Preparation for childbirth and contemporary research on pain, anxiety, and stress reduction: a review and critique.

The literature on psychoprophylaxis (prepared childbirth) manifests little interface with contemporary psychosomatic research, despite the fact that psychosomatic variables are intimately involved in the treatment process. Comments are made regarding the application of research on pain and anxiety reduction to labor preparation, and the employment of this knowledge in the development of more efficacious treatment methods. In addition, an examination of studies designed to evaluate the therapeutic efficacy of psychoprophylaxis reveals that a variety of methodological errors have confounded the measurement of treatment effects. It is concluded that preparation for labor is a valid and desirable subject of inquiry for psychosomatic medicine, with particular relevance for researchers engaged in a study of the cognitive, behavioral, or psychophysiological manifestations of pain, anxiety, or stress.