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Hypnosis for pain relief in labor and childbirth: a systematic review.

13 Jun

Meta-analysis of several studies shows that hypnosis appears to be promising at improving pain scores in laboring women, but a lack of well designed, controlled, randomized studies means that more research is needed..

A recent meta-analysis by the Department of Women''s Anaesthesia of Women''s and Children''s Hospital in Adelaide, South Australia looked at the effects of hypnosis for pain relief during childbirth. 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. There were no language restrictions.

The primary outcome measures involved the labor analgesia requirements (no analgesia, opiate, or epidural use), and pain scores during labor. Meta-analyses were performed on the randomized controlled trials (RCTs), assessed as being of "good" or "adequate" quality by a predefined score.

Investigators identified five randomized, controlled trials and 14 non-randomized comparisons (NRCs) totalling 8395 women where hypnosis was used for labor 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 laboring women using 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 labor 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 labor (P<0.001).

The report concludes that the risk/benefit profile of hypnosis demonstrates a need for well-designed trials to confirm the effects of hypnosis in childbirth.

Citation: Cyna AM, McAuliffe GL, Andrew MI. Hypnosis for pain relief in labor and childbirth: a systematic review. British Journal of Anaesthesia. 2004 Oct; 93 (4): pages 505-11. Epub 2004 Jul 26. This email address is being protected from spambots. You need JavaScript enabled to view it.
Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award