Keywords
Labor Pain
Duration of the Second Stage of Labor
Multigravida
Non-harmacological Pain Management
How to Cite
Abstract
Hypnobirthing is a non-pharmacological method for reducing labor pain and supporting physiological childbirth by disrupting the fear-tension-pain cycle through deep relaxation, visualization, and positive breathing exercises. Although hypnobirthing-based interventions hold potential for intrapartum pain management, empirical research findings remain varied and limited, particularly regarding multigravid women in clinical maternity settings, underscoring the critical necessity of this study. This study aimed to analyze the effectiveness of hypnobirthing in reducing labor pain intensity and shortening the duration of the second stage of labor in multigravid women. A quasi-experimental non-equivalent control group design was employed, with the study conducted from March 1 to May 30, 2024. Thirty eligible multigravid women were recruited using consecutive sampling and assigned to an intervention group (n = 15) receiving structured hypnobirthing sessions or a control group (n = 15) receiving standard intrapartum care. Pain intensity was evaluated pre- and post-intervention using the Numeric Rating Scale (NRS), while the duration of the second stage was monitored using a standard WHO partograph. Data were analyzed using paired t-tests and independent t-tests. Hypnobirthing significantly reduced the mean labor pain score from 9.00 ± 1.31 to 5.93 ± 1.44 (p < 0.001), whereas no statistically significant change was observed in the control group (p = 0.869). The intervention group also exhibited a significantly shorter mean duration for the second stage of labor compared to the control group (28.53 ± 4.10 minutes vs. 41.07 ± 9.95 minutes; p < 0.001). In conclusion, hypnobirthing is effective in reducing labor pain intensity and accelerating second-stage labor duration among multigravid women, supporting its routine integration as an evidence-based, non-pharmacological intervention within clinical midwifery care and hospital delivery protocols.
References
Abdel-Fatah Ibrahim, H., Alshahrani, M. S., Al-Qinnah, A. J., & Elgzar, W. T. (2024). Nonpharmacological pain relief for labour pain: knowledge, attitude, and barriers among obstetric care providers. PeerJ, 12, e16862. https://doi.org/10.7717/peerj.16862
Alehagen, S., Wijma, B., Lundberg, U., & Wijma, K. (2005). Fear, pain and stress hormones during childbirth. Journal of Psychosomatic Obstetrics & Gynecology, 26(3), 153–165. https://doi.org/10.1080/01443610400023072
Althubaiti, A. (2023). Sample size determination: A practical guide for health researchers. In Journal of General and Family Medicine (Vol. 24, Number 2, pp. 72–78). John Wiley and Sons Inc. https://doi.org/10.1002/jgf2.600
Anita, W., Nafratilova, L., & Islami Zalni, R. (2023). Efektivitas managemen nyeri persalinan non farmakologi dengan Deep Back Massage. Jurnal SAGO Gizi Dan Kesehatan, 4(2), 199. https://doi.org/10.30867/gikes.v4i2.1080
Bas, E. K., Bülbül, A., Uslu, S., Bas, V., Elitok, G. K., & Zubarioglu, U. (2020). Maternal characteristics and obstetric and neonatal outcomes of singleton pregnancies among adolescents. Medical Science Monitor, 26. https://doi.org/10.12659/MSM.919922
Beilin, Y., Hossain, S., & Bodian, C. A. (2003). The Numeric Rating Scale and Labor Epidural Analgesia. Anesthesia & Analgesia, 96(6), 1794–1798. https://doi.org/10.1213/01.ANE.0000061581.23351.29
Cai, L., Jiang, J.-J., Wang, T.-T., & Cao, S. (2023). Effects of combined spinal-epidural anesthesia on anxiety, labor analgesia and motor blocks in women during natural delivery. World Journal of Psychiatry, 13(11), 838–847. https://doi.org/10.5498/wjp.v13.i11.838
Dixit, V., Gupta, M., & Agrawal, A. (2025). Impact of prolonged second stage of labor and it’s perinatal outcome. Santosh University Journal of Health Sciences, 11(1), 152–155. https://doi.org/10.4103/sujhs.sujhs_30_25
Ekayanti, N. D., Saadah, N., Setiyani, A., & Joko Santosa, B. (2025). Association Between Anxiety And Labor PainIntensity During The First Stage Of Active Labor in Primigravidas. International Journal of Advanced Health Science and Technology, 5(6), 335–340. https://doi.org/10.35882/ijahst.v5i6.490
Eni, T., Kursih, S., & Tiawaningrum, E. (2018). Pengaruh Yoga Prenatal dan Hypnobrithing Terhadap Proses Persalinan Kala I Pada Ibu Bersalin Di BPM Restu Depok. Jurnal Bidan “Midwife Journal,” 5(01), 26–32. https://media.neliti.com/media/publications/234020-pengaruh-yoga-prenatal-dan-hypnobirthing-ca921800.pdf
Falina, C., Utami, I. T., Handayanti, R., & Susanti, Y. (2024). Efektifitas Massage Effleurage untuk Mengurangi Nyeri Pada Kala I Persalinan Primigravida. Jurnal Kreativitas Pengabdian Kepada Masyarakat (PKM), 7(6), 2797–2809. https://doi.org/10.33024/jkpm.v7i6.15009
Fernández-Gamero, L., Reinoso-Cobo, A., Ruiz-González, M. del C., Cortés-Martín, J., Muñóz Sánchez, I., Mellado-García, E., & Piqueras-Sola, B. (2024). Impact of Hypnotherapy on Fear, Pain, and the Birth Experience: A Systematic Review. In Healthcare (Switzerland) (Vol. 12, Number 6). Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/healthcare12060616
Harrison, M. S., Ali, S., Pasha, O., Saleem, S., Althabe, F., Berrueta, M., Mazzoni, A., Chomba, E., Carlo, W. A., Garces, A., Krebs, N. F., Michael Hambidge, K., Goudar, S. S., Dhaded, S., Kodkany, B., Derman, R. J., Patel, A., Hibberd, P. L., Esamai, F., … Goldenberg, R. L. (2015). A prospective population-based study of maternal, fetal, and neonatal outcomes in the setting of prolonged labor, obstructed labor and failure to progress in low- and middle-income countries. In Reproductive Health (Vol. 12, Number 2). BioMed Central Ltd. https://doi.org/10.1186/1742-4755-12-S2-S9
Jones, L., Othman, M., Dowswell, T., Alfirevic, Z., Gates, S., Newburn, M., Jordan, S., Lavender, T., & Neilson, J. P. (2011). Pain management for women in labour: an overview of systematic reviews. In J. P. Neilson (Ed.), Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd. https://doi.org/10.1002/14651858.CD009234
Ketema, D. B., Leshargie, C. T., Kibret, G. D., Assemie, M. A., Petrucka, P., & Alebel, A. (2020). Effects of maternal education on birth preparedness and complication readiness among Ethiopian pregnant women: A systematic review and meta-analysis. BMC Pregnancy and Childbirth, 20(1). https://doi.org/10.1186/s12884-020-2812-7
Khairunnisa, K., Sari, F. F., Anggelena, M., Agustina, D., & Nursa’adah, E. (2022). Penggunaan Effect Size Sebagai Mediasi dalam Koreksi Efek Suatu Penelitian. Jurnal Pendidikan Matematika (Judika Education), 5(2), 138–151. https://doi.org/10.31539/judika.v5i2.4802
Khalifatunnisak, A., Andarini, A. S., Ilmu, I., Bhakti, K., & Kediri, W. (2026). Hypnobirthing as a Non-Pharmacological Intervention to Reduce Labr Pain and Anxiety: A Quasi-Experimental study. Indonesian Journal of Nutritional Epidemiology and Reproductive, 9(1), 35–39. https://doi.org/10.30994/ijner.v9i1.360
Krismayanti, D., Wistri, H. A., Risanto, E. U., & Ugm, R. (2024). Pengaruh Hypnobirthing Terhadap Lamanya Persalinan Kala 2 Pada Ibu Bersalin di RSA UGM Tahun 2024. Jurnal Bidan Mandira Cendikia, 3(2), 35–39. https://journal-mandiracendikia.com/jbmc
Lee, N., Kearney, L., Jenkinson, B., Howlett, C., & Ballard, E. (2026). The association between women’s use of HypnoBirthing and maternal labour analgesia use and mode of birth: A retrospective propensity score matched study. Women and Birth, 39(3). https://doi.org/10.1016/j.wombi.2026.102215
Lidia, B., Yusuf, N., Ardan, M., Aisyah, N., & Tuko, J. M. (2025). Smarter Hypnobirthing Intervention to Reduce Anxiety and Improve Maternal Birth Outcomes among Primigravid Women in Samarinda, Indonesia. Jurnal Eduhealth, 16(3), 1566–1573. https://doi.org/10.54209/eduhealth.v16i03
Lu, Y., Zhang, Y., Zheng, Y., Song, Y., Zang, Y., Liu, Z., & Xu, Z. (2024). Programmed Intermittent Epidural Bolus vs Manual Epidural Bolus for Labor Analgesia Initiation: A Randomized Non-Inferiority Trial. Drug Design, Development and Therapy, 18, 5063–5072. https://doi.org/10.2147/DDDT.S488920
Madden, K., Middleton, P., Cyna, A. M., Matthewson, M., & Jones, L. (2016). Hypnosis for pain management during labour and childbirth. In Cochrane Database of Systematic Reviews (Vol. 2016, Number 5). John Wiley and Sons Ltd. https://doi.org/10.1002/14651858.CD009356.pub3
Mamuroh, L., Sukmawati, S., & Nurhakim, F. (2023). Intervensi untuk Nyeri Persalinan: a Rapid Review. Malahayati Nursing Journal, 5(8), 2370–2385. https://doi.org/10.33024/mnj.v5i8.10318
Mishra, P., Pandey, C. M., Singh, U., Gupta, A., Sahu, C., & Keshri, A. (2019). Descriptive Statistics and Normality Tests for Statistical Data. Annals of Cardiac Anaesthesia, 22(1), 67–72. https://doi.org/10.4103/aca.ACA_157_18
Oktarina, M., Maidar, M., Fadhullah, F., Abdullah, A., & A. Rani, H. (2025). Dukungan Suami, Pendidikan, Metode Menyusui dan Metode Persalinan Sebagai Determinan Kejadian Depresi pada Ibu Postpartum. Journal of Health Research “Forikes Voice,” 16(1), 153–158. https://doi.org/10.33846/sf16132
Prawirohardjo, S. (2021). Ilmu Kebidanan Sarwono Prawirohardjo. PT Bina Pustaka Sarwono Prawirohardjo.
Puskesmas Cempaka Mulia. (2023). Register Ruang Bersalin Puskesmas Cempaka Mulia Tahun 2020-2022. Puskesmas Cempaka Mulia.
Reyhanah, S., & Sri Purwanti, A. (2025). The Effect of Hypnotherapy on Reducing Labor Pain. Jurnal Kebidanan Malahayati, 11(7), 714–718. http://ejurnalmalahayati.ac.id/index.php/kebidanan
Rosendahl, J., Alldredge, C. T., & Haddenhorst, A. (2023). Meta-analytic evidence on the efficacy of hypnosis for mental and somatic health issues: a 20-year perspective. In Frontiers in Psychology (Vol. 14). Frontiers Media SA. https://doi.org/10.3389/fpsyg.2023.1330238
Sade, G., & Özkan, H. (2025). The effect of mechanical massage on labor pain, duration and maternal satisfaction: a randomized controlled trial. BMC Pregnancy and Childbirth, 25(1). https://doi.org/10.1186/s12884-025-07977-3
Sadiyah, J. (2023). The effect of hypnobirthing classes with a gender-responsive approach to labor anxiety, pain, labor satisfaction at the Tembuni birth center, South Jakarta in 2023. European Journal of Midwifery, 7(Supplement 1), A96. https://doi.org/10.18332/ejm/172523
Sari, Y. W. S., Lestari, R. A. F., Pratiwi, D., & Nafilata, I. (2025). Hypnobirthing: A Systematic Review of Relaxation Techniques in Reducing Prenatal Anxiety. Journal of Community Mental Health and Public Policy, 8(1), 88–98. https://doi.org/10.51602/cmhp.v8i1.303
Shapiro, S. S., & Wilk, M. B. (1965). An analysis of variance test for normality (complete samples). Biometrika, 52(3–4), 591–611. https://doi.org/10.1093/biomet/52.3-4.591
Sihaloho, R. Y., Lathifah, N. S., Fitria, & Anggraini. (2023). Effectiveness of Hypnobirthing on the Pain Scale of Particular. 3(4), 165–171. https://dx.doi.org/10.33024/mj.v3i4.13487
Situmorang, K. (2024). The Effect Of Hypnobirthing On The Anxiety Level Of Pregnant Women In Trimester III. In International Journal of Public Health (Number 2). https://doi.org/10.62951/ijph.v1i2.18
Smith, A., Laflamme, E., & Komanecky, C. (2021). Pain Management in Labor. American Family Physician, 103(6), 355–364. https://pubmed.ncbi.nlm.nih.gov/33719377/
Soviyati, E. (2022). Faktor-Faktor Yang Berhubungan Dengan Lama Persalinan Di Rsud ’45 Kuningan Jawa Barat Tahun 2022. Midwife Journal, 2(1), 33–43. https://media.neliti.com/media/publications/234056-faktor-faktor-yang-berhubungan-dengan-la-a95339f3.pdf
Sulastriningsih, K., Puspita, N. V. I., Nurlelawati, E., & Rosmiati, R. (2023). effect of hypnobirthing on labor pain in primiparous women during the active phase at the midwife independent practice center Bdn L in the city of Depok. International Journal of Health & Medical Sciences, 6(4), 229–234. https://doi.org/10.21744/ijhms.v6n4.2223
Syairaji, M., Nurdiati, D. S., Wiratama, B. S., Prüst, Z. D., Bloemenkamp, K. W. M., & Verschueren, K. J. C. (2024). Trends and causes of maternal mortality in Indonesia: a systematic review. BMC Pregnancy and Childbirth, 24(1). https://doi.org/10.1186/s12884-024-06687-6
Syswianti, D., & Wahyuni, T. (2023). Hypnobirthing and Rebozo Affect The Duration of Labor in II and APGAR Score. Jurnal Kebidanan Malahayati, 9, 46–52. http://ejurnalmalahayati.ac.id/index.php/kebidanan
Tiara Carolin, B., Anna Siauta, J., & Meilani Wuryandari, I. (2021). Pengaruh Aromaterapi Lavender dan Murotal Terhadap Tingkat Nyeri Pada Ibu Bersalin di Wilayah Kerja Puskesmas Mekar Baru. Jurnal Menara Medika, 4(1), 60. https://jurnal.umsb.ac.id/index.php/menaramedika/index
Ulfa, R. M. (2021). Science Midwifery Effect of the Use of Birth Balls on the Reduction of Pain and Duration of Labor During the First Stage of Active and Second Stage of Labor in Primigravida Maternity. Science Midwifery, 9(2). www.midwifery.iocspublisher.org
Utomo, B., Sucahya, P. K., Romadlona, N. A., Robertson, A. S., Aryanty, R. I., & Magnani, R. J. (2021). The impact of family planning on maternal mortality in Indonesia: what future contribution can be expected? Population Health Metrics, 19(1), 2. https://doi.org/10.1186/s12963-020-00245-w
Vandekerckhove, M., Guignard, M., Civadier, M. S., Benachi, A., & Bouyer, J. (2021). Impact of maternal age on obstetric and neonatal morbidity: a retrospective cohort study. BMC Pregnancy and Childbirth, 21(1). https://doi.org/10.1186/s12884-021-04177-7
Wahyuni, S., Setyorini, D., Arisani, G., Nuraina, N., Sukriani, W., Meyasa, L., Pekabanda, K., Rosni H., A., Legawati, L., Rosdiana, R., Nara, A., Rochimatul lailiyah., S., Ch. Endang Sukartiningsih, M., & Sopiatun, S. (2023). Buku Ajar Asuhan Kebidanan Persalinan dan Bayi Baru Lahir. CV. Science Techno Direct.
Wang, R., Lu, J., & Chow, K. M. (2024). Effectiveness of mind–body interventions in labour pain management during normal delivery: A systematic review and meta-analysis. International Journal of Nursing Studies, 158, 104858. https://doi.org/https://doi.org/10.1016/j.ijnurstu.2024.104858
Williamson, A., & Hoggart, B. (2005). Pain: a review of three commonly used pain rating scales. Journal of Clinical Nursing, 14(7), 798–804. https://doi.org/10.1111/j.1365-2702.2005.01121.x
World Health Organization. (2018). WHO Recommendations: Intrapartum Care for a Positive Childbirth Experience: Transforming Care of Women and Babies for Improved Health and Well-being. Executive Summary. World Health Organization. https://apps.who.int/iris/handle/10665/272447
Yaqoob, H., Ju, X. Da, & Jamshaid, S. (2024). Hypnobirthing Training for First-Time Mothers: Pain, Anxiety and Postpartum Wellbeing. Psychology Research and Behavior Management, 17, 3033–3048. https://doi.org/10.2147/PRBM.S465361
Yuseva, S., Windar, N. E., & Hastuti, R. A. N. (2019). Pengaruh Hypnobirthing Terhadap Tingkat Kecemasan Ibu Bersalin Dan Lama Persalinan Di Bidan Praktek Mandiri Wilayah Kabupaten Malang. Jurnal Ilmiah Bidan, Vol 1, No(3), 35–44. https://doi.org/10.61720/jib.v1i3.16
Zaman, A., Fadlalmola, H. A., Ibrahem, S. E., Ismail, F. H., Abedelwahed, H. H., Ali, A. M., Abdelgadim, N. H., Mustafa, A. M. A., Ahmed, I. H., Ahmed, N. M., Eltyeb, A. A., Gaafar, D. A., Alnassry, S. M., Adam, A. A., Yasin, N. S., Ali, R. A., Fadlalla, A. A., Eltayeb, A. E., & Saad, A. M. (2025). The role of antenatal education on maternal self-efficacy, fear of childbirth, and birth outcomes: A systematic review and meta-analysis. In European Journal of Midwifery (Vol. 9, Number March). European Publishing. https://doi.org/10.18332/EJM/200747
Zuarez-Easton, S., Erez, O., Zafran, N., Carmeli, J., Garmi, G., & Salim, R. (2023). Pharmacologic and nonpharmacologic options for pain relief during labor: an expert review. In American Journal of Obstetrics and Gynecology (Vol. 228, Number 5, pp. S1246–S1259). Elsevier Inc. https://doi.org/10.1016/j.ajog.2023.03.003
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