Development and Pilot Evaluation of a Self-Guided Digital Hypnorelaxation Program for Sleep Quality and Psychological Readiness Pregnant Women
DOI:
https://doi.org/10.31674/mjmr.2026.v010i02.001Abstract
Background: Sleep disturbances and psychological distress are common during late pregnancy and are associated with reduced maternal well-being and childbirth preparedness, highlighting the need for accessible non-pharmacological interventions. Objectives: This pilot study aimed to develop and preliminarily evaluate the feasibility and early responsiveness of a self-guided digital hypnorelaxation program integrating relaxation techniques and positive affirmations for late pregnancy. Methods: A developmental quasi-experimental pilot study with a pretest–posttest comparison group design was conducted among 60 third-trimester pregnant women recruited from community antenatal care settings. Participants were non-randomly allocated to an intervention group (n = 35) and a routine care group (n = 25). The intervention consisted of a standardized hypnorelaxation audio program used independently twice daily for 14 days. Sleep-related well-being and psychological readiness for childbirth were assessed using validated Indonesian instruments and analyzed within an exploratory pilot framework. Results: Baseline characteristics were comparable between groups. The intervention group showed greater short-term changes in sleep-related well-being scores (mean change = 8.40) compared with minimal change in the control group (mean change = 0.30). A shift toward higher sleep quality categories and increased childbirth preparedness was observed, with 85.7% of participants classified as highly prepared post-intervention. These findings represent preliminary response patterns within a pilot context. Conclusion: The intervention demonstrated feasibility, high adherence, and early indications of responsiveness. Further randomized controlled trials are required to establish effectiveness.
Keywords:
Digital Hypnorelaxation; , Late Pregnancy;, Maternal Well-Being;, Pilot Study;, Sleep QualityDownloads
References
Abera, M., Hanlon, C., Daniel, B., Tesfaye, M., Workicho, A., Girma, T., Wibaek, R., Andersen, G. S., Fewtrell, M., Filteau, S., & Wells, J. C. K. (2024). Effects of relaxation interventions during pregnancy on maternal mental health, and pregnancy and newborn outcomes: A systematic review and meta-analysis. PloS One, 19(1), e0278432. https://doi.org/10.1371/journal.pone.0278432
Afriyanti, A., Ni'mah, I., Maini, N., Suryani, Y., Irma, Y., & Pradana, A. A. (2021). Efektivitas pemberian hypnosis dalam implementasi keperawatan [The effectiveness of administering hypnosis in nursing implementation]. https://doi.org/10.13140/RG.2.2.12123.44324
Akinwaare, M. O., & Oluwatosin, O. A. (2023). Effect of goal-oriented prenatal education on birth preparedness, complication readiness and institutional delivery among semi-urban pregnant women in Nigeria: A quasi-experimental study. PLoS One, 18(7), e0289414. https://doi.org/10.1371/journal.pone.0289414
Atis, F. Y., & Rathfisch, G. (2018). The effect of hypnobirthing training given in the antenatal period on birth pain and fear. Complementary Therapies in Clinical Practice, 33, 77-84. https://doi.org/10.1016/j.ctcp.2018.08.004
Catsaros, S., & Wendland, J. (2020). Hypnosis-based interventions during pregnancy and childbirth and their impact on women's childbirth experience: A systematic review. Midwifery, 84, 102666. https://doi.org/10.1016/j.midw.2020.102666
Chamine, I., Atchley, R., & Oken, B. S. (2018). Hypnosis intervention effects on sleep outcomes: a systematic review. Journal of Clinical Sleep Medicine, 14(2), 271-283. https://doi.org/10.5664/jcsm.6952
Cheung, P. S., McCaffrey, T., Tighe, S. M., & Mohamad, M. M. (2023). Music as a health resource in pregnancy: A cross-sectional survey study of women and partners in Ireland. Midwifery, 126, 103811. https://doi.org/10.1016/j.midw.2023.103811
Downe, S., Finlayson, K., Melvin, C., Spiby, H., Ali, S., Diggle, P., ... & Williamson, M. (2015). Self‐hypnosis for intrapartum pain management in pregnant nulliparous women: A randomised controlled trial of clinical effectiveness. BJOG: An International Journal of Obstetrics & Gynaecology, 122(9), 1226-1234. https://doi.org/10.1111/1471-0528.14403
Eliyawati. (2024). Pengaruh self hypnosis terhadap penurunan kecemasan pada ibu hamil trimester III dalam menghadapi persalinan [The effect of self-hypnosis on reducing anxiety in pregnant women in the third trimester when facing childbirth]. WOMB Midwifery Journal, 3(1), 27–33. https://doi.org/10.54832/wombmidj.v3i1.335
Fernández-Gamero, L., Reinoso-Cobo, A., Ruiz-González, M. D. 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. Healthcare (Basel, Switzerland), 12(6), 616. https://doi.org/10.3390/healthcare12060616
Gueguen, J., Huas, C., Orri, M., & Falissard, B. (2021). Hypnosis for labour and childbirth: A meta-integration of qualitative and quantitative studies. Complementary Therapies in Clinical Practice, 43, 101380. https://doi.org/10.1016/j.ctcp.2021.101380
Indahwati, L., Azzahra, S. S., & Indrawan, I. W. A. (2023). Pengaruh self hypnosis terhadap kualitas tidur ibu hamil trimester III [The effect of self-hypnosis on the sleep quality of pregnant women in the third trimester]. Jurnal Ilmiah Kesehatan Media Husada, 12(2), 165-171. https://doi.org/10.33475/jikmh.v12i2.358
Islami, A. I., & Hardjanti, T. S. (2022). Hypnotherapy can reduce anxiety score in high-risk pregnant women. Jurnal Kebidanan dan Kesehatan Tradisional, 11-17. https://doi.org/10.37341/jkkt.v0i0.296
Jannah, N., & Selvarajh, G. (2026a). Development and Pilot Testing of a Childbirth Readiness Questionnaire (CRQ) for Third-Trimester Pregnant Women in Indonesia. International Journal of Public Health Excellence (IJPHE), 5(2), 1–8. https://doi.org/10.55299/ijphe.v5i2.1739
Jannah, N., & Selvarajh, G. (2026b). Multidimensional structure of maternal sleep quality in the third trimester: Psychometric evaluation. International Journal of Public Health Excellence (IJPHE), 5(2), 47–54. https://doi.org/10.55299/ijphe.v5i2.1798
Li, W., Ren, T., Xu, G., & Wang, Y. (2025). Evaluating the impact of a multimodal perinatal education program on birth preparedness, mental health, and birth outcomes among rural primiparous women: a retrospective cohort study. BMC Pregnancy and Childbirth, 25(1), 56. https://doi.org/10.1186/s12884-025-07152-8
Manesh, B. K., Tafazoli, M., Fathi, M., Mazloum, S. R., & Moridi, A. (2025). The efficacy of self-hypnosis on sleep quality in the third trimester of pregnancy in primiparous women: A Randomized Clinical Trial. Journal of Midwifery & Reproductive Health, 13(1). https://doi.org/10.22038/jmrh.2023.69364.2040
Montgomery, R. (2025). Sample size justification in feasibility studies: Moving beyond published guidance. Pilot and Feasibility Studies, 11, 88. https://doi.org/10.1186/s40814-025-01675-9
Nasiri, S., Akbari, H., Tagharrobi, L., & Tabatabaee, A. S. (2018). The effect of progressive muscle relaxation and guided imagery on stress, anxiety, and depression of pregnant women referred to health centers. Journal of Education and Health Promotion, 7(1), 41. https://doi.org/10.4103/jehp.jehp_158_16
Naz, S., Khatoon, Z., Karim, S., Atiq, M., & Khattak, I. U. (2024). Effectiveness of hypnobirthing in reducing anxiety level among pregnant women during childbirth: A quasi-experimental study in Tertiary Care Hospital of Islamabad. Journal of Health and Rehabilitation Research, 4(1), 1569-1573. https://doi.org/10.61919/jhrr.v4i1.657
Noorlinda, N., & Sartika, S. (2025). Effectiveness of Hypnobirthing for reducing anxiety before childbirth in third trimester primigravida: A quantitative study in Indonesia. Journal of Current Health Sciences, 5(2), 123–130. https://doi.org/10.47679/jchs.2025124
Özkan, S. A., & Rathfisch, G. (2018). The effect of relaxation exercises on sleep quality in pregnant women in the third trimester: A randomized controlled trial. Complementary Therapies in Clinical Practice, 32, 79–84. https://doi.org/10.1016/j.ctcp.2018.05.008
Panduragan, S. L., & Pardi, K. (2026). Effectiveness of hypnobirthing, music therapy and combined intervention in reducing low back pain among third-trimester pregnant women: A quasi-experimental study. F1000Research, 14, 868. https://doi.org/10.12688/f1000research.168854.2
Paulino, D. S. M., Borrelli, C. B., Faria-Schützer, D. B., Brito, L. G. O., & Surita, F. G. (2022). Non-pharmacological interventions for improving sleep quality during pregnancy: A systematic review and meta-analysis. Revista Brasileira de Ginecologia e Obstetrícia/RBGO Gynecology and Obstetrics, 44(08), 776-784. https://doi.org/10.1055/s-0042-1746200
Sanlı, Y., Goke Arslan, G., Aypar Akbag, N. N., Canbulat Sahiner, N., Yılmaz, D., & Yucel, S. C. (2022). Effects of music on sleep quality and comfort levels of pregnant women. Journal of Perinatal Medicine, 50(4), 467-475. https://doi.org/10.1515/jpm-2021-0551
Santiváñez-Acosta, R., Tapia-López, E. D. L. N., & Santero, M. (2020). Music therapy in pain and anxiety management during labor: A systematic review and meta-analysis. Medicina, 56(10), 526. https://doi.org/10.3390/medicina56100526
Siregar, M., & Panggabean, H. W. (2024). Reducing Effect of Hypnotherapy Anxiety in Pregnant Women. Jurnal Penelitian Pendidikan IPA, 10(SpecialIssue), 482-488. https://doi.org/10.29303/jppipa.v10iSpecialIssue.7828
Teresi, J. A., Yu, X., Stewart, A. L., & Hays, R. D. (2022). Guidelines for designing and evaluating feasibility pilot studies. Medical Care, 60(1), 95–103. https://doi.org/10.1097/MLR.0000000000001664
Totton, N., Lin, J., Julious, S. A., Zhang, J., & Walters, S. J. (2023). A review of sample sizes for UK pilot and feasibility studies on the ISRCTN registry from 2013 to 2020. Pilot and Feasibility Studies, 9, 188. https://doi.org/10.1186/s40814-023-01416-w
Vázquez-Lara, M. D., Ruger-Navarrete, A., Mohamed-Abdel-Lah, S., Gómez-Urquiza, J. L., Fernández-Carrasco, F. J., Rodríguez-Díaz, L., Caparros-Gonzalez, R. A., Palomo-Gómez, R., Riesco-González, F. J., & Vázquez-Lara, J. M. (2025). The Impact of Mindfulness Programmes on Anxiety, Depression and Stress During Pregnancy: A Systematic Review and Meta-Analysis. Healthcare, 13(12), 1378. https://doi.org/10.3390/healthcare13121378
Wang, J., Yang, Q., Cui, N., Wu, L., Zhang, X., Sun, Y., ... & Cao, F. (2025). Effectiveness and mechanisms of a digital Mindfulness–Based intervention for subthreshold to clinical insomnia symptoms in pregnant women: randomized controlled trial. Journal of Medical Internet Research, 27, e68084. https://doi.org/10.2196/68084
Werner, A., Wu, C., Zachariae, R., Nohr, E. A., Uldbjerg, N., & Hansen, Å. M. (2020). Effects of antenatal hypnosis on maternal salivary cortisol during childbirth and six weeks postpartum-A randomized controlled trial. PloS One, 15(5), e0230704. https://doi.org/10.1371/journal.pone.0230704
Zainiyah, Z. Z., Hapsari, V. D., Fitriah, F., & Hasinuddin, M. H. M. (2025). Islamic Sleep Ritual Activity (ISRA) intervention improving sleep quality, physical and psychological comfort for pregnant women in the third trimester. Jurnal Kebidanan, 15(1). https://doi.org/10.33023/jurkeb.v14i1.11921
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Malaysian Journal of Medical Research (MJMR)

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
























