RESEARCH ABOUT HYPNOBIRTHING

"Hypnosis for pain relief in labour and childbirth: a systematic review", Cyan,
AM et al, Adelaide, Australia - British Journal of Anaesthesia, October 2004
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. Metaanalyses 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 was used for labour analgesia. Four
RCTs including 224 patients 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.
"Complementary and alternative therapies for pain management in labour",
Smith, CA et al, Adelaide, Australia - Cochrane Database of Systematic
Reviews, October 2006.
BACKGROUND: Many women would like to avoid pharmacological or
invasive methods of pain management in labour and this may contribute
towards the popularity of complementary methods of pain management.
This review examined currently available evidence supporting the use of
alternative and complementary therapies for pain management in labour.
OBJECTIVES: To examine the effects of complementary and alternative
therapies for pain management in labour on maternal and perinatal
morbidity. SEARCH STRATEGY: We searched the Cochrane Pregnancy and
Childbirth Group's Trials Register (February 2006), the Cochrane Central
Register of Controlled Trials (The Cochrane Library 2006, Issue 1), MEDLINE
(1966 to February 2006), EMBASE (1980 to February 2006) and CINAHL (1980 to
February 2006). SELECTION CRITERIA: The inclusion criteria included published
and unpublished randomised controlled trials comparing complementary
and alternative therapies (but not biofeedback) with placebo, no treatment
or pharmacological forms of pain management in labour. All women whether
primiparous or multiparous, and in spontaneous or induced labour, in the first
and second stage of labour were included. DATA COLLECTION AND
ANALYSIS: Meta-analysis was performed using relative risks for dichotomous
outcomes and mean differences for continuous outcomes. The outcome

measures were maternal satisfaction, use of pharmacological pain relief and

maternal and neonatal adverse outcomes. MAIN RESULTS: Fourteen trials
were included in the review with data reporting on 1537 women using
different modalities of pain management; 1448 women were included in the
meta-analysis. Three trials involved acupuncture (n = 496), one audioanalgesia (n = 24), two trials acupressure (n = 172), one aromatherapy (n =
22), five trials hypnosis (n = 729), one trial of massage (n = 60), and relaxation
(n = 34). The trials of acupuncture showed a decreased need for pain relief
(relative risk (RR) 0.70, 95% confidence interval (CI) 0.49 to 1.00, two trials 288
women). Women taught self-hypnosis had decreased requirements for
pharmacological analgesia (RR 0.53, 95% CI 0.36 to 0.79, five trials 749
women) including epidural analgesia (RR 0.30, 95% CI 0.22 to 0.40) and were
more satisfied with their pain management in labour compared with controls
(RR 2.33, 95% CI 1.15 to 4.71, one trial). No differences were seen for women
receiving aromatherapy, or audio analgesia. AUTHORS' CONCLUSIONS:
Acupuncture and hypnosis may be beneficial for the management of pain
during labour; however, the number of women studied has been small. Few
other complementary therapies have been subjected to proper scientific
study.
"The effect of hypnosis on pain relief during labour and childbirth in Iranian
pregnant women", Abbasi et all, Middlesex, UK - International Journal
of Clinical and Experimental Hypnosis, April 2009
This study describes the effect of hypnosis on pain relief during labor and
childbirth. Using a qualitative approach, 6 pregnant women were trained to
use self-hypnosis for labor. Outcomes were analyzed using Colaizzi's
procedure. Women described their feelings about hypnosis during labor as: a
sense of relief and consolation, self-confidence, satisfaction, lack of suffering
labor pain, changing the feeling of pain into one of pressure, a decrease in
fear of natural childbirth, lack of tiredness, and lack of anxiety. They
expressed increased concentration on the uterus and cervical muscle,
awareness of all the stages of labor, and having "positive thoughts." Births
were perceived as being very satisfactory compared to their previous
experiences.
"Hypnosis for childbirth: a retrospective comparative analysis of outcomes in
one obstetrician's practice", Vandevuss, J et al, Milwaukee, USA - American
Journal of Clinical Hypnosis, October 2007
This exploratory, descriptive study, done retrospectively from perinatal
medical records, compared childbirth outcomes in one obstetrician's
caseload between 50 women who elected antepartal hypnosis preparation
(usually a 5-class series) and 51 who did not. The groups were
demographically similar. To achieve similar numbers to the hypnosis group,
the control group was randomly selected from the women in the caseload
who opted not to take hypnosis preparation, based on characteristics of
parity and delivery mode. Prenatal hypnosis preparation resulted in
significantly less use of sedatives, analgesia, and regional anesthesia during
labor and in higher 1-minute neonatal Apgar scores. Other physiologic and
outcome measures did not reveal statistical significance, although some
trends were of clinical interest. Well-controlled studies are warranted for
clinicians to offer hypnosis more frequently as a pain relief option for

childbirth. Additional information provided includes pragmatic, clinical, and

cost information about incorporating hypnosis into a physician's practice.
"Salient finding: hypnotisability as core construct and the clinical utility of
hypnosis", Barabasz, A et al, Washington, USA - International Journal of Clinical
and Experimental Hypnosis, July 2007.
Six papers of special interest to the hypnosis community have recently
appeared in the general scientific literatures. Three of these papers were
published as part of the 2006 Cochrane Collaboration on the utility of
medical interventions. These reviews analyze the research literature on the
efficacy of hypnosis for treatment of needle-related pain in children, pain
management during childbirth, and conversion disorder. Hypnosis is the most
promising psychological intervention studied for needle-related procedural
pain and distress in children and adolescents; it is effective as an adjunctive
analgesic during childbirth; and it is of uncertain usefulness in treatment of
conversion disorder. A second cluster of three studies unambiguously
demonstrates the central role of hypnotizability as a predictor of
responsiveness in laboratory, analogue treatment, and medical practice
settings. One of these articles may well be the most important hypnosis paper
in many years.
"Antenatal self-hypnosis for labour and childbirth: a pilot study", Cyan, AM et
al, Adelaide, Australia - Anaesthesia and Intensive Care, August 2006
In our institution we have used antenatal training in self-hypnosis for over three
years as a tool to provide relaxation, anxiolysis and analgesia for women in
labour. To assess the effects of hypnotherapy, we prospectively collected
data related to the use of hypnosis in preparation for childbirth, and
compared the birth outcomes of women experiencing antenatal hypnosis
with parity and gestational age matched controls. METHODS: Prospective
data about women taught self-hypnosis in preparation for childbirth were
collected between August 2002 and August 2004. Birth outcome data of
women using hypnosis were compared with routinely collected retrospective
data from parity and gestational age matched women delivering after 37
weeks gestation during 2003. RESULTS: Seventy-seven antenatal women
consecutively taught self-hypnosis in preparation for childbirth were
compared with 3,249 parity and gestational age matched controls. Of the
women taught antenatal self-hypnosis, nulliparous parturients used fewer
epidurals: 36% (18/50) compared with 53% (765/1436) of controls (RR 0.68
[95%CI 0.47-0.98]); and required less augmentation: 18% (9/50) vs 36%
(523/1436) (RR 0.48 [95%CI 0.27-0.90]). CONCLUSIONS: Our clinical findings are
consistent with recent meta-analyses showing beneficial outcomes
associated with the use of hypnosis in childbirth. Adequately powered,
randomized trials are required to further elucidate the effects of hypnosis
preparation for childbirth.
"Hypnosis to facilitate uncomplicated birth", Mehl-Madrona LE, Tuscan USA The Americal Journal of Clinical Hypnosis, April 2004
Prior research by the author showed that psychosocial factors distinguished
complicated from uncomplicated birth outcome. The purpose of this study
was to determine if prenatal hypnosis could facilitate uncomplicated birth.
Following a psychosocial assessment, 520 pregnant women in their first or

second trimester of pregnancy were randomized to receiving prenatal

hypnosis or attention-only groups. The author provided all of the hypnosis in a
manner similar to that taught by David Cheek. The goal was to reduce fear of
birth and parenthood; to reduce anxiety; to reduce stress; to identify specific
fears that might complicate the labor process (addressing them whenever
possible); and to prepare women for the experience of labor. The attentiononly group was matched to a no-contact comparison group. Women
receiving prenatal hypnosis had significantly better outcomes than women
who did not. Further assessment suggested that hypnosis worked by
preventing negative emotional factors from leading to an complicated birth
outcome. Attention only was associated with minimal differences in outcome
over the no-contact group. The routine prenatal use of hypnosis could
improve obstetric outcome.