Painfree childbirth, peaceful labor, comfortable delivery: the practice of hypnobirthing

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Photo: David J Laporte




By Melinda Fontaine


Peaceful labor? Comfortable delivery? Calm childbirth? Do these sound like oxymorons? It’s true!


Jane was a young woman who saw a segment on TV about HypnoBirthing.  She saw pregnant women who looked like they were concentrating really hard on an abdominal workout or a challenging algebra equation.  Then a baby would pop out.  There was no screaming, no squeezing someone’s hand, no cursing or bargaining with a god-figure.  Nothing at all like the births she saw in movies.  This image stuck with her.  Years later she became pregnant with her first child, and she hoped for a labor like she saw in the HypnoBirthing segment.  Jane did not usually turn to alternative and complementary medicine.  She was a scientist with an analytical mind, married to another scientist, and they were accustomed to western medicine. However, HypnoBirthing sounded like it could complement western medicine very well.  After all, if it didn’t work out, western medicine had a number of options for pain relief during delivery as well.  


So Jane went online and signed up for a HypnoBirthing class at her local birth center.  She and her partner went to a series of classes and learned “childbirth is a normal, natural and healthy function for women.”1 They learned the secrets of hypnobirthing. (They are not really secrets. I’ll talk more about them below). Jane and her partner went home to digest all the information. They read a book, listened to the recorded meditation, and practiced what they learned in the classes.   


One Sunday night, she started having contractions very intermittently.  Jane had learned so much about how labor progresses and what to expect that she was not afraid at all.  In fact, she went back to sleep after each contraction until it was time to get up in the morning.  She followed her plan; she listened to her relaxation recordings, lied on her side, ate a snack, and waited for the time to go to the hospital. When her contractions were sufficiently close together, she went to the hospital. When she arrived, she appeared to the staff to be very calm, rested, and comfortable. They thought, “Surely this woman is not in the throes of labor; she must be just beginning”. After a quick exam, Jane was told that her cervix was fully effaced and dilated (thin and open). There was no screaming and very little discomfort. Two hours later, Jane was holding her baby, and she felt like she was on top of the world.


What are the secrets of HypnoBirthing?


HypnoBirthing teaches the physiology of birth, the power of the mind, releasing fear, breathing, relaxation, visualization, deepening, nutrition, positioning, and so much more. The main theme seems to be that birth is a natural process. The body knows what to do; that is why your uterus contracts without you telling it to. Your body works with you throughout pregnancy, delivery, and postpartum. Do you remember hearing how the pregnancy hormone relaxin makes a woman’s body more flexible? This is preparing the body to stretch and make room to push a baby out. So your body has been working for you the whole time. If we look to other mammals,  women in less developed parts of the world, or women in history, their birthing experience is very calm. In her book, Marie Mongan, M.Ed., M.Hy. tells the story of asking a woman to tell her about birthing in her village in Africa. The woman answered “What is there to tell? The women have their babies.” The women go about their day as usual. When they feel the baby move down, they lean against a wall, squat down and receive their own baby. Neither Hippocrates nor Aristotle wrote of pain in their notes on normal uncomplicated births.¹ What has happened in western medicine?  Why does birth have to be so scary? Why is it viewed as a medical procedure?  Doctors and nurses can be excellent support staff to a birthing mother (provided their values and goals align with the mothers’). They are also responsible for saving moms and babies when they are in trouble, so I don’t want to devalue them at all.  However, wouldn’t birth be so much more enjoyable if there was no fear, if we could trust that the body knows what to do, and if we understood the process enough to be able to let go of our anxieties?  With no fear, there is no pain. (We know pain is just a warning of perceived threat from the brain because of this masterpiece from Britt) These are the secrets of HypnoBirthing.


How did birth become so fearful and medicalized?


Once upon a time, childbirth was viewed as a natural, beautiful miracle that brought life into this world.  Then, we humans messed that up, too.  Around the end of the second century AD, men began to feel women were inferior.  St. Clement of Alexandria announced, “Every woman should be filled with shame by the thought that she is a woman.”¹ Midwifery disappeared and doctors were legally not permitted to attend to a birthing woman.  Women were isolated during pregnancy and childbirth because pregnancy was viewed as the result of a carnal sin.  “The Curse of Eve” was written into the Bible explaining why women must experience pain in childbirth.  I’m going out on a limb here, but I’m going to say this is when fear and pain entered into the birthing experience… Fast forward to the 1800s; Queen Victoria demanded she be given chloroform, so her royal body did not have to feel the pain of childbirth.  Thus, childbirth became a medical procedure.  Births occurred in hospitals. Fathers were not needed at the bedside. Women were not in control of their own bodies, and so on and so forth. Today’s view of birth is a result of our combined experiences as a species. What are your beliefs about birth? What are your expectations?


How can a pelvic physical therapist support the efforts of HypnoBirthing?


Physical therapists also believe that birth is a natural process and that the body helps you before, during, and after birth. I see many pregnant women, and address their concerns to help alleviate fear and thus pain.  For example, I may teach a woman and her partner some pain relieving massage techniques or a gentle stretch to use if she feels pain.  I can review what positions might be most comfortable for someone with her given impairments, and I can even teach women how to push effectively, so they feel prepared and confident for vaginal delivery. See this blog for how physical therapists can help pain management. After delivery, the body naturally recovers and prepares for the next stage of life (caring for baby, breastfeeding, etc.). Just as we wouldn’t expect to run a marathon without some residual soreness, many women come out of childbirth with some temporary discomfort or concerns about changes that have taken place in their bodies.  A physical therapist can help the body recover and function optimally. Some things I address postpartum include tailbone pain, stress urinary incontinence, and diastasis recti (separation of the abdominal muscles). Click for more about postpartum care and postpartum pelvic pain.


Birth can be peaceful and calm with the proper knowledge, tools, and support.





  1. Mongan M. HypnoBirthing: the Mongan method. Deerfield Beach:Health Communications Inc; 2005


What are pelvic floor muscles?

The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.

What is pelvic floor physical therapy?

Pelvic floor physical therapy is a specialized area of physical therapy. Currently, physical therapists need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical therapy education in this unique area.

What happens at pelvic floor therapy?

During an evaluation for pelvic floor dysfunction the physical therapist will take a detailed history. Following the history the physical therapist will leave the room to allow the patient to change and drape themselves. The physical therapist will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical therapist will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical therapist will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical therapist will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.

What is pudendal neuralgia and how is it treated?

Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.

Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.

What is interstitial cystitis and how is it treated?

Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.

Who is the Pelvic Health and Rehabilitation Team?

The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical therapists who work at PHRC have undergone more training than the majority of pelvic floor physical therapists and as a result offer efficient and high quality care.

How many years of experience do we have?

Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.

Why PHRC versus anyone else?

PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.

Do we treat men for pelvic floor therapy?

The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical therapists focus solely on people with vulvas, this is not the case here.

Do I need pelvic floor therapy forever?

The majority of people with pelvic floor dysfunction will undergo pelvic floor physical therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.

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