Research: Healthcare professionals' knowledge and attitudes to self-hypnosis
What's happening in the world of midwifery research? A lead author summarises their work.
This study examined healthcare professionals’ attitudes, knowledge and levels of self-efficacy regarding the use of self-hypnosis in childbirth.
Hypnosis involves an altered state of consciousness that reduces awareness of the external environment while increasing receptivity to suggestions in order to facilitate changes in behaviour and perception. During childbirth, suggestions focus on increasing feelings of relaxation, comfort and safety, and reducing anxiety and fear.
The latest Cochrane review on self-hypnosis called for further research regarding its clinical usefulness for pain management and as a psychoeducational technique in childbirth. Examining potential barriers to this research, there is little evidence surrounding healthcare professionals’ attitudes and knowledge of the use of hypnosis, and whether women are supported in using self-hypnosis in labour.
A survey was distributed to members of the maternity team in two large London NHS trusts, and 129 midwives, obstetricians and anaesthetists responded. Midwives and doctors reported low levels of knowledge in relation to self-hypnosis in childbirth. Midwives reported higher levels of knowledge, more positive attitudes and higher levels of self-efficacy when compared with doctors. Midwives also reported more exposure to/experience of hypnosis than doctors, and more exposure was correlated with higher levels of self-efficacy.
Additional themes emerged from free-text comments. Some respondents stated that they had observed self-hypnosis assisting relaxation, increasing feelings of control and relieving pain in labour. Others challenged the benefits, reporting a lack of communication between healthcare professionals and women using this technique. Several staff said they perceived that women using self-hypnosis had a delay during the active second stage of labour, and that a reluctance to push or try methods suggested by staff may impede a spontaneous vaginal birth.
Although a systematic review found no reports of adverse effects attributed to hypnosis, the themes raised relating to communication and the second stage of labour warrant further research. A qualitative study, which aims to gain an in-depth insight into healthcare professionals’ views would be useful to explore this further. Further research is also needed to examine whether educating healthcare professionals would increase the efficacy of self-hypnosis on birth outcomes.
McAllister S, Coxon K, Murrells T, Sandall J. (2017) Healthcare professionals’ attitudes, knowledge and self-efficacy levels regarding the use of self-hypnosis in childbirth: a prospective questionnaire survey. Midwifery 47: 8-14.
Sophie McAllister is a consultant midwife trainee at Imperial College Healthcare NHS Trust