Improve Depression During the Perinatal Period with Mindfulness

Improve Depression During the Perinatal Period with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Pregnancy is a challenging terrain for everyone to navigate. And if you are entering that space with some history of depression, it can be particularly challenging.” – Sona Dimidjian

 

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.

 

Mindfulness practices have been found to help with coping with loss and its consequent grief.  Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy That is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms.

 

In today’s Research News article “Mindfulness-Based Cognitive Therapy for Perinatal Women with Depression or Bipolar Spectrum Disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7021274/), Miklowitz and colleagues recruited women with major depressive or bipolar disorders who were either pregnant, within 1 year postpartum, or trying to get pregnant. They were provided with weekly 2-hour sessions for 8 weeks of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after treatment and at 1 and 6 months later for psychological symptom severity, reoccurrence of major depression, mindfulness, and acceptability of treatment.

 

They found that in comparison to baseline, after Mindfulness-Based Cognitive Therapy (MBCT) there were significant reduction in depression and increases in mindfulness. The women on average moved from mildly to minimally depressed categories. These improvements were maintained 1 and 6 months later. The women who had major depressive disorder had significantly greater improvements in depression than the women with bipolar disorder.

 

These results suggest that Mindfulness-Based Cognitive Therapy (MBCT) is an effective treatment for depression in perinatal women with lasting benefits. This should help relieve the women’s suffering and help them to be better mothers to their children. MBCT has been shown to be effective for a wide variety of patients with depression. The present study increases the types of depression that are known to respond positively to MBCT.

 

So, improve depression during the perinatal period with mindfulness.

 

“mindfulness training could help improve mothers’ experience of labor and reduce the likelihood of postpartum depression.” – Jenn Knudsen

 

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

 

Miklowitz, D. J., Semple, R. J., Hauser, M., Elkun, D., Weintraub, M. J., & Dimidjian, S. (2015). Mindfulness-Based Cognitive Therapy for Perinatal Women with Depression or Bipolar Spectrum Disorder. Cognitive therapy and research, 39(5), 590–600. https://doi.org/10.1007/s10608-015-9681-9

 

Abstract

The perinatal period is a high-risk time for mood deterioration among women vulnerable to depression. This study examined feasibility, acceptability, and improvement associated with mindfulness-based cognitive therapy (MBCT) in perinatal women with major depressive disorder (MDD) or bipolar spectrum disorder (BSD). Following a diagnostic evaluation, 39 perinatal women with a lifetime history of MDD (n = 27) or BSD (n = 12) enrolled in an 8-week program of MBCT classes (2 h each) that incorporated meditation, yoga, and mood regulation strategies. Participants were pregnant (n = 12), planning pregnancy (n = 11), or up to 1-year postpartum (n = 16). Participants were self-referred and most had subthreshold mood symptoms. Assessments of depression, (hypo)mania, and anxiety were obtained by interview and self-report at baseline, post-treatment and at 1- and 6-month post-treatment. Women with a history of MDD were more likely to complete the classes than women with BSD. Of 32 women who completed the classes, 7 (21.9 %) had a major depressive episode during the 6-month post-treatment follow-up. On average, participants with MDD reported improvements in depression from pre- to post-treatment. Mood improvement was not observed in the BSD group. In the full sample, improvements in depression symptoms across time points were associated with increasing mindful tendency scores. This study was limited by its uncontrolled design, heterogeneous sample, and questionnaire-based assessment of mindfulness skills. MBCT may be an important component of care for perinatal women with histories of major depression. Its applicability to perinatal women with BSD is unclear.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7021274/

 

Improve the Psychological and Physical Health of Pregnant Low-Income Women with Mindfulness

Improve the Psychological and Physical Health of Pregnant Low-Income Women with Mindfulness

 

By John M. de Castro, Ph.D.

 

in pregnant women at high risk for excessive weight gain, it is both feasible and effective to use mindfulness strategies taught in a group format. Further, increases in certain mindfulness skills may help with better management of stress and overeating during pregnancy.” – Thomas Vieten

 

The period of pregnancy is a time of intense physiological and psychological change. Anxiety, depression, and fear are quite common during pregnancy. Pregnancy produces vast changes in the woman’s life, her body, her emotions, and her family. These changes may well be desired and welcomed, but they produce stress. Indeed, stress is a common experience in pregnancy. But it must be controlled. Too much stress can produce sleeping problems, headaches, loss of appetite or its opposite, overeating. If the levels of stress are high and prolonged it can produce health problems such as hypertension (high blood pressure) and heart disease in the mother. It can also make it more likely that the baby will be born prematurely or with a low birthweight, both of which are indicators of health problems for the infant and in the later child’s life. These stresses are magnified in low-income women.

 

So, it is important to either control stress during pregnancy or find ways to better cope with it. Mindfulness training has been shown to reduce the individual’s psychological and physiological responses to stress. Hence, mindfulness training may be a safe and effective method to assist the pregnant woman in coping with the stresses of pregnancy. Low-income women are particularly vulnerable to these stresses and have a high rate of rapid weight gain and metabolic syndrome during pregnancy. Indeed, mindfulness training appears to be effective in improving the mental and physical health of low-income individuals. Hence, it is important to study if mindfulness training can improve the health of low-income women.

 

In today’s Research News article “Effects of a Mindfulness-Based Intervention on Distress, Weight Gain, and Glucose Control for Pregnant Low-Income Women: A Quasi-Experimental Trial Using the ORBIT Model.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785577/), Epel and colleagues recruited low-income overweight and obese, pregnant women who were in their12th to 19th week of gestation. They were provided with a 2 hour once a week for 8 weeks program of a Mindful Moms training program. This included mindful movements and mindfulness practices and discussions of stress reduction, mindful eating, and nutrition. They were compared to a comparable group who simply continued with their usual treatments. They were measured for gestational weight gain, postpartum weight retention, and before and after the intervention for physical activity perceived stress, depression, pregnancy related anxiety, acceptance of negative experiences, eating behaviors, eating addiction, and mindfulness. They also received a glucose tolerance test.

 

They found that in comparison to baseline the group that received mindfulness training had significant reductions in perceived stress, depression, food addiction, emotional eating, external eating and significant increases in acceptance of negative experiences, glucose tolerance, and physical activity. Both groups gained excessive weight during pregnancy and retained it postpartum with no significant differences.

 

Conclusions must be tempered with the knowledge that the women were not randomly assigned to intervention and control conditions, rather they were assigned based upon whether their schedules allowed participation in the mindfulness training classes. Hence, there may have been systematic differences between the groups at the outset.

 

Nevertheless, the results are both disappointing and encouraging. They were disappointing in that the intervention did not alter the high weight gains during pregnancy or their retention postpartum even though there were improvements in their eating behaviors, physical activity, and glucose tolerance. These women were overweight and obese at the beginning, so the excess weight gains are unwanted and may further damage their health and that of their offspring.

 

The results, however, are encouraging in that they suggest that mindfulness training may improve the psychological and physical health of these women. Having low-income provides additional difficulty and stress on these pregnant women. So, the ability of mindfulness training to reduce the stress and improve their psychological health is welcome. The improvements in physical activity and glucose tolerance may signal improvements in the overall metabolic health of these women. Follow ups of these women need to be pursued to determine if there were significant impacts of the training on the infants and their development.

 

So, improve the psychological and physical health of pregnant low-income women with mindfulness.

 

women in the mindfulness group had lower stress levels, higher mindfulness measures, and lower weight gains during pregnancy.” Elissa Epel

 

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

 

Epel, E., Laraia, B., Coleman-Phox, K., Leung, C., Vieten, C., Mellin, L., … Adler, N. (2019). Effects of a Mindfulness-Based Intervention on Distress, Weight Gain, and Glucose Control for Pregnant Low-Income Women: A Quasi-Experimental Trial Using the ORBIT Model. International journal of behavioral medicine, 26(5), 461–473. doi:10.1007/s12529-019-09779-2

 

Abstract

Background

Stress can lead to excessive weight gain. Mindfulness-based stress reduction that incorporates mindful eating shows promise for reducing stress, overeating, and improving glucose control. No interventions have tested mindfulness training with a focus on healthy eating and weight gain during pregnancy, a period of common excessive weight gain. Here, we test the effectiveness of such an intervention, the Mindful Moms Training (MMT), on perceived stress, eating behaviors, and gestational weight gain in a high-risk sample of low income women with overweight/obesity.

Method

We conducted a quasi-experimental study assigning 115 pregnant women to MMT for 8 weeks and comparing them to 105 sociodemographically and weight equivalent pregnant women receiving treatment as usual. Our main outcomes included weight gain (primary outcome), perceived stress, and depression.

Results

Women in MMT showed significant reductions in perceived stress (β = − 0.16) and depressive symptoms (β = − 0.21) compared to the treatment as usual (TAU) control group. Consistent with national norms, the majority of women (68%) gained excessive weight according to Institute of Medicine weight-gain categories, regardless of group. Slightly more women in the MMT group gained below the recommendation. Among secondary outcomes, women in MMT reported increased physical activity (β = 0.26) and had lower glucose post-oral glucose tolerance test (β = − 0.23), being 66% less likely to have impaired glucose tolerance, compared to the TAU group.

Conclusion

A short-term intervention led to significant improvements in stress, and showed promise for preventing glucose intolerance. However, the majority of women gained excessive weight. A longer more intensive intervention may be needed for this high-risk population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785577/

 

Better Mental Health During Pregnancy is Associated with Mindfulness

Better Mental Health During Pregnancy is Associated with Mindfulness

 

By John M. de Castro, Ph.D.

 

mindfulness is a seriously beneficial practice during pregnancy, too? Simply tuning in and being aware can be a powerful tool to lessen stress, calm anxiety, and help you feel more connected during those long nine months.” – Carrie Murphy

 

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.

 

In today’s Research News article “An investigation of dispositional mindfulness and mood during pregnancy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676599/), Krusche and colleagues recruited pregnant women and had them complete measures of mindfulness, anxiety, depression, perceived stress, pregnancy distress, worries about labor, prenatal distress, pregnancy related discomforts, and pregnancy expectancies.

 

They found that the higher the levels of mindfulness, the lower the levels of anxiety, depression, perceived stress, worries about labor, pregnancy distress, prenatal distress, first and second trimester discomfort, and frequency and intensity of negative pregnancy experiences, and greater frequency and intensity of positive pregnancy experiences.

 

This study was correlational, so no conclusions can be reached about causation. But the results are striking that mindfulness is associated with better pregnancy related experiences, mood, and mental health. This portends well for the outcome of pregnancy and the health of the child. Future research should attempt to investigate the effects of mindfulness training during pregnancy on the mood, experiences, and mental health of the women.

 

So, better mental health during pregnancy is associated with mindfulness.

 

cultivating moment-to-moment awareness of thoughts and surroundings seem to help pregnant women keep their stress down and their spirits up. . . it may also lead to healthier newborns with fewer developmental problems down the line.” – 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

 

Krusche, A., Crane, C., & Dymond, M. (2019). An investigation of dispositional mindfulness and mood during pregnancy. BMC pregnancy and childbirth, 19(1), 273. doi:10.1186/s12884-019-2416-2

 

Abstract

Background

Mindfulness courses are being offered to numerous groups and while a large body of research has investigated links between dispositional mindfulness and mood, few studies have reported this relationship during pregnancy. The aim of this study was to investigate this relationship in pregnant women to offer insight into whether an intervention which may plausibly increase dispositional mindfulness would be beneficial for this population.

Methods

A cross-sectional analysis was conducted to explore potential relationships between measures of mindfulness and general and pregnancy-specific mood. A sample of pregnant women (n = 363) was recruited using online advertising and community-based recruitment and asked to complete a number of questionnaires online.

Results

Overall, higher levels of mindfulness were associated with improved levels of general and pregnancy-related mood in pregnant women. Controlling for general stress and anxiety, higher scores for mindfulness in (psychologically) healthy women were associated with lower levels of pregnancy-related depression, distress and labour worry but this relationship was not apparent in those with current mental health problems. In participants without children, higher mindfulness levels were related to lower levels of pregnancy-related distress.

Conclusions

These results suggest a promising relationship between dispositional mindfulness and mood though it varies depending on background and current problems. More research is needed, but this paper represents a first step in examining the potential of mindfulness courses for pregnant women. Increasing mindfulness, and therefore completing mindfulness-based courses, is potentially beneficial for improvements in mood during pregnancy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676599/

 

Improve Mental Health Postpartum with Perinatal Mindfulness Training

Improve Mental Health Postpartum with Perinatal Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“the ideal treatment plan for perinatal depression and anxiety often includes mindfulness techniques. Exercises such as deep breathing, progressive muscle relaxation, and meditation, for example, have been shown to reduce blood pressure and promote recovery from many illnesses.” – Edith Gettes

 

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.

 

Mindfulness training has been shown to improve anxiety and depression in general and to relieve maternal anxiety and depression during pregnancy. But it is not known if the effectiveness of mindfulness training during the perinatal period carries over to the postpartum period. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression and consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying depression. So, it would make sense to study the effectiveness of MBCT administered during the perinatal period on postpartum mental health issues.

 

In today’s Research News article “Postpartum Outcomes and Formal Mindfulness Practice in Mindfulness-Based Cognitive Therapy for Perinatal Women.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070304/), Luberto and colleagues recruited pregnant women (average of 15.5 weeks pregnant) and provide them with an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after training and 3 months postpartum for anxiety, depression, worry, mindfulness, self-compassion, meditation frequency, and home practice.

 

They found that after treatment there were significant increases in mindfulness and self-compassion and significant decreases in anxiety, depression, and worry. These improvements were maintained at 3-months postpartum except for depression that had a further significant decline. After the intervention 91% of the women continued to practice meditation and 65% continued practicing yoga. During the postpartum period 55% of the women continued to practice meditation and 25% continued practicing yoga. There were no significant differences in the outcomes for women who continued to practice versus those that didn’t.

 

These results are important in that they demonstrate that Mindfulness-Based Cognitive Therapy (MBCT)  produces important benefits for the mental health of pregnant women that endure into the postpartum period. This is important as “baby blues” and postpartum depression are frequent and difficult consequences of childbirth. The findings suggest that MBCT training during pregnancy may help to prevent “baby blues” and postpartum depression. Hence, MBCT the produces lasting improvements in the psychological state of women during both the perinatal and postpartum periods.

 

So, improve mental health postpartum with perinatal mindfulness training.

 

By paying attention, by being mindful, I was able to accept things that spun me out previously. I still had low points, but I was better equipped to manage and accept them as feelings and moments, and move on. . . . What I thought was caused by hormone fluctuations and “baby blues” was actually much more severe.” – Kristi Pahr

 

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

 

Luberto, C. M., Park, E. R., & Goodman, J. H. (2018). Postpartum Outcomes and Formal Mindfulness Practice in Mindfulness-Based Cognitive Therapy for Perinatal Women. Mindfulness, 9(3), 850–859. doi:10.1007/s12671-017-0825-8

 

Abstract

Anxiety is common during pregnancy and associated with poorer outcomes for mother and child. Our single-arm pilot study of an eight-week Mindfulness-Based Cognitive Therapy (MBCT) intervention for pregnant women with elevated anxiety showed significant pre- to post-intervention improvements in anxiety, depression, worry, mindfulness, and self-compassion. It remains unclear whether these improvements are maintained post-partum and whether amount of formal mindfulness practice is correlated with outcomes. The current study examined whether 1) improvements in psychosocial outcomes were maintained three months postpartum; 2) women were adherent to formal practice recommendations; and 3) amount of mindfulness practice was correlated with outcomes. Twenty-three pregnant women (Mage=33.5, SD=4.40; 75% White; 71% with Generalized Anxiety Disorder) completed home practice logs throughout the intervention, and self-report measures before and after the intervention and three months postpartum. Results indicated that previously reported post-intervention improvements in anxiety, worry, mindfulness, and self-compassion were maintained postpartum (p’s<.05), and reductions in depression further improved (p<.001). Participants were generally adherent to mindfulness practice recommendations during the intervention (54%-80% weekly adherence; M=17.31 total practice hours [SD=7.45]), and many continued practicing one-week post-intervention (91%) and postpartum (55%). Mindfulness practice during the intervention was not significantly correlated with any outcome at post-intervention or postpartum. Mindfulness practice postpartum was only marginally related to improved worry postpartum (p=.05). MBCT may be associated with maintained improvements in psychosocial outcomes for women during pregnancy and postpartum, but the role of mindfulness practice is unclear. Research using larger samples and randomized controlled designs is needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070304/

 

Reduce Depression During and After Pregnancy with Mindfulness

Reduce Depression During and After Pregnancy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness practice, when attention increases in one area of life, the awareness expands in many other areas, as well. A mother who is able to care for and attend to her own vulnerabilities will have much more access to those very same skills as a parent.” – Sonya Dimidjian

 

The perinatal period, from the onset of pregnancy to the end of the infants first year, is a time of intense physiological and psychological change in both the mother and the infant. 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. 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 during and after pregnancy.

 

Since, many drugs can affect the fetus, non-pharmacological treatments for depression are preferable. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. Mindfulness-Based Cognitive Therapy (MBCT) was specificly developed to treat depression and consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying depression. So, it would make sense to further study the effectiveness of MBCT for depression during the perinatal period.

 

In today’s Research News article “Staying Well during Pregnancy and the Postpartum: A Pilot Randomized Trial of Mindfulness Based Cognitive Therapy for the Prevention of Depressive Relapse/Recurrence.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718345/ ), Dimidjian and colleagues recruited pregnant women with Major Depressive Disorder and randomly assigned them to receive either treatment as usual or to Mindfulness-Based Cognitive Therapy (MBCT). MBCT was modified for pregnant women and administered for 2 hours, once a week, for 8 weeks and home practice was assigned. The women were measured for depression before and after treatment and at 1 and 6 months after birth.

 

In regards to depression, they found that relapse rates for depression over the 6-month follow-up period were significantly lower for the MBCT group; 18% vs. 50% for treatment as usual. In addition, the MBCT group had significantly lower levels of depression after treatment. Although the differences were not significant the MBCT group took fewer antidepressant medications and had fewer visits for therapy. A goal of this pilot research study was to assess the acceptability of the program and compliance with its requirements. They found that 89% completed the MBCT program and home practice occurred on over 70% of the available days. In addition, the women reported a high degree of satisfaction with the program.

 

These are impressive results for a pilot study and should provide the encouragement to perform a large randomized controlled clinical trial with an active control group. The results suggest that MBCT treatment is a safe and effective treatment for perinatal depression and has high acceptability and compliance among pregnant women. Hence it is a promising treatment for perinatal depression.

 

So, reduce depression during and after pregnancy with mindfulness.

 

“Not only does cultivating moment-to-moment awareness of thoughts and surroundings seem to help pregnant women keep their stress down and their spirits up—benefits that are well-documented among other groups of people—it may also lead to healthier newborns with fewer developmental problems down the line.” – 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

 

Dimidjian, S., Goodman, S. H., Felder, J., Gallop, R., Brown, A. P., & Beck, A. (2016). Staying Well during Pregnancy and the Postpartum: A Pilot Randomized Trial of Mindfulness Based Cognitive Therapy for the Prevention of Depressive Relapse/Recurrence. Journal of Consulting and Clinical Psychology, 84(2), 134–145. http://doi.org/10.1037/ccp0000068

Abstract

Objective

Clinical decision-making regarding the prevention of depression is complex for pregnant women with histories of depression and their healthcare providers. Pregnant women with histories of depression report preference for non-pharmacological care, but few evidence-based options exist. Mindfulness-based cognitive therapy has strong evidence in the prevention of depressive relapse/recurrence among general populations and indications of promise as adapted for perinatal depression (MBCT-PD). With a pilot randomized clinical trial, our aim was to evaluate treatment acceptability and efficacy of MBCT-PD relative to treatment as usual (TAU).

Methods

Pregnant adult women with depression histories were recruited from obstetrics clinics at two sites and randomized to MBCT-PD (N= 43) or TAU (N=43). Treatment acceptability was measured by assessing completion of sessions, at-home practice, and satisfaction. Clinical outcomes were interview-based depression relapse/recurrence status and self-reported depressive symptoms through 6-months postpartum.

Results

Consistent with predictions, MBCT-PD for at-risk pregnant women was acceptable based on rates of completion of sessions and at-home practice assignments, and satisfaction with services was significantly higher for MBCT-PD than TAU. Moreover, at-risk women randomly assigned to MBCT-PD reported significantly improved depressive outcomes compared to participants receiving TAU, including significantly lower rates of depressive relapse/recurrence and lower depressive symptom severity during the course of the study.

Conclusions

MBCT-PD is an acceptable and clinically beneficial program for pregnant women with histories of depression; teaching the skills and practices of mindfulness meditation and cognitive behavioral therapy during pregnancy may help to reduce the risk of depression during an important transition in women’s lives.

Public Health Significance Statement

This study’s findings support MBCT-PD as a viable non-pharmacological approach to preventing depressive relapse/recurrence among pregnant women with histories of depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718345/

Improve Mental Health During Pregnancy with Mindfulness

Improve Mental Health During Pregnancy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Not only does cultivating moment-to-moment awareness of thoughts and surroundings seem to help pregnant women keep their stress down and their spirits up—benefits that are well-documented among other groups of people—it may also lead to healthier newborns with fewer developmental problems down the line.” – 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. 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. So, it would make sense to review and summarize the studies of the effects of mindfulness training during pregnancy.

 

In today’s Research News article “Mindfulness-Based Interventions During Pregnancy: a Systematic Review and Meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693962/ ), Dhillon and colleagues review, summarize, and perform a meta-analysis of 14 published controlled research studies of the effects of mindfulness training on the psychological health of the mother.

 

They found that the published research reports that mindfulness training during pregnancy produces significant reductions in anxiety, depression, and perceived stress, and increases in mindfulness. Hence, mindfulness training was found to significantly improve the psychological health of the pregnant women. Some studies identified similar trends but not significant differences and so there is some question as to the robustness of the effects. Further research is needed to verify these benefits.

 

It is well established that mindfulness training reduces anxiety, depression, and perceived stress in a wide array of healthy and ill individuals of a variety of ages. So, it is not surprising that mindfulness training has similar effects on pregnant women. But, that it does, is particularly important during pregnancy due to the consequences for the child and its development.

 

So, improve mental health during pregnancy with mindfulness.

 

“Practicing mindfulness during pregnancy and childbirth can bring great benefits, which will extend beyond the birth into the sometimes stressful, always profound and mostly joyful weeks and months of learning to care for our child. Mindfulness can be a source of strength and pleasure in our years as a family.“ – Daniel & Jannette

 

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

 

Dhillon, A., Sparkes, E., & Duarte, R. V. (2017). Mindfulness-Based Interventions During Pregnancy: a Systematic Review and Meta-analysis. Mindfulness, 8(6), 1421–1437. http://doi.org/10.1007/s12671-017-0726-x

 

Abstract

This systematic review aims to assess the effect of mindfulness-based interventions carried out during pregnancy exploring mindfulness and mental health outcomes. A systematic review was conducted to appraise the current literature on the subject area. Inclusion and exclusion criteria were agreed and after reviewing titles, abstracts and full papers, 14 articles met the inclusion criteria and were included in the review. The quality of included articles was checked using the Quality Assessment Tool for Quantitative Studies. Pooled results of the randomised controlled trials (RCTs) reporting outcomes on anxiety, depression and perceived stress indicated no differences between the mindfulness intervention group and the control group. Pooled results of the non-RCTs reporting anxiety, depression and perceived stress showed a significant benefit for the mindfulness group. Mindfulness as an outcome was assessed in four RCTs for which the pooled results show a significant difference in favour of the mindfulness intervention when compared to a control group. The pooled results of the four non-RCTs also indicate a significant difference following mindfulness intervention. Results suggest that mindfulness-based interventions can be beneficial for outcomes such as anxiety, depression, perceived stress and levels of mindfulness during the perinatal period. Further research would be useful to explore if such benefits are sustained during the post-natal period.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693962/

Reduce Postpartum Depression with Mindfulness

Reduce Postpartum Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Interventions that bring a deeper sense of self-knowing and well-being to mothers allow them, in turn, to model this behavior for their children. We can’t possibly have the foresight to see how it ripples out from there, but we can be sure that it does.” – Heather Grimes

 

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.

 

Postpartum depression is treated much like depression in general with medications, psychotherapy, and support groups. But these methods often don’t work or have troublesome side effects. So, alternative treatments are needed. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. So, it would make sense to study the effects of mindfulness training as a treatment for postpartum depression.

 

In today’s Research News article “The effectiveness of mindfulness training on reducing the symptoms of postpartum depression.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586989/, Sheydaei and colleagues recruited new mothers who exhibited symptoms of depression and randomly assigned them to receive either treatment as usual or an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). MBCT consists of mindfulness training and Cognitive Behavioral Therapy (CBT) to investigate and alter aberrant thought patterns underlying depression. MBCT was administered for 2 hours, once a week, for 8 weeks. The women were measured for depression before and after treatment.

 

They found that after treatment the control group showed no change in depression while, on the other hand, the women who received the MBCT program had a significant, 25%, reduction in depression. The conclusions from this study need to be tempered with the fact that the control condition did not have an active treatment. So, placebo effects, demand characteristics, experimenter bias, etc. could be alternative explanations. But, it has been well established that mindfulness training in general and MBCT in particular are effective in treating depression. So, it is likely that MBCT effectively reduced the depression in these women with newborn children. Hence, MBCT appears to be a safe and effective treatment for postpartum depression. Mindfulness training might be employed not only to treat postpartum depression but also as a preventative measure.

 

So, reduce postpartum depression with mindfulness.

 

“mothers in the mindfulness group seemed to have had a better psychological experience of labor compared to the control group. They reported feeling greater “self-efficacy” during childbirth (the sense that they were able to handle it rather than feeling afraid), and lower symptoms of depression after the workshop and several weeks after childbirth.” – Jenn Knudsen

 

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

 

Sheydaei, H., Ghasemzadeh, A., Lashkari, A., & Kajani, P. G. (2017). The effectiveness of mindfulness training on reducing the symptoms of postpartum depression. Electronic Physician, 9(7), 4753–4758. http://doi.org/10.19082/4753

 

Abstract

Background and Aim

Postpartum depression is one of the prevalent disorders among new mothers. The present research aimed to examine the effectiveness of mindfulness training on reducing the symptoms of postpartum depression.

Method

The present quasi-experimental research was conducted on 410 new mothers in Shahid Chamran Hospital, Tehran in 2014. Using the Beck Depression Inventory (BDI), Structured Clinical Interview and Psychological Clinical Diagnosis, 67 mothers were selected and then randomly divided into experimental and control groups, each of which with 32 applicants. Afterwards, the experimental group received mindfulness training for 8 sessions, each lasting for two hours while the control group received no training. The data were analyzed through descriptive statistics and Analysis of Covariance (ANCOVA) in SPSS, version 20.

Results

Results showed that based on Beck Inventory, the scores for the experimental group in post-test were significant (p<0.001), compared to those for the control group. Also, it was revealed that pre- and posttest mean scores for postpartum depression in the control group were 25.81 and 25.12 respectively while the scores for the experimental group were 24.75 and 18.5 respectively. Since the posttest mean score in the experimental group was lower than that in the pretest, it can be said that the treatment, i.e., mindfulness training, was effective in reducing depression symptoms in mothers.

Conclusion

Findings proved that mindfulness training was effective in reducing the symptoms of postpartum depression in new mothers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586989/

Improve Psychological Health in Pregnancy with Mindfulness

Improve Psychological Health in Pregnancy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Not only does cultivating moment-to-moment awareness of thoughts and surroundings seem to help pregnant women keep their stress down and their spirits up—benefits that are well-documented among other groups of people—it may also lead to healthier newborns with fewer developmental problems down the line.” – Kira Newman

 

The perinatal period, from the onset of pregnancy to the end of the infants first year, is a time of intense physiological and psychological change in both the mother and the infant. 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. 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. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. So, it would make sense to further study the effects of mindfulness training during the perinatal period.

 

In today’s Research News article “A Comparative Study of Mindfulness Efficiency Based on Islamic-Spiritual Schemes and Group Cognitive Behavioral Therapy on Reduction of Anxiety and Depression in Pregnant Women.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385237/, Aslami and colleagues recruited Islamic women in their 16th to 32nd week of pregnancy and based upon pretesting of anxiety and depression selected two groups; a high anxiety and a high depression group. The groups were then randomly divided into a no-treatment control condition, a 12-week Cognitive Behavioral Therapy (CBT) condition or an 8-week Mindfulness-Based Stress Reduction (MBSR) condition. Traditional MBSR consists of training and practice in meditation, yoga, and body scan. The researchers modified the training protocol to include Islamic spiritual teachings. The CBT and MBSR conditions were assigned home practice for 45 minutes per day for 6 days per week. The participants were measured for anxiety and depression before and after treatment.

 

They found that both the Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Stress Reduction (MBSR) conditions produced significant decreases in both anxiety and depression while the no-treatment control group did not. In addition, the MBSR condition produced significantly greater reductions than the CBT condition. In fact, MBSR produced a very large reduction, on average, of 79% in anxiety and 81% in depression while CBT produced, on average, only a 45% reduction in anxiety and a 43% reduction in depression. Hence, although CBT was effective, MBSR produced far greater improvements in the pregnant women’s psychological states.

 

These are excellent results. It has been well established that mindfulness training produces significant reductions in anxiety and depression in a wide variety of people with a variety of conditions. But, this trial compared its effectiveness to another known effective treatment, Cognitive Behavioral Therapy (CBT) and found MBSR to be far superior. I am not aware of any other direct comparisons of the two forms of therapy. It is not known, however, if the inclusion of Islamic spiritual teachings added to MBSR’s effectiveness in this group of Islamic women. Regardless, it is clear the MBSR training is highly effective in reducing anxiety and depression in pregnant women. This should be of great assistance in making for a smooth remainder of the pregnancy and delivery and may well produce better outcomes with the infant.

 

So, improve psychological health in pregnancy with mindfulness.

 

“There could not be a better time to learn mindfulness than during pregnancy and early motherhood. For one thing, this is a time when most people have a strong motivation to become the best person they can be in a relatively short period of time. When you realize the full enormity of the responsibility you have taken on by becoming a mom, the primary source of care for another whole human being, not to mention one that you love more than you thought you could ever love, there is a really high level of motivation to try your best to get yourself into the best mental and emotional shape possible.”Cassandra Vieten

 

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

 

Aslami, E., Alipour, A., Najib, F. S., & Aghayosefi, A. (2017). A Comparative Study of Mindfulness Efficiency Based on Islamic-Spiritual Schemes and Group Cognitive Behavioral Therapy on Reduction of Anxiety and Depression in Pregnant Women . International Journal of Community Based Nursing and Midwifery, 5(2), 144–152.

 

Abstract

Background:

Anxiety and depression during the pregnancy period are among the factors affecting the pregnancy undesirable outcomes and delivery. One way of controlling anxiety and depression is mindfulness and cognitive behavioral therapy. The purpose of this study was to compare the efficiency of mindfulness based on the Islamic-spiritual schemas and group cognitive behavioral therapy on reduction of anxiety and depression in pregnant women.

Methods:

The research design was semi-experimental in the form of pretest-posttest using a control group. Among the pregnant women in the 16th to 32nd weeks of pregnancy who referred to the health center, 30 pregnant women with high anxiety level and 30 pregnant women with high depression participated in the research. Randomly 15 participants with high depression and 15 participants with high anxiety were considered in the intervention group under the treatment of mindfulness based on Islamic-spiritual schemes. In addition, 15 participants with high scores regarding depression and 15 with high scores in anxiety were considered in the other group. The control group consisted of 15 pregnant women with high anxiety and depression. Beck anxiety-depression questionnaire was used in two steps of pre-test and post-test. Data were analyzed using SPSS, version 20, and P≤0.05 was considered as significant.

Results:

The results of multivariate analysis of variance test and tracking Tukey test showed that there was a significant difference between the mean scores of anxiety and depression in the two groups of mindfulness based on spiritual- Islamic scheme (P<0.001) and the group of cognitive behavioral therapy with each other (P<0.001) and with the control group(P<0.001). The mean of anxiety and depression scores decreased in the intervention group, but it increased in the control group.

Conclusion:

Both therapy methods were effective in reduction of anxiety and depression of pregnant women, but the effect of mindfulness based on spiritual- Islamic schemes was more.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385237/

Reduce Depression and Anxiety Around Pregnancy with Mindfulness

Reduce Depression and Anxiety Around Pregnancy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“By learning mindfulness skills as part of their childbirth education, expectant mothers can reappraise the impending birth as something they can handle instead of viewing it as something to fear.” – Larissa Duncan

 

The perinatal period, from the onset of pregnancy to the end of the infants first year, is a time of intense physiological and psychological change in both the mother and the infant. 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. 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. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. So, it would make sense to study the effects of mindfulness training during the perinatal period.

 

In today’s Research News article “The Effectiveness of Mindfulness-Based Interventions on Maternal Perinatal Mental Health Outcomes: a Systematic Review.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506176/, Shi & MacBeth reviewed the published research literature on the effectiveness of mindfulness training on the emotional states of women in the perinatal period. They found 18 published studies that employed Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), or mindful yoga as the treatment for anxiety and depression during the perinatal period.

 

They found that the research indicated that mindfulness-based treatments were particularly effective for anxiety and to a lesser extent for depression and its recurrence. The treatments were reported to be safe, with no appreciable negative side effects, and acceptable, with low drop out rates. They note that there is a need for more highly controlled randomized controlled trials that include active control conditions in the future.

 

The results from the summarized 18 studies suggest that mindfulness based interventions are safe and effective treatment for perinatal anxiety and depression. Mindfulness practices have been shown to increase the focus on the present moment. Anxiety tends to revolve around the future while depression appears to revolve around the past. By focusing the individual on what is occurring in the present moment mindfulness training appears to decrease thinking about the past or the future and may thereby reduce anxiety and depression. Mindfulness training has also been shown to reduce the physiological and psychological responses to stress. The reduction in stress responses during the high stress perinatal period may also contribute to the women’s improved mood.

 

So, reduce depression and anxiety around pregnancy with mindfulness.

 

“Since mindfulness has a lot to do with being in touch with the sensations in your body, and being aware, new moms are in a prime state to learn it! In fact, pregnancy and early motherhood, nursing and sleep disturbance, weight gain and weight loss-these all in some way force you to be in your body. For those of us who live most of our lives above our necks, this can actually be a great blessing.”Cassandra Vieten

 

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

 

Shi, Z., & MacBeth, A. (2017). The Effectiveness of Mindfulness-Based Interventions on Maternal Perinatal Mental Health Outcomes: a Systematic Review. Mindfulness, 8(4), 823–847. http://doi.org/10.1007/s12671-016-0673-y

 

Presenting with common mental health difficulties, particularly depression and anxiety, there is also preliminary evidence that mindfulness-based interventions (MBIs) including mindfulness-based cognitive therapy (MBCT), mindfulness-based stress reduction (MBSR) and integrated mindfulness yoga practices may also be effective in reducing common mental health difficulties during pregnancy. We systematically reviewed and synthesized the current literature on the effectiveness of MBIs in reducing severity of perinatal anxiety and depression. Databases including PubMed, Cochrane Library, IndMED and PsychoInfo were searched for relevant studies. Manual searches were conducted in relevant articles and Google Scholar. Seventeen cohorts representing 18 studies were included. Pre-post effect sizes were reported for both treatment and control groups. Seven randomized controlled trials (RCTs), two non-randomized controlled trials and nine treatment evaluations were included. Maternal participation in an MBI was associated with reductions in perinatal anxiety of moderate to large magnitude. Results for the effect of MBIs on depression were less consistent, with pre-post treatment reductions of moderate magnitude, but no significant differences in depression scores when MBI was compared with a control group. There was some evidence that MBIs were associated with increased mindfulness. Risk of bias in studies was variable. Our review offers preliminary evidence for the effectiveness of MBIs in reducing perinatal anxiety, with more equivocal findings with regard to perinatal depressive symptoms. Further methodologically rigorous evaluation using RCTs and longer follow-up periods are recommended.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506176/

Improve Pregnancy and Birthing with Mindfulness

Improve Pregnancy and Birthing with Mindfulness

 

By John M. de Castro, Ph.D.

 

“There could not be a better time to learn mindfulness than during pregnancy and early motherhood. For one thing, this is a time when most people have a strong motivation to become the best person they can be in a relatively short period of time. When you realize the full enormity of the responsibility you have taken on by becoming a mom, the primary source of care for another whole human being, not to mention one that you love more than you thought you could ever love, there is a really high level of motivation to try your best to get yourself into the best mental and emotional shape possible.” Cassandra Vieten

 

The perinatal period, from the onset of pregnancy to the end of the infants first year, is a time of intense physiological and psychological change in both the mother and the infant. 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. 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. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. So, it would make sense to study the effects of mindfulness training during the perinatal period.

 

In today’s Research News article “Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427564/, Duncan and colleagues recruited women who were pregnant with their first child, in their third trimester, and planning on having a hospital birth. They received standard childbirth education and instruction and were then randomly assigned to receive either an additional childbirth course or Mind in Labor training; “a brief intervention for pregnant women and their partners specifically designed to target labor-related fear and pain by teaching tailored mindfulness-based coping strategies.” Training was conducted over a weekend for a total of 18 hours of instruction. It included body scan, yoga, and meditation practices. The women were measured at baseline before treatment on average at 29.4 weeks gestation, at the completion of training, and around 4-6 weeks after birth for childbirth self-efficacy, maladaptive pain, perceived pain in labor, use of pain medications in labor, birth satisfaction, depression, interoceptive awareness, and mindfulness.

 

The mindfulness group but not the control group had a marked and significant increase in childbirth self-efficacy and body awareness and decrease in pain catastrophizing after the intervention. The control group had a significant increase in depression from baseline to post-treatment and a further significant increase at the post-birth follow-up while the mindfulness group has a significant decrease in depression after treatment that was maintained at the post-birth follow-up. There was also a trend for the mindfulness group to be less likely to use opioid analgesics.

 

These are interesting and significant results that suggest that the addition of mindfulness training to standard birth education improves the women’s psychological state prior to and after birth. It decreases depression and worries about pain and makes the women feel more aware of their bodies and in better control of the childbirth process. Mindfulness training is known to decrease depression, and improve emotion regulation. It also focuses the individual on what is transpiring at the present moment which is much more manageable than the worst fears of the women. By focusing on now rather than the scary future, catastrophizing is minimized. These are important benefits that may have consequences for the later health and well-being of not only the mother but also the child.

 

So, improve pregnancy and birthing with mindfulness.

 

“Cue the spotlight on mindfulness. When nausea or aching ligaments can’t be alleviated with medication, or I can’t get away for a much-needed nap, or even just get through the morning without eight trips to the restroom, I try to dwell less on my misery and choose to be mindful instead.” – Ashley Jonkman

 

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

 

Duncan, L. G., Cohn, M. A., Chao, M. T., Cook, J. G., Riccobono, J., & Bardacke, N. (2017). Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison. BMC Pregnancy and Childbirth, 17, 140. http://doi.org/10.1186/s12884-017-1319-3

 

Abstract

Background

Childbirth fear is linked with lower labor pain tolerance and worse postpartum adjustment. Empirically validated childbirth preparation options are lacking for pregnant women facing this problem. Mindfulness approaches, now widely disseminated, can alleviate symptoms of both chronic and acute pain and improve psychological adjustment, suggesting potential benefit when applied to childbirth education.

Methods

This study, the Prenatal Education About Reducing Labor Stress (PEARLS) study, is a randomized controlled trial (RCT; n = 30) of a short, time-intensive, 2.5-day mindfulness-based childbirth preparation course offered as a weekend workshop, the Mind in Labor (MIL): Working with Pain in Childbirth, based on Mindfulness-Based Childbirth and Parenting (MBCP) education. First-time mothers in the late 3rd trimester of pregnancy were randomized to attend either the MIL course or a standard childbirth preparation course with no mind-body focus. Participants completed self-report assessments pre-intervention, post-intervention, and post-birth, and medical record data were collected.

Results

In a demographically diverse sample, this small RCT demonstrated mindfulness-based childbirth education improved women’s childbirth-related appraisals and psychological functioning in comparison to standard childbirth education. MIL program participants showed greater childbirth self-efficacy and mindful body awareness (but no changes in dispositional mindfulness), lower post-course depression symptoms that were maintained through postpartum follow-up, and a trend toward a lower rate of opioid analgesia use in labor. They did not, however, retrospectively report lower perceived labor pain or use epidural less frequently than controls.

Conclusions

This study suggests mindfulness training carefully tailored to address fear and pain of childbirth may lead to important maternal mental health benefits, including improvements in childbirth-related appraisals and the prevention of postpartum depression symptoms. There is also some indication that MIL participants may use mindfulness coping in lieu of systemic opioid pain medication. A large-scale RCT that captures real-time pain perceptions during labor and length of labor is warranted to provide a more definitive test of these effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427564/