Mindfulness-Based Childbirth Education: Incorporating Adult and Experiential Learning With Mindfulness-Based Stress Reduction in Childbirth Education

Improving Online Childbirth Education: A Role for Active Learning

Teaching online poses unique challenges for keeping participants engaged. To enhance the effectiveness of virtual childbirth education, this article explores how active learning techniques can guide the design of online prenatal classes. Active learning involves encouraging class participants to process and engage with ideas as the instructor presents them in class, rather than just hearing about concepts through lectures. This article draws from pedagogical literature on active learning and applies its key components to the needs of childbirth instructors in an online setting. Specific recommendations for activities to involve participants and create lasting learning are also provided for synchronous online classes.

Effectiveness of dietary fiber experiential learning on bowel symptom after surgery for colorectal cancer: A randomized controlled trial

PURPOSE

Patients with colorectal cancer commonly experience postoperative bowel symptoms, and demand dietary and self-care adjustment. Experiential learning (EL) has been effective in promoting dietary management. This study aimed to investigate the effect of dietary-fiber EL on postoperative bowel symptoms in colorectal cancer patients.

METHOD

A randomized controlled trial was conducted. A total of 66 adults with stage I-III colorectal cancer, being scheduled for surgery were recruited in Taiwan. EL group (n = 34) received gaming-based activities along with routine care after surgery and a follow-up consultation. Bowel symptoms was assessed by Low Anterior Resection Syndrome at baseline, and 1, 3, and 6 months after surgery, with dietary fiber intake measured by the Food Frequency Questionnaire, and knowledge, efficacy and literacy assessed by the Dietary Fiber Food Scale as covariates.

RESULTS

The two groups did not significantly differ at baseline. The mean bowel symptom scores were 16.2, 13.8, and 9.8 at 1, 3 and 6 months, respectively. The generalised estimating equations model indicated that after controlling surgical site, information sources, fiber intake, knowledge, efficacy, literacy and emotion, EL group reported significantly lower bowel symptoms by 8.3 score at 1 month and by 9.9 score at 3 months post-surgery than the routine group. Lower bowel symptoms were linked to an upper surgical site, higher dietary fiber intake and lower emotional distress.

CONCLUSIONS

Experiential learning of dietary fiber improved bowel symptoms better than routine patient education alone. Oncology nurses may develop strategies to further implement experiential learning activities in post-surgery colorectal care.

Breastfeeding continuation is associated with trait mindfulness but not with trajectories of postpartum depressive symptoms

OBJECTIVE

The WHO recommends breastfeeding for at least six months as breastfeeding has many benefits for both infant and mother. The association of breastfeeding continuation with trait mindfulness during pregnancy and trajectories of postpartum depressive symptoms has not been examined yet. The current study aimed to assess this association using cox regression analysis.

DESIGN, SETTING AND PARTICIPANTS

The current research is part of a large longitudinal prospective cohort study following women from 12 weeks of pregnancy onwards in the South-East part of the Netherlands.

MEASUREMENTS

A total of 698 participants filled out the Three Facet Mindfulness Questionnaire-Short Form (TFMQ-SF) at 22 weeks of pregnancy and completed both the Edinburgh Postnatal Depression Scale (EPDS) and questions on breastfeeding continuation one week, six weeks, four months, and eight months postpartum. Breastfeeding continuation was defined as exclusive breastfeeding or both breastfeeding and formula. The assessment eight months postpartum was used as a proxy for the WHO recommendation to continue breastfeeding for at least six months.

FINDINGS

Two trajectories (classes) of EPDS scores were determined using growth mixture modeling: 1) low stable (N = 631, 90.4%), and 2) increasing (N = 67, 9.6%). Cox regression analysis showed that the trait mindfulness facet non-reacting was significantly and inversely associated with the risk of breastfeeding discontinuation (HR = 0.96, 95% CI [0.94, 0.99], p = .002), while no significant association was found for belonging to the increasing EPDS class versus belonging to the low stable class (p = .735), adjusted for confounders.

KEY CONCLUSIONS

This study is the first to show that higher trait mindfulness non-reacting scores, but not persistently low levels of postpartum depressive symptoms, increase the likelihood of breastfeeding continuation.

IMPLICATIONS FOR PRACTICE

Improving non-reacting in perinatal women by meditation practice as part of a mindfulness-based intervention may lead to better breastfeeding continuation outcomes. Several mindfulness-based programs may be suitable.

Meditation and Mindfulness in Pregnancy and Postpartum: A Review of the Evidence

Given their growing popularity, mindfulness practices including meditation are actively being studied in clinical trials to assess their efficacy at improving health outcomes during pregnancy and the postpartum period. We conducted a literature review to compile these studies and assessed their findings. There is sufficient evidence to support the practice of mindfulness practices in pregnancy to reduce anxiety, depression, and stress during pregnancy, which may continue to have beneficial effects through the postpartum period. There is limited evidence on the benefits of mindfulness and meditation for other aspects of pregnancy. However, due to the low-risk nature of these techniques, all women should be encouraged to engage in mindfulness practices during pregnancy.

Breastfeeding intention and trait mindfulness during pregnancy

OBJECTIVE

Breastfeeding has been associated with many health benefits for both infant and mother. Trait mindfulness during pregnancy may have a beneficial impact on breastfeeding intention. The current study aimed to examine whether trait mindfulness during pregnancy was associated with antenatal breastfeeding intention.

DESIGN, SETTING AND PARTICIPANTS

The current study is part of a large prospective population-based cohort study among pregnant women in the south of the Netherlands.

MEASUREMENTS

A subsample of participants completed the Three Facet Mindfulness Questionnaire-Short Form at 22 weeks of pregnancy and a question on their breastfeeding intention at 32 weeks of pregnancy (N=790). Moreover, the Edinburgh Depression Scale and Tilburg Pregnancy Distress scale were completed at 32 weeks of pregnancy to assess levels of distress.

FINDINGS

Univariate analyses showed that women with breastfeeding intention during pregnancy had significantly higher scores on the mindfulness facet non-reacting (p<.001, medium effect size) and significantly lower scores on acting with awareness (p=.035, small effect size). A subsequent multiple logistic regression analysis showed that only non-reacting remained significantly associated with antenatal breastfeeding intention (OR=1.09, 95% CI [1.03, 1.15], p=.001), after controlling for confounders. Women who eventually initiated breastfeeding had significantly higher non-reacting scores (p<.001, small to medium effect size).

KEY CONCLUSIONS

The mindfulness facet non-reacting was found to be associated with antenatal breastfeeding intention. More research is needed to confirm our results, since the current study is one of the first assessing the possible relation of trait mindfulness during pregnancy and breastfeeding intention.

IMPLICATIONS FOR PRACTICE

Mindfulness-based programs during pregnancy could be helpful in improving non-reacting in pregnant women, which may enhance breastfeeding intention and ultimately the initiation of breastfeeding.

Trait mindfulness during pregnancy and perception of childbirth

Women's subjective childbirth experience is a risk factor for postpartum depression and childbirth-related posttraumatic stress symptoms. Subjective childbirth experience is influenced not only by characteristics of the childbirth itself but also by maternal characteristics. A maternal characteristic that may be associated with a more positive childbirth experience is trait mindfulness. The current study aimed to assess this association and to assess whether trait mindfulness during pregnancy had a moderating role in the possible association between non-spontaneous delivery and perception of childbirth. A subsample of 486 women, participating in a longitudinal prospective cohort study (Holistic Approach to Pregnancy and the first Postpartum Year study), completed the Three Facet Mindfulness Questionnaire-Short Form at 22 weeks of pregnancy. Women completed the Childbirth Perception Scale and the Edinburgh Postnatal Depression Scale between 7 and 21 days postpartum. The mindfulness facets acting with awareness and non-reacting were significantly associated with a more positive perception of childbirth, after adjusting for covariates. Moderation analyses showed a significant interaction between acting with awareness and non-spontaneous delivery and non-judging and non-spontaneous delivery. Non-spontaneous delivery was associated with a more negative perception of childbirth for low/medium scores of acting with awareness and non-judging, but not for high scores on these mindfulness facets. Trait mindfulness during pregnancy may enhance a positive perception of childbirth. Because this is among the first studies examining the association between maternal dispositional mindfulness and perception of childbirth, future research is needed to confirm the results of the current study.

Understanding Millennial Moms' Choices: A Nursing Survey About Childbirth Education in Primigravid Women

Primigravid women, at some point, feel the need to gain education about childbirth. Our objective was to identify where primigravid millennial moms are seeking their childbirth education. This study, a quantitative nonexperimental survey research, was designed within the context of developmental transition theory. Childbearing women were recruited, considering the phenomenon to be studied. This purposive sample of 100 participants included primigravid millennial mothers (born between 1978 and 1994), status post vaginal birth, or emergent cesarean surgery, on a 455-bed, acute care facility. All participants were able to speak, understand, and read English or Spanish fluently. The author used a self-report survey to collect data from the participants. Primigravid women responded to a series of questions posed by the investigator. Considering the participants' variety of reading levels and their ability to communicate in writing, special attention was given to the simplicity and clarity of the questions on the survey. The responses provided by the participants suggested the need to enhance current childbirth education into culturally friendly and evidence-based technological information. Websites, apps, and social media are important information channels to reach and disseminate valuable childbirth education for millennial primigravid women. However, these channels are not currently being used to their full potential, considering the amount of information available and lack of guidance and clarity to disseminate trustworthy health-care information. By understanding millennial moms' choices, we gain the opportunity to deliver better education and support to Internet savvy women who are seeking online health-care information.

The effect of mindfulness-based stress reduction on maternal anxiety and self-efficacy: A randomized controlled trial

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.

Delphi Expert Parent Study: Factors Needed for 21st Century Pre- and Perinatal Parenting Programs

Using Delphi methodology, the current study utilized a panel of "expert" parents (N = 23 after three rounds) to examine nine content-based and logistical factors perceived to be important when developing pre-and perinatal (PPN) parenting programs for the modern day. The aim was to attain consensus on 235 items generated from literature and panelists. Consensus was reached on 126 items (53.62%). The most notable related to needs-based content, barriers to fathers' attendance, and groups of parents who may benefit most from programs. Consistent with the literature, clarity was not achieved for appropriate timing and length of programs. With the diversity of recommendations, next steps involve developing a range of programs that use randomized clinical trials with control groups, effective sample sizes, and are pre-and posttested.