RESEARCH FINDINGS USING GUIDED
IMAGERY FOR
CHILDBIRTH
July, 2006
The
value of childbirth preparation
About
four million births take place annually in the United
States (Hamilton, Ventura, et al, 2005). Many of the
mothers involved are looking for ways to participate more
actively in preparation for delivery and in the process of
labor, and to avoid “medicalized” births.
A search for books on “natural childbirth” on Amazon.com,
conducted on June 29, 2006, yielded 431 titles, up from 309
titles just three years earlier. Another indicator of this
trend is the rise in the use of midwives, which rose from
0.9% in 1975 to nearly 8% of vaginal deliveries in 2001
(Martin and Hamilton, 2005). A recent survey of nurse
midwives revealed that 48.8% of CNM’S recommend mind-body
techniques for the birthing process (Gentz, 2001).
Although the programs of Lamaze and Dick-Read are the most
widely used forms of childbirth preparation in this
country, psychological and educational preparation with
self-hypnosis and guided imagery have proven effective in
several studies (Harmon, Hynan & Tyre, 1990; Martin,
Schauble, et al, 2001; Oster 1994; Schauble, Werner, et al,
1998).
Self-hypnosis and guided imagery – the terms are used
interchangeably in the literature – combinee deep
relaxation with positive suggestion for a normal,
comfortable birth. Relaxation and breathing techniques can
also reduce anxiety in laboring women (Almeida and de
Sousa, 2005).
In one study, a group of 22 women who learned self-hypnosis
in a four-session program had shorter hospital stays and
fewer surgical interventions than a matched control group
who received psychosocial counseling sessions (Martin,
Schuable, et al, 2001). Harmon, Hynan, and Tyre (1990)
studied 60 pregnant women, half of whom received hypnotic
suggestions for an enjoyable childbirth, deep relaxation,
and glove anesthesia. The treatment group had quicker
progress through Stage 1 of labor, less reported pain, less
use of medication, and their babies had higher Apgar scores
at 1 and 5 minutes.
Imagery and self-hypnosis have
also demonstrated effectiveness in reducing complications
of pregnancy (Mehl, 1994; Torem, 1994). For example, Mehl
used guided imagery with 100 women whose babies were in
breech positions at 37 to 40 weeks' gestation. He compared
them with a matched comparison group. In the hypnosis
group, 81% of the babies spontaneously "turned" to the
proper position, compared with 48% of the comparison group.
Mind-body techniques can also be used for reducing women’s
anxiety and stress during pregnancy; these techniques are
effective across cultural lines, as well, as illustrated by
a 2006 study, where Iranian women using relaxation
techniques had significantly reduced low-weight births,
cesarean sections, and/or instrumental extractions (Bastani
F, Hidarnia, et al, 2006).
Gentz, in her 2001 review of the literature, concluded that
hypnosis is “a helpful adjunct” for women during the
birthing process.
Authors of a 2003 review found that women using hypnosis
were more satisfied with the management of their labor pain
when compared with women using other forms of alternative
and complementary methods of pain management (Smith,
Collins, et al, 2003). More recently, authors of a 2004
review reported that women using hypnosis needed less
analgesia and rated their pain as less severe than those in
the non-hypnosis groups (Cyna, McAuliffe & Andrew,
2004).
Guided imagery with relaxation has also been used
effectively in improving post-partum anxiety, depression,
and self-esteem (Rees, 1995).
Potential
Cost Savings
The
2004 national cesarean section rate climbed another 6% to
an all-time high of 29.1% (Martin, Hamilton et al. 2005),
with individual hospital's rates approaching a staggering
57% (Goldstein, 2005). These numbers far exceed The World
Health Organization's call for a rate no higher than 15%
(WHO, 1985). Clearly there is a need for greater education
of the benefits to both mother and baby of natural
childbirth and the potential complications of medically
unnecessary interventions of "managed" birth.
Reduction of cesarean birth rates to European levels would
save approximately $1.5 billion per year in the U.S. (Sachs
and Kobelin, 1999). Whatever the method of birth, reduction
of hospital stays and complications, like those
demonstrated in the studies mentioned above, would save
additional resources, although the amount has not been
calculated.
Conclusion
Guided imagery can increase
women’s feelings of control and confidence in the labor
process, significantly reduce their perception of pain,
help them handle complications that might arise, and reduce
costs by shortening hospital stays and lowering the
frequency of surgical interventions.
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