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The Effectiveness of Mindfulness-Based Interventions in the Perinatal Period: A Systematic Review and Meta-Analysis
Open accessAbstract
Perinatal mental health difficulties are associated with adverse consequences for parents and infants. However, the potential risks associated with the use of psychotropic medication for pregnant and breastfeeding women and the preferences expressed by women for non-pharmacological interventions mean it is important to ensure that effective psychological interventions are available. It has been argued that mindfulness-based interventions may offer a novel approach to treating perinatal mental health difficulties, but relatively little is known about their effectiveness with perinatal populations. This paper therefore presents a systematic review and meta-analysis of the effectiveness of mindfulness-based interventions for reducing depression, anxiety and stress and improving mindfulness skills in the perinatal period. A systematic review identified seventeen studies of mindfulness-based interventions in the perinatal period, including both controlled trials (n = 9) and pre-post uncontrolled studies (n = 8). Eight of these studies also included qualitative data. Hedge's g was used to assess uncontrolled and controlled effect sizes in separate meta-analyses, and a narrative synthesis of qualitative data was produced. Pre- to post-analyses showed significant reductions in depression, anxiety and stress and significant increases in mindfulness skills post intervention, each with small to medium effect sizes. Completion of the mindfulness-based interventions was reasonable with around three quarters of participants meeting study-defined criteria for engagement or completion where this was recorded. Qualitative data suggested that participants viewed mindfulness interventions positively. However, between-group analyses failed to find any significant post-intervention benefits for depression, anxiety or stress of mindfulness-based interventions in comparison to control conditions: effect sizes were negligible and it was conspicuous that intervention group participants did not appear to improve significantly more than controls in their mindfulness skills. The interventions offered often deviated from traditional mindfulness-based cognitive therapy or mindfulness-based stress reduction programmes, and there was also a tendency for studies to focus on healthy rather than clinical populations, and on antenatal rather than postnatal populations. It is argued that these and other limitations with the included studies and their interventions may have been partly responsible for the lack of significant between-group effects. The implications of the findings and recommendations for future research are discussed.
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“The majority of studies are pilot and feasibility trials that are not adequately powered to demonstrate the effectiveness [3, 18, 19].”
From Mindfulness-based stress reduction adapted to pregnant women with psychosocial vulnerabilities—a protocol for a randomized feasibility study in a Danish hospital-based outpatient setting (2021) · cites this paper as [19]
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“There is evidence that women with elevated levels of depression, anxiety, or stress during this time may benefit more from MBIs than universal perinatal populations (55), suggesting a promising use in hospitalized women with obstetric risk.”
From Acceptance, experiences, and needs of hospitalized pregnant women toward an electronic mindfulness-based intervention: A pilot mixed-methods study (2022) · cites this paper as [55]
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“However, there are only few studies of pregnancy-specific eMBIs with only small samples and lacking randomized controlled approaches (43, 51, 55, 63).”
From Acceptance, experiences, and needs of hospitalized pregnant women toward an electronic mindfulness-based intervention: A pilot mixed-methods study (2022) · cites this paper as [55]
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“Systematic reviews and meta-analyses point towards a trend in favor of mindfulness-based interventions but state that shortcomings in study designs limit the conclusions.”
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“However, more research is needed to explore the possible benefits of mindfulness-based interventions on mental health in pregnancy, and in particular in psychosocially vulnerable groups [3, 19].”
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“…compassion-focused therapies, which have shown promise in enhancing psychological functioning during the perinatal period (O’Shaughnessy, 2025; Hulsbosch et al., 2023; Lever Taylor et al., 2016; Millard & Wittkowski, 2023), may be especially beneficial when integrated into routine antenatal care.”
Yıldırım, İ. K., & Di̇ri̇k, G. (2025) · Psychology and Health · doi:10.1080/08870446.2025.2572474 · Cited by 2
Bao, R., Yang, C., Zhu, R., Li, W., Bai, Y., Jiang, Y., & Zhang, G. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1641154 · Cited by 1
Chapter 3 Impact of maternal prenatal psychosocial stress and maternal obesity on infant microbiota
Browne, P. D., den Berg, E. V., & de Weerth, C. (2017) · Wageningen Academic Publishers eBooks · doi:10.3920/978-90-8686-839-1_3 · Cited by 2
Riley, K., Gent, A., McLaren, S., Caunt, J., & Stavropoulos, V. (2018) · Mindfulness · doi:10.1007/s12671-018-0941-0 · Cited by 1
Ooi, S. L., & Pak, S. C. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182.033 · Cited by 1
Dieppe, P. A., Goldingay, S., & Warber, S. L. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182.042 · Cited by 3
Emotional Intelligence and Its Role in Sustaining Fulfillment in Life
Sax, H. C., & Gewertz, B. L. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182.038 · Cited by 1
Family Relations, Friendships, and Love
Alsup, S., Weisbaum, E., Vogel, T., & Siegel, D. J. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182.047 · Cited by 1
Mindfulness-based cognitive therapy and depression
Ewais, T. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-817933-8.00042-6 · Cited by 1
Smith, R. D., Hung, S. C., Goh, J., Ip, H. L., Fong, D., Ali, S., Wilson, C. A., & Lok, K. Y. W. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-048764 · Cited by 1
Assessing the Effects of Mindfulness-Based Intervention on Anxiety and Cortisol in Pregnancy
Kundarti, F. I., Komalyna, I. N. T., Titisari, I., Kiswati, K., & Jamhariyah, J. (2023) · Universal Journal of Public Health · doi:10.13189/ujph.2023.110524 · Cited by 1
Branjerdporn, G., Gillespie, K. M., Martin, E. K., Kissane, V., Young, A. D., Ewais, T., Goldsmith, K., Wilson, S., Adhikary, S. R., Mcgahan, G., et al. (2023) · Trials · doi:10.1186/s13063-023-07746-7 · Cited by 1
Evidencias en el diagnóstico y tratamiento de la depresión posparto: revisión narrativa
Fuentes-Ureña, V., Herrera, T. T., Orobio, A., Manzano, M., Blanco, I., & Hinestroza, A. (2024) · Revista Peruana de Ginecología y Obstetricia · doi:10.31403/rpgo.v70i2592 · Cited by 1
New treatments: Opportunities and challenges
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The Role of Aesthetics in Wellness
Mikhail, A. A., & Ngor, A. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182.032 · Cited by 1
Ogunyemi, D. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182.011 · Cited by 1
Volle, D. C., & DeBonis, K. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182.023 · Cited by 1
Allergic, Infectious, and Immunological Processes
Riaz, O., Orimaye, S. O., Al-Khateeb, T., Sodeke, P. O., Awujoola, A. O., & Goodkin, K. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182.012 · Cited by 1
Kvasnak, K., Brunton, G., Lemonde, M., Chyzzy, B., & Dick, J. A. (2021) · International Health Trends and Perspectives · doi:10.32920/ihtp.v1i2.1438 · Cited by 1
Melchert, T. P. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182.004 · Cited by 1
IsHak, W. W. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182.052 · Cited by 2
Preparing To Parent: Mindfulness In Expectant Parents Exposed To Adversity
Hicks, L. M. (2017) · Human Biology
Carr, S. E. (2017) · ePrints Soton (University of Southampton)
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Budd, K. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182.028
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Groningen, N. V., IsHak, W. W., Ganjian, S., Ong, M. K., & Slusser, W. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182.045
Acupuncture, Herbs, and Ayurvedic Medicine
Postolov, L., & Gilberg-Lenz, S. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182.031
Circadian Rhythm in the Digital Age
Ezzat-Velinov, M., & Guarneri, M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182.035
Chaudhry, M., Gordon, A., Tadros, E., Sun, C., Tobia, G., & IsHak, W. W. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182.019
Metadata
- Authors
- Lever Taylor, B., Cavanagh, K., & Strauss, C.
- Affiliations
- University of Sussex (GB)
- Corresponding author
- Strauss, Clara
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2016-05-16
- Volume
- 11
- Issue
- 5
- Pages
- e0155720
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4868288
- OpenAlex
- W2350328130
- Cited by
- 284
- References
- 71
- Citations by year
- 2026: 16 · 2025: 26 · 2024: 20 · 2023: 41 · 2022: 22 · 2021: 43 · 2020: 73 · 2019: 18 · 2018: 13 · 2017: 10 · 2016: 2
- FWCI
- 2.12
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Sussex Research Online (University of Sussex) (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- University of Surrey
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- mindfulness-based interventions, perinatal mental health, perinatal depression, perinatal anxiety, perinatal stress, mindfulness skills, prenatal period, postpartum period, non-pharmacological treatment, pregnant and lactating women, intervention completion
- MeSH terms
- Anxiety, Depression, Female, Health Surveys, Humans, Pregnancy, Stress, Psychological, Outcome Assessment, Health Care, Publication Bias, Perinatal Care, Early Medical Intervention, Mindfulness
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