Summary of clinical evidence for the use of hypnosis in pregnancy & childbirth
Reducing incidence of premature labour
A study examined the role hypnosis can play in reducing preterm labour for patients who have higher levels of psychosocial stress. In the hypnosis group there were three preterm deliveries (4.7%) (before 37 + 0 weeks' gestation) whereas in the control group there were 220 preterm deliveries (10.3%).(Reinhard, Hatzmann & Schiermeier, 2009)
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 recordings 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. (Omer & Friedlander, 1986)
Reduction of anxiety using hypnosis in pregnancy
Mothers who used hypnosis for anxiety and stress management had foetuses who moved in a much more active manner than a control group. (Zimmer, Peretz, Eyal & Fuchs, 1988)
Downe (2015) 680 women were randomized. Women in the hypnosis intervention group had lower actual than anticipated levels of fear and anxiety between baseline and 2 weeks postnatal (Anxiety: OR -0.72, 95% CI -1.16 to -0.28); (Fear OR -0.62, 95% CI -1.08 to -0.16).
Hypnosis effects on turning foetuses from breech position
One hundred pregnant women whose foetuses were in breech position at 37-40 weeks’ gestation and a matched control group. 81% of breech babies were successful conversions to a vertex position compared with 48% in the control group. The success was thought to be down to psychophysiological factors which may influence the breech position. (Mehl, 1994)
Reduction in length of labour using hypnosis
Jenkins and Pritchard (1993) found a reduction of 3 hours for prim gravid women (from 9.3 hours to 6.4 hours) and 1 hour for multi gravid women (from 6.2 hours to 5.3 hours) for active labour (262 subjects and 600 controls). Pushing was statistically shorter for first time mothers (from 50 min to 37 min). These women were more satisfied with labour and reported other benefits of hypnosis such as reduced anxiety and help with getting to sleep.
Abramson and Heron (1950) & Gallagher (2001) found a shorter first stage of labour for 100 women trained with hypnosis (by 3.23 hours) compared to a control group of 88 women.
Forty-five Hypnosis for Childbirth clients (first time mothers) had an average of 4.5 hours for the active labour, a significant reduction compared to the usual 9 hours. (Harmon, Hynan and Tyre, 1990)
Adams et al (2012) found an average difference of 1 hour 32 minutes in the length of labour for women with fear of childbirth than those without significant fear. The study comprised 2206 women with intended vaginal delivery.
Bobart and Brown's (2002) study using 72 mothers 36 of whom had received hypnotic training compared to a control group of 36 who delivered on the same day without such training:
Control Group Hypnosis Group
Regional anaesthesia 35 (97%) 14 (38%)
Analgesia 27 (75%) 2 (5.5%)
No anaesthetic or premedication 1 (2.7%) 22 (61%)
At birth Baby Apgar scores are significantly higher.
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. (Harmon, Hynan and Tyre, 1990)
A meta-analysis compiling data from 14 studies that included more than 1,400 women showed that hypnosis reduces the need for drug pain relief in labour, lessens the need for medications that augment labour and increases the number of spontaneous vaginal births. 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). (Smith, Collins, Cyna & Crowther, 2006)
Harmon, Hynan and Tyre (1990) reported more spontaneous deliveries, higher Apgar scores and reduced medication use in a study of 60 women.
“A woman’s ‘self-efficacy for labor’ or confidence in her ability to cope has a powerful relationship to decreased pain perception and decreased medication/analgesia during labour. Anxiety is commonly associated with increased pain during labor, and may modify labor pain through psychological and physiologic mechanisms. “Fear of pain may be one component of labour related anxiety, and has a huge correlation with pain levels reported during first stage labor.” (Lowe, N. 2002)
Rates of Intervention
Thirty-eight out of forty-five Hypnosis for Childbirth mums, delivered spontaneously without the use of caesarean, forceps or venteuse. This rate of 84% is higher than the average rate of normal birth for the general population of first time mothers. (Harmon, Hynan and Tyre, 1990)
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. (Martin, Schauble, Surekha & Curry, 2001)
520 pregnant women in their first or second trimester of pregnancy were randomized to receiving prenatal hypnosis or attention-only groups. 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 attention-only 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. (Mehl-Madrona, 2004).
McCarthy (1998) 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. Harmon et al also reported lower depression scores in the hypnotically treated group.
Harmon et al (1990) reported a reduced incidence of postnatal depression in women who had been taught hypnotic analgesia for childbirth.
Effect of suggestions during labour
Hao et al (1997) in China measured the effect of nursing suggestions to labouring women and recommends that the conversation of the nurses be “controlled carefully for the purpose of advancing the birth process”. This randomized control trial examined 60 first time mothers with a matched control group of 60 first time mothers and found a statistically significant reduction in the lengths of the first and second stages of labour.
Postnatal reflection on childbirth experience
In a randomized, controlled, single-blinded trial, 1,222 healthy nulliparous women were allocated to one of three groups during pregnancy: A hypnosis group participating in three 1-hour sessions teaching self-hypnosis to ease childbirth, a relaxation group receiving three 1-hour lessons in various relaxation methods and Mindfulness, and a usual care group receiving ordinary antenatal care only. The postnatal analysis indicated that women in the hypnosis group experienced their childbirth as better compared with the other two groups. The tendency toward a better childbirth experience in the hypnosis group was also seen in subgroup analyses for mode of delivery and for levels of fear. (Werner, Uldbjerg, Zachariae & Nohr, 2013)
Mairs (1995) studied the efficacy of hypnosis as an adjunct to pain control in childbirth in 28 primigravida women. Their experiences were compared with those of 27 primigravida women who did not receive any hypnosis training. Postbirth those trained in the use of hypnosis reported significant lower ratings of both pain and anxiety. There were no significant differences in drug usage during labor.
Hypnosis can be used to promote and to suppress lactation. (August, 1961; Cheek & LeCron, 1968; Kroger, 1977)