Improve the Psychological Health of Obstetrics and Gynecology Patients during Covid-19 with a Mindfulness App

The COVID-19 vaccine and pregnancy — what women need to know | Keck School  of Medicine of USC

Improve the Psychological Health of Obstetrics and Gynecology Patients during Covid-19 with a Mindfulness App

 

By John M. de Castro, Ph.D.

 

mindfulness meditation might be a viable low-cost intervention to mitigate the psychological impact of the COVID-19 crisis and future pandemics.” – Julie Lei Zhu

 

Mindfulness training has been shown to improve health and well-being in healthy individuals. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. One of the primary effects of mindfulness that may be responsible for many of its benefits is that it improves the physiological and psychological responses to stress. The Covid-19 pandemic is extremely stressful particularly for patients who are pregnant or awaiting surgery. This training has been shown to improve the well-being of a wide variety of individuals. So, it should be helpful with these patients.

 

The vast majority of the mindfulness training techniques, however, require a trained teacher. The participants must be available to attend multiple sessions at scheduled times that may or may not be compatible with their schedules and at locations that may not be convenient. As an alternative, apps for smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. These should be particularly useful during the Covid-19 pandemic as attending in-person therapy sessions may not be safe or practicable. But the question arises as to the effectiveness of these apps in inducing mindfulness and reducing stress and improving psychological well-being in real-world medical patients.

 

In today’s Research News article “Mindfulness Effects in Obstetric and Gynecology Patients During the Coronavirus Disease 2019 (COVID-19) Pandemic: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8132566/ ) Smith and colleagues recruited adult

obstetrics and gynecology patients who were either pregnant or awaiting gynecological surgery delayed due to the Covid-19 pandemic. They were randomly assigned to receive either standard care or to practice mindfulness for 10 minutes per day for 30 days with a commercially available smartphone app “Calm”. They were measured before training, at 14 days into training, and after training for perceived stress, anxiety, depression, and sleep disturbance.

 

They found that in comparison to baseline and the usual care control group, the group that practiced mindfulness with the “Calm” app had significantly lower levels of perceived stress, anxiety, depression, and sleep disturbance at 14 days and 30 days. The mindfulness group also reported lower levels of perceived stress due to Covid-19 and less worry about infections in their families. A high degree of satisfaction with the “Calm” app was reported.

 

Covid-19 has affected the psychological health of virtually everyone and past research has shown that mindfulness improves their psychological health. The present study demonstrates that this occurs in pregnant women and women awaiting gynecological surgery. An important aspect of the present study was the use of a smartphone app to do the mindfulness training. These apps are particularly useful during the Covid-19 pandemic as attending in-person therapy sessions may not be safe or practicable. This allows for mindfulness training with its benefits for the well-being of the patients to occur even in the midst of a pandemic.

 

So, improve the psychological health of obstetrics and gynecology patients during covid-19 with a mindfulness app.

 

Mindfulness can help us acknowledge this situation, without allowing us to be carried away with strong emotions; it can, in turn, help bring ourselves back to a centered calm. Only then can we see more clearly what it is we have control over and what it is that we do not.“ – Michigan Medicine

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Smith, R. B., Mahnert, N. D., Foote, J., Saunders, K. T., Mourad, J., & Huberty, J. (2021). Mindfulness Effects in Obstetric and Gynecology Patients During the Coronavirus Disease 2019 (COVID-19) Pandemic: A Randomized Controlled Trial. Obstetrics and gynecology, 137(6), 1032–1040. https://doi.org/10.1097/AOG.0000000000004316

 

Abstract

OBJECTIVE:

To assess the effect of a consumer-based mobile meditation application (app) on wellness in outpatient obstetric and gynecology patients during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS:

We conducted a randomized controlled trial at a university outpatient clinic of obstetric and gynecology patients during the COVID-19 pandemic. Women were randomly assigned to the intervention group, who was prescribed a mobile meditation app for 30 days, or the control group, which received standard care. The primary outcome was self-reported perceived stress. Secondary outcomes included self-reported depression, anxiety, sleep disturbance, and satisfaction with the meditation app. A sample size of 80 participants (40 per group) was calculated to achieve 84% power to detect a 3-point difference in the primary outcome.

RESULTS:

From April to May 2020, 101 women were randomized in the study—50 in the meditation app group and 51 in the control group. Analysis was by intention-to-treat. Most characteristics were similar between groups. Perceived stress was significantly less in the intervention group at days 14 and 30 (mean difference 4.27, 95% CI 1.30–7.24, P=.005, d=0.69 and mean difference 4.28, 95% CI 1.68–6.88, P=.002, d=0.69, respectively). Self-reported depression and anxiety were significantly less in the intervention group at days 14 and 30 (depression: P=.002 and P=.04; anxiety: P=.01, and P=.04, respectively). Sleep disturbance was significantly less in the intervention group at days 14 and 30 (P=.001 and P=.02, respectively). More than 80% of those in the intervention group reported high satisfaction with the meditation app, and 93% reported that mindfulness meditation improved their stress.

CONCLUSION:

Outpatient obstetric and gynecology patients who used the prescribed consumer-based mobile meditation app during the COVID-19 pandemic had significant reductions in perceived stress, depression, anxiety, and sleep disturbance compared with standard care.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8132566/

Reduce Pregnancy-Related Anxiety with Mindfulness

Reduce Pregnancy-Related Anxiety with Mindfulness

 

By John M. de Castro, Ph.D.

 

Mindfulness practice provides an opportunity for the discovery of previously unrecognized inner resources of strength and resilience. By the time the workshop is over, women’s confidence levels increase and their fears begin to dissipate. They realize that even if giving birth is hard, it’s something that they can manage, moment by moment.” Nancy Bardacke

 

The period of pregnancy is a time of intense physiological and psychological change. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. These feelings during pregnancy can weigh on the mother’s mind when she contemplates another pregnancy. Hence, there is a need for methods to treat pregnancy-related anxiety in the postnatal period. Mindfulness training has been shown to improve anxiety normally and to relieve maternal anxiety and depression during pregnancy. So, mindfulness training may be helpful for the psychological health of women after having a child to make it more likely to contemplate another pregnancy.

 

In today’s Research News article “A Shift Toward Childbearing in One-Child Families Through a Mindfulness-Based Stress Reduction Program: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8346737/ ) and colleagues recruited women who have had one child but did not intend to have another due to pregnancy-related anxiety. They were randomly assigned to either a no-treatment control condition or to receive 2.5 hours, once a week for 8 weeks of Mindfulness-Based Stress Reduction (MBSR). MBSR includes training and practice in meditation, body scan, and yoga and includes group discussion along with home practice. Before and after training they completed measures of pregnancy-related anxiety, including subscales measuring fear of childbirth, fear of giving birth to disabled children, fear of changing in marital relationships, fear of changing in mood and its impact on the child, and self-centered fears.

 

They found that in comparison to pre-training and the no-treatment control group, the women who received Mindfulness-Based Stress Reduction (MBSR) training had significantly lower levels of pregnancy-related anxiety, including all subscales; fear of childbirth, fear of giving birth to disabled children, fear of changing in marital relationships, fear of changing in mood and its impact on the child, and self-centered fears.

 

The present study did not include an active control condition or follow up. So, it is not known whether the training had lasting effects and whether the benefits may have been due to confounding factors such as attentional effects, placebo effects, or experimenter bias. Prior controlled research, however, has routinely demonstrated that mindfulness training reduces anxiety. So, it is likely that the mindfulness training in the present study produced the reductions in anxiety. The reductions in pregnancy-related anxiety produced by Mindfulness-Based Stress Reduction (MBSR) training would tend to make it more likely that the women would be open to another pregnancy. But unfortunately, this was not measured. Future research should include an active comparison condition such as exercise, follow up with the women several weeks later, and measures of the likelihood of a future pregnance.

 

So, reduce pregnancy-related anxiety with mindfulness.

 

Jen . . . who recently had her first child, was put on bed rest and couldn’t even exercise to keep her stress down. “I had so much anxiety,” she recalls. “Meditation really helped me stay calm and sane.” – Kira Newman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Malekpoorafshar, M., Salehinejad, P., Pouya, F., Khezri Moghadam, N., & Shahesmaeili, A. (2021). A Shift Toward Childbearing in One-Child Families Through a Mindfulness-Based Stress Reduction Program: A Randomized Controlled Trial. Journal of family & reproductive health, 15(1), 19–27. https://doi.org/10.18502/jfrh.v15i1.6070

 

Abstract

Objective: Fertility patterns are a key to the estimation of future population size, but they are restricted by serious indecision. One-child families are one of these patterns that is caused by a set of factors and one of these factors is the fear of re-pregnancy. In this regard, this study aimed to use a mindfulness-based stress reduction (MBSR) program to reduce the fear of women who have been experiencing anxiety after their first pregnancy and delivery.

Materials and methods: This interventional study was conducted on 67 one-child women, who at least 6 years have been passed since the birth of their child and according to the short form of the Pregnancy Related Anxiety Questionnaire (PRAQ-17), have been experienced anxiety. These women were randomly divided into control and intervention groups. For the intervention group, the MBSR program was conducted in 8 sessions, once every week, each session lasting 2.5 hours. At the end of the program, a second PRAQ-17 was completed by both groups.

Results: The findings showed that the MBSR approach in the intervention group significantly decreased the anxiety score in total (p=0.001) and individually in all subcategories.

Conclusion: The MBSR approach can reduce the anxiety of one-child women who have experienced anxiety after their pregnancy and childbirth. Thus, using this method in helping women with pregnancy-related anxiety is recommended to increase the birth rate.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8346737/

 

Improve the Psychological Health of Women with Unwanted Pregnancies with Mindfulness

Improve the Psychological Health of Women with Unwanted Pregnancies with Mindfulness

 

By John M. de Castro, Ph.D.

 

mindfulness-based interventions can be beneficial for outcomes such as anxiety, depression, perceived stress and levels of mindfulness during the perinatal period.” – Anjulie Dhillon

 

The period of pregnancy is a time of intense physiological and psychological change. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. These feelings can be amplified if the pregnancy is unplanned and unwanted. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy and to relieve postpartum depression. It is possible, then, that mindfulness training may be helpful for the psychological health of women with unwanted pregnancies.

 

In today’s Research News article “The influence of mindfulness-based stress reduction (MBSR) on stress, anxiety and depression due to unwanted pregnancy: a randomized clinical trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8283654/ ) Nejad and colleagues recruited pregnant women with an unplanned pregnancy who had symptoms of anxiety, depression, or stress. They were randomly assigned to receive either standard care or 8 weekly 2-hour sessions of Mindfulness-Based Stress Reduction (MBSR) with additional home practice. MBSR includes training and practice in meditation, body scan, and yoga and includes group discussion. They were measured before and after training for anxiety, depression, and stress.

 

They found that in comparison to baseline and the usual care group, the group that received Mindfulness-Based Stress Reduction (MBSR) had significant reductions in anxiety, depression, and stress. Previous research has demonstrated in a wide variety healthy and ill groups that mindfulness training produces reductions in perceived stress, anxiety and depression. The present research demonstrates that MBSR is similarly effective in women with unwanted pregnancies, improving their well-being.

 

The study, however, did not include an active control condition or follow up. So, it is not known whether the training had lasting effects and whether the benefits may have been due to confounding factors such as attentional effects, placebo effects, or experimenter bias. Future research should include an active comparison condition such as stretching exercises and follow up with the women several weeks later.

 

So, improve the psychological health of women with unwanted pregnancies with mindfulness.

 

mindfulness practices can help anxiety, depression, and stress during the perinatal period.” – Carrie Murphy

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Nejad, F. K., Shahraki, K. A., Nejad, P. S., Moghaddam, N. K., Jahani, Y., & Divsalar, P. (2021). The influence of mindfulness-based stress reduction (MBSR) on stress, anxiety and depression due to unwanted pregnancy: a randomized clinical trial. Journal of preventive medicine and hygiene, 62(1), E82–E88. https://doi.org/10.15167/2421-4248/jpmh2021.62.1.1691

 

Summary

Background

Individuals with unwanted pregnancies often experience high levels of anxiety, stress and depression that associated with maternal-neonatal outcomes. Mindfulness training is a safe and acceptable strategy to support mental health before parturition.

Purpose

The main objective of present study was to evaluate the influence of eight-week application of mindfulness-based stress reduction on stress, anxiety and depression caused by unplanned pregnancy.

Method

In this study, 60 women with unwanted pregnancy before 32 weeks of gestational age were selected and randomly divided into two groups. Intervention group received MBSR sessions, practice at home and the recorded sound. Mental health was evaluated before intervention and at the end of the eight sessions by standard stress, anxiety and depression DASS-21 questionnaire. Data were analyzed using Chi-square, Mann-Whitney U and Wilcoxon tests.

Findings

In order to compare pre-test and post-test scores in each group, the Wilcoxon Test was used. The results revealed that the participants in the intervention group reported a significant decrease in mean scores of stress, anxiety and depression compared to baseline (P = 0.0). Whereas no significant decrease in mean stress, anxiety and depression score were found in control group. P-value was estimated to be 0.346, 0.212 and 0.343 respectively.

Conclusions

The mindfulness program has effectively reduced stress, anxiety and depression. Further research is needed to investigate the mechanisms and effects of mindfulness on maternal-neonatal outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8283654/

 

Mindfulness is Associated with Better Perinatal Mental Health Among Uncertainty Produced by Covid-19

Mindfulness is Associated with Better Perinatal Mental Health Among Uncertainty Produced by Covid-19

 

By John M. de Castro, Ph.D.

 

use of a mindfulness-based meditation app may benefit patients who are navigating the stressors of being pregnant during the COVID-19 pandemic.” –  Orli K. Florsheim, MD

 

The period of pregnancy is a time of intense physiological and psychological change. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight.

 

In addition, immediately after birth it is common for the mother to experience mood swings including what has been termed “baby blues,” a sadness that may last for as much as a couple of weeks. But some women experience a more intense and long-lasting negative mood called postpartum depression. This occurs usually 4-6 weeks after birth in about 15% of births; about 600,000 women in the U.S. every year. For 50% of the women the depression lasts for about a year while about 30% are still depressed 3 years later.

 

Hence, it is clear that there is a need for methods to treat depression, and anxiety during the perinatal period. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy and to relieve postpartum depression.

 

The COVID-19 pandemic has challenged the mental and physical health of the population. It has created intense stress for everyone including women during the perinatal period. Mindfulness is known to decrease the psychological and physical responses to stress and to improve well-being during the perinatal period. So, mindfulness training may be helpful in coping with the mental and physical challenges during the perinatal period resulting from the COVID-19 pandemic.

 

In today’s Research News article “The Indirect Effect of Parental Intolerance of Uncertainty on Perinatal Mental Health via Mindfulness During COVID-19.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8171361/ ) Sbrilli and colleagues recruited pregnant women or women who had given birth in the last 6 months during the Covid-19 pandemic. They were measured for Intolerance of uncertainty, mindfulness, and psychological symptoms, including anxiety, depression, and somatization.

 

They performed a path analysis and found that in these perinatal women intolerance of uncertainty was associated with psychological symptoms, especially anxiety and depression, directly and also indirectly by being associated with lower mindfulness which was, in turn, associated with greater psychological symptoms. The mindfulness facets that were significant in the indirect path were acting with awareness, non-reactivity, and describing.

 

The present study is correlational and as such caution must be exercised in reaching causal conclusions. But mindfulness has been shown in prior research to produce reductions in anxiety and depression. So, reduced mindfulness in the present study was probably the cause of the increased psychological symptoms. What’s new here is the finding that intolerance of uncertainty is directly and through mindfulness indirectly associated with increased psychological symptoms in perinatal women.

 

Intolerance of uncertainty is a fear of the unknown. During Covid-19 this fear is greatly amplified and the present results suggest that this results in greater anxiety and depression in these women. But since mindfulness is an intermediary it is possible that improvements in mindfulness, perhaps through training, could intervene to block the effects of intolerance of uncertainty on psychological symptoms. This is supported by the findings that mindfulness during Covid-19 improves psychological well-being.

 

Anxiety and depression during pregnancy can affect the birth and condition of the newborn. In addition, after birth they can affect post-partum depression. So, improving mindfulness is important during the perinatal period to improve the health and well-being of the infant and the mother. This becomes more important during the pandemic where uncertainty can exacerbate anxiety and depression.

 

So, mindfulness is associated with better perinatal mental health among uncertainty produced by Covid-19.

 

The strength of mediation habits may play a role in pregnant women’s mental health during COVID-19. Stronger meditation habits may prevent increases in stress despite increased worry related to getting infected by COVID-19 and may reduce symptoms of depression and PTSD.” – Jennifer Huberty

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are a also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Sbrilli, M. D., Haigler, K., & Laurent, H. K. (2021). The Indirect Effect of Parental Intolerance of Uncertainty on Perinatal Mental Health via Mindfulness During COVID-19. Mindfulness, 1–10. Advance online publication. https://doi.org/10.1007/s12671-021-01657-x

 

Abstract

Objectives

The COVID-19 pandemic is associated with mental health difficulties, especially during pregnancy and early postpartum. Intolerance of uncertainty (IU) and reduced capacity for mindfulness—a protective factor for child-bearers—may be particularly relevant factors driving mental health problems given the unpredictable nature of the pandemic. The current study aims to shed light on modifiable paths to perinatal psychological distress by testing whether there is an indirect effect of IU on psychological symptoms through a perceived reduction in mindfulness during the pandemic.

Methods

Pregnant individuals (67%, n = 133) and new mothers within 6 months postpartum (33%, n = 66) participated in a cross-sectional online survey assessing IU, current and retrospective pre-pandemic mindfulness (FFMQ), and psychological symptoms (anxiety, depression, somatization; BSI). Perceived change in mindfulness was captured by including retrospective mindfulness as a covariate in the PROCESS macro used for analyses.

Results

Tests of the direct association between mindfulness, IU, and psychological symptoms showed significant effects of IU (b = 0.46, SE = 0.064; p < .001) and perceived decrease in mindfulness during the pandemic (b =  − 0.72, SE = 0.08, p < .001) on psychological symptoms (R2 = .21–.34; F[2, 197] = 51.13–52.81, p < .001). The indirect effect of IU on symptoms via perceived decrease in mindfulness during the pandemic (b = 0.13, SE = 0.043, 95%CI [.060, .226]) was significant (R2 = .41, F[3, 195] = 45.08, p < .001).

Conclusions

Results suggest that mothers who are less able to tolerate uncertainty experience more psychological symptoms, in part due to perceived reduction in mindfulness during the pandemic. Future research should examine whether IU is a screening risk marker and target for mindfulness-based interventions to improve maternal well-being and family outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8171361/

 

Yoga Improves Pregnancy and Childbirth Outcomes

Yoga Improves Pregnancy and Childbirth Outcomes

 

By John M. de Castro, Ph.D.

 

“Much like other types of childbirth-preparation classes, prenatal yoga is a multifaceted approach to exercise that encourages stretching, mental centering and focused breathing. Research suggests that prenatal yoga is safe and can have many benefits for pregnant women and their babies.” – Mayo Clinic

 

The period of pregnancy is a time of intense physiological and psychological change. The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Childbirth fear is associated with “low childbirth self-efficacy, greater use of pain medication during labor, more unwanted obstetric interventions in labor, as well as increased risk of postpartum depression.” Hence, it is clear that there is a need for methods to treat childbirth fear, depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Yoga has been shown to relieve maternal anxiety and depression during pregnancy. So, it would make sense to study the effects of yoga during pregnancy.

 

In today’s Research News article “The effect of yoga on the delivery and neonatal outcomes in nulliparous pregnant women in Iran: a clinical trial study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8091762/ )  Yekefallah and colleagues recruited women during their first pregnancy in their 26th-28th week and randomly assigned them to a no-treatment control condition or to receive 10 weeks of twice a week 75-minute Hatha yoga classes. They completed demographic information and body size and information was recorded about the pregnancy, childbirth, and neonatal outcome (Apgar score).

 

They found that the yoga group was significantly less likely to have labor induced, have a preterm delivery, had a significantly shorter labor duration, and had significantly lower episiotomy rupture grades. In addition, the children of the yoga group had significantly higher birthweights, were born at a later gestational age, and had significantly higher Apgar scores.

 

The results clearly demonstrate that yoga practice during a first pregnancy improves the pregnancy, delivery, and neonatal outcomes. It should be noted, however, that the comparison group did not receive any treatment. So, it is not clear if the benefits were due to practicing yoga or if they would have been produced by any gentle exercise. Nevertheless, the study found evidence that practicing yoga during pregnancy is of great benefit to the mother and the infant.

 

So, yoga improves pregnancy and childbirth outcomes.

 

The combination of length and strength in the pelvic floor creates muscles with great integrity to support a baby in addition to all of the organs that rest on it. These strong muscles in conjunction with the gluteus medius are called upon during the second stage of labor (pushing) and are responsible for helping the bones of the pelvis come back together after delivery.“ – Karly Treacy

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Yekefallah, L., Namdar, P., Dehghankar, L., Golestaneh, F., Taheri, S., & Mohammadkhaniha, F. (2021). The effect of yoga on the delivery and neonatal outcomes in nulliparous pregnant women in Iran: a clinical trial study. BMC pregnancy and childbirth, 21(1), 351. https://doi.org/10.1186/s12884-021-03794-6

 

Abstract

Background

Yoga can reduce the risk of preterm delivery, cesarean section (CS), and fetal death. The aim of the present study was to investigate the effects of Yoga on pregnancy, delivery, and neonatal outcomes.

Methods

This was a clinical trial study and using the random sampling without replacement 70 pregnant women entered Hatha Yoga and control groups according to the color of the ball they took from a bag containing two balls (blue or red). The data collection tool was a questionnaire pregnancy, delivery, and neonatal outcomes. The intervention in this study included pregnancy Hatha Yoga exercises that first session of pregnancy Yoga started from the 26th week and samples attended the last session in the 37th week. They exercised Yoga twice a week (each session lasting 75 min) in a Yoga specialized sports club. The control group received the routine prenatal care that all pregnant women receive.

Results

The results showed that yoga reduced the induction of labor, the episiotomy rupture, duration of labor, also had a significant effect on normal birth weight and delivery at the appropriate gestational age. There were significant differences between the first and second Apgar scores of the infants.

Conclusion

The results of the present study showed that Yoga can improve the outcomes of pregnancy and childbirth. They can be used as part of the care protocol along with childbirth preparation classes to reduce the complications of pregnancy and childbirth.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8091762/

 

Improve Women’s Perception of Childbirth with Mindfulness

Improve Women’s Perception of Childbirth with Mindfulness

 

By John M. de Castro, Ph.D.

 

It is inspiring to witness a mother with extreme fear of childbirth cancel an elective caesarian because she now feels confident enough in her own strength to go through the birthing process,” – Kira Newman

 

The period of pregnancy is a time of intense physiological and psychological change. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. A debilitating childbirth fear has been estimated to affect about 6% or pregnant women and 13% are sufficiently afraid to postpone pregnancy. It is difficult to deal with these emotions under the best of conditions but in combinations with the stresses of pregnancy can turn what could be a joyous experience of creating a human life into a horrible worrisome, torment.

 

The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Women’s perception of the childbirth experience can influence their later psychological health. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. It is reasonable, then, to hypothesize that women’s mindfulness will be related to their perception of the childbirth experience.

 

In today’s Research News article “Trait mindfulness during pregnancy and perception of childbirth.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7979659/ ) Hulsbosch and colleagues recruited pregnant women. In their 22nd week of pregnancy and measured them for mindfulness. At 7 to 21 days postpartum they completed measures of their perception of the childbirth experience and depression.

 

They found that the higher the levels of the mindfulness facets of acting with awareness and non-reactivity during pregnancy the greater the perception of childbirth experience after delivery. This remained the case even after accounting for demographic variables, depression, and physical events during delivery. Non-spontaneous delivery, includes induced labor, instrumental vaginal delivery, and unplanned Caesarean section and reflects a negative childbirth experience. Non-spontaneous delivery was associated with negative perceptions of the childbirth experience except for mothers who were high in the mindfulness facets of acting with awareness and non-judging during pregnancy.

 

These results are correlational and as such causation cannot be determined. But they suggest that mindfulness enhances the perception of the childbirth experience for the mothers. This is true even in the case where the birth was not a natural spontaneous event. Since negative perceptions of childbirth are associate with later depression and post-traumatic stress disorder symptoms, being mindful during pregnancy is important for the psychological health of the mother. This suggests that mindfulness training during pregnancy my help to improve the mother’s perception of childbirth and improve subsequent psychological health.

 

So, improve women’s perception of childbirth with mindfulness

 

Taking part in a mindfulness course during pregnancy has been shown in a recent study to reduce the fear of labour, decrease the use of pain relief and lower the risk of postnatal depression.” – Tommy’s

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Hulsbosch, L. P., Boekhorst, M., Potharst, E. S., Pop, V., & Nyklíček, I. (2021). Trait mindfulness during pregnancy and perception of childbirth. Archives of women’s mental health, 24(2), 281–292. https://doi.org/10.1007/s00737-020-01062-8

 

Abstract

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.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7979659/

 

Reduce Insomnia and Rumination in Pregnant Women with Mindfulness

Reduce Insomnia and Rumination in Pregnant Women with Mindfulness

 

By John M. de Castro, Ph.D.

 

“practicing mindfulness during the day, ideally for 20 minutes, . . The idea is to create a reflex to more easily bring forth a sense of relaxation. That way, it’s easier to evoke the relaxation response at night when you can’t sleep.” – Herbert Benson

 

Pregnancy is a time of intense physiological and psychological change. Anxiety, depression, and insomnia are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. Sleep disturbance including insomnia is also common affecting around 75% of pregnant women. The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Insomnia has been linked to an increased risk of giving birth to a baby that’s too large or too small for its age, longer labor, and higher likelihood of a cesarean section.

 

Hence, it is clear that there is a need for methods to treat depression, anxiety, and insomnia during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety, depression, and sleep normally and to relieve maternal anxiety and depression during pregnancy. In addition, mindfulness is known to reduce worry and rumination which can also lead to restlessness and sleep disturbance. So, it would make sense to study the relationship of mindfulness during the pregnancy to depression, rumination, and insomnia.

 

In today’s Research News article “Mindfulness and nocturnal rumination are independently associated with symptoms of insomnia and depression during pregnancy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190270/ )  Kalmbach and colleagues recruited pregnant women in their third trimester and had them complete measures of mindfulness, rumination, insomnia, and depression. These data were subjected to multivariate linear regression analysis.

 

They found that women who were high in mindfulness had significantly lower levels of rumination, insomnia, and depression. Women who were high in rumination had significantly lower levels of mindfulness and higher levels of insomnia, and depression. Employing multivariate modelling they found that mindfulness and rumination separately and independently were related to insomnia and that mindfulness and rumination separately and independently were related to depression.

 

These results were correlational and as such causation cannot be determined. But previous research has demonstrated that mindfulness training reduces rumination, insomnia, and depression. So, the relationships observed here are likely due to causal relationships among the variables. It appears that mindfulness and rumination work in opposite directions. Mindfulness helps pregnant women sleep better and helps relieve depression while rumination does the opposite of interfering with sleep and increasing depression.

 

Interestingly, mindfulness and rumination affect sleep and depression independently but are negatively related such that mindfulness decreases rumination while rumination lowers mindfulness. Mindfulness is an asset to pregnant women while worry produces problems. This suggests that pregnant women should be trained in mindfulness and also trained to reduce worry. Both of these goals can be accomplished with Mindfulness-Based Cognitive Therapy (MBCT). Future research should investigate this possibility.

 

So, reduce insomnia and rumination in pregnant women with mindfulness.

 

It seems important to develop mindfulness to improve sleep in pregnancy or reduce the impact of insomnia symptoms (common at pregnancy).” – M. Marques

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Kalmbach, D. A., Roth, T., Cheng, P., Ong, J. C., Rosenbaum, E., & Drake, C. L. (2020). Mindfulness and nocturnal rumination are independently associated with symptoms of insomnia and depression during pregnancy. Sleep health, 6(2), 185–191. https://doi.org/10.1016/j.sleh.2019.11.011

 

Abstract

Background:

Insomnia and depression are highly prevalent perinatal complications. Ruminating on stress is etiologically implicated in both disorders, and ruminating while trying to fall asleep has been linked to insomnia and depression during pregnancy. Incompatible with rumination is everyday mindfulness, i.e., living with intentional and nonjudgmental awareness of internal and external experiences in the present moment. Responding to stress mindfully may protect against stress-related perinatal complications such as insomnia and depression. The present study described the association between everyday mindfulness and nocturnal rumination, and examined whether these trait characteristics were independently related to perinatal insomnia and depression.

Methods:

Cross-sectional and secondary analysis of existing data from 65 pregnant women recruited from a multisite hospital in Metro Detroit, MI, USA. Subjects completed online surveys including the Insomnia Severity Index, Edinburgh Postnatal Depression Scale, Presleep Arousal Scale, and the revised Cognitive and Affective Mindfulness Scale.

Results:

Over half (53.8%) of women screened positive for clinical insomnia and 12.3% screened positive for major depression. Women high in mindfulness, relative to those low in mindfulness, reported less nocturnal rumination (Cohen’s d=1.16), insomnia symptoms (Cohen’s d=1.24), and depressive symptoms (Cohen’s d=1.35). Multivariate linear regression revealed that both mindfulness (β=−.24, p=.03) and rumination (β=.38, p<.01) were independently associated with insomnia. Similarly, a multivariate model showed that mindfulness (β=−.41, p<.001) and rumination (β=.35, p<.01) were independently associated with depression.

Conclusions:

Ruminating in bed at night is strongly associated with insomnia and depression during pregnancy, whereas mindfulness may potentially protect against these stress-related perinatal complications.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190270/

 

Relieve Maternal Perinatal Depression with Smartphone-Based Mindfulness Training

Relieve Maternal Perinatal Depression with Smartphone-Based Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“the ideal treatment plan for perinatal depression and anxiety often includes mindfulness techniques.” – Edith Gettes

 

The period of pregnancy is a time of intense physiological and psychological change. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight.

 

In addition, immediately after birth it is common for the mother to experience mood swings including what has been termed “baby blues,” a sadness that may last for as much as a couple of weeks. But some women experience a more intense and long-lasting negative mood called postpartum depression. This occurs usually 4-6 weeks after birth in about 15% of births; about 600,000 women in the U.S. every year. For 50% of the women the depression lasts for about a year while about 30% are still depressed 3 years later.

 

Hence, it is clear that there is a need for methods to treat depression, and anxiety during the perinatal period. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy and to relieve postpartum depression.

 

The vast majority of the mindfulness training techniques, however, require a trained teacher. The participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with busy employee schedules and at locations that may not be convenient. As an alternative, apps for smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the effectiveness of these apps and their ability to relieve depression during the perinatal period.

 

In today’s Research News article “Effectiveness of Smartphone-Based Mindfulness Training on Maternal Perinatal Depression: Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875700/ ) Sun and colleagues recruited pregnant women who were diagnosed with depression and randomly assigned them to receive 8-weeks of either health consultation or mindfulness training. Mindfulness training occurred in 8 weekly sessions delivered on a smartphone app. The training was Mindfulness-Based Cognitive Therapy (MBCT) modified for pregnant women. Health consultation also occurred via smartphone app. They were measured before during, and after training, 10 weeks later, and 6-months after delivery for depression, anxiety symptoms, perceived stress, positive and negative emotions, sleep-related problems, fatigue, memory, and fear of childbirth. There was a 52% completion rate for the trainings.

 

They found that after training the mindfulness group had significantly lower levels of depression and anxiety and significantly higher levels of positive emotions but these were not maintained 6 months after delivery. The mindfulness group also had a significantly higher rate of depression symptom remission. Hence the smartphone-based mindfulness training improved the psychological health of the pregnant women.

 

These findings replicate previous findings that mindfulness training reduces anxiety and depression in non-pregnant individuals and relieves maternal anxiety and depression during pregnancy. The strength of the current study was that these effects were produced by mindfulness training with a smartphone app. This is important as this training is highly scalable at minimal cost and so can be made available to virtually all pregnant women who want it. Hence, it may be able to reduce the psychological misery that occurs in many women during the perinatal period, making pregnancy a happier time for the women and produce better outcoms for the infant.

 

So, relieve maternal perinatal depression with smartphone-based mindfulness training.

 

the risk of having moderate depressive symptoms was reduced by nearly 90% in participants receiving the MMT [Mindfulness] intervention.” – Ruta Nonacs

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Sun, Y., Li, Y., Wang, J., Chen, Q., Bazzano, A. N., & Cao, F. (2021). Effectiveness of Smartphone-Based Mindfulness Training on Maternal Perinatal Depression: Randomized Controlled Trial. Journal of medical Internet research, 23(1), e23410. https://doi.org/10.2196/23410

 

Abstract

Background

Despite potential for benefit, mindfulness remains an emergent area in perinatal mental health care, and evidence of smartphone-based mindfulness training for perinatal depression is especially limited.

Objective

The objective of this study was to evaluate the effectiveness of a smartphone-based mindfulness training intervention during pregnancy on perinatal depression and other mental health problems with a randomized controlled design.

Methods

Pregnant adult women who were potentially at risk of perinatal depression were recruited from an obstetrics clinic and randomized to a self-guided 8-week smartphone-based mindfulness training during pregnancy group or attention control group. Mental health indicators were surveyed over five time points through the postpartum period by online self-assessment. The assessor who collected the follow-up data was blind to the assignment. The primary outcome was depression as measured by symptoms, and secondary outcomes were anxiety, stress, affect, sleep, fatigue, memory, and fear.

Results

A total of 168 participants were randomly allocated to the mindfulness training (n=84) or attention control (n=84) group. The overall dropout rate was 34.5%, and 52.4% of the participants completed the intervention. Mindfulness training participants reported significant improvement of depression (group × time interaction χ24=16.2, P=.003) and secondary outcomes (χ24=13.1, P=.01 for anxiety; χ24=8.4, P=.04 for positive affect) compared to attention control group participants. Medium between-group effect sizes were found on depression and positive affect at postintervention, and on anxiety in late pregnancy (Cohen d=0.47, –0.49, and 0.46, respectively). Mindfulness training participants reported a decreased risk of positive depressive symptom (Edinburgh Postnatal Depression Scale [EPDS] score>9) compared to attention control participants postintervention (odds ratio [OR] 0.391, 95% CI 0.164-0.930) and significantly higher depression symptom remission with different EPDS reduction scores from preintervention to postintervention (OR 3.471-27.986). Parity did not show a significant moderating effect; however, for nulliparous women, mindfulness training participants had significantly improved depression symptoms compared to nulliparous attention control group participants (group × time interaction χ24=18.1, P=.001).

Conclusions

Smartphone-based mindfulness training is an effective intervention in improving maternal perinatal depression for those who are potentially at risk of perinatal depression in early pregnancy. Nulliparous women are a promising subgroup who may benefit more from mindfulness training.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875700/

Improve Perinatal Mental Health with Prenatal Mindfulness Training

Improve Perinatal Mental Health with Prenatal Mindfulness Training

 

By John M. de Castro, Ph.D.

 

In addition to support, therapy, and medication, the ideal treatment plan for perinatal depression and anxiety often includes mindfulness techniques.” – Edith Gettes

 

The period of pregnancy is a time of intense physiological and psychological change. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. A debilitating childbirth fear has been estimated to affect about 6% or pregnant women and 13% are sufficiently afraid to postpone pregnancy. It is difficult to deal with these emotions under the best of conditions but in combinations with the stresses of pregnancy can turn what could be a joyous experience of creating a human life into a horrible worrisome, torment.

 

The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Hence, it is clear that there is a need for methods to treat depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy.

 

The birth of a child is most often a joyous occasion. But often the joy turns to misery. Immediately after birth it is common for the mother to experience mood swings including what has been termed “baby blues,” a sadness that may last for as much as a couple of weeks. But some women experience a more intense and long-lasting negative mood called postpartum depression. This occurs usually 4-6 weeks after birth in about 15% of births; about 600,000 women in the U.S. every year. For 50% of the women the depression lasts for about a year while about 30% are still depressed 3 years later. It is not known if the effectiveness of mindfulness training during the perinatal period carries over to the postpartum period. So, it would make sense to study the effectiveness of mindfulness training administered during the perinatal period on postpartum mental health issues.

 

In today’s Research News article “Effects of prenatal mindfulness-based childbirth education on child-bearers’ trajectories of distress: a randomized control trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559171/ ) Sbrilli  and colleagues recruited pregnant women in their 3rd trimester with their first child and randomly assigned them to either no treatment other than the standard childbirth education program or to receive and additional intensive 2.5 day program of mindfulness training termed “Mind in Labor (MIL).” The training integrates mindfulness “strategies for coping with pain and fear with formal mindfulness meditation for a total of 18 h of mindfulness training.” The participants were measured before and after training, 6 weeks after giving birth, and 1 to 2 years later for depression, anxiety, perceived stress, and mindfulness.

 

They found that at baseline the higher the levels of mindfulness, the lower the levels of anxiety, depression, and perceived stress. Importantly, they found that while the treatment as usual group had increasing depression over the period from before birth till 12 months after birth, the groups that received the mindfulness training had significantly decreasing depression over the same period. They further found that these effects were greater in women who were either high in anxiety or low in mindfulness at baseline.

 

These are encouraging results that need to be investigated in a larger trial. But they demonstrate that mindfulness training during the 3rd trimester can reduce depression not only during the pregnancy but also for at least a year following the birth of the child. This period and especially the postpartum period are very often periods of increased psychological distress, especially depression. Mindfulness training appears to be an antidote, relieving the distress and allowing for the joy of a new child to be fully experienced.

 

So, improve perinatal mental health with prenatal mindfulness training.

 

A growing body of research suggests that mindfulness-based therapy can benefit perinatal women. . . MBT appears to reduce symptoms of depression and anxiety.” – Rinette Badker

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Sbrilli, M. D., Duncan, L. G., & Laurent, H. K. (2020). Effects of prenatal mindfulness-based childbirth education on child-bearers’ trajectories of distress: a randomized control trial. BMC Pregnancy and Childbirth, 20, 623. https://doi.org/10.1186/s12884-020-03318-8

 

Abstract

Background

The perinatal period is a time of immense change, which can be a period of stress and vulnerability for mental health difficulties. Mindfulness-based interventions have shown promise for reducing distress, but further research is needed to identify long-term effects and moderators of mindfulness training in the perinatal period.

Methods

The current study used data from a pilot randomized control trial (RCT) comparing a condensed mindfulness-based childbirth preparation program—the Mind in Labor (MIL)—to treatment as usual (TAU) to examine whether prenatal mindfulness training results in lower distress across the perinatal period, and whether the degree of benefit depends on child-bearers’ initial levels of risk (i.e., depression and anxiety symptoms) and protective (i.e., mindfulness) characteristics. Child-bearers (N = 30) in their third trimester were randomized to MIL or TAU and completed assessments of distress—perceived stress, anxiety, and depressive symptoms—at pre-intervention, post-intervention, six-weeks post-birth, and one-year postpartum.

Results

Multilevel modeling of distress trajectories revealed greater decreases from pre-intervention to 12-months postpartum for those in MIL compared to TAU, especially among child-bearers who were higher in anxiety and/or lower in dispositional mindfulness at baseline.

Conclusions

The current study offers preliminary evidence for durable perinatal mental health benefits following a brief mindfulness-based program and suggests further investigation of these effects in larger samples is warranted.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559171/

 

Reduce Depression After Stillbirth with Yoga

Reduce Depression After Stillbirth with Yoga

 

By John M. de Castro, Ph.D.

 

“Bereaved mothers with stillbirth (death at >20 weeks of gestation) have more than a 6-fold higher risk for Post Traumatic Stress Disorder (PTSD) compared to mothers after live birth. . . . Non-pharmacological approaches, such as yoga, may be an alternative option for bereaved women with stillbirth.” – Jennifer Huberty

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime with 7%-8% of the population developing Post-Traumatic Stress Disorder (PTSD). It involves a number of troubling symptoms including reliving the event with the same fear and horror in nightmares or with a flashback.

 

Having a stillbirth is a traumatic event for young women. It inevitably produces profound depression, grief, and symptoms of PTSD. Obviously, this is a troubling problem that needs to be addressed. There are a number of therapies that have been developed to treat depression, grief and  PTSD. One of which, mindfulness training has been found to be particularly effective for depression, PTSD symptoms, and grief.  Yoga practice has also been found to reduce depression and PTSD symptoms. There is, however, no studies to date on the effectiveness of yoga practice to help alleviate the trauma produced by stillbirth.

 

In today’s Research News article “Online yoga to reduce post traumatic stress in women who have experienced stillbirth: a randomized control feasibility trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275350/) Huberty and colleagues recruited women who had experienced stillbirth within the last 2 years and randomly assigned them to receive 12 weeks of either low dose Hatha yoga (60 minutes per week), moderate dose Hatha yoga (150 minutes per week), or stretching and toning practice (60 minutes per week). All practice was led by online videos. They were measured before and after training and 8 weeks later for acceptability and demand for the program, PTSD symptoms, anxiety, depression, grief, self-compassion, emotion regulation, mindfulness, and sleep quality.

 

They found that PTSD symptoms decreased significantly over the measurement period with a 43% and 56% decrease for the low and moderate yoga groups and a 22% decrease for the stretching and toning group. But there were no significant differences between groups. On the other hand, in comparison to the stretching and toning group, both of the yoga groups had significant decreases in depression and grief. Unfortunately, the low dose yoga group only practiced on the average for 44 minutes per week and the high dose yoga only practiced for 77 minutes per week. This was well below the desired amount of practice.

 

The lack of a significant difference between the yoga and control groups was disappointing. Previous research has demonstrated that yoga practice reduces PTSD symptoms. It is possible that attempting to teach yoga remotely, online, to participants who are depressed simply may not be an effective way to encourage practice. Depressed patients lack motivation and it is possible that they need the encouragement of a group and an instructor to motivate their participation. Future research should employ traditional in person yoga classes for the treatment of women who had stillbirths.

 

Nevertheless, the yoga practice, even though it was below the dose desired, did significantly reduce depression. This corroborates previous findings that yoga practice is effective in treating a variety of forms of depression and suggests that it is also effective in treating depression emanating from stillbirth. Perhaps in person yoga classes may potentiate the effects on PTSD and other symptoms in women who had stillbirths.

 

So, reduce depression after stillbirth with yoga.

 

“a trauma-focused hatha yoga program may be a helpful adjunctive treatment for chronic PTSD.” – Sarah Krill Williston

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Huberty, J., Sullivan, M., Green, J., Kurka, J., Leiferman, J., Gold, K., & Cacciatore, J. (2020). Online yoga to reduce post traumatic stress in women who have experienced stillbirth: a randomized control feasibility trial. BMC complementary medicine and therapies, 20(1), 173. https://doi.org/10.1186/s12906-020-02926-3

 

Abstract

Background

About 1 in every 150 pregnancies end in stillbirth. Consequences include symptoms of post traumatic stress disorder (PTSD), depression, and anxiety. Yoga has been used to treat PTSD in other populations and may improve health outcomes for stillbirth mothers. The purpose of this study was to determine: (a) feasibility of a 12-week home-based, online yoga intervention with varying doses; (b) acceptability of a “stretch and tone” control group; and (c) preliminary efficacy of the intervention on reducing symptoms of PTSD, anxiety, depression, perinatal grief, self-compassion, emotional regulation, mindfulness, sleep quality, and subjective health.

Methods

Participants (N = 90) were recruited nationally and randomized into one of three groups for yoga or exercise (low dose (LD), 60 min per week; moderate dose (MD), 150 min per week; and stretch-and-tone control group (STC)). Baseline and post-intervention surveys measured main outcomes (listed above). Frequency analyses were used to determine feasibility. Repeated measures ANCOVA were used to determine preliminary efficacy. Multiple regression analyses were used to determine a dose-response relationship between minutes of yoga and each outcome variable.

Results

Over half of participants completed the intervention (n = 48/90). Benchmarks (≥70% reported > 75% satisfaction) were met in each group for satisfaction and enjoyment. Participants meeting benchmarks (completing > 90% of prescribed minutes 9/12 weeks) for LD and MD groups were 44% (n = 8/18) and 6% (n = 1/16), respectively. LD and MD groups averaged 44.0 and 77.3 min per week of yoga, respectively. The MD group reported that 150 prescribed minutes per week of yoga was too much. There were significant decreases in PTSD and depression, and improvements in self-rated health at post-intervention for both intervention groups. There was a significant difference in depression scores (p = .036) and grief intensity (p = .009) between the MD and STC groups. PTSD showed non-significant decreases of 43% and 56% at post-intervention in LD and MD groups, respectively (22% decrease in control).

Conclusions

This was the first study to determine the feasibility and preliminary efficacy of an online yoga intervention for women after stillbirth. Future research warrants a randomized controlled trial.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275350/