I birthed using self-hypnosis in a hospital (DS1), at a freestanding birth center (DS2) and at home (DS3). It worked beautifully for me in all three settings. It was a little more difficult on my husband at the hospital, because he was in charge of keeping the atmosphere calm so I could just do my thing. Without a doula, it would have been harder for him to keep things relaxed at the hospital, but it wasn't a problem for us.