Outcomes of HypnoBirthing

Abstract: Compared with two surveys of usual care, these data provide strong support for the hypotheses that HypnoBirthing mothers have: fewer medical inductions (3.3%-21.1% difference); less IV fluids (37.9%-42.1% difference); less continuous fetal monitoring (42.4%-44.3% difference; less pitocin infusion (18%19% difference); fewer artificial rupture of membranes (18.8%-18.9% difference); fewer IV/IM anesthesias (4.4%-5.7% difference); fewer episiotomies (13.3%-15.1% difference); fewer epidural anesthesias (44.6%-49.1% difference); fewer caesarian sections (14.4%-17% difference); less frequent use of obstetricians (25%-39.7% difference); more frequent use of midwives (42.2%-45.3% difference); less use of hospitals (11.5%-12.3% difference); more use of home and birthing centers; more use of a wider variety of birthing positions; and infants of older gestational age than usual care. Self-selection is likely a major factor in our findings.Keywords: HypnoBirthing, Childbirth, Childbirth PreparationHypnoBirthing ® (Mongan, 2005) builds on the work of Dye (1891) and Grantly Dick-Read (2006). Dick-Read was called to attend the birth of a woman in Whitechapel, London early in the twentieth century and found her in a hovel near the railway arches. There was a pool of water on the floor, the window was broken, rain was pouring in, and the bed had no proper covering. Despite the poor conditions, he noted an atmosphere of "quiet kindliness. " He offered the woman chloroform, but she refused, the first in his experience to refuse. When asked why, she replied, "It didn't hurt. It wasn't meant to, was it doctor? "(Dick-Read, 2004, p. 19)Dick-Read goes on to explain that the uterus is composed of three layers: outside longitudinal muscle fibers which, when they contract, tend to expel the baby and pull the cervix open; themiddle layer of mainly blood vessels and support; and the inner circular muscle fibers which when they contract, tend to hold the cervix closed (Dick-Read, 2004, p. 34). Conditioning and tradition in Western societies teaches fear of childbirth and expectation of pain. This fear causes tension. Fear and tension activate the fight or flight or emergency (adrenergic) reaction, producing catecholamines, which shunt blood flow to the arms and legs and away from viscera. This causes the smooth muscle circular fibers around the lower half of the uterus to contract and close the cervix. The longitudinal muscles contract and push the baby against a closed cervix, causing pain. This is a vicious cycle and can lead to failure to progress, and medical or surgical intervention (Dick-Read, 2004, p. 45). Dick-Read discussed the role of imagery and conditioning in expectation of fear, tension and pain, and the role of counterconditioning and relaxation in reversing this cycle. He considered a possible role for hypnosis (Dick-Read, 2004, p. 178) and cites Kroger and Freed, (1951) but did not make it a part of his method, opting instead for the progressive relaxation method of Jacobson (1968) and denying that progressive relaxation had similarities to hypnosis (Dick-Read, 2004, p. 273). Kroger and Freed (1951) and Kroger (1961) promoted the use of hypnosis in childbirth, but their perspective developed no following and was not a comprehensive program, lacking childbirth education, breathing techniques, and imagery.Chiasson (1990) used hypnosis for childbirth, and August (1961) attended more than 1,000 births using hypnosis as the only anesthetic. David Cheek, an obstetrician who was a president of the American Society of Clinical Hypnosis, used and taught hypnosis for childbirth (Rossi & Cheek, 1988). Hassan-Schwartz Galle (2000) presents a detailed account of a case using hypnosis for labor preparation as well as birthing.The American Psychological Association's Division of Psychological Hypnosis defines hypnosis as "Hypnosis typically involves an introduction to the procedure during which the subject is told that suggestions for imaginative experiences will be presented. …