1998
Schauble, Paul G.; Werner, William E. F.; Rai, Surekha H.; Martin, Alice (1998). Childbirth preparation through hypnosis: The hypnoreflexogenous protocol. American Journal of Clinical Hypnosis, 40 (4), 273-283.
A verbatim protocol for the "hypnoreflexogenous" method of preparation for childbirth is presented wherein the patient is taught to enter a hypnotic state and then prepared for labor and delivery. The method provides a "conditioned reflex" effect conducive to a positive outcome for labor and delivery by enhancing the patient's sense of readiness and control. Previous applications of the method demonstrate patients have fewer complications, higher frequency of normal and full-term deliveries, and more positive postpartum adjustment. The benefit and ultimate cost effectiveness of the method are discussed.
1993
Jenkins, M. W.; Pritchard, M. H. (1993). Hypnosis: Practical applications and theoretical considerations in normal labour. British Journal of Obstetrics and Gynecology, 100, 221-226.
This important, well controlled and large N study assessed effects of hypnotherapy on the first and second stages of labor in 126 primigravid women with 300 age-matched controls, and 136 parous women having their second baby with 300 age- matched controls. Only women undergoing spontaneous deliveries were included. Six sessions of hypnosis were used. The mean length of first stage labor in primigravid women was 6.4 hours after hypnosis and 9.3 hours in the control group (p <.0001), and the mean length of the second stage was 37 minutes and 50 minutes, respectively (p <.001). In the parous women, the corresponding times were 5.3 hours and 6.2 hours (p <.01), and 24 and 22 minutes (not significant). The use of analgesic agents was significantly less (p <.001) in both hypnotized groups compared with their controls.
1990
Edelmann, R. J. (1990). The treatment of infertility by hypnosis: A note of caution. [Comment/Discussion] .
A case report recently published in this journal by Maden (1989) appeared to suggest that six weekly sessions of hypnosis were responsible for facilitating conception in a woman with unexplained infertility. The present paper argues that Maden's report presented no evidence for this claim and no rationale for why hypnosis might be effective as a treatment for unexplained infertility. Both deserve a far more thoughtful and systematic investigation" (p. 184).
Harmon, Teresa M.; Hynan, Michael T.; Tyre, Timothy E. (1990). Improved obstetric outcomes using hypnotic analgesia and skill mastery combined with childbirth education. Journal of Consulting and Clinical Psychology, 58, 525-530.
Studied the benefits of hypnotic analgesia as an adjunct to childbirth in 60 nulliparous women. Subjects were divided into high- and low-susceptibility groups before receiving six sessions of childbirth education and skill mastery using an ischemic pain task. Half of the subjects in each group received a hypnotic induction at the beginning of each session; the remaining control subjects received relaxation and breathing exercises typically used in childbirth education. Both hypnotic subjects and highly susceptible subjects reported reduced pain. Hypnotically prepared births had shorter Stage 1 labors, less medication, higher Apgar scores, and more frequent spontaneous deliveries than control subjects' births. Highly susceptible, hypnotically treated women had lower depression scores after birth than women in the other three groups. The authors believe that repeated skill mastery facilitated the effectiveness of hypnosis in the study.
McLintock, T. T.; Aitken, H.; Downie, C. F.; Kenny, G. N. (1990). Postoperative analgesic requirements in patients exposed to positive intraoperative suggestions. British Medical Journal, 301 (6755), 788-790.
Sixty-three women undergoing elective abdominal hysterectomy were randomly assigned to a tape of positive suggestions or a blank tape during the operation. Anesthesia was standardized for all of the women. Postoperative analgesia was provided through a patient-controlled analgesia system for the first 24 hours. Pain scores were recorded every 6 hours. The outcome measures were morphine consumption in the first 24 hours and pain scores. Mean morphine requirements were 51.0 mg in women who were played positive suggestions, and 65.7 mg in those played a blank tape (p = 0.028). Pain scores were similar in the two groups. It was concluded that intraoperative suggestions seem to have a positive effect in reducing patients' morphine requirements in the early postoperative period.
Tiba, Janos (1990). Clinical, research and organizational aspects of preparation for childbirth and the psychological diminution of pain during labour and delivery. British Journal of Experimental and Clinical Hypnosis, 7 (1), 61-64.
NOTES
Studied patients in Hungary and arrived at the following conclusions:
1.Hypnotizability of women coming for hypnosis preparation for birth is higher than non-pregnant women.
2. Primagravidas score higher than women having second child.
3. High hypnotizables have virtually painless delivery "if they are prepared for birth" and can maintain medium depth during birth.
4. Even highly hypnotizable women require sensory imaginative techniques and anaesthesia suggestions to maintain hypnosis throughout the process.
5. "Continuous hypnosis throughout delivery for analgesic reasons is questionable."
6. Benefits of hypnosis include "favourable effect on the course of birth, on reducing pain during birth, on the subjective judgement of birth and on developing positive experiences."
7. Imaginative ability is higher than in a non-pregnant group, and increases with progression of pregnancy.
8. Author developed "a complex psychophysical preparation for birth integrating the imaginative capacity, hypnosis and the preparation of husbands together with their wives has been developed."
The author recommends that followup studies investigate whether hypnotizability and imaginative capacity really increase during pregnancy.
1988
Omer, H.; Darnel, A.; Silberman, N.; Shuval, D.; Palti, T. (1988). The use of hypnotic-relaxation cassettes in a gynecologic-obstetric ward. In Lankton, S. R.; Zeig, J. K. (Ed.), Research, comparisons and medical applications of Ericksonian techniques (pp. 28-36). New York: Brunner-Mazel.
NOTES
They did three studies in which they gave women having gynecologic procedures tapes with a Rapid Induction Analgesia hypnosis experience.
STUDY 1. Women heard tapes before a painful Fallopian tube procedure (salpingography). The patients reported less pain, tension, anxiety, and fear than control patients. (N.B. Physicians' ratings did not show that difference.)
STUDY 2. Women practiced with the tapes at home before labor and delivery. One day after delivery, there was no difference in pain report or experience report between treated and control patients.
STUDY 3. Women used the tapes during labor. They reported worse pain and labor experiences than the control patients.
The authors conclude that their research does not support the hypothesis that Rapid Induction Analgesia is useful for acute pain.
1987
Venn, Jonathan (1987). Hypnosis and Lamaze method--an exploratory study. International Journal of Clinical and Experimental Hypnosis, 35, 79-82.
Literature on obstetrical hypnosis includes the hypotheses (a) that the ideal form of childbirth preparation would combine hypnosis with didactic education and (b) that Lamaze and natural childbirth methods are essentially the same thing as hypnosis. In the present study, 122 parturient women self-selected into three groups: Lamaze-only, hypnosis-only, and Lamaze-plus-hypnosis. Amount of medication, duration of labor, self- ratings, and nurses' ratings were used as dependent measures of pain and satisfaction. Treatment groups were compared by analysis of variance, and correlation coefficients were obtained between the dependent variables and scores on the SHCS. Neither hypnosis, Lamaze, nor a combination of the 2 emerged as a superior form of treatment. The SHCS scores were moderately correlated (r - .55) with self-ratings that Lamaze had lessened pain during delivery. This may suggest a functional similarity between hypnosis and Lamaze, but the present study suffered a number of methodological problems and alternative explanations are discussed.
Omer, Haim; Friedlander, Dov; Palti, Zvi (1986). Hypnotic relaxation in the treatment of premature labor. Psychosomatic Medicine, 48, 351-361.
Hypnotic relaxation was used as an adjunct to pharmacologic treatment with 39 women hospitalized for premature contractions in pregnancy. The control group received medication alone and consisted of 70 women. Treatment was started at the time of hospitalization and lasted for 3 hr on the average. patients were also given cassettes with a hypnotic - relaxation exercise for daily practice. The rate of pregnancy prolongation was significantly higher for the hypnotic - relaxation than for the medication- alone group. Infant weight also showed the advantage of the hypnotic - relaxation treatment. Background variables of the two groups were compared and it was shown that they could not have explained the treatment effect obtained.
Wideman, Margaret V.; Singer, Jerome E. (1984). The role of psychological mechanisms in preparation for childbirth. American Psychologist, 39, 1357-1371.
Psychoprophylactic (Lamaze) preparation for childbirth consists of six to eight classes held during the last trimester of pregnancy. These classes include instruction in the anatomy and physiology of gestation and parturition, respiration techniques, controlled neuromuscular relaxation, visual focusing, and the training of a labor coach. Although the techniques are based upon psychological principles, they have remained largely unstudied by either psychologists or physicians. This article presents a brief history of the development of the training regimen and critically examines the few empirical studies that have been conducted. Because explanations for the efficacy of the preparation, if it exists, are equivocable, literature on the explicit components of the training--that is, information, respiration techniques, conditioned relaxation, cognitive restructuring, and social support--in situations other than child delivery are reviewed and their implications for the Lamaze method discussed. However, because there exist several, more implicit factors that may affect the type of child delivery a prepared woman experiences, the literature concerning social comparison, the effects of commitment and conformity, perceived control, and endorphin secretion are also discussed as they may apply to psychoprophylactic preparation. Problems associated with the study of childbirth preparation are presented, and suggestions for the direction of future research are made.
1982
Werner, William E. F.; Schauble, Paul G.; Knudson, Marshall S. (1982). An argument for the revival of hypnosis in obstetrics. American Journal of Clinical Hypnosis, 24, 149-171.
Available research, clinical reports, and extensive personal experience demonstrate that hypnosis, and especially the hypnoreflexogenous technique, facilitates the mother's comfort in pregnancy, labor, and delivery; is superior to the use of chemicals or other psychophysical methods as the primary aid in childbirth; and results in lasting benefit for the mother, the child, and the family as a whole. Prior to delivery, with the patient in hypnotic trance, a verbal conditioning technique is used that (1) neutralizes the fear of delivery with a positive emotion that exalts maternity as a sublime experience, (2) substitutes the uterine contraction concept for the pain concept, and (3) presumably lowers the excitability of the cortex by psychological sedation. While hypnosis experienced a temporary decrease in popularity due to a number of misconceptions, there has been renewed and promising application of hypnosis to obstetrics and other areas of medicine.
1980
Fuchs, K.; Paldi, E.; Abramovici, H.; Peretz, B. A. (1980). Treatment of hyperemesis gravidarum by hypnosis. International Journal of Clinical and Experimental Hypnosis, 28 (4), 313-323.
Nausea and vomiting are the most common complaints in the first trimester of pregnancy. Hyperemesis gravidarum presents a unique challenge to the obstetrician trained in medical hypnosis. Between the years 1965-1977, 138 women suffering from extremely severe vomiting in the first trimester of pregnancy were successfully treated by medical hypnosis. 87 patients were treated in groups and 51 received individual therapy. The results with patients in group hypnotherapy were markedly better than those with patients in individual hypnotherapy. With group hypnotherapy, hospitalization was not necessary; treatement [sic] was given to a number of patients simultaneously and the women felt safer and less lonely. The common motivation of the patients consolidated the psychotherapeutic effect. This made treatment easier and more efficient.
1975
Samko, Michael R.; Schoenfeld, Lawrence S. (1975). Hypnotic susceptibility and the Lamaze childbirth experience. American Journal of Obstetrics and Gynecology, 121, 631-6.
This study explored the relationship between childbirth training and hypnotic susceptibility. A multiple linear regression analysis was performed on the various medical and attitudinal variables related to the subjects' Lamaze childbirth experience and these were tested against hypnotic susceptibility. The results of the analysis indicate that hypnotic susceptibility is not significantly related to Lamaze training, nor is it significantly related to the type of childbirth experience that a Lamaze trained woman has.
NOTES
Subjects used in this experiment (N = 55) were women who had received Lamaze training within the last two years, and had delivered only one child. The HIP was administered to find a score of hypnotizability and the women were given two questionnaires. The first of the questionnaires sought demographic and medical information, the second was an attitude questionnaire about her childbirth. A third questionnaire was given to the attending physician. "The correlations between hypnotic susceptibility and the physician's rating of how successful he felt the subject's use of the Lamaze technique (r = 0.12) and the physician's rating of how helpful he found the mother's use of the Lamaze technique was to delivery (r = 0.17) were both nonsignificant" p. 634).
1969
Rock, Nicholas; Shipley, Thomas; Campbell, Colin (1969). Hypnosis with untrained, nonvolunteer patients in labor. International Journal of Clinical and Experimental Hypnosis, 17, 25-36.
20 nonvolunteer, untrained Ss were individually hypnotized during active labor and compared with 18 controls selected by the same criteria and receiving the same obstetrical treatment. Hypnotized Ss required less medication and obtained greater relief of pain than the controls. The time involved in induction of hypnosis was only 20 min., and the total time added by hypnotic procedures was only 45 min. longer than the regular care of the control group. It was concluded that hypnosis can be used easily on nonvolunteer, untrained patients in active labor, even in a noisy environment, without any serious sequelae. (Spanish & German summaries) (16 ref.) (PsycINFO Database Record (c) 2002 APA, all rights reserved)
1961
Cheek, David B. (1961). Value of ideomotor sex-determination technique of LeCron for uncovering subconscious fear in obstetric patients. International Journal of Clinical and Experimental Hypnosis, 9, 249-259.
Author''s Summary
Unrecognized subconscious fears can be uncovered while using ideomotor questioning with a Chevreul pendulum or with finger signals. The technique described by LeCron for evaluating knowledge regarding the sex of an unborn child is a most helpful way of approaching subconscious fears. The frightened patient refuses to indicate knowledge of the sex of her unborn child. Uncovered fears can be resolved by appealing to conscious-level understanding with adroit questioning" (p. 258).
1955
Kline, Milton V.; Guze, Henry (1955). Self-hypnosis in childbirth: A clinical evaluation of a patient conditioning program. Journal of Clinical and Experimental Hypnosis, 3 (3), 142-147.
NOTES:
The author reports use of self hypnosis for childbirth by 30 patients. Many required no drugs or greatly reduced drugs. The obstetricians usually had no prior experience with hypnosis and were cautious in providing medication at the earliest sign of discomfort.
"Summary. A two year experimental study of the use of self-hypnosis in childbirth has indicated its general effectiveness for virtually all the patients who received this type of pre-natal preparation. Although problems of selecting patients capable of utilizing this method have not been discussed in detail in this paper, it must be understood that this study depended upon a patient population selected on the basis of specific psychological characteristics which were indicative of both the judiciousness and effectiveness of self-hypnosis for obstetrics.
"Within the limits set by these selective characteristics, which in themselves may be greatly broadened by further study, self-hypnosis as a means of patient participation in childbirth appears to have very great merit. It is a method that lends itself to simple administration and can be extended to many more patients than any other hypnotic approach. It minimizes the need of the obstetrician to utilize time and effort in patient conditioning without sacrificing any of the advantages of hetero-hypnotic techniques. Its use on a larger scale than reported upon here, with more exacting investigative techniques, seems clearly indicted" (pp. 146-147).
Kroger, William S. (1953). Hypnotherapy in obstetrics and gynecology. Journal of Clinical and Experimental Hypnosis, 1 (2), 61-70.
Author's Summary
A high percentage of gynecologic complains [sic] are due to psychic factors. Therapeutic efforts, therefore, must be directed primarily toward the psychologic component. Until recently, the principal weapon of the dynamically oriented physician was orthodox psychoanalysis. However, the increased interest for a relatively rapid approach has demonstrated the diagnostic and therapeutic value of hypnoanalysis. This development has been concomitant with the psychoanalysist's [sic] interest in 'brief psychotherapy' and narcosynthesis.
"In many functional gynecologic disorders, hypnoanalysis has supplanted the parent therapy even though this form of treatment utilizes the concepts of dynamic psychiatry.
"The relevant literature on the use of hypnotherapy in functional obstetrical and gynecological disorders has been reviewed.
"Significant areas for research have been pointed out.
"This review emphasizes that hypnosis _per se_ is only of value in obtaining symptomatic relief. On the other hand, hypnoanalysis elicits the responsible dynamics behind the symptom, and is effective in reaching all aspects of the personality.
"Hypnoanalysis will be more applicable in obstetrics and gynecology when there is a wider acceptance of its techniques" (p. 68).
Research on Hypnosis for Childbirth Preparation
Hypnosis for Childbirth:
A retrospective survey of birth outcome using prenatal self-hypnosis
2001
Shawn Gallagher, BA, CH
Objective: To assess the effects of prenatal hypnotherapy classes on the length of labour, use of pain medication, intervention rates, maternal pain perception and maternal satisfaction.
Design: Retrospective survey completed by the woman and her partner.
Subjects: Self-referred clients, nulliparous (first baby) and low risk.
Setting: Toronto, Canada
Intervention: Three sessions of 2.5 to 3 hours in length in a group setting in mid-pregnancy, plus one session of 2.5 hours in length in late pregnancy. The sessions were provided by a Certified Hypnotherapist. The woman’s partner was trained to provide additional hypnosis support during the birth as needed (the hypnotherapist did not attend the births).
Outcome Measures: Anesthetic and analgesic requirements, duration of the early, active and second stages, planned place of birth and actual place of birth, interventions required, pain scale of 0-10 as reported by the mother post-delivery, breastfeeding rates and reported maternal satisfaction.
Results
Participants: 45 nulliparous women
Control group: none
Planned home birth: 16
Actual home birth: 15 (a - see below)
Primary care midwife: 29
Primary care physician:16
Averages of
Length of early labour: 10.7 hours (range: 45 min to 3 days)
Length of active labour: 4.5 hours (range: 54 min to 14 hours)
Length of pushing: 1.2 hours (range: 15 min to 4.5 hrs)
Newborn weight: 7.68 lbs (range: 5 lbs 6 oz to 10 lbs)
Maternal pain perception: “6” on a self-scoring scale of 0-10
Pain medication rate
Epidural 18%, n=8 (b - see below)
Nitrous oxide 3%, m=1
Narcotics 4.4%, n=2
Interventions
• Caesarian 6.5%, n=3 (c - see below)
• Forceps 9.7%, n=3 (d - see below)
• Vacuum 3%, n=1
• Pitocin augmentation 4.4%, n=2
• Pitocin/gel induction 18%, n=8 (e = see below)
The total number of participants who received an intervention was 8 for a rate of 18%. (Some women received more than one intervention.)
Breastfeeding without formula supplementation: 93%, n=42
Length of labour
The average length of active labour for nulliparous women is 12 hours. Participants in the Hypnosis for Childbirth series averaged 4.5 hours of active labour.
The average length of pushing for nulliparous women is about 2 hours. Participants in the Hypnosis for Childbirth series averaged just over 1 hour.
Hypnosis is associated with faster births (statistically significant) throughout the research for both the first and second stages of labour.
Medication rates
The epidural rate in Toronto and Mississauga ranges from 40 to 95% for nulliparous women.
This survey notes an 18% epidural rate for Hypnosis for Childbirth participants (11% for caesarians and forceps, 7% for maternal request).
This survey’s reduction in medication use is supported by statistically significant reductions in other research for women using hypnosis preparation for birth.
Caesarian rates
The caesarian section rate in Toronto ranges from 20 to 25%, depending on the institutional setting.
This survey notes a caesarian section rate of 6.7% for Hypnosis for Childbirth participants. Other research also notes the reduction of birth interventions with the prenatal use of hypnosis.
Notes
a. The one planned homebirth delivered in the hospital was a change of plans in late pregnancy based on a poor biophysical profile (94% successful homebirth rate). Of the 15 planned homebirths at the onset of labour, 100% delivered at home. All planned hospital births delivered in the hospital.
b. The three maternal requests for epidurals were highly correlated to unfavourable fetal positioning (ie. posterior presentation). The other five epidurals were for caesarians (3) and forceps (2).
c. Breech presentation (n=1) at term; fetal distress/prolonged labour/posterior (n=1); fetal distress and poor descent in second stage (n=1).
d. Fetal distress (n=2); poor descent (n=1).
e. Three of the eight had no additional interventions; five of the eight had epidurals (3), forceps (2) and nubaine (1). An additional four were midwifery clients who induced at home using either homeopathy or castor oil (9%). No additional interventions were noted with this group.
As a result of the Hypnosis for Childbirth series a very high percentage of women reported an increased sense of self-confidence prior to the onset of labour. In addition, 96% were pleased at the use of hypnosis, would use hypnosis in a subsequent birth and recommend its use to other women planning natural childbirth
Women who would use this method again: 96%, n=43
The Effects of Hypnosis on the Labor Processes and Birth Outcomes of Pregnant Adolescents
Alice A. Martin, PhD
Paul G. Schauble, PhD
Surekha H. Rai, PhD
R. Whit Curry, Jr, MD
Gainesville, Florida
The Journal of Family Practice • MAY 2001 • Vol. 50, No. 5
General
We evaluated how childbirth preparation incorporating hypnotic techniques affected the labor processes and birth outcomes of pregnant adolescents. The study included 42 teenaged patients receiving prenatal treatment at a county public health department before their 24th week of pregnancy. They were randomly assigned to either a treatment group receiving a childbirth preparation protocol under hypnosis or a control group receiving supportive counseling. When labor and delivery outcome measures were compared in the 2 groups, significant differences favoring the hypnosis intervention group were found in the number of complicated deliveries, surgical procedures, and length of hospital stay. Larger studies in different populations are needed.
Hypnosis has been used to control pain during labor and delivery for more than a century, but the introduction of chemo-anesthesia and inhalation anesthesia during the late 19th century led to the decline of its use. Recently there has been a resurgence of this technique in obstetrics. Hypnotherapy has been found to be effective in providing pain relief, reducing the need for chemical anesthesia, and reducing anxiety, fear, and pain related to childbirth. Hypnosis has also been helpful in both managing various complications of pregnancy (such as premature labor) and reducing the likelihood of premature labor and birth in high-risk patients. It has also has been effective in the treatment of hyperemesis gravidarum, acute hypertension associated with pregnancy and conversion of breech to the vertex presentation.
One promising application of hypnosis is in the area of labor and delivery. The use of hypnosis in preparing the patient for labor and delivery is based on the premise that such preparation reduces anxiety, improves pain tolerance (lowering the need for medication), reduces birth complications, and promotes a rapid recovery process. The key aspect of this treatment is involvement of the patient before labor begins, to promote her active participation and sense of control in the labor and delivery process. This is accomplished through educating the patient about this process and teaching her alternate ways to produce hypno-analgesia and anesthesia. Hypnotic preparation thus provides the expectant mother with a sense of control for managing her anxiety and physical discomfort.
Although there have been numerous reports suggesting the value of hypnosis in obstetrics, our study is one of the first to report a randomized controlled evaluation of childbirth preparation incorporating hypnotic techniques on labor processes and birth outcomes.
STUDY DESIGN
Both groups of patients received the standard prenatal treatment protocol from the medical staff, nurse practitioners, and hospital staff, all of whom were blind to group assignments. All patients were delivered at the local teaching hospital by obstetrics department staff who were blind to the study. The study interventions were begun with individual meetings with patients during regular clinic visits between 20 and 24 weeks’ gestation. Continuing clinic visits were scheduled for all patients on a biweekly basis, making the time span of the 4-session experimental conditions approximately 8 weeks.
The study counselor (the primary author) provided hypnosis preparation training for the treatment group; a nurse midwife provided the supportive contact with the control group. Both interventions were completed before delivery; no prompting occurred during the labor and delivery process.
The 2 groups of patients were compared on medication use (Pitocin, anesthetic, and postpartum medication), complications and surgical intervention during delivery, and length of hospital stay for mothers and neonatal intensive care unit (NICU) admission for the infants.
Complications fell into 36 categories of events (eg, multiple pregnancies, preeclampsia, vacuum-assisted delivery) that were entered in subjects’ records by obstetric staff who were unaware of the study. Statistical analysis was based on a simple count of the presence or absence of complications in the medical record by researchers (the researchers were not blinded to the patient’s study assignment).
RESULTS
Of the 47 patients, 3 moved out of the geographic area before delivery, and 2 patients (1 in each group) did not complete the research protocol and were not included in the research. Results were thus obtained for 22 patients in the hypnosis group and 20 in the control group, resulting in a total of 42 subjects. A two-tailed Fisher exact analysis at the .05 level was used to test for significance.
Only one patient in the hypnosis group had a hospital stay of more than 2 days compared with 8 patients in the control group (P=.008). None of the 22 patients in the hypnosis group experienced surgical intervention compared with 12 of the 20 patients in the control group (P=.000). Twelve patients in the hypnosis group experienced complications compared with 17 in the control group (P=.047). Although consistently fewer patients in the hypnosis group used anesthesia (10 vs 14), Pitocin (2 vs 6), or postpartum medication (7 vs 11), and fewer had infants admitted to the NICU (1 vs 5), statistical analysis was nonsignificant.
DISCUSSION
We focused on the educational preparation of the patient while in hypnosis to create the expectation of a normal labor and delivery, develop a conditioned response of comfort and confidence, and facilitate an increased sense of control in achieving a healthy delivery.
The subjects in the treatment group received a 4-session sequence of standard hypnotic interventions incorporating childbirth preparation information (ie, the hypnoreflexogenous method) in which they were instructed in the methods and benefits of focused relaxation and imagery to increase the likelihood of a safe and relatively pain-free delivery. The sessions provided an opportunity to experience and practice hypnotic induction and deep relaxation. The suggestions directed toward the expectant mothers during the hypnotic state focused on the conceptualization of pregnancy and childbirth as a healthy natural process.
CONCLUSIONS
Our study provides support for the use of hypnosis to aid in preparation of obstetric patients for labor and delivery. The reduction of complications, surgery, and hospital stay show direct medical benefit to mother and child and suggest the potential for a corresponding cost-saving benefit.
Hypnosis: practical applications and theoretical considerations in normal labour
Jenkins, MW
Pritchard MH
Aberdare District Maternity Unit, Mid Glamorgan, Wales.
Br J Obstet Gynaecol, 1993 March, 100(3): 221-6
Objective: To assess the designs of hypnotherapy on the first and second stages of labour in a large group of pregnant women.
Design: A semi-prospective case control study in which women attending antenatal clinics were invited to undergo hypnotherapy.
Subjects: One hundred twenty-six primigravid women with 300 age matched controls, and 136 parous women having their second baby with 300 age matched controls. Only women who had spontaneous deliveries were included.
Intervention: Six sessions of hypnotherapy given by a trained medical hypnotherapist during pregnancy.
Outcome Measures: Analgesic requirements, duration of first and second stages of labour.
Results: The mean lengths of the first stage of labour in the primigravid women was 6.4 h after hypnosis and 9.3 h in the control group (P<0.0001); the mean lengths of the second stage were 37 min and 50 min, respectively (P<0.001). In the parous women the corresponding values were 5.3 h and 6.2 h (P<0.01); and 24 and 22 min (ns). The use of analgesic agents was significantly reduced (P<0.001) in both hypnotized groups compared with their controls.
Conclusion: In addition to demonstrating the benefits of hypnotherapy, the study gives some insight into the relative proportions of mechanical and psychological components involved in the longer duration of labour in primigravid women.
Improved obstetric outcomes using hypnotic analgesia and skill mastery combined with childbirth education
Harmon TM
Hynan MT
Tyre TE
The University of Wisconsin, Milwaukee
J Consult Clin Psychol • 1990 Oct • 58(5):525-30
The benefits of hypnotic analagesia as an adjunct to childbirth education were studied in 60 nulliparous women. Subjects were divided into high and low hypnotic susceptibility groups before receiving 6 sessions of childbirth education and skill mastery using an ischemic pain task. Half of the subjects in each group received a hypnotic induction at the beginning of each session; the remaining control subjects received relaxation and breathing exercises typically used in childbirth education.
Both hypnotic subjects and highly susceptible subjects reported reduced pain. Hypnotically prepared births had shorter Stage One labours, less medication, higher Apgar scores and more frequent spontaneous deliveries than control subjects’ births.
Highly susceptible, hypnotically treated women had lower depression scores after birth than women in the other three groups.
We propose that repeated skill mastery facilitated the effectiveness of hypnosis in our study.
This research is classified as both a Clinical Trial and Randomized Controlled Trial.
