Hypnosis for pain management during childbirth : a meta-analysis

The objective of this study was to examine the effects of hypnosis for pain management during childbirth. Randomised controlled trials and quasi-randomised controlled trials comparing preparation for labour using hypnosis and/or use of hypnosis during labour, with placebo, no treatment or any analgesic drug or technique were eligible to be included in the analysis. Participants in the studies were pregnant women. A random effects model was used to analyse the data due to the high level of statistical heterogeneity between the trials. Seven trials randomising a total of 1213 women were included in the analysis. All but one of these trials were assessed to be at moderate to high risk of bias. One trial was assessed as being at low risk of bias across all domains. The results indicated that hypnosis did not have a significant effect on the use of pharmacological analgesia, including epidural, on mode of birth or on satisfaction with pain relief. There was a trend towards women in the hypnosis group being less likely to use pharmacological pain relief or analgesia than those in the control group, although the result did not reach statistical significance (p = 0.06, average risk ratio (RR) 0.63, 95% confidence interval (CI) 0.39, 1.01, 6 studies, 1032 women). However, there was statistically significant heterogeneity. Overall, there are still only a small number of studies assessing the use of hypnosis for labour and childbirth. Although the intervention shows some promise, further research is needed before recommendations can be made regarding its clinical usefulness for pain management in maternity care.