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

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...

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Autores principales: Duncan, Larissa G., Cohn, Michael A., Chao, Maria T., Cook, Joseph G., Riccobono, Jane, Bardacke, Nancy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427564/
https://www.ncbi.nlm.nih.gov/pubmed/28499376
http://dx.doi.org/10.1186/s12884-017-1319-3
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author Duncan, Larissa G.
Cohn, Michael A.
Chao, Maria T.
Cook, Joseph G.
Riccobono, Jane
Bardacke, Nancy
author_facet Duncan, Larissa G.
Cohn, Michael A.
Chao, Maria T.
Cook, Joseph G.
Riccobono, Jane
Bardacke, Nancy
author_sort Duncan, Larissa G.
collection PubMed
description 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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spelling pubmed-54275642017-05-15 Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison Duncan, Larissa G. Cohn, Michael A. Chao, Maria T. Cook, Joseph G. Riccobono, Jane Bardacke, Nancy BMC Pregnancy Childbirth Research Article 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. BioMed Central 2017-05-12 /pmc/articles/PMC5427564/ /pubmed/28499376 http://dx.doi.org/10.1186/s12884-017-1319-3 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Duncan, Larissa G.
Cohn, Michael A.
Chao, Maria T.
Cook, Joseph G.
Riccobono, Jane
Bardacke, Nancy
Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison
title Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison
title_full Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison
title_fullStr Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison
title_full_unstemmed Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison
title_short Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison
title_sort benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427564/
https://www.ncbi.nlm.nih.gov/pubmed/28499376
http://dx.doi.org/10.1186/s12884-017-1319-3
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