Effectiveness of hypnosis for pain relief during childbirth

Medline, Embase, Pubmed, and the Cochrane library 2004.1 were searched for clinical trials where hypnosis during pregnancy and childbirth was compared with a non-hypnosis intervention, no treatment or a placebo. Primary outcome measures were labor analgesia requirements (no analgesia, opiate, or epidural use), and pain scores in labor. Meta-analyses were performed of the included randomized controlled trials (RCTs), assessed as being of "good" or "adequate" quality by a predefined score.

Five RCTs and 14 non-randomized comparisons (NRCs) studying 8395 women were identified where hypnosis was used for labor analgesia. Four RCTs including 224 patients examined the primary outcomes of interest. One RCT rated poor on quality assessment.

Meta-analyses of the three remaining RCTs showed that, compared with controls, fewer women in labor who used hypnosis required analgesia. Of the two included NRCs, one showed that women using hypnosis rated their labour pain less severe than the controls (P<0.01). The other showed that hypnosis reduced opioid (meperidine) requirements (P<0.001), and increased the incidence of not requiring pharmacological analgesia in labour (P<0.001).

This study concludes that the promising risk/benefit profile of hypnosis demonstrates a need for well-designed trials to confirm the effects of hypnosis in childbirth.

Citation: Cyna AM, McAuliffe GL, Andrew MI. Hypnosis for pain relief in labour and childbirth: a systematic review. British Journal of Anaesthesia. 2004 Oct; 93 (4): pages 505-11. Epub 2004 Jul 26. cynaa@wch.sa.gov.au