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Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison
Open accessAbstract
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 [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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“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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Citations
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“The VAS is one of the most commonly used pain measures and it has been used successfully to assess labor pain [22].”
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BackgroundInfluential
Cited by
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The Effect of Health Education in Controlling Perinatal Depression: A Systematic Review
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Scientific Interventions to Reduce Maternal Stress: Improvement of Maternal and Fetal Outcomes
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A network of strength: How social support and functionality appreciation mitigate fear of childbirth
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“The results showed that 18 h of mindfulness training delivered over 2.5 days in the intervention group led to an increase in childbirth self-efficacy scores and a reduction in postpartum depressive symptoms, as well as a relative decrease in the use of narcotic analgesics during labor [32].”
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“Sample sizes ranged from 30 [26] to 832 [29].”
InfluentialMindfulness-Based Interventions in Perinatal Populations: a Scoping Review
Anderson, M. R., Roske, C., Carr, C., Go, M., Sharp, M., & Musicaro, R. M. (2026) · Mindfulness · doi:10.1007/s12671-026-02884-w
Küçükkaya, B., Öztürk, S., & Ekrem, E. C. (2026) · BMC Complementary Medicine and Therapies · doi:10.1186/s12906-026-05452-w
“This practice has been shown to decrease stress, anxiety, and depression while increasing self-efficacy, thereby reducing childbirth fear, pain, and opioid use during labor [44, 45].”
Mindfulness: Foundations, interventions, and effects
Burattini, S., Giannandrea, A., D'Onofrio, M., Srinivasan, N., & Raffone, A. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-29258-3.00088-4
Prenatal Education Strategies Designed to Support Women's Mobility During Labor: A Scoping Review
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“36 37 Each session introduces key mindfulness concepts and includes brief guided practices.”
Metadata
- 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.
- Venue
- BMC Pregnancy and Childbirth
- Published
- 2017-05-12
- Volume
- 17
- Issue
- 1
- Pages
- 140-140
- ISSN
- 1471-2393 (ISSN-L)
- 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
- gold
- doi.org
- 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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