Effect of hypnotherapy on prolactin level in women after cesarean section

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Supriyadi Hari Respati
Risang Bhaskoro
Eric Edwin Yuliantara
Uki Retno Budihastuti
Debree Septiawan


Postpartum depression occurs in women after cesarean section, due to increased cortisol and decreased prolactin levels, leading to delayed breast milk production. Hypnotherapy is one of the most effective and efficient complementary therapy options for reducing postpartum depression. Hypnotherapy increases oxytocin secretion from the paraventricular nucleus of the anterior pituitary gland, decreases cortisol levels, and increases prolactin, thereby increasing breast milk production. This study evaluates hypnotherapy’s effect on prolactin levels after a cesarean section.

This study was an experimental non-blinded randomized controlled trial with a post-test-only control group design conducted at Dr. Moewardi General Hospital and UNS hospital. A total of 20 post-cesarean -section women were included in the study. They were randomized into two groups, a group I: given hypnotherapy, and group 2: the control group (without hypnotherapy). Both groups were tested for prolactin levels. Group I received hypnotherapy 6 to 12 hours post-cesarean section, and study participants were confirmed to be unaffected by the anesthetic. Data analysis used the independent t-test and p<0.05.

At baseline, there was no significant difference in age, parity, and indication for cesarean section between the hypnotherapy and the control groups (p>0.05). After intervention, the mean prolactin level was higher in the hypnotherapy group (247.6 ± 81.1 ng/mL) compared to the control group (120.1 ± 55.4 ng/mL) (p<0.001).

Hypnotherapy increases post-cesarean prolactin levels compared to the controls. Our findings open up a wide range of potential hypnotic applications among women with postpartum depression.

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How to Cite
Respati, S. H., Bhaskoro, R., Yuliantara, E. E., Budihastuti, U. R., & Septiawan, D. (2023). Effect of hypnotherapy on prolactin level in women after cesarean section. Universa Medicina, 42(1), 6–11. https://doi.org/10.18051/UnivMed.2023.v42.6-11
Original Articles


Mengesha MB, Adhanu HH, Weldegeorges DA, et al. Maternal and fetal outcomes of cesarean delivery and factors associated with its unfavorable management outcomes in Ayder Specialized Comprehensive Hospital, Mekelle, Tigray, Ethiopia, 2017. BMC Res Notes 2019;12:4–9. doi: 10.1186/s13104-019-4690-5.

Boerma T, Ronsmans C, Melesse DY, et al. Global epidemiology of use of and disparities in caesarean sections. Lancet 2018;392:1341–8. doi: 10.1016/S0140-6736(18)31928-7.

Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. The increasing trend in caesarean section rates: Global, regional and national estimates: 1990-2014. PLoS One 2016;11:1–12. doi: 10.1371/journal.pone.0148343.

Kementrian Kesehatan Republik Indonesia/Kemenkes RI. Laporan Nasional RISKESDAS 2018. Badan Penelitian dan Pengembangan Kesehatan. Jakarta: Badan Penelitian dan Pengembangan Kesehatan; 2018.

Chan CLJ, Tan CW, Chan JJI, et al. Factors associated with the development of postnatal depression after cesarean delivery: a prospective study. Neuropsychiatr Dis Treat 2020;16:715–27. doi: 10.2147/NDT.S241984.

Benton M, Salter A, Tape N, Wilkinson C, Turnbull D. Women’s psychosocial outcomes following an emergency caesarean section: A systematic literature review. BMC Pregnancy Childbirth 2019;19. doi: 10.1186/s12884-019-2687-7.

Mohd Shukri NH, Wells JCK, Fewtrell M. The effectiveness of interventions using relaxation therapy to improve breastfeeding outcomes: a systematic review. Matern Child Nutr 2018;14: e12563. doi: 10.1111/mcn.12563.

Ýsik Y, Dag ZO, Tulmac OB, Pek E. Early postpartum lactation effects of cesarean and vaginal birth. Ginekol Pol 2016;87:426–30. doi: 10.5603/GP.2016.0020.

Anuhgera DE, Kuncoro T, Sumarni S, Mardiyono M, Suwondo A. Hypnotherapy is more effective than acupressure in the production of prolactin hormone and breast milk among women having given birth with caesarean section. Med Sci Int Med J 2017;1. doi: 10.5455/medscience.2017. 06.8659.

Beevi Z, Low WY, Hassan J. The effectiveness of hypnosis intervention in alleviating postpartum psychological symptoms. Am J Clin Hypn 2019; 61:409–25. doi: 10.1080/00029157.2018.1538870.

Anuhgera DE, Kuncoro T, Sumarni S, Mardiyono, Suwondo A. Effect of combination of hypnobreastfeeding and acupressure on anxiety and wound pain in post-caesarean mothers. Belitung Nurs J 2017;3:525–32. doi: 10.33546/bnj.191.

Aini YN, Hadi, Rahayu S, Pramono N, Mulyantoro DK. Effect of combination of oxytocin massage and hypnobreastfeeding on uterine involution and prolactin levels in postpartum mothers. Belitung Nurs J 2017;3:784-90. doi: 10.33546/bnj.293.

Redshaw M, Henderson J. From antenatal to postnatal depression: associated factors and mitigating influences. J Womens Health (Larchmt) 2013;22:518-25. doi: 10.1089/jwh.2012.4152.

Catsaros S, Wendland J. Hypnosis-based interventions during pregnancy and childbirth and their impact on women’s childbirth experience: a systematic review. Midwifery 2020;84: 102666. doi: 10.1016/j.midw.2020.102666.

McGuire TM. Drugs affecting milk supply during lactation. Aust Prescr 2018;41:7–9. doi: 10.18773/austprescr.2018.002.

Torner L. Actions of prolactin in the brain: from physiological adaptations to stress and neurogenesis to psychopathology. Front Endocrinol (Lausanne) 2016;7:25. doi: 10.3389/fendo.2016.00025.

Yuan Y, Wu W, Chen M, et al. Reward inhibits paraventricular CRH neurons to relieve stress. Curr Biol 2019;29:1243-51.e4. doi: 10.1016/j.cub.2019.02.048.

Stephens MAC, McCaul ME, Wand GS. The potential role of glucocorticoids and the HPA axis in alcohol dependence. In : Noronha ABC, Cui C, Harris RA, Crabbe JC, editors. Neurobiology of Alcohol Dependence. Academic Press;2014. p.429-50. https://doi.org/10.1016/C2012-0-02501-X.

Begum T, Rahman A, Nababan H, et al. Indications and determinants of caesarean section delivery: evidence from a population-based study in Matlab, Bangladesh. PLoS One 2017;12:1–16. doi: 10.1371/JOURNAL.PONE. 0188074.

Bernard V, Young J, Binart N. Prolactin - a pleiotropic factor in health and disease. Nat Rev Endocrinol 2019;15:356–65. doi:10.1038/s41574-019-0194-6.

Mahandaru AH, Respati SH, Sulistyowati S, Laqif A, Prasetya H. The effect of hypnotherapy on postpartum pain and depression in women with post caesarean delivery. Indones J Med 2021; 6:194–205. doi: 10.26911/theijmed.2021.06.02.08.

Alizamar A, Ifdil I, Fadli RP, et al. The effectiveness of hypnotherapy in reducing stress levels. Addict Disord Trea 2018;17:191–5. doi: 10.1097/ADT. 0000000000000140.

Fisch S, Trivakoviæ-Thiel S, Roll S, et al. Group hypnosis for stress reduction and improved stress coping: a multicenter randomized controlled trial. BMC Complement Med Ther 2020; 20:344. doi: 10.1186/s12906-017-1806-0.