Hypnosis Antenatal Training for Childbirth: a randomised controlled trial

Abstract

Objective To determine the use of pharmacologic analgesia during childbirth when antenatal hypnosis is added to standard care.Design Randomised controlled clinical trial, conducted from December 2005 to December 2010.Setting The largest tertiary referral centre for maternity care in South Australia.Population A cohort of 448 women at >34 weeks of gestation, with a singleton pregnancy and cephalic presentation, planning a vaginal birth. Exclusions were: the need for an interpreter; preexisting pain; psychiatric illness; younger than 18 years; and previous experience of hypnosis for childbirth.Methods All participants received usual care. The group of women termed Hypnosis + CD (hypnotherapist guided) were offered three antenatal live hypnosis sessions plus each session's corresponding audio CD for further practise, as well as a final fourth CD to listen to during labour. The group of women termed CD only (nurse administered) were played the same antenatal hypnosis CDs as group 1, but did not receive live hypnosis training. The control group participants were given no additional intervention or CDs.Main outcome measure Use of pharmacological analgesia during labour and childbirth.Results No difference in the use of pharmacological analgesia during labour and childbirth was found comparing hypnosis + CD with control (81.2 versus 76.2%; relative risk, RR 1.07; 95% confidence interval, 95% CI 0.95-1.20), or comparing CD only with control (76.9 versus 76.2%, RR 1.01, 95% CI 0.89-1.15).Conclusions Antenatal group hypnosis using the Hypnosis Antenatal Training for Childbirth (HATCh) intervention in late pregnancy does not reduce the use of pharmacological analgesia during labour and childbirth.

The Complementary Therapies for Labour and Birth Study making sense of labour and birth – Experiences of women, partners and midwives of a complementary medicine antenatal education course

“…Medical management of labour and birth are now part of the childbirth education teaching curriculum and accepted as part of normal birth (Ferguson et al, 2013;Lothian, 2007Lothian, , 2008aWalker, Visger, & Rossie, 2009). The literature supports the notion that antenatal educational interventions, including psychoprophylaxis and hypnosis, increases feelings of confidence and agency, but demonstrate little impact on reducing interventions and associated morbidity (Bergström, Kieler, & Waldenström, 2009;Byrne, Hauck, Fisher, Bayes, & Schutze, 2014;Cyna et al, 2013;Downe et al, 2015;Gagnon & Sandall, 2007;Koehn, 2002;Madden, Middleton, Cyna, Matthewson, & Jones, 2012).…”

Preventing traumatic childbirth experiences: 2192 women’s perceptions and views

“…However, one could also hypothesize that choice of birthing class could be influenced by expectations or even personality, so this finding would need to be re-examined in a randomized setting. The effects of hypnobirthing, where the woman and her partner are taught self-hypnosis during labor and are told that childbirth does not have to be painful, on delivery and patient satisfaction have not yet been studied in depth (Cyna et al 2013; Finlayson et al 2015). …”

Self‐hypnosis for intrapartum pain management in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness

“…This illustrates both the current popularity of hypnosis‐based antenatal education sessions and the general methodological difficulty of undertaking a controlled study to evaluate a technique that is popular and relatively widely available privately. The two other recent trials in this area report access to antenatal education, including hypnosis, outside of the trial protocol, but neither report rates of use of hypnosis in labour for each of the randomised groups …”

“…The hypnosis scripts used in a recent Australian trial of self‐hypnosis for labour pain were adapted, based on a methodology developed for the control of abdominal symptoms by members of the research team (P.W., V.M. ) in thousands of patients.…”