OPEN Research Support
head

Midwife
Anette Werner
Department of Gynaecology and Obstetrics, Odense University Hosptial


Projekt styring
Projekt status    Sampling ongoing
 
Data indsamlingsdatoer
Start 01.01.2009  
Slut 28.02.2018  
 



Antenatal hypnosis training and cortisol

Short summary

Labor and childbirth is a time of intense psychophysiological stress. Cortisol has often been used as a biomarker for stress response during labor and childbirth as well as a biomarker to capture postpartum depression. We developed a brief course in antenatal self-hypnosis to provide women with skills to cope with childbirth and aim to investigate whether this course will have a positive effect on the saliva cortisol level during childbirth and on diurnal cortisol 6 weeks post partum. 


Rationale

Labor and childbirth is a time of intense psychophysiological stress. During this event, meaningful and adequate support must be given to the woman in order to reduce the risk of a negative birth experience as the costs for the society and the individual may be substantial if the woman experience a negative and traumatic birth experience.

Cortisol is in general considered as a biomarker reflecting the responsiveness of the hypothalamic-pituitary-adrenal (HPA) axis. Several studies have used cortisol as a biomarker for stress response during labor and childbirth as well as a biomarker to capture postpartum depression.

Hypnosis has been used as intervention in many different clinical settings, including childbirth. The ability to experience hypnosis increases during pregnancy and could therefore potentially be a useful tool for parturient women. We developed a brief course in antenatal self-hypnosis to provide women with skills to cope with childbirth and have earlier reported a positive effect on the childbirth experience (Werner et al. 2013b). On the contrary, we did not find any effect of the intervention on labour pain, length of childbirth and other birth outcomes (Werner et al. 2013a; Werner et al. 2012).  We also aim that the short hypnosis intervention will have a positive effect on the saliva cortisol level during childbirth and on diurnal cortisol 6 weeks post partum. As such we plan to test two hypotheses:

  1. Women participating in a short antenatal training course in self-hypnosis to ease childbirth will have a lower level of saliva cortisol during childbirth compared to women participating in a short course in relaxation and Mindfullness and women only receiving usual care.
  2. A short antenatal training course in self-hypnosis to ease childbirth will help the woman to return to a normal daily cortisol rhythm 6 weeks post partum compared to women participating in a short course in relaxation and Mindfullness and women only receiving usual care.


Description of the cohort

All women referred to the Obstetrics Department at Aarhus University hospital for childbirth were invited to join the study if they fulfilling the following eligibility criteria: No chronic diseases, uncomplicated pregnancy, nulliparous, older than 18 years, and able to understand and speak Danish


Data and biological material

Baseline characteristics derived from a questionnaire the participants had completed at recruitment.

Information about the childbirth were drawn from “The Aarhus Birth Cohort”. In case of missing information or if the woman gave birth at another hospital, the necessary data were extracted from medical records.

Six weeks postpartum, the women completed a second questionnaire that included information about i.a. the childbirth, breastfeeding and wellbeing.

The women were as well asked to perform saliva cortisol samples in pregnancy at gestational week 32, at birth and 6 weeks post partum.  


Collaborating researchers and departments

Institute of Clinical Research, University of Southen Denmark, and Midwife at department of Gynaecology and Obstetrics, Odense University Hospital

  • Associate professor Anette Werner

Institute of Clinical Research, University of Southen Denmark and department of Gynaecology and Obstetrics, Odense University Hospital

  • Associate professor Chunsen Wuu

Unit for Psychooncology and Health Psychology, Dept. of Oncology, Aarhus University Hospital and Dept of Psychology and Behavioural Science, Aarhus University

  • Robert Zachariae, Professor, DMSc., MSc.

Institute of Clinical Research, University of Southern Denmark, Department of Obstetrics & Gynaecology, Odense University Hospital

  • Professor & Consultant Midwife Ellen Aagaard Nøhr

Department of Gynecology and Obstetrics, Aarhus University Hospital Skejby

  • Professor Niels Uldbjerg

Section of Social Medicine, Department of Public Health, University of Copenhagen

  • Professor Åse Marie Hansen

 

Publications associated with the project

Werner, A., N. Uldbjerg, R. Zachariae, and E. A. Nohr. 2013a. "Effect of self-hypnosis on duration of labor and maternal and neonatal outcomes: a randomized controlled trial." Acta Obstet Gynecol Scand 92(7):816-23.

Werner, A., N. Uldbjerg, R. Zachariae, G. Rosen, and E.A. Nohr. 2012. "Self-hypnosis for coping with labour pain: a randomised controlled trial." BJOG: An International Journal of Obstetrics & Gynaecology:n/a-n/a.

Werner, A., N. Uldbjerg, R. Zachariae, C. S. Wu, and E. A. Nohr. 2013b. "Antenatal hypnosis training and childbirth experience: a randomized controlled trial." Birth 40(4):272-80.