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Hypnosis for
Childbirth – Research Findings http://www.easybirthing.com/science_and_research.htm
Hypnosis for
Childbirth is as much a philosophy as it is a technique. Dr. Grantly Dick-Read,
a British physician, was the first to propose the “fear-tension-pain”
syndrome in his work Natural Childbirth (1933) and he therefore recommended
childbirth preparation as a means to prepare for birth. While midwives and
physicians recommend natural childbirth preparation, hypnosis is an extremely
effective way to eliminate the fear-tension cycle. Hypnosis applies the theory
on the subconscious level, which at the same time allows your physical body to
deeply relax, not only during the sessions, but also during the birth. Jenkins and
Pritchard found a reduction of 3 hours for prim gravid women (from 9.3 hours to
6.4 hours, p<0.0001) and 1 hour for multi gravid women (from 6.2 hours to 5.3
hours, p<0.01) for active labour (262 subjects and 600 controls). Pushing was
statistically shorter for first time mothers (from 50 min to 37 min,
p<0.001). In a study that
compared hypnosis and Lamaze training, 96 women chose between hypnosis (n=45)
and Lamaze (n=51). The first stage of labour was shortened in the hypnosis group
by 98 minutes for first time mothers and by 40 minutes for second time mothers.
These women were more satisfied with labour and reported other benefits of
hypnosis such as reduced anxiety and help with getting to sleep. A British study
found a statistically significant reduction (p<0.001) in the length of labour
of first and second time mothers: 70 hypnosis patients (6 h 21 min) compared to
70 relaxation patients (9 h 28 min) and 70 control group (9 h 45 min). Mellegren noted a
reduction of two to three hours of labour. Medication use: In a British study,
55% of 45 patients (first and second time mothers) required no medication for
pain relief. In the other non-hypnosis groups, only 22% of 90 women required no
medication. Two research pieces reported on 1,000 consecutive births: 850 women
used hypnotic analgesia resulting in 58 percent rate of no medication. Five
other research pieces reported an incidence of 60 to 79 percent non-medicated
births. My retrospective
survey notes an epidural rate of 18 percent in Southern Ontario, where the
epidural rate in most hospitals is 40 to 95 percent (depending on the setting)
for first time mothers. Rates of Intervention: In a randomized
control trial of 42 teenagers in Florida, 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). Harmon, Hynan and
Tyre reported more spontaneous deliveries, higher Apgar scores and reduced
medication use in their study of 60 women. Of the 45 Hypnosis for Childbirth
clients, 38 delivered without the use of caesarian, forceps or vacuum, a rate of
spontaneous birth of 84%. This is a higher than average rate of normal birth for
the general population of first time mothers. Postpartum: In a randomized
control trial of 42 teenagers in Florida, only 1 patient in the hypnosis group
had a hospital stay of more than two days compared with 8 patients in the
control group (p=.008). Postpartum
Depression: McCarthy provided
five 30-minute sessions to 600 women and found a virtual absence of postpartum
depression, compared to the typical rates of 10 to 15 percent. Women with a
history of postpartum depression did not develop this condition, even though an
estimated 50 percent eventually do. It appears that a
simple intervention, hypnotherapy, has far-reaching effects both medically and
socially. Some, but not all, of the above studies are randomized, have large
numbers, include control groups and demonstrate statistical significance. There
remains, therefore, a clear need for more research, especially Canadian based,
in the use of hypnosis for childbirth preparation. Medline: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
Other
References: Jenkins,
M.W., & Pritchard, M.H. Hypnosis: Practical applications and theoretical considerations in normal
labour. British Journal of Obstetrics and Gynecology, 100(3), Brann
LR, Guzvica SA. Comparison of hypnosis with conventional relaxation for antenatal and
intrapartum use: A feasibility study in general practice. J R Coll Gen Pract
1987; 37:437-440. Davidson, J, MD.
An assessment of the value of hypnosis in pregnancy and labour. Br Med Journal
Oct 13, 1962, 951-953. Mellegren, A.
Practical experiences with a modified hypnosis-delivery. Psychotherapy and
Psychosomatics, 14, 425-428, 1966. Abramson, M., & Heron, W.T.An objective evaluation of hypnosis in obstetrics: Preliminary report. American Journal of Obstetrics and Gynecology, 59, 1069-1074, 1950.
August,
R.V.Obstetric hypnoanesthesia. American Journal of Obstetrics and Gynecology, 79,
1131-1137, 1960, and August, R.V. Hypnosis in obstetrics. New York: McGraw Hill,
1961. Alice A. Martin, PhD; Paul G.
Schauble, PhD;
Surekha H. Rai, PhD; and R. Whit Curry, Jr, MD The Effects of Hypnosis on the
Labor Processes and Birth Outcomes of Pregnant Adolescents. The Journal of
Family Practice, MAY 2001, 50(5): 441-443. Harmon,
T.M., Hynan, M., & Tyre, T.E.Improved obstetric outcomes using hypnotic analgesia and skill mastery combined
with childbirth education. Journal of Consulting and Clinical Psychology, 58,
525, 530, 1990. Gallagher, S.Hypnosis for Childbirth: prenatal education and birth outcome. unpublished. June
2001. McCarthy,
P.Hypnosis
in obstetrics. Australian Journal of Clinical and Experimental Hypnosis, 26,
35-42, 1998. A Balanced Perspective:British Journal of Anaesthesia 93 (4): 505–11 (2004) CLINICAL INVESTIGATIONS Hypnosis for pain relief in labour and childbirth: a systematic review A. M. Cyna1*, G. L. McAuliffe2 and M. I. Andrew1 1Department of Women’s Anaesthesia, Women’s and Children’s Hospital, Adelaide, South Australia 5006, Australia. 2Department of Anaesthesia, Lyell McEwin Hospital, Adelaide, South Australia, Australia
*Corresponding author. E-mail: cynaa@wch.sa.gov.au
Background. In view of widespread claims of efficacy, we examined the evidence regarding the effects of hypnosis for pain relief during childbirth. Methods. Medline, Embase, Pubmed, and the Cochrane library 2004.1 were searched for clinical trials where hypnosis during pregnancy and childbirth was compared with a non-hypnosis intervention, no treatment or placebo. Reference lists from retrieved papers and hypnotherapy texts were also examined. There were no language restrictions. Our primary outcome measures were labour analgesia requirements (no analgesia, opiate, or epidural use), and pain scores in labour. Suitable comparative studies were included for further assessment according to predefined criteria. Meta-analyses were performed of the included randomized controlled trials (RCTs), assessed as being of ‘good’ or ‘adequate’ quality by a predefined score. Results. Five RCTs and 14 non-randomized comparisons (NRCs) studying 8395 women were identified where hypnosis wa sused for labour analgesia. FourRCTsincluding 224patients examined the primary outcomes of interest. One RCT rated poor on quality assessment. Meta-analyses of the three remaining RCTs showed that, compared with controls, fewer parturients having hypnosis required analgesia, relative risk=0.51 (95% confidence interval 0.28, 0.95). Of the two included NRCs, one showed that women using hypnosis rated their labour pain less severe than controls (P<0.01). The other showed that hypnosis reduced opioid (meperidine) requirements (P<0.001), and increased the incidence of not requiring pharmacological analgesia in labour (P<0.001). Conclusion. The risk=benefit profile of hypnosis demonstrates a need for well-designed trials to confirm the effects of hypnosis in childbirth.
Br J Anaesth 2004; 93: 505–11 Keywords: analgesia, obstetric; pain, childbirth; pain, hypnosis; pain, hypnotherapy; pregnancy Accepted for publication: May 20, 2004
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