14.4: Hypnobirthing- The Mongan Method
By the end of this section, you will be able to:
- Discuss the history of HypnoBirthing: Mongan Method of childbirth education
- Summarize the evidence that supports the Mongan Method of childbirth education, including the benefits for the birthing person
- Verbalize the positive expectations that birthing persons will have from learning the Mongan Method
- Summarize the visualization and deepening process that occurs and how it benefits the birthing person during labor and birth
- Generalize the normal physical and emotional changes that the birthing person will experience during childbirth
HypnoBirthing is a vastly different form of preparation for childbirth than most other courses. This method focuses less on the details of how a baby is born and more on how to process the sensations of birth in a way that provides pain control for the birthing person using only their mind. By practicing self-hypnosis daily, birthing people can change the way they experience birth.
History of the Mongan Method
Marie F. Mongan (1933–2019), an award-winning hypnotherapist, was fascinated with birth from an early age but unhappy with how most people’s births occurred, including her own births with forced anesthesia. She created a method of childbirth education to honor birth and ease the process. Over time, more people began to see the benefits of this kind of birthing, and Mongan started to teach classes. She perfected the method and created HypnoBirthing (Mongan, 2015).
What Do Millennial Patients Choose for Childbirth Education?
According to a study of 100 patients aged 21 to 38 years, websites and mobile apps providing education regarding pregnancy and birth were accessed more often than in-person childbirth education classes (Campbell, 2020). The most common online education was Baby Center owned by Johnson & Johnson that has over 45 million participants per month worldwide. Only 24% of study participants attended live childbirth classes. When questioned why they did not participate in live classes, 42.7% stated no interest in live classes, 29.3% stated not enough time for classes, 10.7% could not find a live class, 8% stated financial insecurity as a barrier, and 9% had differing answers. Nurses and healthcare providers must consider new ways to engage and educate the Millennial generation.
Evidence Base for the Mongan Method
HypnoBirthing uses visualization , affirmations , and breathing exercises to create a deep relaxation state in labor. The technique proposes that laboring persons can train themselves to get into a deep state of relaxation upon command. The technique also uses words like “surges” or “waves” instead of “pain” or “contractions” to include as chants (Isidro-Cloudas & Hargrove, 2023). HypnoBirthing borrowed the philosophy of Dr. Dick-Read, the author of Childbirth Without Fear , which proposes the idea that fear causes muscles to tense, causing more pain. Dr. Dick-Read believed that tension in muscles took blood away from the uterus and that relaxation, as illustrated in Figure 14.5, would reverse that effect. HypnoBirthing teaches that if relaxation occurs, labor will progress naturally (Isidro-Cloudas & Hargrove, 2023).
Benefits of the Mongan Method
Birthing people who successfully utilize the Mongan Method often report little discomfort during their births, ranging from reports of pain-free births all the way to births described as powerful work without suffering. The benefits of this method include learning controlled breathing, using meditation to become deeply relaxed, and feeling empowered by the affirmations (Isidro-Cloudas & Hargrove, 2023). Research shows that HypnoBirthing increases a person’s confidence and trust in their own body, provides them a sense of control, and allows people to feel good about their childbirth regardless of the outcome (Uldal et al., 2023).
Shortcomings of the Mongan Method
Just as hypnosis does not always provide the desired effect, HypnoBirthing may not provide all the expected benefits. Not everyone will be successful in self-hypnosis. Another drawback is HypnoBirthing’s encouragement to limit childbirth information beyond the method, believing that this additional information can be fear-inducing. Because of this, people who do not respond well to the Mongan Method in labor may have few other tools or information to use as an alternative.
Mongan Method: Build a Positive Expectancy
The Mongan Method seeks to eradicate fear of childbirth and replace it with peaceful confidence. Focusing on the fact that most pregnancies have low risk factors and positive outcomes is the first step to believing that birth can happen without suffering or interference. The preparatory work done through the Mongan Method helps to equip the birthing person with tools to breathe, relax, and birth as the body was designed to do. The method teaches that birth is not an awful experience; it is an experience people should use to help them grow as a person (Uldal et al., 2023).
Fear-Tension-Pain Syndrome
Mongan believed the fear-tension-pain theory was the reason birth within the medical model often leads to interventions, painful birth experiences, and the use of pain medications to treat that sensation. This crucial underlying concept is the reason Mongan recommends release of fear and protection of comfort in labor (Mongan, 2015).
Release Fears Regarding Birth
Mongan believed that by creating a safe, dark, quiet, familiar environment where the birthing person feels respected, fears will be eliminated. Prior to birth, Mongan also recommends identifying and releasing any fear of birth, negative emotions, and past negative experiences to prevent those from interfering in the birth. The way to release these fears is through the HypnoBirthing fear-releasing hypnosis sessions incorporated into the teachings. Hypnosis is especially helpful for people who have experienced birth trauma or abuse in the past because this practice can significantly decrease the fear and tension in labor by releasing fear (Mongan, 2015).
Mongan Method: Advanced Visualization and Deepening
The Mongan Method teaches that relaxation, deep breathing, visualization, and deepening , which is relaxation to the point where the birthing person is limp, can produce an almost anesthetized state. This state is achieved through routine practice of self-hypnosis, relaxation, abdominal breathing techniques, visualization exercises, and affirmations. These specific exercises are included in the HypnoBirthing courses and texts for pregnant people to practice daily (Mongan, 2015).
Learning Self-Hypnosis/Deepening
HypnoBirthing involves learning to enter a state of hypnosis. To do this, consistent daily practice using hypnosis techniques is necessary. The Mongan Method recommends learning and utilizing several techniques to find the state where a peaceful birth full of endorphins is possible. Some techniques used are an “On, Off” switch, the glove technique where you “put on” the endorphins like a glove, and the use of a “meter” to measure the depth of the hypnotic state by counting down (Mongan, 2015). While techniques like these are not exclusive to HypnoBirthing, they have been adopted by the Mongan Method.
Affirmations
Affirmation statements for birth are a part of the fear-releasing process. Reprogramming the brain to remember that birth is physiologic, safe, and normal takes practice and confidence. Repetition of certain suggested phrases or ones created by the birthing person can be a significant way to improve their confidence in birth.
Relaxation, Breathing, Hypnosis
The combination of relaxation, breathing, and hypnosis techniques leads to release of the fear-tension-pain cycle. All the tools work together to encourage the normal process of the autonomic nervous system and prevent the “ fight-or-flight ” parasympathetic nervous system reaction. This combination allows for a more peaceful birth (Mongan, 2015).
Avoidance of Hard Pushing
To stay within a restful state, ease the second stage of labor, and allow for birth to progress easily, forced pushing efforts are discouraged in the Mongan Method. Instead, HypnoBirthing encourages birthing people to breathe their baby out through controlled, slow, abdominal breathing that allows the uterine muscle to expel the fetus with little additional effort (Mongan, 2015).
Mongan Method: Overview of Childbirth
HypnoBirthing is more of a philosophy than a specific childbirth method. This philosophy includes the ideas that interventions should be used only when medically indicated, that birth should be respected and unimpaired, and that any interruption in the birthing process can cause birth to deviate from normal. This philosophy teaches that labor can decelerate or accelerate and should not be managed. This philosophy also believes that birth is rooted in sexuality and as such belongs to those who created the pregnancy itself (Mongan, 2015).
Normal Physical and Emotional Changes
Nutrition and exercise are discussed as methods to prepare the body for birth. Emotional changes during pregnancy are normal, and birthing persons should release fear and prepare to bond with the newborn. This method suggests that all the physical and emotional changes of pregnancy are normal (Mongan, 2015).
What to Expect in the Birth Experience
HypnoBirthing teaches the thinning and opening phase followed by the birthing phase. The birthing person can listen to hypnosis sessions with reminders to do nothing except remain loose and limp during the labor so that the normal progression can occur. This surrender into the physiology of birth, using breathing, relaxation, visualization, and deepening techniques, increases the endorphins that accompany the sensations of birth. The room should be quiet, dark, and comfortable. The birthing person will be in a state of self-hypnosis and should not be disturbed. The nurse or health-care providers should not talk about “pain” and instead talk about “sensations” or “surges” (Mongan, 2015).