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Childbirth

There's an enormous amount of research into hypnotherapy and issues surrounding childbirth. Many papers are based around reducing fears and anxieties, around relaxation, which is both beneficial for the unborn baby, and an easier birth.

 

Irland, Jacqueline M. (2010). Childbirth. In Barabasz, Arreed Franz 
(Ed); Olness, Karen (Ed); Boland, Robert (Ed); Kahn, Stephen (Ed), 
Medical Hypnosis Primer: Clinical and Research Evidence, (pp. 59-
64). New York, NY: Routledge/Taylor & Francis Group. 

Childbirth is one of the most profound events a woman and couple will experience. 
Unfortunately, the experience can be fraught with anxiety, as well as fear of pain 
and loss of control. Often during childbirth, a woman engages a fight-or-flight 
response, which increases her perception of pain intensity and decreases internal 
blood flow. Armed with the ability to use self-hypnotic techniques, women and 
their partners can effectively enter the childbirth experience with calm and focus. 
Following an introduction to self-hypnosis for childbirth, this chapter discusses 
childbirth as an adventure; the childbirth partner; pain management; variations in 
sensory preferences; hypnosis for operative childbirth; and working with varying 
cultures and religious beliefs. 


Reinhard, Joscha; Huesken-Janßen, Helga; Hatzmann, Hendrike; 
Schiermeier, Sven. (Dec 2009). Preterm Labour and Clinical 
Hypnosis. Contemporary Hypnosis, Vol 26(4), 187-193. 

Hypnosis may play an important role in reducing preterm labour for patients who 
have higher levels of psychosocial stress. This study examines the rate of late-preterm birth in a hypnosis group (directed to all women) and a historical control 
group. From July 2007 all women (n = 64), who were in their 28th to 34th weeks’ 
gestation, were offered self-hypnosis training using the hypno-reflexogenous 
protocol after Hüsken-Janßen and Schauble. Expectant mothers with uncertain 
anticipated days of delivery were excluded. All women who delivered after 31 
weeks’ gestation served as a control group (n = 2135) from January 2006 till June 
2007. 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%) (p = 0.01). Average cigarette usage during the current pregnancy was lower 
in the hypnosis group (p = 0.02). Higher work-educated employments (p = 0.01), 
higher age of the mother (p < 0.001) and fewer previous pregnancies (p < 0.03) 
were found in the hypnosis group. Preterm birth correlated with the number of 
previous pregnancies (-0.38; p < 0.001) but not with smoking. Hypnosis was shown 
to be effective therapy without side-effects, which can reduce preterm delivery. 
This clinical study showed a significant prevention of preterm delivery. Prospective 
randomized controlled studies are required to evaluate fully the preventive value of 
clinical hypnosis. 


Abbasi, Marzieh; Ghazi, Fery; Barlow-Harrison, Ann; Sheikhvatan, 
Mehrdad; Mohammadyari, Fatemeh. (Apr 2009). The Effect of 
Hypnosis on Pain Relief during Labour and Childbirth in Iranian 
Pregnant Women. International Journal of Clinical and Experimental 
Hypnosis, Vol 57(2), 174-183. 

This study describes the effect of hypnosis on pain relief during labour and 
childbirth. Using a qualitative approach, 6 pregnant women were trained to use self-hypnosis for labour. Outcomes were analysed using Colaizzi’s procedure. Women 
described their feelings about hypnosis during labour as: a sense of relief and 
consolation, self-confidence, satisfaction, lack of suffering labour pain, changing the 
feeling of pain into one of pressure, a decrease in fear of natural childbirth, lack of 
tiredness, and lack of anxiety. They expressed increased concentration on the uterus 
and cervical muscle, awareness of all the stages of labour, and having “positive 
thoughts.” Births were perceived as being very satisfactory compared to their 
previous experiences. 


Brown, Donald C. (2009). Evidence-Based Efficacious Hypnosis for 
Obstetrics, Labour and Delivery, and Preterm Labour. In Brown, 
Donald C. (Ed). Advances in the Use of Hypnosis for Medicine, 
Dentistry and Pain Prevention/Management, (pp. 195-226). Norwalk, 
CT: Crown House Publishing Limited. 

The most important five minutes of our lives is the first five minutes after birth. 
How quickly we adapt to extrauterine life often determines how quick we are the 
rest of our lives. We are missing a tremendous opportunity by not making hypnosis 
available to all our obstetric patients. They and their new-born infants have so much 
to gain, so little to lose (Bobart & Brown, 2002). The use of hypnotic techniques in 
obstetrics to control pain goes back more than a century (Werner, Schauble, & 
Knudson, 1982). The key aspect of the use of hypnotherapy in the birth process is 
the involvement of the patient before the labour process begins, so that she can assist the physician in the labour and delivery (Oster, 1994). 


VandeVusse, Leona; Irland, Jacqueline; Berner, Margaret A.; Fuller, 
Shauna; Adams, Debra. (Oct 2007). Hypnosis for Childbirth: A 
Retrospective Comparative Analysis of Outcomes in One 
Obstetrician’s Practice. American Journal of Clinical Hypnosis, Vol 
50(2), 109-119. 

This exploratory, descriptive study, done retrospectively from perinatal medical 
records, compared childbirth outcomes in one obstetrician’s caseload between 50 
women who elected ante-partum hypnosis preparation (usually a 5-class series) and 
51 who did not. The groups were demographically similar. Prenatal hypnosis 
preparation resulted in significantly less use of sedatives, analgesia, and regional 
anaesthesia during labour and in higher 1-minute neonatal Apgar scores. Other 
physiologic and outcome measures did not reveal statistical significance, although 
some trends were of clinical interest. Additional information provided includes 
pragmatic, clinical, and cost information about incorporating hypnosis into a 
physician’s practice. 


Brown, Donald Corey; Hammond, D. Corydon. (Jul 2007). Evidence-Based Clinical Hypnosis for Obstetrics, Labour and Delivery, and 
Preterm Labour. International Journal of Clinical and Experimental 
Hypnosis, Vol 55(3), 355-371. 

This paper reviews the benefits and effectiveness of hypnosis in obstetrics and labour and delivery, demonstrating significant reductions in the use of analgesics and anaesthesia and in shorter Stages 1 and 2 labours. It presents empirical and theoretical rationales for use of hypnosis in preterm labour (PTL) and labour and delivery at term. The benefits of hypnosis in relation to labour length, pain levels, and the enjoyment of labour, as well as its effectiveness in preterm labour are noted in randomized controlled trials and in a meta-analysis. Risk factors are reported for preterm delivery; hypnosis significantly prolongs pregnancy. Six cases are presented of hypnosis stopping PTL a number of times and when indicated at term. A case report of successful use of hypnosis in quadruplets is presented with some scripts. 


German, Ester. (Nov 2004). Hypnotic Preparation of a Mother-to-Be. Australian Journal of Clinical & Experimental Hypnosis, Vol 
32(2), 157-169. 

This paper outlines the hypnotic preparation of a mother-to-be, Poppy, who 
presented for anxiety management of panic attacks of moderate severity. These 
panic attacks predated the pregnancy and related to a fear of no escape and lack of 
mobility. A recent panic attack when the client was having fetal monitoring initiated 
the referral from her obstetrician. Initially, Poppy requested assistance to deal with 
the panic attacks in general. Later on, the focus of treatment changed when the she 
and her husband in consultation with the obstetrician decided to change delivery 
plans and attempted a natural delivery instead of an elective caesarian. Poppy 
requested assistance to have a “panic-free delivery.” The therapeutic interventions 
combined general psycho-education about anxiety, learning about hypnosis, and 
self-hypnosis on agreed cues and environmental manipulation to ensure an optimum 
delivery environment. 


Mehl-Madrona, Lewis E. (Apr 2004). Hypnosis to Facilitate 
Uncomplicated Birth. American Journal of Clinical Hypnosis, Vol 
46(4), 299-312. 

Prior research by the author showed that psychosocial factors distinguished 
complicated from uncomplicated birth outcome. The purpose of this study was to 
determine if prenatal hypnosis could facilitate uncomplicated birth. Following a 
psychosocial assessment, 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 labour process 
(addressing them whenever possible); and to prepare women for the experience of 
labor. 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 a complicated birth outcome. 
The routine prenatal use of hypnosis could improve obstetric outcome. 


Kandyba, Kristina; Binik, Yitzchak M. (May-Jun 2003). 
Hypnotherapy as a Treatment for Vulvar Vestibulitis Syndrome: A 
Case Report. Journal of Sex & Marital Therapy, Vol 29(3), 237-242. 

The effectiveness of hypnotherapy in alleviating pain has been demonstrated with 
several disorders and diseases involving acute and chronic pain. Although hypnosis 
has been suggested as treatment for dyspareunia resulting from vulvar vestibulitis 
syndrome (VVS), empirical data and case reports showing its effectiveness have 
been lacking. This article presents a case report on the use of hypnotherapy to treat 
a 26-year-old woman suffering from VVS. Psychotherapy consisted of twelve 
sessions, of which eight were devoted to hypnosis. The goal of hypnosis was to help 
the client decrease her anticipatory anxiety, create a positive association of pleasure 
with intercourse, and create a sense of control over her pain. Despite having 
persistent pain during intercourse for 3 years with several partners, she experienced 
no more pain following treatment, and remained pain free at a 12-month follow up. 


Jackson, Peter. (Mar 2003). Hypnosis for Birthing -- A Natural 
Option: Part 1. Australian Journal of Clinical Hypnotherapy and 
Hypnosis, Vol 24(1), 45-52. 

The author explores a contemporary view of hypnosis as communication using first 
hand experiences with hypnosis clients as examples. The author argues that 
486 Journal of Heart-Centred Therapies, 2010, Vol. 13, No. 1 
hypnosis for childbirth is a natural way to assist mothers and couples as they 
prepare for the birth of their child. This natural tool has the potential to allay fear 
and anxiety while building confidence in the mother’s belief that birth is a natural 
process. 


Ketterhagen, Debra; VandeVusse, Leona; Berner, Margaret Ann. (Nov-Dec 2002).

Self-Hypnosis: Alternative Anaesthesia for Childbirth. 
MCN: The American Journal of Maternal/Child Nursing, Vol 27(6), 
335-341. 

The purpose of this article is to inform nurses about the use of self-hypnosis in 
childbirth. When used for childbirth pain, the primary aim of self-hypnosis is to 
help the woman maintain control by managing anxiety and discomfort though 
inducing a focused state of relaxation. Before the widespread use of 
pharmaceuticals for pain, hypnosis was one of the few pain relief methods available 
for labour. However, as new technologies for pain relief emerged, hypnosis received 
less attention. Most nurses have little experience with hypnosis, and there is limited 
information available in the literature. However, because nurses are at labouring 
women’s bedsides, it is important that nurses learn about self-hypnosis to be able to 
inform pregnant women fully about all pain control options and to maximize the 
benefits for the woman choosing hypnosis. 


McCarthy, Patrick. (May 1998). Hypnosis in Obstetrics. Australian 
Journal of Clinical & Experimental Hypnosis, Vol 26(1), 35-42. 

Clinicians trained in hypnosis often state that hypnosis is beneficial in childbirth, 
but few have actual personal experience of teaching hypnotic methods to pregnant 
women. This paper reviews some recent literature confirming the value of hypnosis 
in childbirth and also outlines a simple structured hypnotic approach for clinicians 
to utilise which can be taught in just two and a half hours during the third trimester. 
Labour length, analgesic requirement, and anxiety are decreased; satisfaction with 
labour and spontaneous deliveries are increased; and there may be a reduction in the incidence of post-natal depression. 


Schauble, Paul G.; Werner, William E. F.; Rai, Surekha H.; Martin, 
Alice (1998). Childbirth Preparation through Hypnosis: The 
Hypno-reflexogenous Protocol. American Journal of Clinical 
Hypnosis, 40 (4), 273-283. 

A verbatim protocol for the “hypno-reflexogenous” method of preparation for 
childbirth is presented wherein the patient is taught to enter a hypnotic state and 
then prepared for labour and delivery. The method provides a “conditioned reflex” 
effect conducive to a positive outcome for labour and delivery by enhancing the 
patient’s sense of readiness and control. Previous applications of the method 
demonstrate patients have fewer complications, higher frequency of normal and 
Hartman: Literature Review for Hypnosis and Hypnotherapy 87
full-term deliveries, and more positive postpartum adjustment. The benefit and 
ultimate cost effectiveness of the method are discussed. 
Dreher, H. (Sum 1996). Can Hypnosis Rotate a Breech Baby Before 
Birth? Advances, Vol 12(3), 46-50. 
Discusses a study by L. E. Mehl (1994) on the use of hypnotherapy to convert 
breech birth presentations to the normal vertex position. Mehl hypothesized that 
muscular contractions of the lower uterus, perhaps caused by stress and/or 
emotional conflicts, could prevent the natural downward movement of the baby’s 
head and thus, if the lower uterus could be relaxed by hypnosis, the baby’s position 
would spontaneously shift to headfirst. 100 women with breech presentation at 37 
to 40 weeks received hypnotherapy from Mehl. A spontaneous movement into the 
vertex position or a successful external cephalic version were considered successful 
conversions. 81% of subjects receiving hypnotherapy successfully converted as compared to 48% of matched controls. Possible mechanisms governing the effect and implications for the use of hypnosis in the prevention of other birth complications are discussed. 


Mehl, L. E. (1994). Hypnosis and Conversion of the Breech to the 
Vertex Presentation. Archives of Family Medicine, Vol. 3, 881-7. 

OBJECTIVE: To evaluate the effectiveness of hypnosis to convert a breech 
presentation to a vertex presentation. DESIGN: Prospective case series compared 
with historical, matched comparison group. SUBJECTS: One hundred pregnant 
women whose fetuses were in breech position at 37 to 40 weeks’ gestation and a 
matched comparison group of women with similar obstetrical and 
sociodemographic parameters derived from databases for other studies from the 
same time period and geographical areas. INTERVENTION: The intervention 
group received hypnosis with suggestions for general relaxation with release of fear 
and anxiety. While in the hypnotic state women were asked for the reasons why 
their baby was in the breech presentation. As much hypnosis was provided as was 
convenient and possible for the women until they were delivered of the baby or the 
baby converted to the vertex position. MAIN OUTCOME VARIABLES: A 
successful conversion for the intervention group was scored when the baby 
spontaneously converted to the vertex position before delivery or successful 
external cephalic version. The conversion rate of the intervention group was 
compared with the comparison group who received standard obstetrical care 
without the opportunity for hypnosis. DATA ANALYSIS: Parametric testing of 
statistically significant differences in the rate of conversion between the two groups. 
RESULTS: Eighty-one percent of the fetuses in the intervention group converted to 
vertex presentation compared with 48% of those in the comparison group. This 
difference was statistically significant. CONCLUSIONS: Motivated subjects can be 
influenced by a skilled hypnotherapist in such a manner that their fetuses have a 
higher incidence of conversion from breech to vertex presentation. 
Psychophysiological factors may influence the breech presentation and may explain 
this increased frequency of conversion to vertex presentation. 


Oster, M. I. (1994). Psychological Preparation for Labour and 
Delivery Using Hypnosis. American Journal of Clinical Hypnosis, 
Vol. 37, 12-21. 

Hypnotic preparation for labour and delivery is enjoying renewed interest. This 
interest lies in the mother’s psychological comfort and sense of involvement in the 
birth process. In this paper I present a model of psychological preparation, 
illustrated with case examples, that appears to be superior to Lamaze. This model 
488 Journal of Heart-Centred Therapies, 2010, Vol. 13, No. 1 
offers the mother a sense of involvement in the process, control, awareness, and a 
level of anxiety relief and pain management superior to that provided by Lamaze. 
This method requires no more time than does Lamaze and uses the following 
elements: (1) a unique opportunity for the mother to participate in tailoring the 
protocol to address her needs along with the husband or coach participating in the 
training; (2) utilization of a parts model for the hypnotic induction, deepening, and 
imagery; (3) incorporation of hypnotic rehearsal, dissociation, time distortion, and 
cognitive reframing; and (4) continued application of the hypnotic procedure after 
delivery and into the recovery period. Following the delivery, for which they had 
been specifically prepared, subjects reported they were also able to use their 
hypnosis skills in other situations, medical or dental, as needed. 


Smith, Barbara J. (1990). Hypnosis in Obstetrics and Gynaecology. In 
Zahourek, Rothlyn P. (Ed). Clinical Hypnosis and Therapeutic 
Suggestion in Patient Care, (pp. 115-126). Philadelphia, PA: 
Brunner/Mazel. 

explores the use of hypnotic techniques with gynaecological and obstetrical patients 
the primary techniques and theoretical frameworks are explained, followed by case 
examples with a problematic obstetrical patient, and antenatal group, two cases of 
hyperemesis, gravidarum, and a patient fearful of inserting a vaginal applicator 
Kroger’s method, which is primarily used, and the process, problems, and issues are 
explored while the case examples focus on pathological situations, these techniques 
are also useful in normal obstetrical and gynaecological situations 


Harmon, T. M, Hynan, M. T., Tyre, T. E. (Oct 1990). Improved 
Obstetric Outcomes Using Hypnotic Analgesia and Skill Mastery 
Combined with Childbirth Education. Journal of Consulting & 
Clinical Psychology, Vol 58(5), 525-530. 

The benefits of hypnotic analgesia as an adjunct to childbirth education were 
studied in 60 nulliparous women. Subjects were divided into high and low hypnotic 
susceptibility groups before receiving 6 sessions of childbirth education and skill 
mastery using an ischemic pain task. Half of the subjects in each group received a 
hypnotic induction at the beginning of each session; the remaining control subjects 
received relaxation and breathing exercises typically used in childbirth education. 
Both hypnotic subjects and highly susceptible subjects reported reduced pain. Hypnotically 
prepared births had shorter Stage 1 labours, less medication, higher Apgar scores, 
and more frequent spontaneous deliveries than control Ss’ births. Highly 
susceptible, hypnotically treated women had lower depression scores after birth 
than women in the other 3 groups. We propose that repeated skill mastery 
facilitated the effectiveness of hypnosis in our study.


Mehl, Lewis E. (Fal 1988). Psycho-biosocial Intervention in 
Threatened Premature Labour. Journal of Prenatal & Perinatal 
Psychology & Health, Vol 3(1), 41-52. 

Investigated whether psycho-biosocial intervention could be a useful adjunct to 
medical management of 44 women threatening premature delivery (20–34 wks 
gestation). Interventions included hypnosis and body awareness techniques 
designed to decrease autonomic reactivity and muscle tension. Findings indicate 
Hartman: Literature Review for Hypnosis and Hypnotherapy 89
that 40 of 44 subjects progressed to term. Three subjects went into premature labour and 1 subject who did not progress to term had received only 1 session of hypnosis. Common concerns expressed by subjects during hypnosis included (1) lack of social support; (2) high levels of internal stress (fear and anxiety); (3) high external stress, low body awareness, and high neuromuscular reactivity; and (4) negative beliefs about birth. 


Omer, H., Friedlander, D., Palti, Z. (May-Jun 1986). Hypnotic 
Relaxation in the Treatment of Premature Labour. Psychosomatic 
Medicine, Vol 48(5), 351-361. 

Evaluated the potential utility of hypnotic relaxation (HR) as an adjunct to 
pharmacologic treatment with 39 women (mean age 27.48 yrs) hospitalized for 
premature contractions in pregnancy. The control group received medication alone 
and consisted of 70 women (mean age 27.62 yrs). Treatment was started at the time 
of hospitalization and lasted for 3 hrs on the average. Experimental subjects were also given cassettes with an HR exercise for daily practice. The rate of pregnancy 
prolongation was significantly higher for the HR than for the medication-alone 
group. Infant weight also showed the advantage of the HR treatment. Background 
variables of the 2 groups were compared, and it was shown that they could not have 
explained the treatment effect obtained.

 

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