Psychological impact of hypnosis for pregnancy and childbirth: A systematic review

Hypnosis has been used for many decades as part of the care of women during their pregnancy and childbirth [5], including all aspects of their experience throughout the reproductive cycle, from enhancing fertility to postnatal use of hypnosis as a personal skill [2]. During the prenatal period, hypnosis focuses, for one part, on alleviating pregnancy-related symptoms, such as difficulty in sleeping, hypertension or nausea and vomiting symptoms [2]. There are some encouraging but not yet conclusive results for the use of hypnosis for hyperemesis gravidarum [[6], [7], [8]]. Hypnosis seems to reduce analgesics required for parturients [9], but not the use of epidurals. The use of hypnosis is aimed at giving women a way to control pain during pregnancy and birth through suggestions of pain relief and reinterpretation of pain perception with hypnoanalgesia. These techniques are intended to increase the pain threshold and on giving women a sense of control over their physical experience. One of the main goals of the hypnotic preparation is to reframe the birthing experience into a non-threatening one. This is partly achieved by changing the words used by the medical world and caregivers in general, for example, by switching terms like “more painful” for “less comfortable”. Research has indeed shown to what extent healthcare providers' words and attitudes can impact the experience of pain [10]. However, whether hypnosis improves women's satisfaction with pain relief during labor still remains ambiguous [11].

Training women for self-hypnosis is intended to empower them to use it as a tool when needed, during labor or even in the postnatal period, in order to protect themselves from a stressful environment [2]. Feeling in control over one's own body is essential for women because a perceived lack of control constitutes one of the main ingredients of fear of childbirth [12]. A high subjective controllability during childbirth seems to be positively correlated with less severe reported pain, more intense positive and less intense negative reported emotions related to birth [13]. Hypnotic preparation aims at enhancing the consciousness of what is happening within the body and the changes associated with the development of the baby. It is also intended to lead women to connect with their natural ability to give birth, while motivating them to go through the birthing process to meet their babies [14]. Recent literature has underlined the positive effect of hypnosis on women's outlook and experience of childbirth [15].

The perinatal period is critical for women's mental health [16]. This has particularly been brought to light during the recent pandemic [17]. Literature points to the importance of screening for perinatal mood and anxiety disorders [18], as mental health issues can have lasting consequences on women's wellbeing and on their infants' development [19,20]. While acknowledging the limited amount of evidence-based research on the efficacy of interventions lead during this period, health experts are urging for preventive interventions, notably for maternal depression [21], or for perinatal mental health in general [3].

The body changes involved in pregnancy are challenging for women both for their bodily experiences and for the psychological impact these constant changes engender. Interestingly, body symptoms, complaints and dissatisfaction seem to be related to mood disorder symptoms [22,23]. Hence, mind and body approaches seem particularly relevant during this period of life [24]. Literature reviews indicate that there is evidence, yet still modest, for the efficacy of mind and body interventions in preventing mood disorders in pregnancy [24,25]. These reviews stress out the methodological weaknesses frequently observed in this domain of research.

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