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
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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
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.
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.
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.
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.