothers are encouraged to "breathe the baby down" with an open glottis and their own birthing instincts, rather than hold their breath and push hard (Valsalva). [source: Swencionis, Rendell, Dolce, Massry & Mongan 2012, p. 125; HypnoBirthing Institute course page; Shortform; Fernandez; OpenStax/LibreTexts 14.4]
• Steps (as summarised from the book): short in-breaths through the nose, the breath directed to the back of the throat and imagined moving downward, then a long out-breath through the nose; repeat. [source: Blinkist] The method treats this as working with the body's own expulsive reflex. [source: Shortform]
• Boundary: how she pushes or breathes in second stage is decided with her midwife, who may advise directed pushing for clinical reasons; she can practise birth breathing as one option among others [synthesis].
• Example language (illustrative): "With each breath out, imagine the energy moving down and out, softly and steadily."
• Watch for: strain in face and neck (a sign of bearing down hard rather than breathing down).

Rainbow relaxation

• Purpose: the course's core guided relaxation recording, for daily home practice and stress reduction; the book suggests practising it in alternation with the companion's readings. [source: Embrace Birth; Fernandez; Wake County catalogue; Bookmate excerpts of Mongan] Its script is not drawn on here [uncertain]; the colour imagery below is inferred from the name only.
• Steps [synthesis, generic]: induction by progressive relaxation; deepening by imagining moving through bands of colour, each one deepening calm; suggestions of comfort, confidence and connection with the baby; re-alerting by counting up. Record it in your own words or use the course recording if she is enrolled.
• Example language (illustrative): "Imagine a soft red light around your feet, warming and loosening… now orange, flowing up through your legs…"
• Watch for: falling asleep is common and harmless at home; suggest practice sitting up if she wants to stay with it.

The birth companion's reading (birth rehearsal imagery)

• Purpose: the companion reads a script aloud that takes her through labour calmly and ends with bonding with the newborn; she rehearses this regularly. [source: Shortform; Wake County catalogue ("birth rehearsal imagery" track)]
• Steps: (1) She relaxes with her usual induction and anchor. (2) The companion reads slowly (pauses at commas, softer voice). (3) The rehearsal walks through onset, surges met with breathing, staying loose, the birth, holding the baby skin to skin. (4) Include short scenes of changes of plan met calmly (e.g., moving to hospital, a monitor, an epidural, theatre) [synthesis]. (5) Re-alert and talk about what felt easy or difficult.
• Example language (illustrative): "Your surge rises like a wave… you breathe up and over it… and as it fades you sink even deeper into calm."
• Watch for: spikes of anxiety at particular scenes, which show where fear work is still needed.

The opening blossom

• Purpose: imagery of a flower bud opening petal by petal with each surge, linked to the cervix opening. [source: Wake County catalogue; Edmonds 2023; Tommy's]
• Steps: during relaxation or surge practice, she pictures a bud (her choice of flower) opening a little further with each surge; in labour the companion can cue it briefly.
• Example language (illustrative): "With each wave, the petals unfold a little more, gently and in their own time."
• Watch for: progress-checking ("it's not opening enough"); keep the image about softness, not speed [synthesis].

Blue satin ribbons

• Purpose: imagery of the lower uterine muscles as soft, flexible blue satin strands that yield to the upper muscles as they work. [source: Shortform]
• Steps: after induction, describe the ribbons softening and loosening as she breathes out; pair with surge breathing practice.
• Example language (illustrative): "Picture soft blue satin ribbons, smooth and loose, easily giving way as each wave passes."
• Watch for: some women dislike anatomical imagery; offer neutral images (opening, softening) instead.

The arm-wrist relaxation test

• Purpose: listed among visualisation techniques; presumably a check of relaxation depth [uncertain: procedure not found in the Institute's pages, the 2012 course paper or Bookmate excerpts]. The educator training covers "judging trance depth", which fits this use. [source: Wake County catalogue; HypnoBirthing Institute educator course outline]
• Steps [synthesis, generic]: with her permission, the companion lifts her wrist slightly and lets it rest back; a loose, heavy arm that falls without help suggests deep relaxation; if stiff, repeat the deepener.
• Example language (illustrative, companion): "I'm just going to lift your wrist a little… let it be heavy."
• Watch for: she should know in advance that this will happen; never use it as a test she can "fail".

Glove relaxation

• Purpose: an ultra-deepening technique giving localised comfort: she imagines putting on a silver glove made of her natural endorphins, the hand becomes numb, and she can place that hand where she wants comfort. [source: Blinkist; Edmonds 2023; OpenStax/LibreTexts 14.4]
• Steps: (1) Deep relaxation. (2) She imagines drawing the glove onto one hand while the companion lightly strokes it. (3) Suggest growing coolness and numbness, like a hand in icy water. (4) Check (she rates the difference between hands). (5) She places the hand on another area (e.g., lower back, belly) and lets the comfort flow there. (6) Re-alert and suggest normal sensation returns fully. [source: Blinkist; final step synthesis]
• Example language (illustrative): "As the glove slides on, notice coolness spreading through your fingers… and when you rest your hand on your belly, let that cool comfort flow into it."
• Safety [synthesis]: comfort suggestions must not stop her noticing or reporting pain that is different from surges (constant, sharp or one-sided pain, or pain with bleeding); tell her the hypnosis will "let through" anything her body needs her or her midwife to know.

The depthometer

• Purpose: a countdown "meter" she uses to gauge and deepen hypnotic depth. [source: OpenStax/LibreTexts 14.4; Wake County catalogue]
• Steps [synthesis for details]: she imagines a dial or gauge; on each out-breath, she lets the needle drop a number; she reports the number with a finger or word; she can lower it again when needed.
• Example language (illustrative): "See the needle at ten… with each breath out, watch it drift lower… nine… eight… and tell me the number when it settles."
• Watch for: a gauge that will not move; switch to counting breaths.

The sensory gate control valve

• Purpose: listed among the ultra-deepening techniques [uncertain: procedure not found in the Institute's pages, the 2012 course paper, summaries or Bookmate excerpts]. The name suggests imagery of turning down incoming sensation; do not attribute details to Mongan.
• Steps [synthesis, generic dial imagery]: in deep relaxation, she imagines a control (valve, dial) that sets how much sensation passes through, and turns it down to a comfortable level while keeping awareness of her body.
• Example language (illustrative): "Find the dial… notice where it sits… turn it down just enough to feel comfortable, still aware and in charge."
• Safety: same as glove relaxation.

Time distortion

• Purpose: suggest that time passes faster in labour, e.g. that 20 minutes feels like 5; the companion repeats the cue during harder stretches. [source: Blinkist]
• Steps: introduce in deep relaxation; rehearse in practice; give the companion a short cue phrase.
• Example language (illustrative): "Time can move quickly in this calm place… a long stretch can feel like a few short minutes."
• Watch for: confusion about time is harmless in practice; staff keep the clinical times.

On/off switch

• Purpose: a self-hypnosis cue to enter and leave the state quickly (described in OpenStax with the glove and countdown meter). [source: OpenStax/LibreTexts 14.4]
• Steps [synthesis for details]: in relaxation she imagines a switch; "on" with a slow breath out brings the practised calm; "off" with a breath in and counting up returns her to full alertness. Practise both directions.
• Example language (illustrative): "Switch on… and let calm flood in. When you're ready, switch off, count one to three, and come back clear and alert."

Self-hypnosis practice routine and re-alerting

• Purpose: build an independent skill for pregnancy and labour. [source: Shortform; Tommy's]
• Steps [synthesis]: (1) Daily 15–20 minutes: calm breathing, progressive relaxation or recording, one imagery piece, affirmations. (2) Short "in-the-moment" drills: anchor plus three surge breaths, standing, walking or on all fours. (3) Always re-alert: count up, suggest normal sensation and alertness, open eyes, stretch, check she feels fully back before driving or caring for others. (4) Log practice and calm ratings.
• Watch for: drowsiness or heaviness after sessions; extend re-alerting.

Birth preferences and environment

• Purpose: plan a calm environment (quiet, dim lights, practised music, massage, not being disturbed in self-hypnosis) and share preferences with staff. [source: OpenStax/LibreTexts 14.4; DBTH NHS; Tommy's; Embrace Birth]
• Therapist role [synthesis]: help her write preferences about environment, communication and language; tell staff she is using hypnobirthing (a relaxed woman may look less far into labour); all medical preferences (monitoring, pain relief, induction, birth place) are discussed with her midwife or obstetrician, not with you.
• Example language (illustrative): "What would you like staff to know about how to speak to you during surges?"

Course content outside psychotherapy scope

The book and course also cover nutrition, exercising and toning ("the leaping frog", pelvic floor exercises), perineal massage, choosing care providers, styles of labour management, breech presentation, the time before labour, "when nature needs assistance", practice positions, post-birth activities and breastfeeding. [source: Wake County catalogue; Embrace Birth] These are midwifery and obstetric topics. Teach them only if you hold the relevant qualification (midwife, certified practitioner using the course materials); otherwise refer her to her maternity team and antenatal classes. No instructions are given here [synthesis].

Postnatal debrief

• Purpose: integrate the birth experience, whatever happened [synthesis].
• Steps [synthesis]: invite her account at her pace; validate what she did well, including any change of plan; screen for perinatal depression, anxiety and birth-related PTSD symptoms with standard measures; refer to a perinatal mental-health service where indicated; if she wants clinical details explained, refer her to her maternity unit's birth-reflections service where one exists.

5. Handling problems

The sources say little about problems beyond these: not everyone succeeds at self-hypnosis; the method's discouragement of other birth information may leave non-responders with few tools; benefits depend on regular practice; a deeply relaxed woman may be judged to be in earlier labour than she is; and rare psychiatric complications have been reported [source: OpenStax/LibreTexts 14.4; Tommy's; Cyna 2011]. Everything else below is my own synthesis [synthesis].

• Low hypnotic response or "I can't relax". Normalise; shorten sessions; use eyes-open methods (calm breathing, counting, light touch); try other senses (sound, touch) instead of visual imagery; measure progress by calm ratings, not depth. Make sure she also knows from her midwife about the full range of pain relief, so hypnosis is one tool, not the only plan.
• Not practising. Explore barriers (time, tiredness, partner availability, doubt); cut practice to 5–10 minutes linked to an existing routine (e.g., bedtime); use recordings; have her rehearse one surge drill daily rather than full sessions; review a log each session.
• Companion disengaged or anxious. Give the companion a small set of tasks (anchor, cue words, reading); invite their own fears; if no companion, the client records her own cues, or a doula or friend learns the anchor.
• Fear rises as the due date nears. Return to fear-release work; separate information needs (to the midwife) from anxiety; rehearse the moments she fears most with calm imagery; check for severe tokophobia and refer to the perinatal mental-health team if fear is disabling or she is asking about planned caesarean for fear, which is a discussion for her obstetric team.
• Overwhelm, abreaction or dissociation in session. Stop suggestions; ask her to open her eyes, name five things she can see, feel her feet on the floor and the chair under her, and breathe out slowly; orient to date and place; when settled, talk about what came up; do not return to it under hypnosis. If it recurs, pause hypnosis and assess for PTSD or dissociative disorder, using trauma-focused therapy with stabilisation first.
• Unusual reactions (persistent heaviness, confusion, distressing images, new compulsive or intrusive symptoms, signs of psychosis or mania, especially postnatally). Re-alert fully and check orientation; stop hypnosis; arrange urgent perinatal psychiatric assessment for psychotic or manic symptoms, given the case reports in Cyna's thesis.
• Rigid birth ideals ("hypnobirthing means no interventions"). Gently question all-or-nothing beliefs; reframe the goal as staying calm and making informed choices in any birth; add flexible affirmations and rehearse changes of plan. Refer all questions about interventions to her care providers; do not take sides between her and her maternity team.
• Conflict with maternity staff. Help her prepare short, polite requests (e.g., quiet voice, preferred words, not being disturbed during surges); encourage her to discuss preferences at antenatal appointments in advance.
• Pain or worry in labour that the techniques do not ease. Prepare her in advance to ask for help and pain relief without guilt; affirm that using pain relief or other care is consistent with using HypnoBirthing skills, which can continue alongside medicated or caesarean birth [source for continuity: Hunterdon].
• Disappointment, guilt or trauma after birth. Debrief (Section 4); counter self-blame ("I didn't practise enough"); screen for postnatal depression and birth-related PTSD; treat or refer.
• Rupture with the therapist (e.g., feeling judged for choosing an epidural, or feeling pushed to an ideal birth). Name it, apologise for any pressure, restate that her choices and her maternity team's advice come first, and re-agree goals.
• Safeguarding and risk. Pregnancy is a time of raised risk of domestic abuse; ask privately (without the companion) and follow safeguarding procedures. If suicidal thoughts or thoughts of harming the baby appear, follow standard perinatal risk assessment and refer urgently to perinatal mental-health services.

Sources

Sources:

• Hypnobirthing: the Mongan method (4th ed., 2015), catalogue record with contents
• Embrace Birth – About HypnoBirthing
• Fernandez Hospital HypnoBirthing course leaflet
• Hunterdon Health – 2026 Hypnobirthing description and dates
• OpenStax Maternal-Newborn Nursing 14.4: Hypnobirthing – The Mongan Method (LibreTexts)
• Blinkist – HypnoBirthing book summary
• Shortform – HypnoBirthing summary preview
• Doncaster and Bassetlaw Teaching Hospitals NHS FT – Hypnobirthing: what is it?
• Tommy's – What is hypnobirthing?
• Edmonds J (2023) The contextual factors that contribute to the effectiveness of hypnobirthing, Oakland University honors thesis
• Cyna AM (2011) Hypnosis Antenatal Training for Childbirth (HATCh) Trial, PhD thesis, University of Adelaide
• Wikipedia – Marie Mongan
• Staley (2015) An ethnographic study of women using HypnoBirthing: The Mongan Method, UTMB repository record (abstract only)

• HypnoBirthing Institute – The Official HypnoBirthing Institute
• HypnoBirthing Institute – The Official HypnoBirthing Course
• HypnoBirthing Institute – Educator Training course outline
• HypnoBirthing Institute – HypnoBirthing Book: The Mongan Method (4th Edition)
• HypnoBirthing Australia – About HypnoBirthing, The Mongan Method
• HypnoBirthing Israel (affiliated with HypnoBirthing International) – course content
• Swencionis C, Rendell SL, Dolce K, Massry S, Mongan M (2012) Outcomes of HypnoBirthing, Journal of Prenatal and Perinatal Psychology and Health 27(2)
• Bookmate – Marie Mongan, Hypnobirthing, reader-highlighted excerpts
• Healthline – Hypnobirthing (reviewed by M. Wallis, CNM, 2023)

Books cited:

• Mongan, M. F. (2015). HypnoBirthing: The Mongan Method (4th ed.). Deerfield Beach, FL: Health Communications. (Contents and summaries only; full text not drawn on.)
• Dick-Read, G. Childbirth Without Fear (cited via OpenStax as the source of the fear-tension-pain idea).

Not drawn on [uncertain]: the full text of Mongan's book (no legitimate preview beyond Bookmate excerpts); the Rainbow Relaxation and birth-rehearsal scripts; specific procedures for disappearing letters, the arm-wrist test and the sensory gate control valve; Mongan's breathing counts. Verified in this revision: the organisation's name and leadership, the five-unit course structure and unit contents, the three breathing techniques and their uses, the 20-hour practice guideline, the educator training, and the light touch massage strokes.