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Cited by 224Mindfulness and Compassion InterventionsMaternal and Perinatal Health InterventionsMaternal Mental Health During Pregnancy and Postpartum

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

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Duncan, Larissa G., Cohn, Michael A., Chao, Maria T., Cook, Joseph G., Riccobono, Jane, Bardacke, Nancy·2017·BMC Pregnancy and Childbirth
DOI 10.1186/s12884-017-1319-3PMC PMC5427564
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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.

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  • Given the demonstrated benefit of mindfulness training in pregnancy for improving depression symptoms and preventing depression relapse, mindfulness may be especially suited, in combination with CBT-I, for treating insomnia in pregnant women with a history of depression.

    “Given the demonstrated benefit of mindfulness training in pregnancy for improving depression symptoms and preventing depression relapse [12, 20], mindfulness may be especially suited, in combination with CBT-I, for treating insomnia in pregnant women with a history of depression.”

    From Online prenatal trial in mindfulness sleep management (OPTIMISM): Protocol for a pilot randomized controlled trial (2020) · cites this paper as [20]

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  • Several brief adaptations of mindfulness-based childbirth and parenting programs exist.

    “Further, several brief adaptations of mindfulness-based childbirth and parenting programs exist (e.g., a weekend workshop, 4 vs. 9 weeks [105, 107]), thereby enhancing the accessibility of these interventions.”

    From Trajectories of Maternal and Paternal Internalizing Symptoms from Pregnancy to 2 Years Postpartum: Identifying Modifiable Risk and Protective Factors (2024) · cites this paper as [107]

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Authors
Duncan, L. G., Cohn, M. A., Chao, M. T., Cook, J. G., Riccobono, J., & Bardacke, N.
Affiliations
  • University of Wisconsin–Madison (US)
  • University of California, San Francisco (US)
Corresponding author
Duncan, Larissa G.
ORCID
Venue
BMC Pregnancy and Childbirth
Publisher
Springer Science and Business Media LLC
Published
2017-05-12
Volume
17
Issue
1
Pages
140-140
ISSN
1471-2393 (ISSN-L)
DOI
10.1186/s12884-017-1319-3
PMC
PMC5427564
OpenAlex
W2613725497
Cited by
224
References
44
Citations by year
2026: 17 · 2025: 29 · 2024: 25 · 2023: 38 · 2022: 32 · 2021: 32 · 2020: 26 · 2019: 13 · 2018: 9 · 2017: 3
FWCI
17.13
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Pregnancy and Childbirth (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Center for Complementary and Integrative Health (K01AT005270, K01AT006545)
  • Mt. Zion Health Fund
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Keywords
fear of childbirth, labor pain, postpartum depression, childbirth self-efficacy, maternal mental health, primiparous women, childbirth education
MeSH terms
Adaptation, Psychological, Adult, Fear, Female, Humans, Labor, Obstetric, Pregnancy, Treatment Outcome, Depression, Postpartum, Self Efficacy, Parturition, Delivery, Obstetric, Pregnant People, Labor Pain, Prenatal Education, Mindfulness

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