|
Clinical studies Supporting Hypnosis in Birth
Hypnosis for Childbirth: A retrospective survey
of birth outcome using prenatal self-hypnosis, Retrospective
Survey 2001
Shawn Gallagher, B.A. C.Ht www.midwiferyconsulting.com
Objective: To assess the effects of prenatal hypnotherapy
classes on the length of labour, use of pain medication,
intervention rates,
maternal pain perception and maternal satisfaction.
Design: Retrospective survey completed by the woman and her partner.
Subjects: Self-referred clients, nulliparous (first baby) and low
risk.
Setting: Toronto, Canada
Intervention: Three sessions of 2.5 to 3 hours in length in a group
setting in mid-pregnancy, plus one session of 2.5 hours in length
in late pregnancy. The sessions were provided by a Certified Hypnotherapist.
The woman’s partner was trained to provide additional hypnosis
support during the birth as needed (the hypnotherapist did not
attend the births).
Outcome Measures: Anesthetic and analgesic requirements, duration
of the early, active and second stages, planned place of birth
and actual place of birth, interventions required, pain scale of
0-10
as reported by the mother post-delivery, breastfeeding rates and
reported maternal satisfaction.
Results:
Participants: 45 nulliparous women
Control group: none
Planned home birth: 16
Actual home birth: 15 A
Primary care midwife: 29
Primary care physician:16
Averages of:
Length of early labour: 10.7 hours (range: 45 min to 3 days)
Length of active labour: 4.5 hours (range: 54 min to 14 hours)
Length of pushing: 1.2 hours (range: 15 min to 4.5 hrs)
Newborn weight: 7.68 lbs (range: 5 lbs 6 oz to 10 lbs)
Maternal pain perception: “6” on a self-scoring scale
of 0-10
Pain medication rate:
Epidural x 8 (18%) B
Nitrous oxide x 1 (3%)
Narcotics x 2 (4.4%)
Interventions:
• Caesarian x 3 (6.5%) C
• Forceps x 3 (9.7%) D
• Vacuum x 1 (3%)
• Pitocin augmentation x 2 (4.4%)
• Pitocin/gel induction x 8 (18%) E
The total number of participants who received an intervention
was 8 for a rate of 18%. (Some women received more than one intervention.)
Breastfeeding without formula supplementation: 42 (93%)
Women who would use this method again: 43 (96%)
Length of labour:
The average length of active labour for nulliparous women is 12
hours. Participants in the Hypnosis for Childbirth series averaged
4.5 hours
of active labour. The average length of pushing for nulliparous
women is about 2 hours. Participants in the Hypnosis for Childbirth
series
averaged just over 1 hour. Hypnosis is associated with faster births
(statistically significant) throughout the research for both the
first and second stages of labour.
Medication rates:
The epidural rate in Toronto and Mississauga ranges from 40 to
95% for nulliparous women. This survey notes an 18% epidural rate
for
Hypnosis for Childbirth participants (11% for caesarians and forceps,
7% for maternal request). This survey’s reduction in medication
use is supported by statistically significant reductions in other
research for women using hypnosis preparation for birth.
Caesarian rates:
The caesarian section rate in Toronto ranges from 20 to 25%, depending
on the institutional setting. This survey notes a caesarian section
rate of 6.7% for Hypnosis for Childbirth participants. Other research
also notes the reduction of birth interventions with the prenatal
use of hypnosis.
A. The one planned homebirth delivered in the hospital was a change
of plans in late pregnancy based on a poor biophysical profile
(94% successful homebirth rate). Of the 15 planned homebirths at
the onset
of labour, 100% delivered at home. All planned hospital births
delivered in the hospital.
B. The three maternal requests for epidurals were highly correlated
to unfavourable fetal positioning (ie. Posterior presentation).
The other five epidurals were for caesarians (3) and forceps (2).
C. Breech presentation (n=1) at term; fetal distress/prolonged
labour/posterior (n=1); fetal distress and poor descent in second
stage (n=1).
D. Fetal distress (n=2); poor descent (n=1).
E. Three of the eight had no additional interventions; five of
the eight had epidurals (3), forceps (2) and nubaine (1). An additional
four were midwifery clients who induced at home using either homeopathy
or castor oil (9%). No additional interventions were noted with
this
group.
As a result of the Hypnosis for Childbirth series a very high percentage
of women reported an increased sense of self-confidence prior to
the onset of labour. In addition, 96% were pleased at the use of
hypnosis, would use hypnosis in a subsequent birth and recommend
its use to other women planning natural childbirth.
|
|
