Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison.
Study Goal
The researchers aimed to determine whether a mindfulness-based childbirth preparation course could improve childbirth-related appraisals, psychological functioning, and pain management compared to standard childbirth education.
Results Summary
The mindfulness-based course improved childbirth self-efficacy, mindful body awareness, and reduced postpartum depression symptoms, with a trend toward lower opioid use during labor. However, it did not significantly reduce perceived labor pain or epidural use compared to standard education.
Population
First-time mothers in the late third trimester of pregnancy.
Effective Dosage
A 2.5-day intensive mindfulness-based childbirth preparation course (Mind in Labor workshop).
Duration
2.5 days (weekend workshop).
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
mindfulness-based childbirth education | increase | women's childbirth-related appraisals and psychological functioning | first-time mothers in the late 3rd trimester of pregnancy | - | improved | #1 |
MIL program | increase | childbirth self-efficacy | first-time mothers in the late 3rd trimester of pregnancy | - | showed greater | #2 |
MIL program | increase | mindful body awareness | first-time mothers in the late 3rd trimester of pregnancy | - | showed greater | #3 |
MIL program | no change | dispositional mindfulness | first-time mothers in the late 3rd trimester of pregnancy | - | no changes in | #4 |
MIL program | decrease | post-course depression symptoms | first-time mothers in the late 3rd trimester of pregnancy | - | lower | #5 |
MIL program | decrease | opioid analgesia use in labor | first-time mothers in the late 3rd trimester of pregnancy | - | trend toward a lower rate of | #6 |
MIL program | no change | perceived labor pain | first-time mothers in the late 3rd trimester of pregnancy | - | did not report lower | #7 |
MIL program | no change | epidural less frequently | first-time mothers in the late 3rd trimester of pregnancy | - | did not use | #8 |
mindfulness training carefully tailored to address fear and pain of childbirth | increase | childbirth-related appraisals | pregnant women facing childbirth fear | - | may lead to important maternal mental health benefits | #9 |
mindfulness training carefully tailored to address fear and pain of childbirth | decrease | postpartum depression symptoms | pregnant women facing childbirth fear | - | prevention of | #10 |
MIL participants | decrease | systemic opioid pain medication | first-time mothers in the late 3rd trimester of pregnancy | - | may use mindfulness coping in lieu of | #11 |
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.