Soviet Rational Psychotherapy for Painless Childbirth

Painless Childbirth in the Soviet Union

Hypnotherapy and Rational Psychotherapy as Psychoprophylaxis

Copyright (c) Donald Robertson, 2010.  All rights reserved.

Following the large-scale use of Pavlovian hypnotherapy at the start of the 20th century, as a means of reducing pain and anxiety during childbirth and dealing with associated complications, Soviet clinicians began to employ rational psychotherapy in a group setting as a preventative (prophylactic) against pain during childbirth.  These techniques were generally influenced by Pavlovian conditioning theory.  Today we would probably refer to what the Soviet therapists called “psychoprophylaxis” as “psycho-education”.

In a collection of papers by experts in this field, Shugom provides a brief review of Soviet statistical data on the results of psychoprophylaxis of labour pain.  His first observation is that the duration of labour among women who have attended group rational psychotherapy seminars in preparation for childbirth is reduced by an average of two hours, compared to childbirth under anaesthetic, or 3-4 hours compared to labour without anaesthesia.  Shugom provides a table illustrating this conclusion by reference to data from fifteen studies by different authors.  Eight of these were studies specifically on psychoprophylaxis, which report average duration of labour to be between 5hrs 40 min. and 16hrs.  The seven other studies, on duration of labour without psychoprophylaxis, found labour duration to range from 11hrs to 24hrs.

Soviet Rational Psychotherapy for Prophylaxis of Pain during Childbirth
Soviet Rational Psychotherapy for Prophylaxis of Pain during Childbirth

Shugom reports the following mean figures collated from many thousands of cases, measured on a standard five-point clinical scale,

Summing up the results of pain prevention by the psychoprophylactic method on the basis of the reports of 20 authors, including 9 foreign authors, using the materials of more than 15,000 childbirths, A. Nikolayev reported at the Tenth All-Union Congress of Obstetrics and Gynaecology the following data on the effectiveness of rendering childbirth painless by the psychoprophylactic method:

Complete effect of preparation (5): 45-50%
Considerable partial effect (4): 30%
Insignificant (3): 15%
No effect (2): 4-5%

In old studies of this kind, complete or significant partial improvement are often pooled to provide a success rate figure, which in this case would be 75-80%, based on Nikolayev’s data from 15,000 women undergoing childbirth following psychoprophylaxis by the Soviet method. 

Shugom also provides a table of data, summarised in the chart above, which (excluding one site where the number of participants was unknown) shows that among a total sample of 5,610 pregnant women at seven different sites in the Soviet Union, psychoprophylaxis resulted in complete or significant reduction of pain during 83% of childbirths, on average.  Comparison of the figures across sites shows that they are fairly consistent, lending some additional credibility to the finding.

In a direct comparison between the psychoprophylactic method and Pavlovian suggestion-based hypnotherapy for labour pain, another Soviet author, Velvovsky, reported data from exactly 1,000 childbirths.  In this study, the reported level of pain during labour of 641 women who had preventative rational psychotherapy (psychoprophylaxis) was compared directly against a sample of 113 women who received hypnotherapy.  See my article on Velvovsky’s comparison between psychoprophylaxis and hypnotherapy for a more detailed discussion.  The graph below places the data on psychoprophylaxis from Nikolayev’s study alongside the figures from Velvovsky’s direct comparison,

Combined data from Velvovsky and Nikolayev's Studies
Combined data from Velvovsky and Nikolayev's Studies

These figures need to be treated with caution because little information is provided on the studies and any comparison the two sets of data can only be very tentative indeed.  However, they may provide some inspiration for further research in this area using modern research design methods.  There certainly seems to be an indication, from large numbers of women treated with these methods in the Soviet Union, that psychological methods can reduce the pain of labour to varying degrees, and that the inclusion of Pavlovian-style relaxation hypnosis may substantially improve the effect of psycho-education and suggestion, although non-hypnotic relaxation techniques may be found to have similar properties.

Velvovsky, I.; Platonov, K.; Ploticher, V.; Shugom, E.   (1960).  Painless Childbirth through Psychoprophylaxis.
Zdravomyslov, V.I.   (1956).  ‘The Significance of Psychotherapy in Obstetrics and Gynecology’ in Psychotherapy in the Soviet Union, Ralph B. Winn (ed.).  Grove Press: New York.