Self-hypnosis for intrapartum pain management in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness


Downe, S, Finlayson, K, Melvin, C, Spiby, H, Ali, S, Diggle, P, Gyte, G, Hinder, S, Miller, V, Slade, Pauline ORCID: 0000-0001-5877-2706 et al (show 4 more authors) (2015) Self-hypnosis for intrapartum pain management in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness. BJOG, 122 (9). pp. 1226-1234.

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SHIP trial BJOG final as published May 11th 2015.pdf - Author Accepted Manuscript
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Abstract

OBJECTIVE: (Primary) To establish the effect of antenatal group self-hypnosis for nulliparous women on intra-partum epidural use. DESIGN: Multi-method randomised control trial (RCT). SETTING: Three NHS Trusts. POPULATION: Nulliparous women not planning elective caesarean, without medication for hypertension and without psychological illness. METHODS: Randomisation at 28-32 weeks' gestation to usual care, or to usual care plus brief self-hypnosis training (two x 90-minute groups at around 32 and 35 weeks' gestation; daily audio self-hypnosis CD). Follow up at 2 and 6 weeks postnatal. MAIN OUTCOME MEASURES: Primary: epidural analgesia. Secondary: associated clinical and psychological outcomes; cost analysis. RESULTS: Six hundred and eighty women were randomised. There was no statistically significant difference in epidural use: 27.9% (intervention), 30.3% (control), odds ratio (OR) 0.89 [95% confidence interval (CI): 0.64-1.24], or in 27 of 29 pre-specified secondary clinical and psychological outcomes. Women in the intervention group had lower actual than anticipated levels of fear and anxiety between baseline and 2 weeks post natal (anxiety: mean difference -0.72, 95% CI -1.16 to -0.28, P = 0.001); fear (mean difference -0.62, 95% CI -1.08 to -0.16, P = 0.009) [Correction added on 7 July 2015, after first online publication: 'Mean difference' replaced 'Odds ratio (OR)' in the preceding sentence.]. Postnatal response rates were 67% overall at 2 weeks. The additional cost in the intervention arm per woman was pound4.83 (CI - pound257.93 to pound267.59). CONCLUSIONS: Allocation to two-third-trimester group self-hypnosis training sessions did not significantly reduce intra-partum epidural analgesia use or a range of other clinical and psychological variables. The impact of women's anxiety and fear about childbirth needs further investigation.

Item Type: Article
Uncontrolled Keywords: Adult, Analgesia, Epidural, utilization, Analgesia, Obstetrical, utilization, Female, Humans, Hypnosis, Labor Pain, epidemiology, therapy, Pain Management, methods, Patient Compliance, statistics & numerical data, Patient Education as Topic, Patient Satisfaction, Pregnancy, Reminder Systems, Self Care, methods, Surveys and Questionnaires, Treatment Outcome, Cost-analysis, epidural, group antenatal training, labour pain, psychological outcomes, randomised trial
Depositing User: Symplectic Admin
Date Deposited: 10 Aug 2016 15:32
Last Modified: 19 Jan 2023 07:32
DOI: 10.1111/1471-0528.13433
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3002869
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