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Bakhteh A, Jaberghaderi N, Rezaei M, Naghibzadeh ZAS, Kolivand M, Motaghi Z. The effect of interventions in alleviating fear of childbirth in pregnant women: a systematic review. J Reprod Infant Psychol 2024; 42:5-21. [PMID: 35435061 DOI: 10.1080/02646838.2022.2059458] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The Fear of Childbirth (FOC) is regarded as a general problem, which affects women's health and well-being, justifying demanding caesarean section. Several primary studies have been performed in relation to the interventions performed to reduce the fear of childbirth, which show contradictions between the results of these studies. OBJECTIVE This review aims to provide a comprehensive review of the different types of interventions used to reduce the fear of childbirth in pregnant mothers. METHODS In this study, systematic review of study information related to the effect of different therapies on reducing the fear of childbirth using subject-related keywords and validated with MeSH in SID, MagIran, IranMedex, IranDoc, Embase, ProQuest, Scopus, PubMed, Web of Science (ISI) databases and Google Scholar Search Engine were extracted without any time limit until February 2021. RESULTS After removing duplicates and irrelevant works from among the 5396 articles found, 63 articles remained in the study. The participants in these 63 articles were 5415 cases and 5770 controls. In addition, three studies were on epidural anesthesia, 33 on the effects of psychotherapy, 19 on the effects of education, and eight on the influence of other interventions on alleviating FOC. As shown by the results, psychotherapy intervention and education decreased FOC significantly. CONCLUSION According to the results of this study, to prevent the fear of childbirth, pregnancy training and prenatal preparation courses are recommended to empower pregnant women. It also seems beneficial to use psychotherapy approaches for women who are afraid of childbirth.
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Affiliation(s)
- Azam Bakhteh
- Student Research Center, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Nasrin Jaberghaderi
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mansour Rezaei
- Department of Biostatistics, School of Health & Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Mitra Kolivand
- Department of Reproductive Health, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Motaghi
- Reproductive Health Department, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
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Wang S, Zhang C, Sun M, Zhang D, Luo Y, Liang K, Xu T, Pan X, Zheng R, Shangguan F, Wang J. Effectiveness of mindfulness training on pregnancy stress and the hypothalamic-pituitary-adrenal axis in women in China: A multicenter randomized controlled trial. Front Psychol 2023; 14:1073494. [PMID: 36935954 PMCID: PMC10018028 DOI: 10.3389/fpsyg.2023.1073494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/14/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction In the past two decades, mindfulness-based intervention programs have gradually become popular.Many studies have confirmed that these programs can effectively alleviate prenatal stress and negative emotion.The mindfulness-based stress-buffering hypothesis suggests that mindfulness training can induce changes in the levels of the cortisol secreted by the HPA axis, thereby reducing stress susceptibility. However, to date, only a few high-quality evidence-based medical studies have analyzed the effect of the mindfulness-based intervention in a maternal population.Thus, this study investigated the effects of a mindfulness-based psychosomatic intervention on pregnancy stress and the HYPERLINK "javascript:;" hypothalamic-pituitary-adrenal (HPA) axis of pregnant Chinese women. Methods Women experiencing first-time pregnancy (n = 117) were randomly allocated to the intervention group or parallel active control group, and data were collected at baseline and post-intervention periods. The participants completed questionnaires regarding mindfulness and pregnancy stress. Saliva samples was collected at the time of waking up, and 30, 45, and 60 min after waking up for analyzing the salivary cortisol levels. We analyzed differences between the two groups and changes within the same group before and after the intervention. Results and discussion A total of 95 participants completed the trial. Compared with the parallel active control group, the intervention group exhibited lower levels of stress after the intervention (P = 0.047). For HPA-axis-related indicators after the intervention, Delta value (P = 0.01) and AUCM value (P = 0.031) of the intervention group were significantly higher than that of the control group. Mindfulness-based interventions effectively reduced the level of pregnancy stress and adjusted the HPA axis function in pregnant women in China. Clinical Trial Registration https://www.chictr.org.cn, identifier ChiCTR 2000033149.
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Affiliation(s)
- Shulei Wang
- National Center for Women and Children’s Health, China CDC, Beijing, China
- Yantai Center for Disease Control and Prevention, Yantai, Shandong, China
| | - Chen Zhang
- Fengtai Mental Health Center, Beijing, China
- School of Psychology, Capital Normal University, Beijing, China
| | - Mengyun Sun
- National Center for Women and Children’s Health, China CDC, Beijing, China
| | - Daming Zhang
- Shanxi Maternal and Child Health Hospital, Taiyuan, Shanxi, China
| | - Ying Luo
- Shandong Maternal and Child Health Hospital, Jinan, Shandong, China
| | - Kairu Liang
- Sichuan Maternal and Child Health Hospital, Chengdu, Sichuan, China
| | - Tao Xu
- National Center for Women and Children’s Health, China CDC, Beijing, China
| | - XiaoPing Pan
- National Center for Women and Children’s Health, China CDC, Beijing, China
| | - Ruimin Zheng
- National Center for Women and Children’s Health, China CDC, Beijing, China
- *Correspondence: Ruimin Zheng,
| | - Fangfang Shangguan
- School of Psychology, Capital Normal University, Beijing, China
- Fangfang Shangguan,
| | - Jia Wang
- Shandong Provincial Hospital, Jinan, Shandong, China
- Jia Wang,
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Study protocol of guided mobile-based perinatal mindfulness intervention (GMBPMI) - a randomized controlled trial. PLoS One 2022; 17:e0270683. [PMID: 35802637 PMCID: PMC9269359 DOI: 10.1371/journal.pone.0270683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 06/14/2022] [Indexed: 11/19/2022] Open
Abstract
Background Psychological distress is a common occurrence among women during the perinatal period. Maternal psychological distress (MPS) can also have a negative influence on neonatal outcomes such as infant health, child development or mother-child interaction. Hence, interventions to improve mental wellbeing during this period are vital. Mindfulness based intervention (MBI) has been found to be effective in reducing psychological distress. Delivery of MBI via the internet, making it accessible and inexpensive, is showing a promising positive effect in reducing psychological distress. A randomized control trial with sufficient power is required to confirm its positive effect among pregnant women. The positive effects of MBI have been found to be associated with heart rate variability (HRV) biofeedback; however, the efficacy of MBI on HRV has been rarely studied among pregnant women. Also, the potential association of HRV with MBI and psychological wellbeing needs further examination. This research aims to test the effectiveness of guided mobile-based perinatal mindfulness intervention (GMBPMI) among pregnant women experiencing psychological distress during the pre- and post-natal period, as well as examining the efficacy of GMBPMI on HRV. Method This study is a randomized controlled trial that follows a parallel design. Consenting pregnant women in their second trimester (between 12th and 20th week gestation) will be randomly assigned to an intervention group (GMBPMI) or a control group (psychoeducation). The intended sample size is 198, with 99 participants in each group. Three levels of outcomes will be measured at baseline, post intervention in both the intervention and control groups, and at 36-week gestation and five-week postpartum. The primary outcomes include maternal psychological stress, mindfulness and positive appraisal HRV. Secondary outcomes are psychological and physical wellbeing. Tertiary outcomes include obstetric and neonatal outcomes, and social support. Analyses will follow an intention-to-treat method and repeated measures MANOVA will be conducted to compare changes in primary and secondary outcomes. A series of mixed-effects models will be fitted to assess the mediation effects. Discussion This trial expects to increase understanding of GMBPMI on HRV and psychological wellbeing for pregnant women, with extended support in both pre-and post-natal periods. The study could also potentially provide evidence for delivery of cost-effective and accessible services to pregnant women. Trial registration ClinicalTrials.gov: NCT04876014, registered on 30 March 2021. Protocol Version 1.0., 10 May 2021.
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Mannocci A, Ciavardini S, Mattioli F, Massimi A, D’Egidio V, Lia L, Scaglietta F, Giannini A, Antico R, Dorelli B, Svelato A, Orfeo L, Benedetti Panici P, Ragusa A, La Torre G, Group HAPPYMAMA. HAPPY MAMA Project (Part 2)-Maternal Distress and Self-Efficacy: A Pilot Randomized Controlled Field Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1461. [PMID: 35162482 PMCID: PMC8835492 DOI: 10.3390/ijerph19031461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 12/04/2022]
Abstract
INTRODUCTION The aim of the pilot randomized controlled field trial is to assess if a midwifery intervention is able to increase the maternal self-efficacy and reduce the stress level during the first six months after birth. METHODS The study was conducted in two different hospitals in Rome, Italy, involving women delivering at or beyond term, aged >18 years old and with normal APGAR scores of the infant. The participants were randomly divided into two groups: "Individual Intervention Group" (they received home midwifery assistance for one month after birth, I) and the "Control Group" (C). A self-administered questionnaire was administered four times: at the baseline about one week after the hospital delivery (T0), after the intervention about one month after the delivery (T1), and at three months (T2) and at six months after birth (T3). The questionnaire included different validated scales needed to assess maternal perceived self-efficacy (KPCS), parental stress scale stress (PSS) and maternal depressive risk symptoms (EPDS). RESULTS The study population counted 51 mothers: 28 women in the "C" group and 23 women in the "I" group. The PSS score was statistically higher in the "C" than "I" group at T1 (p = 0.024); whereas the KPCS score was statistically higher in the "I" (p = 0.039) group; EPDS score did not show significant difference between the two groups in the follow-up period. An inverse significant correlation between KPCS and PSS was found during the study window time (p < 0.0001). CONCLUSIONS These results potentially give the opportunity to explore this area of focus further, in order to better address maternal individual needs for the successful transition to motherhood. More research in this area is required.
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Affiliation(s)
- Alice Mannocci
- Faculty of Economics, Mercatorum University, 00186 Rome, Italy
| | - Sara Ciavardini
- Department of Public Health and Infectious Diseases, Sapienza University, 00185 Rome, Italy; (S.C.); (F.M.); (A.M.); (V.D.); (L.L.); (F.S.); (R.A.); (B.D.); (G.L.T.); (H.M.G.)
| | - Federica Mattioli
- Department of Public Health and Infectious Diseases, Sapienza University, 00185 Rome, Italy; (S.C.); (F.M.); (A.M.); (V.D.); (L.L.); (F.S.); (R.A.); (B.D.); (G.L.T.); (H.M.G.)
| | - Azzurra Massimi
- Department of Public Health and Infectious Diseases, Sapienza University, 00185 Rome, Italy; (S.C.); (F.M.); (A.M.); (V.D.); (L.L.); (F.S.); (R.A.); (B.D.); (G.L.T.); (H.M.G.)
| | - Valeria D’Egidio
- Department of Public Health and Infectious Diseases, Sapienza University, 00185 Rome, Italy; (S.C.); (F.M.); (A.M.); (V.D.); (L.L.); (F.S.); (R.A.); (B.D.); (G.L.T.); (H.M.G.)
| | - Lorenza Lia
- Department of Public Health and Infectious Diseases, Sapienza University, 00185 Rome, Italy; (S.C.); (F.M.); (A.M.); (V.D.); (L.L.); (F.S.); (R.A.); (B.D.); (G.L.T.); (H.M.G.)
| | - Franca Scaglietta
- Department of Public Health and Infectious Diseases, Sapienza University, 00185 Rome, Italy; (S.C.); (F.M.); (A.M.); (V.D.); (L.L.); (F.S.); (R.A.); (B.D.); (G.L.T.); (H.M.G.)
| | - Andrea Giannini
- Department of Maternal and Child Health and Urological Sciences, Umberto I Teaching Hospital, Sapienza University, 00185 Rome, Italy; (A.G.); (P.B.P.)
| | - Roberta Antico
- Department of Public Health and Infectious Diseases, Sapienza University, 00185 Rome, Italy; (S.C.); (F.M.); (A.M.); (V.D.); (L.L.); (F.S.); (R.A.); (B.D.); (G.L.T.); (H.M.G.)
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, 00186 Rome, Italy; (A.S.); (A.R.)
| | - Barbara Dorelli
- Department of Public Health and Infectious Diseases, Sapienza University, 00185 Rome, Italy; (S.C.); (F.M.); (A.M.); (V.D.); (L.L.); (F.S.); (R.A.); (B.D.); (G.L.T.); (H.M.G.)
| | - Alessandro Svelato
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, 00186 Rome, Italy; (A.S.); (A.R.)
| | - Luigi Orfeo
- Neonatal Intensive Care Unit, “San Giovanni Calibita” Fatebenefratelli, 00186 Rome, Italy;
| | - Pierluigi Benedetti Panici
- Department of Maternal and Child Health and Urological Sciences, Umberto I Teaching Hospital, Sapienza University, 00185 Rome, Italy; (A.G.); (P.B.P.)
| | - Antonio Ragusa
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, 00186 Rome, Italy; (A.S.); (A.R.)
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University, 00185 Rome, Italy; (S.C.); (F.M.); (A.M.); (V.D.); (L.L.); (F.S.); (R.A.); (B.D.); (G.L.T.); (H.M.G.)
| | - HAPPY MAMA Group
- Department of Public Health and Infectious Diseases, Sapienza University, 00185 Rome, Italy; (S.C.); (F.M.); (A.M.); (V.D.); (L.L.); (F.S.); (R.A.); (B.D.); (G.L.T.); (H.M.G.)
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Gheibi Z, Abbaspour Z, Haghighyzadeh MH, Javadifar N. Effects of a mindfulness-based childbirth and parenting program on maternal-fetal attachment: A randomized controlled trial among Iranian pregnant women. Complement Ther Clin Pract 2020; 41:101226. [PMID: 32853900 DOI: 10.1016/j.ctcp.2020.101226] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 07/22/2020] [Accepted: 07/30/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND PURPOSE Although mindfulness-based childbirth and parenting is suggested to promote maternal-fetal attachment, no study has yet addressed its potential effects. This study aimed to determine the effects of a mindfulness-based childbirth and parenting program on maternal-fetal attachment among Iranian pregnant women. MATERIALS AND METHODS This study was conducted on pregnant women, who were divided into two groups to either receive routine care plus mindfulness training for childbirth and parenting (i.e., eight 2-h group sessions once a week and one 3-h session of silent meditation) or receive routine care alone. Maternal-fetal attachment was evaluated by the Cranley's Maternal-Fetal Attachment Scale. RESULTS After the intervention, the total score of maternal-fetal attachment was significantly higher in the experimental group (P < 0.001; effect size = 0.640). In the intervention group, all dimensions of maternal-fetal attachment significantly improved, except the dimension of "differentiation of self from the fetus", whereas in the control group, only the dimension of "attributing characteristics to the fetus" improved. CONCLUSION The implemented program in this study was potentially effective in promoting maternal-fetal attachment.
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Affiliation(s)
- Zeinab Gheibi
- Student Research Committee, Department of Midwifery, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Zabihollah Abbaspour
- Department of Psychology, School of Education and Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran.
| | | | - Nahid Javadifar
- Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Zarenejad M, Yazdkhasti M, Rahimzadeh M, Mehdizadeh Tourzani Z, Esmaelzadeh-Saeieh S. The effect of mindfulness-based stress reduction on maternal anxiety and self-efficacy: A randomized controlled trial. Brain Behav 2020; 10:e01561. [PMID: 32162450 PMCID: PMC7177577 DOI: 10.1002/brb3.1561] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 01/07/2020] [Accepted: 01/13/2020] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE The aim of the study was to assess the effect of mindfulness-based stress reduction (MBSR) on anxiety and self-efficacy in coping with childbirth. MATERIAL AND METHODS This randomized controlled trial was conducted on 70 pregnant women in Abyek city of Qazvin province in Iran. The convenient sampling method was recruited. Samples were assigned to control and intervention groups using random blocks. In addition to routine care, individuals in the intervention group received 6 MBSR training sessions. The data gathering questionnaire in this study included mindfulness, Pregnancy-Related Anxiety Questionnaire, and self-efficacy in coping with childbirth questionnaire. RESULTS There was no statistically significant difference between the demographic characteristics in the control and intervention groups. The results of the analysis of variance (ANOVA) with repeated measures indicated the effect of time on the change in the total score of anxiety in the intervention group (p = .001). There was a significant difference between the two groups (p = .001). Also, the results of ANOVA with repeated measures showed that time had no impact on the score of self-efficacy in delivery coping (p = 0/1) and that there was no significant difference between the two groups in this respect (p = .6). CONCLUSION The result of this study showed that mindfulness reduces anxiety of pregnant mothers, and it is suggested that mindfulness programs be educated for healthcare providers and pregnant mothers to reduce maternal anxiety and improve pregnancy outcomes and delivery.
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Affiliation(s)
- Masoomeh Zarenejad
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Mansooreh Yazdkhasti
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mitra Rahimzadeh
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Sara Esmaelzadeh-Saeieh
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
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Van der Riet P, Francis L, Rees A. Exploring the impacts of mindfulness and yoga upon childbirth outcomes and maternal health: an integrative review. Scand J Caring Sci 2019; 34:552-565. [PMID: 31797402 DOI: 10.1111/scs.12762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 08/26/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Foetal development and the long-term outcomes of the infant are influenced by the intrauterine environment. Strategies to enhance maternal health in pregnancy are needed to improve health outcomes for childbearing women and babies, advancing the well-being of our general population. AIM To synthesise the existing literature to determine the impacts of mindfulness and yoga practice upon birth outcomes and maternal health. METHODS An integrative literature review using Whittemore and Knafl's framework was undertaken in 2016-2017. Two search strategies included database peer-reviewed journal articles and ancestry searching, that is exploring the reference list of relevant research articles. After screening and checking the eligibility, a total of 12 articles were included in this review. Data analysis involved coding, visual displays, thematic analysis and comparison, and conclusion drawing. RESULTS The results of this review identified a broad theme that mindfulness and yoga practice is associated with improved maternal mental health antenatally and postnatally. Subthemes have been presented under the central theme including the following: increased mindfulness correlates with decreased fear of childbirth; reduced symptoms of anxiety and depression; and supportive group settings found to be beneficial by pregnant women. CONCLUSION The evidence presented in this review suggests that mindfulness and yoga practice are feasible and cost-effective interventions to enhance maternal mental health, particularly for women experiencing mental health challenges. Mindfulness and yoga practised regularly in the antenatal period can significantly promote the health of pregnant women and potentially their developing babies.
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Affiliation(s)
- Pamela Van der Riet
- School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, Australia
| | - Lyn Francis
- Western Sydney University, Penrith, NSW, Australia
| | - Angela Rees
- University of Newcastle, Penrith, NSW, Australia
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Sacristan-Martin O, Santed MA, Garcia-Campayo J, Duncan LG, Bardacke N, Fernandez-Alonso C, Garcia-Sacristan G, Garcia-Sacristan D, Barcelo-Soler A, Montero-Marin J. A mindfulness and compassion-based program applied to pregnant women and their partners to decrease depression symptoms during pregnancy and postpartum: study protocol for a randomized controlled trial. Trials 2019; 20:654. [PMID: 31779683 PMCID: PMC6956498 DOI: 10.1186/s13063-019-3739-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 09/21/2019] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Pregnancy and the postpartum period are times of great change for women and their partners, often bringing substantial challenges and stress. Approximately 10%-20% of women suffer from mood disorders such as depression in the perinatal period. There are risks involved in using psychopharmacological interventions to treat perinatal depression. Mindfulness and compassion-based educational programs could be efficacious and cost-effective options for the prevention and treatment of perinatal mood disorders. The aim of this study is to assess the efficacy of an adapted Mindfulness-Based Childbirth and Parenting (MBCP) program that includes compassion training for pregnant women in primary care (PC) settings in the Spanish National Health System to decrease perinatal depression. METHODS A multicenter randomized controlled trial (RCT) will be conducted. Participants will be pregnant women (n = 122) and their partners who wish to participate. They will be enrolled and assessed in PC settings and randomly assigned to either: (1) an adapted MBCP educational program tailored to the Spanish National Health System + treatment as usual (TAU); or (2) TAU only. The main outcome to be assessed will be depression, evaluated with the Edinburgh Postnatal Depression Scale (EPDS). Secondary outcomes will include self-reported measures of perceived stress, affects, mindfulness, self-compassion, maternal self-efficacy, and use of health and social services. Patients will be assessed at four timepoints: baseline; post-treatment; and at three and six months after childbirth. Intention-to-treat and per-protocol analyses will be carried out using linear regression mixed models. Effect sizes will be estimated using Cohen's d. DISCUSSION Perinatal depression is a significant health problem. An effective and low-cost childbirth education program that incorporates mindfulness and compassion practices may be a beneficial preventive complementary healthcare modality for expectant women and their partners. This study will be the first multicenter RCT in Spanish PC settings using adapted MBCP and compassion practices to reduce symptoms of depression during pregnancy and the postpartum period. TRIAL REGISTRATION ClinicalTrials.gov, NCT03247491. Registered on 31 July 2017.
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Affiliation(s)
- Olga Sacristan-Martin
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Valladolid, Spain
- International School of Doctorate Studies, National University of Distance Education (UNED), Madrid, Spain
| | - Miguel A. Santed
- Department of Personality Psychology, National University of Distance Education (UNED), Madrid, Spain
| | - Javier Garcia-Campayo
- Aragon Institute for Health Research (Instituto de Investigacion Sanitaria Aragón (IIS Aragon), Miguel Servet Hospital, Psychiatry Service, University of Zaragoza, Zaragoza, Spain
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
| | - Larissa G. Duncan
- Center for Child & Family Well-Being, School of Human Ecology, University of Wisconsin-Madison, Madison, WI USA
| | - Nancy Bardacke
- Mindful Birthing and Parenting Foundation, Oakland, CA USA
| | | | | | - Diana Garcia-Sacristan
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Valladolid, Spain
| | - Alberto Barcelo-Soler
- Aragon Institute for Health Research (Instituto de Investigacion Sanitaria Aragón (IIS Aragon), Miguel Servet Hospital, Psychiatry Service, University of Zaragoza, Zaragoza, Spain
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
| | - Jesus Montero-Marin
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
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A systematic mixed-studies review on mindfulness-based childbirth education programs and maternal outcomes. Nurs Outlook 2019; 67:696-706. [DOI: 10.1016/j.outlook.2019.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/29/2019] [Accepted: 05/15/2019] [Indexed: 11/18/2022]
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Joseph R, Wellings A, Votta G. Mindfulness-Based Strategies: A Cost-Effective Stress Reduction Method for Parents in the NICU. Neonatal Netw 2019; 38:135-143. [PMID: 31470380 DOI: 10.1891/0730-0832.38.3.135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Stress in parents who have an infant in the NICU is well documented in literature. Prematurity and related comorbid conditions, high-tech NICU environments, presence of multidisciplinary health care professionals, altered parenting roles, and concerns of health outcomes in the infant are common stress factors. Further, inadequate management of stress can result in poor parent-infant bonding, poor infant outcome, and postpartum depression in parents. Effective stress management strategies may help parents adapt to their parental role thereby improving infant outcomes. Research has shown mindfulness-based strategies help reduce stress in the general population. Can this strategy be applied in the context of parents of infants in the NICU? Literature is scant on the impact of mindfulness-based strategies on parents of infants in the NICU and on the infant's health outcomes. This article explores the application of mindfulness-based strategies to reduce stress in parents of infants in the NICU.
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Lönnberg G, Nissen E, Niemi M. What is learned from Mindfulness Based Childbirth and Parenting Education? - Participants' experiences. BMC Pregnancy Childbirth 2018; 18:466. [PMID: 30509218 PMCID: PMC6276167 DOI: 10.1186/s12884-018-2098-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 11/19/2018] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND In the search for effective interventions aiming to prevent perinatal stress, depression and anxiety, we are evaluating a Mindfulness Based Childbirth and Parenting (MBCP) Program. In this study we explore the participants' experiences of the program. METHOD This is a descriptive qualitative study with influences of phenomenology. The participants were expectant couples who participated in the program and the pregnant women had an increased risk of perinatal stress, anxiety and depression. Ten mothers and six fathers were interviewed in depth, at four to six months postpartum. Thematic analysis of the transcripts was conducted. RESULTS The participants' descriptions show a variety in how motivated they were and how much value they ascribed to MBCP. Those who experienced that they benefitted from the intervention described that they did so at an intra-personal level-with deeper self-knowledge and self-compassion; and on an inter-personal level-being helpful in relationships. Furthermore, they perceived that what they had learned from MBCP was helpful during childbirth and early parenting. CONCLUSION Our findings demonstrate that most of the parents experienced MBCP as a valuable preparation for the challenges they met when they went through the life-changing events of becoming parents. The phenomenon of participating in the intervention, integrating the teachings and embodying mindfulness seems to develop inner resources that foster the development of wisdom. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT02441595, May 4, 2015.
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Affiliation(s)
- Gunilla Lönnberg
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18, 171 76 Stockholm, Sweden
| | - Eva Nissen
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18, 171 76 Stockholm, Sweden
| | - Maria Niemi
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18, 171 76 Stockholm, Sweden
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Beevi Z, Low WY, Hassan J. The Effectiveness of Hypnosis Intervention for Labor: An Experimental Study. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2017; 60:172-191. [PMID: 28891771 DOI: 10.1080/00029157.2017.1280659] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Hypnosis has been shown to help pregnant women experience improved labor and postpartum periods. The present study compares the differences between experimental (n = 23) and control groups (n = 22) on specific variables measured both during labor and 24 hr postpartum. The participants in the experimental group received the hypnosis intervention at weeks 16, 20, 28, and 36 of pregnancy, while those in the control group received only routine antenatal care. The data collected at the labor stage describe the length of the labor stage, pain relief used during labor, the method of delivery, and the type of assisted vaginal delivery. Within 24 hr of delivery, data on neonatal birth weight, neonatal Apgar scores, and self-reported pain were obtained. The labor stage results showed no significant differences in the length of the second and third stages of labor. Although the participants in the experimental group reported higher pain levels immediately prior to, during, and immediately after delivery, their use of pethidine during labor was significantly lower than the control group participants. None of the experimental group participants opted for an epidural, and they had a greater number of assisted vaginal deliveries than the control group participants. The 24 hr postpartum results showed that the neonates of the experimental group participants had nonsignificantly higher Apgar scores than those of the women in the control group. Group differences in neonatal weight were not significant. The results of the present study indicate that hypnosis is useful for assisting pregnant women during labor and the postpartum period.
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Affiliation(s)
- Zuhrah Beevi
- Heriot-Watt University Malaysia, Putrajaya, Malaysia
| | - Wah Yun Low
- University of Malaya, Kuala Lumpur, Malaysia
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Korukcu O, Kukulu K. The effect of the mindfulness-based transition to motherhood program in pregnant women with preterm premature rupture of membranes. Health Care Women Int 2017; 38:765-785. [DOI: 10.1080/07399332.2017.1318882] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Oznur Korukcu
- Department of Obstetrics and Gynaecological Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Kamile Kukulu
- Department of Obstetrics and Gynaecological Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
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Lever Taylor B, Cavanagh K, Strauss C. The Effectiveness of Mindfulness-Based Interventions in the Perinatal Period: A Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0155720. [PMID: 27182732 PMCID: PMC4868288 DOI: 10.1371/journal.pone.0155720] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 05/03/2016] [Indexed: 12/20/2022] Open
Abstract
Perinatal mental health difficulties are associated with adverse consequences for parents and infants. However, the potential risks associated with the use of psychotropic medication for pregnant and breastfeeding women and the preferences expressed by women for non-pharmacological interventions mean it is important to ensure that effective psychological interventions are available. It has been argued that mindfulness-based interventions may offer a novel approach to treating perinatal mental health difficulties, but relatively little is known about their effectiveness with perinatal populations. This paper therefore presents a systematic review and meta-analysis of the effectiveness of mindfulness-based interventions for reducing depression, anxiety and stress and improving mindfulness skills in the perinatal period. A systematic review identified seventeen studies of mindfulness-based interventions in the perinatal period, including both controlled trials (n = 9) and pre-post uncontrolled studies (n = 8). Eight of these studies also included qualitative data. Hedge's g was used to assess uncontrolled and controlled effect sizes in separate meta-analyses, and a narrative synthesis of qualitative data was produced. Pre- to post-analyses showed significant reductions in depression, anxiety and stress and significant increases in mindfulness skills post intervention, each with small to medium effect sizes. Completion of the mindfulness-based interventions was reasonable with around three quarters of participants meeting study-defined criteria for engagement or completion where this was recorded. Qualitative data suggested that participants viewed mindfulness interventions positively. However, between-group analyses failed to find any significant post-intervention benefits for depression, anxiety or stress of mindfulness-based interventions in comparison to control conditions: effect sizes were negligible and it was conspicuous that intervention group participants did not appear to improve significantly more than controls in their mindfulness skills. The interventions offered often deviated from traditional mindfulness-based cognitive therapy or mindfulness-based stress reduction programmes, and there was also a tendency for studies to focus on healthy rather than clinical populations, and on antenatal rather than postnatal populations. It is argued that these and other limitations with the included studies and their interventions may have been partly responsible for the lack of significant between-group effects. The implications of the findings and recommendations for future research are discussed.
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Affiliation(s)
| | - Kate Cavanagh
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Clara Strauss
- Sussex Partnership NHS Foundation Trust, Brighton, United Kingdom
- School of Psychology, University of Sussex, Brighton, United Kingdom
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Gambrel LE, Piercy FP. Mindfulness-based relationship education for couples expecting their first child-part 2: phenomenological findings. JOURNAL OF MARITAL AND FAMILY THERAPY 2015; 41:25-41. [PMID: 24443965 DOI: 10.1111/jmft.12065] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This phenomenological study is the second phase of a larger mixed methods study of a relationship-enhancement program for couples expecting their first child (see Gambrel & Piercy, this issue). The 4-week Mindful Transition to Parenthood Program uses mindfulness practices and interpersonal activities to develop skills of internal and interpersonal attunement. Based on semi-structured interviews with thirteen couples, four overarching themes emerged: (a) positive changes for self, (b) improvements in couple relationship, (c) more prepared for baby, and (d) male involvement. Participants stated that the program increased their acceptance and awareness, deepened connections with their partners, and led them to be more confident about becoming parents. Male participants felt they became more identified as fathers. The authors discuss the clinical implications of these findings.
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Gambrel LE, Piercy FP. Mindfulness-based relationship education for couples expecting their first child--part 1: a randomized mixed-methods program evaluation. JOURNAL OF MARITAL AND FAMILY THERAPY 2015; 41:5-24. [PMID: 24433518 DOI: 10.1111/jmft.12066] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This article is Part 1 of a two-part series, in which we report on our evaluation of a mindfulness-based relationship enhancement program for couples who are expecting their first child. In this mixed-methods randomized clinical trial, we assigned 33 couples to the 4-week Mindful Transition to Parenthood Program treatment group (n = 16 couples) or to a waitlist control condition (n = 17 couples). Men in the treatment group significantly improved in relationship satisfaction, mindfulness, and negative affect; women had no significant treatment effects. Small to large effect sizes were present for treatment group men and women in multiple areas. Mixed-methods analyses demonstrated that this intervention may be especially helpful for men because of differences in social support needs, effects of program enrollment, and relational processes in the prenatal period.
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Woolhouse H, Mercuri K, Judd F, Brown SJ. Antenatal mindfulness intervention to reduce depression, anxiety and stress: a pilot randomised controlled trial of the MindBabyBody program in an Australian tertiary maternity hospital. BMC Pregnancy Childbirth 2014; 14:369. [PMID: 25343848 PMCID: PMC4215015 DOI: 10.1186/s12884-014-0369-z] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 10/15/2014] [Indexed: 11/11/2022] Open
Abstract
Background Mindfulness interventions to reduce psychological distress are well-suited to pregnancy, due to their brief and non-pharmacological nature, but there is a need for more robust evidence determining their usefulness. This pilot study was designed to explore the feasibility of a randomised controlled trial of a mindfulness intervention to reduce antenatal depression, anxiety and stress. Methods The study was designed in two parts 1) a non-randomised trial targeting women at risk of mental health problems (a selected population) and 2) a randomised controlled trial (RCT) of a universal population. Process evaluation focused on feasibility of recruitment pathways, participant retention, acceptability of study measures, and engagement with mindfulness practices. Measurement of psychological distress was taken pre and post intervention through the Centre for Epidemiologic Studies Depression Scale Revised, the Depression Anxiety and Stress Scale-21, the State-Trait Anxiety Inventory, and the Perceived Stress Scale. Results 20 women were recruited to the non-randomised trial, and 32 to the RCT. Recruitment through a mailed study brochure at the time of booking-in to the hospital resulted in the largest number of participants in the RCT (16/32; 50%), and resulted in considerably earlier recruitment (50% in first trimester, 50% second trimester) compared to recruitment through the antenatal clinic waiting room (86% in second trimester, 14% third trimester). Over a third of women in the universal population scored above clinical cut-offs for depression and anxiety, indicating a sample with more symptomology than the general population. The most common reason for loss to follow-up was delivery of baby prior to follow-up (n = 9). In the non-randomised study, significant within group improvements to depression and anxiety were observed. In the intervention arm of the RCT there were significant within group improvements to anxiety and mindfulness. No between group differences for the intervention and ‘care as usual’ control group were observed. Conclusions This small pilot study provides evidence on the feasibility of an antenatal mindfulness intervention to reduce psychological distress. Major challenges include: finding ways to facilitate recruitment in early pregnancy and engaging younger women and other vulnerable populations. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12613000742774 (31/10/2012).
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Relational Aspects of Mindfulness: Implications for the Practice of Marriage and Family Therapy. CONTEMPORARY FAMILY THERAPY 2010. [DOI: 10.1007/s10591-010-9129-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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