Hypnosis for Pain in Childbirth: A Cochrane Systematic Review

Objectives To examine the effects of hypnosis for pain management during labour and childbirth. Methods The Cochrane Pregnancy and Childbirth Group’s Trials Register and reference lists of primary studies and review articles were searched to 11th January 2012. Inclusion criteria were Randomised controlled trials (RCTs) and quasi-RCTs comparing preparation for labour using hypnosis and/or use of hypnosis during labour, with placebo, no treatment or any analgesic drug or technique. Two assessors independently extracted data and assessed trial quality. Results We included seven trials randomising a total of 1213 women. All but one trial involved antenatal preparation for labour using hypnosis: five trials investigated training in self-hypnosis; one trial provided antenatal hypnotherapy and one trial provided hypnotherapy during labour. No significant differences between the hypnosis and control conditions were found in primary outcomes: use of pharamacological pain relief (average risk ratio (RR) 0.63, 95% confidence interval (CI) 0.39 to 1.01, 6 studies, 1032 women); spontaneous vaginal birth (average RR 1.35, 95% CI 0.93 to 1.96, 4 studies, 472 women); or satisfaction with pain relief (RR 1.06, 95% CI 0.94 to 1.20, 1 study, 264 women). Only one trial was assessed as being at low risk of bias across all domains. Conclusions There are still only a small number of studies, largely of high risk of bias, assessing the use of hypnosis for labour and childbirth. Although the intervention shows some promise, further high quality research is needed before recommendations can be made regarding its clinical usefulness for pain management in childbirth.