As a doula with two lots of hypnobirthing teacher training courses under my belt, I know it’s controversial to question hypnobirthing, especially when so many women genuinely find it transformative. Hypnobirthing has done wonders in helping women harness the power of their minds, understand they have options in birth and develop a toolbox of effective comfort measures. But along with the “a'hah” moments, I’ve also had a few “ick” ones. Here are three aspects of hypnobirthing I find challenging.
Hypnobirthing Basics
Hypnobirthing builds on Dr. Grantly Dick-Read’s ‘Fear-Tension-Pain’ theory, which suggests that fear in childbirth creates tension in the body, which then leads to pain. At its core, hypnobirthing seeks to eliminate these fears by targeting the subconscious mind with positive birth messages using hypnosis, aiming to create a pain-free birth experience.
The Whitechapel Woman by Natalie Lennard. A staged photograph depicting Grantly Dick-Read's famous story of the Whitechapel Girl, which inspired his 'Fear-Tension-Pain' Theory.
Two Sides of the Same Coin
What’s interesting is that hypnobirthing’s approach isn’t as different from the medical view of birth as it might seem. In the medical model, birth pain is often treated like pain from an injury, such as a tooth extraction, and the solution to eliminate the pain is interventions such as epidurals. The goal is simple: reduce fear by managing risks and keeping birth “safe” and eliminate pain with pharmaceutical pain-relief.
So, both approaches treat birth pain as something to be minimised and fear as something to be managed—one through hypnosis, the other through medical intervention. I think it’s interesting to reflect on the fact that a movement that has set itself up as the antithesis of the medical model actually shares some of the same fundamental beliefs about birth. The further I delve into my work as a doula, the more I believe there is another way to approach birth…
The Reality of Pain in Childbirth
One of my main concerns with hypnobirthing is its tendency to sidestep pain altogether (The first rule of 'pain' is: you don't talk about 'pain') This feels a bit infantilising, like if you have open conversations with women about childbirth you’ll scare them into the arms of the anaesthetists. However, I firmly believe that by downplaying pain, hypnobirthing risks leaving women unprepared for the intense physical and mental demands of labour. After all, it’s called “labour” for a reason.
Where hypnobirthing truly excels is in teaching the science of birth, exploring the roles of hormones and the nervous system. It effectively covers the mind-body connection, explaining how perceived threats can trigger a fight-or-flight response, flooding the body with adrenaline, which leads to tension and amplifies pain. This understanding is valuable- our perception of threat from our environment really does impact our perception of pain. But I don’t believe the equation is as simple as “fear of childbirth through social conditioning= pain in childbirth.” While fostering a positive mindset can help, suggesting that “releasing” ALL fear will lead to a pain-free birth is overly simplistic.
Fear- Tension- Pain cycle with the role of hormones added. Source: Your Downtown Doula.
Pain perception is influenced by many factors beyond fear. Beliefs, values, past experiences, emotional state, the stage and progress of labour, the baby’s position, the birth environment, the support (or lack of it) from the birth team, confidence in one’s ability to cope, and the philosophy of the care providers—all play a role in how pain is experienced. Fear of childbirth is just one piece of this complex puzzle. Recognising this complexity allows us to create a more adaptable, realistic approach to pain management that considers the many influences shaping each person’s experience of childbirth.
A new approach: Pain as normal
In my work as a doula, I focus on recognising the purpose of pain in labour. Birth is intense and can push people to their emotional and physical limits in ways few other experiences can. I work with women to see pain as part of the process, helping them build skills to cope with the intensity, confidence in their capacity to 'cope', but also being able to recognise when they might want pain relief. My aim is to foster confidence in facing these challenging moments, not to make someone feel they’ve “failed” if they experience pain.
This approach involves reframing our understanding of pain. Instead of viewing it as something negative (like pain from an injury), we redefine labour pain with a more supportive perspective:
Purposeful: Labour pain triggers instincts to seek safety, releases hormones that help manage discomfort, and shifts one into an altered state of consciousness.
Anticipated: Unlike an injury, labour pain is expected, so one can prepare and practise coping techniques in advance.
Intermittent: Labour contractions come with natural breaks, giving moments for rest and recovery.
Normal: Labour pain typically signals the uterus working at its peak and indicates that things are progressing as they should.
When reframed in this way, pain serves a function and isn’t a sign that something’s “wrong.” Research shows that acknowledging pain as a normal part of labour can actually improve one’s ability to cope. Hypnobirthing, by not fully recognising the functional role of pain, risks leaving people feeling as though they’ve “failed” if they do experience it.
Understanding Pain vs. Suffering
Much of my birth preparation work focuses on understanding the difference between pain and suffering. (Pain is an unpleasant physical sensation, while suffering is the emotional reaction to that sensation: For instance, a runner experiences muscle pain due to exertion, but this doesn’t mean they are suffering. Their emotional reaction to the pain determines whether they simply endure or suffer through it.) Building resilience to work with and through pain is essential, as is recognising that pain can escalate into suffering for various reasons. Hypnobirthing doesn’t typically address this—that pain can reach a point of suffering, which leaves many confused, disappointed and sometimes traumatised when they have suffered or have had to reach for pain-relief.
Good birth preparation should give you strategies to work through pain, awareness of your options if pain turns into suffering, and support without judgement. It should NEVER make you feel you’ve “failed” if pain becomes overwhelming. Effective preparation respects the reality of both pain and the different ways people respond to it.
Can Fear Really Be ‘Released’?
The idea that you can simply listen to hypnobirthing tracks, fill your mind with positive affirmations, and glide into a pain-free birth is, admittedly, comforting. However, as a doula, I understand that it’s rarely so straightforward.
Hypnobirthing can play a valuable role in challenging the cultural fear narratives surrounding childbirth. Today, many people approach birth with little understanding of what to expect, a by-product of the medicalisation of birth and its movement from the community to hospital settings. This transition has often created a distance from birth as a shared, witnessed experience, which can heighten fear. Historically, birth was a communal event, a rite of passage observed by female members of the community, where wisdom was absorbed by watching others go through it. I’ve seen women shift from a place of anxiety to confidence simply through learning about birth and realising it doesn’t have to play out like it often does on TV.
If you google 'childbirth' images like this are likely to come up. In hospital, in a gown, on her back. Many of us will have this perception of birth
However, hypnobirthing’s notion that all fear can be “released” through hypnosis suggests fear is merely a cultural construct. During hypnobirthing training, we were told not to question the power of hypnosis; it “just works—like gravity!” Yet, this blanket approach feels inadequate when addressing the complexities of real fears and worries. For many people—particularly those with past trauma—fear is rooted in real, lived experiences, not simply cultural conditioning. I don’t believe it’s right to suggest that listening to a hypnosis track at bedtime is enough to address deeply embedded anxieties. In my work as a doula, I’ve come to understand just how multi-layered people’s worries can be, and how much they benefit from having someone to truly listen, acknowledge their fears, and give them time and space to work through them. Telling someone who’s experienced birth trauma to “just let go of fear” can feel, at best, dismissive, and at worst, may add to their trauma.
I believe that good birth preparation recognises that carrying some level of fear and worry is perfectly normal, and instead offers practical strategies to build trust in oneself within a supportive environment where real feelings can be expressed and worked through. Even in the most straightforward births, birth is ultimately a journey into the unknown, and it’s entirely natural to have concerns about health, safety, and well-being.
Hypnobirthing often refers to the notion that “tribal women” outside of our birth culture experience “fear-free” births. But I genuinely believe that even in a birth-positive culture, most people would still carry some fear, simply because that’s a normal human response. Embracing fear is part of the experience for many women as they embark on the path to motherhood. My approach as a doula is to stand alongside women as they confront their fears, offering reassurance, comfort, and support during labour when it’s needed most, rather than promoting the unrealistic expectation of a completely fear-free birth.
Victim blaming and the overly simplistic portrayal of birth
Too often, I hear individuals say, “Hypnobirthing didn’t work for me,” or worse, that they felt their bodies failed them because they experienced pain, felt out of control instead of calm, struggled to cope with pain, accepted pain relief when they didn’t anticipate needing it, or had a birth that didn’t unfold as planned.
Hypnobirthing jumps at the chance of showing you calm and quiet women 'breathing' out their babies and sells a very specific vision of what birth looks like. Just like the medical model, it is selling the solution of not being the wild primal woman, but the one fully in control of her body- it peddles the same sexiest tropes of how women should act and hold their body. Birth often IS wild, free, powerful and loud- but when women experience this they can be left feeling ashamed that they didn't act like the videos they had been shown.
Hypnobirthing is sometimes portrayed as a magical solution that guarantees a smooth, pain-free birth, but the reality is far more complex. Birth is influenced by a multitude of factors—physical, emotional, and systemic—that all shape the experience. I’ve seen women blamed for their birth outcomes in hypnobirthing circles ‘they didn’t put in the work’ they ‘didn’t listen to the tracks enough’- eurgh, ick!
Typical image you would be shown in Hypnobirthing. I quiet and calm woman in a birth pool. You are sold the image of needing to be calm and deny the wild and raw essence of birth.
One of the critical shortcomings of hypnobirthing is its tendency to oversimplify the birth process, often neglecting the broader context of the healthcare system in which women give birth. Let’s be honest: most of us aren’t giving birth in the woods. In reality, the majority of births occur in hospitals, where standardised procedures are prioritised to effectively ‘manage’ the process. This reliance on routine monitoring, screening, technology, and clinical assessments can lead women to depend on external evaluations of their and their baby’s well-being, reinforcing a narrative that places power in the hands of medical experts rather than the birthing person.
In response, hypnobirthing often advocates a simple mantra: “just say no” and utilise the B.R.A.I.N. tool for decision-making. However, this approach fails to acknowledge that many women have been socialised from a young age to trust authority figures and defer responsibility to experts. In the high-stakes environment of labour, many women find themselves swept up in the authority of their care providers, often following their advice without fully understanding or advocating for their own needs. Hypnobirthing repeatedly says ‘trust your instinct’ without acknowledging that most of us have gone through our lives doing the COMPLETE opposite of that- learning to know, interpret and trust your body takes deep work.
Moreover, when in labour, individuals enter an altered state of consciousness, which can make it challenging to think and act logically. In this vulnerable state, they become more susceptible to the influence of those around them.
Ultimately, when crafting a birth plan within the hypnobirthing framework, many do not realise that they may be articulating wishes that frequently do not align with the realities of the healthcare system they are navigating. This is setting women up to ‘fail’. This disconnect can lead to disappointment and feelings of inadequacy when expectations do not match the experience. In the end, women blame themselves and the hypnobirthing community continues to point the finger at them for ‘not doing the work’.
My Approach to Hypnobirthing as a Doula
As a doula, I take a balanced and realistic approach to birth preparation. While I recognise the many benefits of hypnobirthing, I also see its limitations. I never promise a pain-free birth. Instead, my focus is on developing effective coping strategies, fostering a mindset that embraces a helpful understanding of pain, and clearly distinguishing between pain and suffering.
I invest time in genuinely understanding each woman on a deeply personal level, acknowledging her unique worries and concerns. My approach centres on nurturing self-knowledge, encouraging women to tune into their instincts and build self-trust. I never dismiss a woman’s fears; rather, I work with her to cultivate confidence in her own ability to navigate her birth journey, however it may unfold.
Ultimately, my goal is for each woman to approach birth with genuine confidence—not because she expects it to be pain-free, but because she feels prepared to meet it with resilience, trust, and the freedom to make choices that resonate with her and her needs.
I offer a number of doula and birth prep packages (both in person and virtually) to suit each individual woman. Do check out my website for further information.
So, here is a non-hypnobirthing task that can help you develop self-knowledge.
Task: Develop Self-Knowledge for Birth Preparation
Understand Your Monthly Cycle: Reflect on how different phases of your cycle impact your body, mood, and energy levels. This can provide insight into how hormones influence you emotionally and physically.
Explore Your Body’s Responses: Reflect on your body’s responses to intimacy, relaxation, and connection. This can help you understand the conditions that promote oxytocin release, essential for relaxation and emotional openness during birth.
Identify Comfort Measures in Response to Pain: Think about past experiences of physical or emotional pain and what genuinely brought you comfort. This understanding will help guide your choices for comfort measures in labour.
Examine Your Responses to Authority: Reflect on past experiences with authority figures or medical professionals. What helps you feel confident to ask questions and assert your preferences? Identify the support types that empower you to advocate for yourself during labour.
Each step builds a foundation of self-knowledge that’s invaluable for birth preparation, providing a personalised, empowering base for the birth experience ahead.
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