HYPNOSIS AND CHILDBIRTH
Hypnosis, pregnancy and preparation to childbirth. An integrative technique to take care of both mother and child.
Even if childbirth is among the most significant events in a woman’s life, the idea of the pain that comes with it, which is often described as the most extreme pain ever experienced1, may greatly scare future mothers. Even if modern remedies are effective in reducing discomfort, using them may lead to side effects that may increase the length of the procedure or may even, in some cases, hurt the newborn. Modern research, for example, reports that epidurals may interfere with the ability of the mother to push forcefully2, may cause hypotension and thus may increase the risk of motor blocks and instrumental delivery3. Even though narcotics are effective to control pain, its use may cause in the newborn a condition called “neurobehavioral depression” (characterized by poor muscle tone, decreased alertness and attention and respiratory problems) that can last for several days4,5. For these kinds of reasons, researchers focused on finding methods that can reduce delivery pain along with protecting both mother and child. Because of the efficacy of hypnosis in reducing other kinds of pain6, it was natural to test its effects in this area too. A study conducted in 20077 reports that women trained in self-hypnosis felt less pain compared to those in a control group. Pain reduction was so remarkable that allowed the administration of lower doses of sedatives and analgesics along with reducing of the times in which epidurals were needed. The positive effects of the intervention were also evident in the newborns, who showed higher 1-minute APGAR scores (an index of the newborn’s health that is commonly registered in delivery rooms) compared to newborns of mothers of a control group. Similar results were also obtained by a team of Australian researchers who, along with what already described, noticed that, after four hypnosis sessions that were carried out around the 35th week of pregnancy, the need of labor augmentation with oxytocics decreased8. To make the experience of birth as fluid as possible, the ability of hypnosis to reduce the time of labor was tested9. This study also comprised two groups of subjects: women prepared to delivery with 6 self-hypnosis training sessions, and women who received standard medical care. Results demonstrate that the first group, along with effects similar to those described above, obtained a reduction of the duration of the first and second phase of labor, which are commonly described as the most painful10. Furthermore it was interesting that the differences between the self-hypnosis group and the control group were bigger in primigravid women. We can therefore state that, compared to standard medical care, preparation to childbirth with hypnosis allows future mothers to alleviate pain, to use epidurals less frequently, to receive lower doses of analgesics and to reduce the duration of labor. These factors have positive effects on the health of the newborn too but what are the results if hypnosis, instead of being compared to a control group, is compared to other kinds of preparation to childbirth? A study conducted in 200411 compared women prepared to childbirth with hypnosis to others who attended to supportive counseling groups. Results, confirming what was already reported by previous literature12, show that the benefits obtained by the first group were numerous: a reduction of caesarean sections, of labor augmentation with oxytocics and epidurals, along with a reduction of the doses of administered analgesics and of the frequency of complicated deliveries. Similar researches were carried out evaluating the effects of the integration of hypnosis with childbirth education classes, which aim to provide strategies to cope with emotional stress and pain, and general information about childbirth. These courses often teach relaxation and breathing techniques along with explaining what positions to assume in order to facilitate the first phase of labor13. Women who attend to these courses usually report greater benefits than those who follow standard medical care14. A studyibid. demonstrates that the integration of hypnosis in such kind of courses, along with abbreviating the first phase of labor and with reducing the doses of pharmaceuticals administered during the procedure, has a greater positive effect of the newborn’s APGAR score. In summary we can state that hypnosis constitutes an effective integration to traditional analgesic remedies. Its effect on pain, along with the reduction of the length of labor, makes the experience of childbirth more confortable for both the mother and the newborn.
Bibliografia
Bibliografia
1. | Niven C, Murphy-Black T. Memory for labor pain: A review of the literature. Birth: issues in perinatal care. 2000;27:244-253 |
2. | Littleton, L. Y., & Engebretson, J. (2004) Maternity nursing care (1° ed.). Albany, NY: Delmar. |
3. | Anim-Somuah, M., Smyth, R. M. D., & Howell, C. J. (2005). Epidural versus non-epidural or no analgesia in labour. Cochrane Database of Systematic Reviews, 4, 1-81. |
4. | Pillitteri, A. (2009). Maternal and child health nursing: Care of the childbearing and childrearing family (6° ed.). Baltimora, MD: Lippincott William & Wilkins. |
5. | Simpson, K. R., & Creehan, P. A. (2008). AWHONN’s perinatal nursing (3° ed.). Philadelphia, PA: Lippincott Williams & Wilkins. |
6. | Patterson, D., & Jensen, M. (2003). Hypnosis and clinical pain. Psychological bullettin, 129, 495-521. |
7. | VandeVusse, L., Irland, J., Berner, M., Fuller, S., & Adams, D. (2007). Hypnosis for childbirth: A retrospective comparative analysis of outcomes in one obstetrician’s practice. American Journal of Clinical Hypnosis, 50, 109-119. |
8. | Cyna, A. M., Andrew, M. I., McAuliffe, G. L. (2006). Antenatal self-hypnosis for labor and childbirth: a pilot study. Anesthesia Intensive Care, 34, 464-469. |
9. | Jenkins, M. W., & Pritchard, M. H. (1993). Hypnosis: practical applications and theoretical considerations in normal labour. British journal of obstetrics and gynecology, 100, 221-226. |
10. | Landolt, A. S., Milling, L. S. (2011). The efficacy of hypnosis as an intervention for labor and delivery pain: A comprehensive methodological review. Clinical psychology review, 31, 1022-1031. |
11. | Mehl-Madrona, L. (2004). Hypnosis to facilitate uncomplicated birth. American journal of clinical hypnosis, 46, 299-312. |
12. | Letts, P. J., Baker, P. R. A., Ruderman, J., & Kennedy, K. (1993). The use of hypnosis in labor and delivery: A preliminary study. Journal of women’s health, 2, 335-341. |
13. | Spiby, H. Slade, P., Escott, D., Henderson, B. & Fraser, , R. (2003). Selected coping strategies in labor: An investigation of women’s experiences. Birth: Issues in perinatal care, 30, 189-194. |
14. | Harmon, T., Hynan, M., & Tyre, T. (1990). Improved obstetric outcomes using hypnotic analgesia and skill mastery combined with childbirth education. Journal of Consulting and Clinical Psychology, 58, 525-530. |