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Randomized Controlled Trial
. 2017 May 12;17(1):140.
doi: 10.1186/s12884-017-1319-3.

Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison

Larissa G Duncan  1   2   3 , Michael A Cohn  4 , Maria T Chao  4   5 , Joseph G Cook  4 , Jane Riccobono  6 , Nancy Bardacke  4   7   8
Affiliations
Randomized Controlled Trial

Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison

Larissa G Duncan et al. BMC Pregnancy Childbirth. .

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.

Trial registration: The ClinicalTrials.gov identifier for the PEARLS study is: NCT02327559 . The study was retrospectively registered on June 23, 2014.

Keywords: Childbirth; Fear; Labor; Mindfulness; Pain; Postpartum depression.

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Figures

Fig. 1
Fig. 1
CONSORT flow chart
Fig. 2
Fig. 2
Childbirth Self-Efficacy scores (MIL = Mind in Labor; TAU = Treatment as Usual)
Fig. 3
Fig. 3
Pain Catastrophizing scores (MIL = Mind in Labor; TAU = Treatment as Usual)
Fig. 4
Fig. 4
CES-D depression symptom scores (MIL = Mind in Labor; TAU = Treatment as Usual)
See this image and copyright information in PMC

References

    1. Alehagen S, Wijma K, Wijma B. Fear during labor. Acta Obstet Gynecol Scand. 2001;80(4):315–320. doi: 10.1034/j.1600-0412.2001.080004315.x. - DOI - PubMed
    1. Laursen M, Johansen C, Hedegaard M. Fear of childbirth and risk for birth complications in nulliparous women in the Danish national birth cohort. Br J Obstet Gynaecol. 2009;116(10):1350–1355. doi: 10.1111/j.1471-0528.2009.02250.x. - DOI - PubMed
    1. Ryding EL, Wijma B, Wijma K, Rydhstrom H. Fear of childbirth during pregnancy may increase the risk of emergency cesarean section. Acta Obstet Gynecol Scand. 1998;77(5):542–547. doi: 10.1080/j.1600-0412.1998.770512.x. - DOI - PubMed
    1. Lobel M, DeLuca RS. Psychosocial sequelae of cesarean delivery: review and analysis of their causes and implications. Soc Sci Med. 2007;64(11):2272–2284. doi: 10.1016/j.socscimed.2007.02.028. - DOI - PubMed
    1. Sorenson DL. Uncertainty in pregnancy. NAACOGS Clin Issu Perinat Womens Health Nurs. 1990;1(3):289–296. - PubMed

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