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Ruiz RJ, Avant KC. Effects of maternal prenatal stress on infant outcomes: a synthesis of the literature. Adv Nurs Sci. 2005;28(4):345–55. Becoming pregnant is a beautiful moment in any person's life, but we understand that it can be challenging to keep your body nurtured and supported throughout this journey. Don't worry, DK has got you covered!
Kraemer HC, Wilson GT, Fairburn CG, Agras WS. Mediators and moderators of treatment effects in randomized clinical trials. Arch Gen Psychiatry. 2002;59(10):877. Clear, concise and easy to follow techniques which are presented step-by-step, grounded in their scientific benefitsAmongst all the sleepless nights, crying babies and endless nappy-changes, we will discover moments of wonder, joy and peace, with those moments of frustration and anxiety becoming more infrequent and disappearing fast.
This study provides preliminary evidence that a brief mindfulness-based childbirth preparation program during pregnancy can shift child-bearers’ trajectories of distress through one-year post-birth. In particular, we found that participation in MIL (compared to TAU) predicted a decrease in the depressive symptom component of perinatal distress, with trend-level effects on an overall distress aggregate. We further found that those with the greatest mental health needs—i.e., pregnant people with higher anxiety and/or lower mindfulness at baseline—received the most benefit, with significant reductions in distress slopes and lower ending levels of postpartum distress compared to their TAU counterparts. Processes driving these findings and implications for perinatal mental health promotion are considered below. Warriner S, Crane C, Dymond M, Krusche A. An evaluation of mindfulness-based childbirth and parenting courses for pregnant women and prospective fathers/partners within the UK NHS (MBCP-4-NHS). Midwifery. 2018;64:1–10.
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Alongside multiple strengths of this study, including the RCT design and long-term follow-up period, there are limitations that should be considered. As a modestly scaled pilot study, this work is best framed as providing an essential foundation for a larger RCT to develop evidence-based recommendations. Small sample size restricts power for detecting effects, particularly smaller-sized effects such as would be expected for interactions, and both null and significant findings in the present study should be considered preliminary. Due to the schedule of funding for this project, the timing of the final assessment was varied across participants (between one and a half to 2 years postpartum), which warrants consideration. The trajectory approach taken here, which highlights slopes of changes over time rather than change between distinct timepoints mitigates the issue this may pose in interpreting results. Future studies should include additional assessments beyond 2 years to examine trajectories into childhood. Conclusions are necessarily limited by the particular measures used, which offered a multidimensional but far from comprehensive measure of the perinatal distress umbrella. It may be worthwhile in future research to include measures of perinatal-specific psychological and somatic symptoms, as well as measures that cover different time frames from immediate state affect—perhaps using experience sampling methods—to more stable trait-like features of psychological functioning.
When a change of plan occurred with the birth of my son, I was quite upset. The nurses told me, “You’re fine! Stop crying. We do this every day,” and that didn’t help. What did help was my midwife telling those nurses that the journey ahead of me was about as far from my initial homebirth dream as it could be and that I had every right to feel disappointed in that moment. And that’s exactly how much longer I gave into those feelings, one moment. Then I made a conscious decision to let it go and choose to be present for the birth of my baby. All study procedures were approved by the University of California, San Francisco (UCSF) Committee for Human Research (institutional review board), and signed informed consent was obtained from all participants. Participants were randomized to either MIL ( n = 15) or TAU ( n = 15) using a pre-programmed computer database. Self-report measures were completed online at four time points: time 1 (T1) was the third trimester baseline (immediately pre-intervention and pre-randomization), time 2 (T2) was the week immediately following the intervention (post-intervention but prior to birth), time 3 (T3) was the postpartum follow-up (approximately 6 weeks post-birth), and time 4 (T4) was 1 to 2 years post-birth. Due to the timing of received project funding for long-term follow-up, T4 assessment timing varied such that earlier cohorts completed T4 up to 2 years post-birth while later cohorts completed T4 at 1 year post-birth. Participants completed the T4 assessment on average 1.79 years post-birth ( M = 93.08 weeks, SD = 0.17 years, range = 1.47–2.20 years. All eligibility screening and assessment was conducted through an online survey software (see [ 33] for further details of compensation and time period of data collection). The current study was submitted in fulfillment of the first author’s master’s thesis (see [ 49]). Interventions Mind in labor (MIL): working with pain in childbirth Those in MIL with very low initial levels of anxiety showed ending distress that was similar to that of higher anxiety MIL participants, which represented higher ending distress compared to their TAU counterparts with initial low anxiety. This pattern may reflect the increased awareness that comes with beginning engagement with mindfulness practice. That is, individuals who are living on autopilot may simply not be aware of much of their internal experience and report lower symptoms. Being guided into greater awareness of what is going on with oneself somatically, and with one’s thoughts and emotions, may in itself bring about more reporting of symptoms for those who had little awareness prior to an MBI. It is possible that a longer period of follow up—particularly with those who continue in their mindfulness practice—would show an increase in wellbeing and lower symptoms following this initial dip. That is, the benefits of mindfulness practice for child-bearers who start with negligible symptoms may require a longer time scale of sustained practice to observe, and future research should examine this longer term trajectory.Dunn, C., Hanieh, E., Roberts, R. et al. Mindful pregnancy and childbirth: effects of a mindfulness-based intervention on women’s psychological distress and well-being in the perinatal period. Arch Women's Ment Health (2012);15, 139–143. doi:10.1007/s00737-012-0264-4
