Meta-Analysis Shows Hypnosis Appears Promising at Improving Pain Scores for Women in Labor

The primary outcome measures involved the labor analgesia requirements (no analgesia, opiate, or epidural use), and pain scores during labor. Meta-analyses were performed on the randomized controlled trials (RCTs), assessed as being of "good" or "adequate" quality by a predefined score.

Investigators identified five randomized, controlled trials and 14 non-randomized comparisons (NRCs) totalling 8395 women 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 laboring women using hypnosis required analgesia, relative risk=0.51 (95% confidence interval 0.28, 0.95). Of the two included NRCs, one showed that women using hypnosis rated their labor pain less severe than 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 labor (P<0.001).

The report concludes that the 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 labor and childbirth: a systematic review. British Journal of Anaesthesia. 2004 Oct; 93 (4): pages 505-11. Epub 2004 Jul 26. Australia.cynaa@wch.sa.gov.au