11 May 2015
Spending less than £5 per pregnant woman on self-hypnosis for labour makes little difference to pain but reduces anxiety and fear about birth, study finds
A three-year NIHR (National Institute for Health Research) funded study into the effectiveness of self-hypnosis during childbirth has found that, while the therapy only made a minor difference to the number of women requesting pain relief during labour, it did have a significant impact on the women’s levels of postnatal anxiety and fear about childbirth.
Self-hypnosis came under the spotlight in 2013 when it was reported that the Duchess of Cambridge was allegedly considering the use of hypnobirthing to ease pain during childbirth. With the arrival of another Royal baby last week the study findings are certainly timely.
Published today in the British Journal of Obstetrics and Gynaecology, the trial, led by international childbirth expert Professor Soo Downe from the University of Central Lancashire (UCLan) and sponsored by East Lancashire Hospitals NHS Trust, involved 680 first-time mums from three hospitals in the North West. It was the largest randomised controlled trial on self-hypnosis for labour undertaken in the UK to date, and the second largest in the world.
"Adding prenatal self-hypnosis training to usual care in a UK setting does not seem to affect rates of epidural pain relief. However, the results do suggest that the therapy might reduce postnatal anxiety and fear about childbirth."
The findings show that of the women who were randomised to self-hypnosis during pregnancy, 27.9% requested an epidural in comparison to 30.3% of the women in the control group. When asked two weeks after birth, women in the self-hypnosis group had a greater reduction in anxiety and fear about childbirth than women in the usual care group. Interviews were also done with some of the women and birth companions in the hypnosis group.
The participants in the hypnosis group were invited to two 90 minute group self-hypnosis sessions at 32 and 35 weeks of pregnancy, as well as having a CD to listen to daily. They, and their birth companions, were sent questionnaires at two and six weeks after giving birth. Both the hypnosis and the usual care groups received the usual NHS care, including antenatal clinic attendances and screenings. On average, the two sessions and the CD cost £4.83 per woman.
Professor Downe commented: “Adding prenatal self-hypnosis training to usual care in a UK setting does not seem to affect rates of epidural pain relief. However, the results do suggest that the therapy might reduce postnatal anxiety and fear about childbirth, which would suggest there may be benefits for their next pregnancy. All those who agreed to be interviewed found the hypnosis helpful, both in labour and in other areas of their lives. The main issue they reported was that (even though overall there was little difference in use of pain medication) some women appeared to be so relaxed that maternity care staff did not realise they were in labour, and sent them home.”
"I would highly recommend this technique to women as I had big babies and with the help of the hypnobirthing was relaxed and in control. I used gas and air with one labour and nothing with my second.”
One of the participants, who has since gone onto have another baby and practised self-hypnosis during both pregnancies, commented: “Hypnotherapy is something that I had never considered before. I have an anxious personality and friends had suggested that it might be something that I could try, particularly during labour. The hypnobirthing script provided during the trial was easy to listen to and during the latter stage of my pregnancy I practiced it twice a day. I think that this was the key to it being successful during my labours. I would highly recommend this technique to women as I had big babies and with the help of the hypnobirthing was relaxed and in control. I used gas and air with one labour and nothing with my second.”
Maria Williamson, a Midwife at East Lancashire Hospitals NHS Trust who took part in the study, said: “Women and their families engaged so well with the sessions, you could see their confidence grow. Their ability to remain calm and relaxed enabled them to have a positive birth experience. For me as a midwife, to see a family begin is a privilege but to experience women and their birth companions leaving the sessions not terrified about giving birth, but actually feeling excited about meeting their babies, was truly amazing.”
Professor Downe added: “The results suggest that self-hypnosis poses no danger to participants, and that two group sessions in pregnancy along with a CD is very inexpensive. However, if self-hypnosis is offered to women, maternity care staff will need to be made aware of how relaxed some women can appear when they are using self-hypnosis, even if they are actually in strong labour.”
All of the women that took part were aged between early-20s and mid-30s. Most were White British and some were of South Asian origin. All had never given birth before and none were receiving treatment for high blood pressure or psychiatric illnesses.
The study, entitled Self-Hypnosis for Intrapartum Pain management (SHIP) in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness, involved researchers from UCLan, University of Manchester, University of Nottingham, University of Liverpool, University of York, and Lancaster University alongside East Lancashire Hospitals NHS Trust, the Liverpool Women’s Hospital and Royal Preston Hospital.