Hypnosis to Facilitate Uncomplicated Birth

American Journal of Clinical Hypnosis, Apr 2004 by Mehl-Madrona, Lewis E

A complicated birth, therefore, required the use of obstetrical technology, including Cesareans, induction and augmentation of labor with oxytocin, fetal distress resulting in intervention or fetal scalp sampling, low Apgar scores, or postpartum hemorrhage. An obstetrician and two certified nurse-midwives reviewed each case to assess normal versus complicated. They were blind to the existence of this study. They agreed on 95% of cases. For the remaining cases, their consensus was accepted. These were borderline cases in which, for example, blood loss was on the borderline of excessive or fetal distress was on the borderline of being excessive.

Data analysis

The t-test procedure and the discriminant analysis procedures from the Systat statistical package for the Macintosh computer was used. Statistics provided are already corrected using the Bonferoni method for the number of comparisons made. Chi-square tests were used to test statistical significance of differences between groups. Variables were compared by actual outcome group, by whether or not women had received hypnosis and by the interaction of these conditions.

Results

No differences in outcomes were found by geographic regions, so the three geographic regions were combined for subsequent analysis. Outcomes for the first 5 years were compared to outcomes for the second 5 years. No significant differences emerged between the two 5-year periods. No one obstetrical provider or group contributed enough patients to warrant statistical testing. Table 1 compares demographics between women having uncomplicated and complicated births in this sample. No significant differences were expected between women in the hypnosis and the comparison group. When women were compared by actual outcome, no demographic differences emerged (see Table)). Age of the total sample of patients varied from 18 years to 39 years with an average of 27 years. Years of education ranged from 9 to 19, with an average of 13 years. Fifty-two percent of the women were primigravidas, 24% were secundigravidas, 11% were having their third child, and 13% were pregnant with their fourth or greater child. No significant differences in level of medical risk were found between subjects who had complicated outcomes versus uncomplicated outcomes. No differences were found in the range of distance from place of birth for women in uncomplicated and complicated outcomes.

Contribution of medical and demographic variables to risk

Table 2 shows no differences in the two groups for members having previous live births, previous abortions and previous miscarriages. Women in the complicated birth group showed significantly more previous (to the pregnancy) infections, injuries and hospitalizations. These events were not obstetrical or gynecological and did not increase their obstetrical risk on the Popras Obstetrical Risk Screening Criteria. There were no differences in number of prior surgeries or diagnosed illnesses. Women in the complicated birth group showed more frequent past drug use. Neither group was using drugs during the pregnancy. Women in the uncomplicated birth group were more physically active.