Hypnosis Antenatal Training for Childbirth (HATCh): a randomised controlled trial [NCT00282204]

Allan M Cyna, Marion I Andrew, Jeffrey S Robinson, Caroline A Crowther, Peter Baghurst, Deborah Turnbull, Graham Wicks, Celia Whittle, Allan M Cyna, Marion I Andrew, Jeffrey S Robinson, Caroline A Crowther, Peter Baghurst, Deborah Turnbull, Graham Wicks, Celia Whittle

Abstract

Background: Although medical interventions play an important role in preserving lives and maternal comfort they have become increasingly routine in normal childbirth. This may increase the risk of associated complications and a less satisfactory birth experience. Antenatal hypnosis is associated with a reduced need for pharmacological interventions during childbirth. This trial seeks to determine the efficacy or otherwise of antenatal group hypnosis preparation for childbirth in late pregnancy.

Methods/design: A single centre, randomised controlled trial using a 3 arm parallel group design in the largest tertiary maternity unit in South Australia. Group 1 participants receive antenatal hypnosis training in preparation for childbirth administered by a qualified hypnotherapist with the use of an audio compact disc on hypnosis for re-enforcement; Group 2 consists of antenatal hypnosis training in preparation for childbirth using an audio compact disc on hypnosis administered by a nurse with no training in hypnotherapy; Group 3 participants continue with their usual preparation for childbirth with no additional intervention. Women > 34 and < 39 weeks gestation, planning a vaginal birth, not in active labour, with a singleton, viable fetus of vertex presentation, are eligible to participate. Allocation concealment is achieved using telephone randomisation. Participants assigned to hypnosis groups commence hypnosis training as near as possible to 37 weeks gestation. Treatment allocations are concealed from treating obstetricians, anaesthetists, midwives and those personnel collecting and analysing data. Our sample size of 135 women/group gives the study 80% power to detect a clinically relevant fall of 20% in the number of women requiring pharmacological analgesia - the primary endpoint. We estimate that approximately 5-10% of women will deliver prior to receiving their allocated intervention. We plan to recruit 150 women/group and perform sequential interim analyses when 150 and 300 participants have been recruited. All participant data will be analysed, by a researcher blinded to treatment allocation, according to the "Intention to treat" principle with comprehensive pre-planned cost- benefit and subgroup analyses.

Discussion: If effective, hypnosis would be a simple, inexpensive way to improve the childbirth experience, reduce complications associated with pharmacological interventions, yield cost savings in maternity care, and this trial will provide evidence to guide clinical practice.

Figures

Figure 1
Figure 1
Title. HATCh Trial Flow

References

    1. ANZCA working party . The pregnant patient. In: Macintyre P, editor. Acute pain management: Scientific evidence. 2. Melbourne: Australian and New Zealand College of Anaesthetists and the Faculty of Pain Medicine; 2005. pp. 222–237.
    1. Howell CJKC, Roberts W, Upton P, Lucking L, Jones PW, Johanson RB. A randomised controlled trial of epidural compared with non-epidural analgesia in labour. British Journal of Obstetrics and Gynaecology. 2001;108:27–33. doi: 10.1016/S0306-5456(00)00012-7.
    1. Morgan BM, Bulpitt CJ, Clifton P, Lewis PJ. Analgesia and satisfaction in childbirth (the Queen Charlotte's 1000 Mother Survey) Lancet. 1982;2:808–10. doi: 10.1016/S0140-6736(82)92691-5.
    1. Bromage PR. Neurologic Complications of Labor, Delivery, and Regional Anesthesia. In: Chestnut DH, editor. Obstetric anesthesia. St. Louis: Mosby; 1999. pp. 639–61.
    1. Weeks S. Postpartum Headache. In: Chestnut DH, editor. Obstetric anaesthesia. St. Louis: Mosby; 1999. pp. 621–38.
    1. Weir EC. The sharp end of the dural puncture. BMJ. 2000;320:127. doi: 10.1136/bmj.320.7227.127.
    1. Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine Working Party . Acute Pain Management:Scientific Evidence. Melbourne: NHMRC endorsed guidelines; 2005.
    1. Shapiro A, Fredman B, Zohar E. Delivery room analgesia: An analysis of maternal satisfaction. Int J Obstet Anesth. 1998;7:226–30. doi: 10.1016/S0959-289X(98)80043-5.
    1. Johanson R, Newburn M, MacFarlane A. Has the medicalisation of childbirth gone too far? BMJ. 2002;324:892–5. doi: 10.1136/bmj.324.7342.892.
    1. Smith CA, Collins CT, Cyna AM, Crowther CA. Complementary and alternative therapies for pain management in labour. Cochrane Database Syst Rev. 2003:CD003521.
    1. Creedy DK, Shochet IM, Horsfall J. Childbirth and the development of acute trauma symptoms: Incidence contributing factors. Birth Issues in Perinatal Care. 2000;27:104–11.
    1. Cooper PJML. Postnatal depression. BMJ. 1998;316:1884–1886.
    1. Bailham D, Joseph S. Post-traumatic stress following childbirth: a review of the emerging literature and directions for research and practice. Psych Health & Med. 2003;8:159–68. doi: 10.1080/1354850031000087537.
    1. Montgomery GH, David D, Winkel G, Silverstein JH, Bovbjerg DH. The effectiveness of adjunctive hypnosis with surgical patients: a meta-analysis. Anesth Analg. 2002;94:1639–45. doi: 10.1097/00000539-200206000-00052. table of contents.
    1. Montgomery GH, Weltz CR, Seltz M, Bovbjerg DH. Brief presurgery hypnosis reduces distress and pain in excisional breast biopsy patients. Int J Clin Exp Hypn. 2002;50:17–32.
    1. Faymonville ME, Fissette J, Mambourg PH, Roediger L, Joris J, Lamy M. Hypnosis as adjunct therapy in conscious sedation for plastic surgery. Reg Anesth. 1995;20:145–51.
    1. Yapko MD, editor . Hypnosis And The Treatment Of Depression: Strategies For Change. Florence, KY USA: Bruner/Mazel; 1992.
    1. Deltito J, Baer L. Hypnosis in the treatment of depression: research and theory. Psychol Rep. 1986;58:923–9.
    1. Werner WE, Schauble PG, Knudson MS. An argument for the revival of hypnosis in obstetrics. Am J Clin Hypn. 1982;24:149–71.
    1. Erickson JC., 3rd The use of hypnosis in anesthesia: a master class commentary. Int J Clin Exp Hypn. 1994;42:8–12.
    1. McCarthy P. Hypnosis in Obstetrics and Gynecology. In: Thomas C, Fredericks LE, editor. The use of Hypnosis in Surgery and Anesthesiology: Psychological preparation for the patient. Springfield Illinois: WW Norton; 2001. pp. 163–211.
    1. Cyna AM, McAuliffe G, Andrew MI. Hypnosis for pain relief in childbirth: a systematic review. British Journal Of Anaesthesia. 2004;93:505–11. doi: 10.1093/bja/aeh225.
    1. August RV. Obstetrical hypoanesthesia. American Journal of Obstetrics and Gynecology. 1960;79:1131–8.
    1. Bejenke CJ. Obstetrics. In: J B, editor. Hypnosis and suggestion in the treatment of pain: A clinical guide. London: WW Norton; 1996. pp. 250–55.
    1. Mushin WW. Foreward. In: Scott DL, editor. Modern Hospital Hypnosis Especially for Anaesthetists. London: Lloyd-Luke; 1973.
    1. Lucas-Polomeni MM. Hypnosis: a new anesthetic technique! Pediatric Anesthesia. 2004;14:975–6. doi: 10.1111/j.1460-9592.2004.01425.x.
    1. Faymonville ME, Roediger L, Del Fiore G, Delgueldre C, Phillips C, Lamy M, et al. Increased cerebral functional connectivity underlying the antinociceptive effects of hypnosis. Brain Res Cogn Brain Res. 2003;17:255–62. doi: 10.1016/S0926-6410(03)00113-7.
    1. Lang EV, Benotsch EG, Fick LJ, Lutgendorf S, Berbaum ML, Berbaum KS, et al. Adjunctive non-pharmacological analgesia for invasive medical procedures: a randomised trial. Lancet. 2000;355:1486–90. doi: 10.1016/S0140-6736(00)02162-0.
    1. Maquet P, Faymonville ME, Degueldre C, et al. Functional neuroanatomy of hypnotic state. BIOL PSYCHIAT. 1999;45:327–333. doi: 10.1016/S0006-3223(97)00546-5.
    1. Faymonville ME, Laureys S, Degueldre C, DelFiore G, Luxen A, Franck G, et al. Neural mechanisms of antinociceptive effects of hypnosis. Anesthesiology. 2000;92:1257–67. doi: 10.1097/00000542-200005000-00013.
    1. Koyama T, McHaffie JG, Laurienti PJ, RC C. The subjective experience of pain: where expectations become reality. Proc Natl Acad Sci. 2005;102:12950–12955. doi: 10.1073/pnas.0408576102.
    1. Greenleaf E. Defining hypnosis during hypnotherapy. Int J Clin Exp Hypn. 1974;22:120–30.
    1. Gamsa A. Hypnotic Analgesia. In: Melzack R, Wall PD, editor. Handbook of Pain Management. Sydney: Curchill Livingstone; 2003. pp. 521–531.
    1. Yapko MD. Trancework: an introduction to the practice of clinical hypnosis. Florence, KY USA: Bruner/Mazel; 1990.
    1. Bonica JJ. Labour Pain. In: Wall PDMR, editor. Textbook of Pain. Churchill Livingstone; 1984. pp. 377–91.
    1. Tiba J. Clinical, Research and organisational aspects of preparation for childbirth and the psychological diminution of pain during labour and delivery. British Journal of Experimental and Clinical Hypnosis. 1990;7:61–64.
    1. Jenkins MW, Pritchard MH. Hypnosis:Practical applications and theoretical considerations in normal labour. British Journal of Obstetrics and Gynaecology. 1993;100:221–26.
    1. Rock NL, Shipley TE, Campbell C. Hypnosis with untrained nonvolunteer patients in labor. International Journal of Clinical and Experimental Hypnosis. 1969;17:25–36.
    1. Harmon TM, Hynan MT, Tyre TE. Improved obstetric outcomes using hypnotic analgesia and skill mastery combined with childbirth education. J Consult Clin Psychol. 1990;58:525–30. doi: 10.1037/0022-006X.58.5.525.
    1. Martin AA SP, Rai SH, Curry RW. The effects of hypnosis on the labour processes and birth outcomes of pregnant adolescents. Journal of Family Practice. 2001;50:441–443.
    1. Freeman RM, Macaulay AJ, Eve L, Chamberlain GVP. Randomised trial of self hypnosis for analgesia in labour. British Medical Journal. 1986;292:657–8.
    1. Guthrie k, Taylor DJ, Defriend D. Maternal hypnosis induced by husbands. Journal of Obststrics and Gynaecology. 1984;5:93–6.
    1. Huntley AL, Coon JT, E E. Complementary and alternative medicine for labor pain A systematic review. American Journal of Obstetrics and Gynecology. 2004;191:36–44. doi: 10.1016/j.ajog.2003.12.008.
    1. Mehi-Madrona LE. Hypnosis to facilitate uncomplicated birth. Am J Clin Hypn. 2004;46:299–312.
    1. Waxman D. Management of antenatal hypnotic training. In: DC H, editor. Handbook of hypnotic suggestions and metaphors. London: WW Norton; 1990. pp. 279–81.
    1. McCarthy P. Hypnosis in Obstetrics. Australian Journal of Clinical and Experimental Hypnosis. 1998;26:35–42.
    1. Cyna AM, Andrew MI, McAuliffe GL. Antenatal hypnosis for labour analgesia. Int J Obstet Anesth. 2005;14:365–6. doi: 10.1016/j.ijoa.2005.04.008.
    1. Leeb J. A protocol for training individual pregnant patients in self-hypnosis for labour. European Journal of Clinical Hypnosis. 1995;3:5–9.
    1. Fuchs K, Paldi E, Abramovici H, Peretz BA. Treatment of hyperemesis gravidarum by hypnosis. Int J Clin & Exp Hypn. 1980;28:313–23.
    1. Yapko M. Hypnosis in treating symptoms and risk factors of major depression. Am J Clin Hypn. 2001;44:97–108.
    1. Lang EV, Rosen MP. Cost analysis of adjunct hypnosis with sedation during outpatient interventional radiologic procedures. Radiology. 2002;222:375–82.
    1. Faymonville ME, Mambourg PH, Joris J, Vrijens B, Fissette J, Albert A, et al. Psychological approaches during conscious sedation. Hypnosis versus stress reducing strategies: a prospective randomized study. Pain. 1997;73:361–7. doi: 10.1016/S0304-3959(97)00122-X.
    1. Werner WEF, Schauble PG, Knudsen MS. An argument for the revival of hypnosis in obstetrics. Am J Clin Hypn. 1982;24:149–171.
    1. Cyna AM. A post-partum complication of hypnosis for analgesia during labour. Aus J Clin Exp Hypn. 2003;31:185–90.
    1. Hoffman G, Kipenhauer D. Medical hypnosis and its use in Obstetrics. American Journal of Medical Science. 1961;241:788.
    1. BMA Working Party Medical use of hypnotism. BMA Subcommittee to Council, Supplementary report of BMJ, App X. 1955. pp. 190–193.
    1. Nash M. The truth and the hype of hypnosis. Scientific American. 2001:47–53.
    1. Van Der Does AJ, Van Dyck R, Spinhoven P, Kloosman A. The effectiveness of standardized versus individualized hypnotic suggestions: a brief communication. Int J Clin Exp Hypn. 1989;37:1–5.
    1. Begg C CM, Eastwood S, Horton R, Moher D, Olkin I, Pitkin R, Rennie D, Schulz K, Simel D, Stroup D. Improving the quality of reporting of randomized controlled trials: The CONSORT statement. JAMA. 1996;276:637–639. doi: 10.1001/jama.276.8.637.
    1. Spielberger CD. Stait Trait Anxiety Inventory. Redwood, California: Mind Garden, 1690 Woodside Rd Suite 202; 2004.
    1. Cox JL. Detection of postnatal depression scale. British Journal of Psychiatry. 1987;150:782–6.
    1. Barber TX wS. The Barber Suggestibility Scale and the Creative Imagination Scale: Experimental and Clinical Applications. American Journal of Clinical Hypnosis. 1978;21:84–107.
    1. Lumley J. Attempts to prevent postnatal depression. BMJ. 2005;331:5–6. doi: 10.1136/bmj.331.7507.5.
    1. Whitehead J. The design and analysis of sequential clinical trials. 2. Chichester, UK: John Wiley and sons; 1992.
    1. Merskey H, Bogduk N. Classification of Chronic Pain Descriptions of Chronic Pain: Syndromes and Definitions of Pain Terms. 2. Seattle: IASP Press; 1994.
    1. Irving L, Pope S. Is the use of hypnosis during childbirth preparation associated with beneficial obstetric and psychological outcomes? Aus J Clin Exp Hypn. 2002;30:24–34.
    1. Warner R, Appleby L, Whitton A, Faraghen B. Demographic and obstetric risk factors for postnatal psychiatric morbidity. British Journal of Psychiatry. 1996;168:607–611.
    1. Eckert K, Turnbull D, MacLennan A. Immersion in water in the first stage of labor: A Randomised Controlled Trial. Birth. 2001;28:84–93. doi: 10.1046/j.1523-536X.2001.00084.x.
    1. Weitzenhoffer AM. The depth of hypnosis and related measures. In: AM W, editor. The Practice of Hypnotism. New York: John Wiley & Sons Inc; 2000. pp. 250–309.
    1. De L Horne DJ, Powlett V. Hypnotizability and rating scales. In: Burrows GD, Stanley RO, editor. Handbook of hypnosis and psychosomatic medicine. Amsterdam: Elsevier; 1980. pp. 119–131.
    1. Spiegel H. Current Perspectives on Hypnosis in Obstetrics. Fortschr Psychosom Med. 1963;11:412–29.
    1. Meurisse M, Defechereux T, Hamoir E, Maweja S, Marchettini P, Gollogly L, et al. Hypnosis with conscious sedation instead of general anaesthesia? Applications in cervical endocrine surgery. Acta Chir Belg. 1999;99:151–8.
    1. Kuttner L. Management of young children's acute pain and anxiety during invasive medical procedures. Pediatrician. 1989;16:39–44.
    1. Spiegel D. Neurophysiological correlates of hypnosis and dissociation. J Neuropsychiatry Clin Neurosci. 1991;3:440–5.
    1. Scott DL. Modern hospital hypnosis especially for anaesthetists. London: Lloyd-Luke; 1974. Clinical uses of hypnosis in anaesthesia; pp. 93–100.
    1. Spiegel H, Greenleaf M. Current perspectives on hypnosis in obstetrics. NY St J Med. 1963;63:2933–41.
    1. Cyna AM. Hypno-analgesia for a labouring parturient with contra-indications to central neuraxial block. Anaesthesia. 2003;58:101–2. doi: 10.1046/j.1365-2044.2003.296825.x.
    1. Davenport-Slack B. A comparative evaluation of obstetrical hypnosis and antenatal childbirth training. Int J Clin Exp Hypn. 1975;23:266–81.

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