The Effect of Hypnotherapy on Postpartum Pain and Depression in Women with Post Caesarean Delivery
Abstract
Background: Postoperative pain is one of the most common problems in women after cesarean section. Caesarean section is also associated with post-partum depression. Hypnotherapy is one of the complementary therapy options that are effective and efficient in reducing pain symptoms and post-partum depression. This study aimed to analyze the effect of hypnotherapy on the level of pain and post-partum depression in post-cesarean section patients.
Subjects and Method: This was an experimental single-blind randomized controlled trial with a post-test group design, which was conducted from January to April 2021, at the Dr. Moewardi and Universitas Sebelas Maret Hospitals, Surakarta. A sample of 80 patients with cesarean section was divided into two groups, namely 40 patients in the hypnotherapy group and 40 patients in the control group. The independent variable was hypnotherapy. The dependent variables were pain and depression. Hypnotherapy was carried out by self-hypnosis using audio recordings of hypnotherapy in 2 sessions before and after the cesarean section procedure. The pain was measured by the Numeric Rating Scale. Post-partum depression was measured by the Edinburgh Postnatal Depression Scale. The data were analyzed by an independent t-test.
Results: Post-cesarean section pain in the group of hypnotherapy (Mean= 4.58; SD= 1.20) was lower than without hypnotherapy (Mean= 6.48; SD= 1.01), and it was statistically significant (p<0.001). Postpartum de-pression in the group of hypnotherapy (Mean= 6.08; SD= 1.60) was lower than non-hypnotherapy group (Mean= 8.48; SD= 3.78), and it was statistically significant (p <0.001).
Conclusion: Hypnotherapy has a significant effect on reducing pain and post-partum depression in post-cesarean section patients.
Keywords: Hypnotherapy, pain levels, post-partum depression, post-cesarean section
Correspondence: Araafi Hariza Mahandaru. Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta, Jl. Kolonel Sutarto, Jebres, Surakarta 57126, Central Java. Email: mahandarurafi@gmail.com.
Indonesian Journal of Medicine (2021), 06(02): 194-205
https://doi.org/10.26911/theijmed.2021.06.02.08
References
ACOG (2013). ACOG committee opinion no. 559: Cesarean delivery on maternal request. Obstet Gynecol, 121(4): 904–907. https://doi.org/10.1097/0-1.aog.0000428647.67925.d3.
Aini F, Pratidina ESG (2017). Pengaruh hipnoterapi terhadap intensitas nyeri pada pasien post section cesarea di Rumah Sakit PKU Muhammadiyah Kabupaten Temanggung (The effect of hypnotherapy on pain intensity in post section cesarean patients at PKU Muhammadiyah Hospital, Temang-gung Regency). Pros Semin Nasdan Int, 1(1): 163–171.
Alifah FN (2016). Hubungan faktor psiko-sosial terhadap kejadian post partum blues di ruang nifas RSUD dr. Abdoer Rahem Situbondo (The relationship between psychosocial factors and the incidence of post partum blues in the postpartum ward of Dr. Abdoer Rahem Situbondo Hospital). 1–104. http://repository.unair.ac.id/id/eprint/54236.
Azizmohammadi S, Sima A (2019). Hypno-therapy in management of delivery pain: A review. Eur J Trans Myol, 29(3): 210–217. https://dx.doi.org/-10.4081%2Fejtm.2019.8365.
Beevi Z, Low WY, Hassan J (2017). The effectiveness of hypnosis intervention for labor: An experimental study. Am J Clin Hyp, 60(2): 172–191. https://-dx.doi.org/10.1080/00029157.2017.1280659.
Beevi Z, Low WY, Hassan J (2019). The effectiveness of hypnosis intervention in alleviating post-partum psycholo-gical symptoms. Am JClin Hyp, 61(4): 409–425. https://dx.doi.org/10.108-0/00029157.2018.1538870.
Betrán AP, Ye J, Moller AB, Zhang J, Gül-mezoglu AM, Torloni MR (2016). The increasing trend in caesarean section rates: Global, regional and national estimates: 1990-2014. PLoS ONE, 11(2): 1–12. https://dx.doi.org/10.13-71/journal.pone.0148343.
Borges N, Ce Silva BC, Pedroso CF, Silva TC, Tatagiba BSF, dan Pereira LV (2017). Postoperative pain in women undergoing caesarean section. Enferm Glob, 16(4): 374–383.
Carter FA, Frampton CMA, Mulder RT (2006). Cesarean section and post-partum depression: A review of the evidence examining the link. Psycho-som Med, 68(2): 321–330. doi: 10.10-97/01.psy.0000204787.83768.0c.
Dira IKPA, Wahyuni AAS (2016). Prevalensi dan faktor risiko depresi postpartum di kota Denpasar menggunakan Edinburgh postnatal depression scale (Prevalence and Risk factors for post-partum depression in Denpasar city using the Edinburgh postnatal depre-ssion scale). E-Jurnal Med Udayana, 5(7): 5–9. https://ojs.unud.ac.id/in-dex.php/eum/article/view/21560.
Haefeli M, Elfering A (2006). Pain assess-ment. Eur Spine J, 15(1): 17–24. https://dx.doi.org/10.1007/s00586-005-1044-x.
Han C, Pae CU (2015). Pain and depress-ion: A neurobiological perspective of their relationship. Psychiatry Investig, 12(1);1–8. doi: 10.4306/pi.2015.12.1.1.
IASP (2018). IASP Announces revised defi-nition of pain. IASP, 1. Tersedia pada: https://www.iasp-pain.org/Publicati-onsNews/NewsDetail.aspx?ItemNumber=9218%0Ahttps://journals.lww.com/pain/Abstract/9000/The_revised_International_Association_for_the.98346.aspx%0Ahttps://www.iasp-pain.org/PublicationsNews/NewsDetail.aspx?ItemNumber=10475.
Iwata H, Mori E, Tsuchiya M, Sakajo A, Maehara K, Ozawa H, Morita A, et al. (2015). Predicting early post-partum depressive symptoms among older primiparous Japanese mothers. Japan J Nurs Sci, 12(4): 297–308. https://-doi.org/10.1111/jjns.12069.
Jasim HH, Sulaiman SABS, Khan AH, Rajah UAS (2017). Factors affecting post caesarean pain intensity among women in the northern peninsular of Malaysia. J Clin Diagnostic Res, 11(9): IC07-IC11. doi: 10.7860/JCDR/2017-/25364.10630.
Kaufman J, DeLorenzo C, Choudhury S, Parsey RV (2016). The 5-HT1A recep-tor in major depressive disorder. Eur Neuropsychopharmacol, 26(3): 397–410. doi: 10.1016/j.euroneuro.2015.-12.039.
Kendrick C, Sliwinski J, Yu Y, Johnson A, Fisher W, Kekecs Z, Elkins G (2016). Hypnosis for acute procedural pain: A critical review. Int J Clin Exp Hypn, 64(1): 75–115. https://doi.org/10.108-0/00207144.2015.1099405.
Kravits K (2013). Hypnosis: adjunct therapy for cancer pain management. J Adv Pract Oncol. 4(2): 83-88. https://dx.-doi.org/10.6004%2Fjadpro.2013.4.2.2.
Madden K, Middleton P, Cyna AM, Mat-thewson M, Jones L (2016). Hypnosis for pain management during labour and childbirth. Cochrane Database Syst Rev. 2016(5): CD009356. doi: 10.1002/14651858.CD009356.pub3.
Mubarokah RI, Prasetya H, Respati SH (2020). The Effectiveness of hypno-therapy to reduce anxiety in pre-caesarean sectio women. J Maternal Child Health, 5(1): 13-17. https://doi.org/10.26911/thejmch.2020.05.01.02
Mughal S, Azhar Y, Siddiqui W (2020). Post-partum depression. StatPearls Publishing. https://www.ncbi.nlm.-nih.gov/books/NBK519070/.
Niraski V (2015). Pengaruh hipnoterapi ter-hadap tingkat nyeri pada ibu post sectio caesarea di RSB Jeumpa Ponti-anak Tahun 2015. Jurnal Proners. 3(1). http://dx.doi.org/10.26418/jpn.v3i1.11037.
Payne JL, Maguire J (2019). Pathophysio-logical mechanisms implicated in post-partum depression. Front Neuro-endocrinol, 52: 165–180. https://-doi.-org/10.1016/j.yfrne.-2018.12.001.
Price SA, Wilson LM (2012). Patofisiologi Konsep Klinis Proses-Proses Penyakit. Edisi 6. Jakarta: EGC.
Sado M, Ota E, Stickley A, Mori R (2012). Hypnosis during pregnancy, child-birth, and the postnatal period for preventing postnatal depression. Co-chrane Database Syst Rev, (6). doi: 10.1002/14651858.cd009062.pub2.
Sadock BJ, Sadock VA (2015) Synopsis of Psychiatry: Behavioral Sciences and Clinical Psychiatry, 11th ed. 11 ed.
Sandall J, Tribe RM, Avery L, Mola G, Visser GH, Homer CS, Gibbons D, et al. (2018). Short-term and long-term effects of caesarean section on the health of women and children. Lancet, 392(10155): 1349–1357. https://doi.org/10.1016/s0140-6736(18)31930-5.
Sanders VM (2012). The beta2-adrenergic receptor on T and B lymphocytes: Do we understand it yet?. Brain Behav Immun. 26(2): 195–200. doi: 10.101-6/j.bbi.2011.08.001.
Setyadi AW, Murti B, Demartoto A (2016). The effect of hypnotherapy on depres-sion, anxiety, and stress, in people living with HIV/AIDS, in "Friendship Plus" peer supporting group, in Kediri, East Java. J Health Promot Be-hav. 1(2): 99–108. doi: 10.26911/the-jhpb.2016.01.02.05.
Thompson T, Terhune DB, Oram C, Sha-rangparni J, Rouf R, Solmi M, Ve-ronese N, Stubbs B (2019). The effec-tiveness of hypnosis for pain relief: A systematic review and meta-analysis of 85 controlled experimental trials. Neurosci Biobehav Rev. 99: 298–310. https://doi.org/10.1016/j.neubiorev.-2019.02.013.
Tripathi L, Kumar P (2014). Challenges in pain assessment: Pain intensity scal-es. Indian J Pain, 28(2): 61. doi: 10.-4103/0970-5333.132841.
Varga K, Kekecs Z (2014). L’oxytocine et le cortisol en interaction hypnotique. International Journal of Clinical and Experimental Hypnosis, 62(1): 111–128. doi: 10.1080/00207144.2013.84-1494.
Wahyuni R, Rohani S (2019). Faktor - fak-tor yang berhubungan dengan riwayat persalinan sectio caesarea, eellness and healthy magazine, 2: 187–192. https://wellness.journalpress.id/well-ness/article/view/v1i218wh.
Xu H, Ding Y, Ma Y, Xin X, Zhang D (2017). Cesarean section and risk of post-partum depression: A meta-analysis. J Psychosom Res, 97: 118–126. doi: 10.1016/j.jpsychores.2017.04.016.
Yexley MJ (2007). Treating post-partum depression with hypnosis: Addressing specific symptoms presented by the client. Am J Clin Hypn, 49(3): 219–223. doi: 10.1080/00029157.2007.-10401584.
