Keywords
Mindfulness-based stress reduction (MBSR), unintended pregnancy, stress, anxiety, depression
Abstract
Background. Individuals with unwanted pregnancies often experience high levels of anxiety, stress and depression that associated with maternal-neonatal outcomes. Mindfulness training is a safe and acceptable strategy to support mental health before parturition.
Purpose. The main objective of present study was to evaluate the influence of eight-week application of mindfulness-based stress reduction on stress, anxiety and depression caused by unplanned pregnancy.
Method. In this study, 60 women with unwanted pregnancy before 32 weeks of gestational age were selected and randomly divided into two groups. Intervention group received MBSR sessions, practice at home and the recorded sound. Mental health was evaluated before intervention and at the end of the eight sessions by standard stress, anxiety and depression DASS-21 questionnaire. Data were analyzed using Chi-square, Mann-Whitney U and Wilcoxon tests.
Findings. In order to compare pre-test and post-test scores in each group, the Wilcoxon Test was used. The results revealed that the participants in the intervention group reported a significant decrease in mean scores of stress, anxiety and depression compared to baseline (P = 0.0). Whereas no significant decrease in mean stress, anxiety and depression score were found in control group. P-value was estimated to be 0.346, 0.212 and 0.343 respectively.
Conclusions. The mindfulness program has effectively reduced stress, anxiety and depression. Further research is needed to investigate the mechanisms and effects of mindfulness on maternal-neonatal outcomes.
References
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[30] Hicks LM, Dayton CJ, Victor BG. Depressive and trauma symptoms in expectant, risk-exposed, mothers and fathers: Is mindfulness a buffer? Journal of Affective Disorders. 2018;238:179-86. . doi:10.1016/j.jad.2018.05.044
[2] Everett BG, McCabe KF, Hughes TL. Sexual orientation disparities in mistimed and unwanted pregnancy among adult women. Perspectives on Sexual and Reproductive Health. 2017;49(3):157-65. doi: 10.1363/psrh.12032
[3] Misgav R, Limor L, Shir D, Ron K, Noam S, Zvi V. Unintended pregnancies among women serving in the Israeli military. Contraception. 2017;96(1):62 - 5. https://doi.org/10.1016/j.contraception.2017.03.006
[4] Bishwajit G, Tang S, Yaya S, Feng Z. Unmet need for contraception and its association with unintended pregnancy in Bangladesh. BMC Pregnancy and CHildbirth. 2017;17(1):186. https://doi.org/10.1186/s12884-017-1379-4
[5] Nyarko SH. Unintended Pregnancy among pregnant women in Ghana: prevalence and predictors. Journal of Pregnancy. 2019;2019:8.https://doi.org/10.1155/2019/2920491
[6] Herzog AG, Mandle HB, MacEachern DB. Association of unintended pregnancy with spontaneous fetal loss in women with epilepsy: findings of the epilepsy birth control registry. JAMA Neurology. 2019;76(1):50-5. doi:10.1001/jamaneurol.2018.3089
[7] Dott M, Rasmussen SA, Hogue CJ, Reefhuis J. Association between pregnancy intention and reproductive-health related behaviors before and after pregnancy recognition, National Birth Defects Prevention Study, 1997–2002. Maternal and child health journal. 2010;14(3):373-81. doi: 10.1007/s10995-009-0458-1.
[8] Kost K, Lindberg L. Pregnancy intentions, maternal behaviors, and infant health: investigating relationships with new measures and propensity score analysis. Demography. 2015;52(1):83-111. doi:10.1001/jamaneurol.2018.3089
[9] Tsegaye AT, Mengistu M, Shimeka A. Prevalence of unintended pregnancy and associated factors among married women in west Belessa Woreda, Northwest Ethiopia, 2016. Reproductive Health. 2018;15(1):201. https://doi.org/10.1186/s12978-018-0649-6
[10] Dibaba Y, Fantahun M, Hindin MJ. The association of unwanted pregnancy and social support with depressive symptoms in pregnancy: evidence from rural Southwestern Ethiopia. BMC pregnancy and childbirth. 2013;13(1):135. https://doi.org/10.1186/1471-2393-13-135
[11] Abajobir AA, Maravilla JC, Alati R, Najman JM. A systematic review and meta-analysis of the association between unintended pregnancy and perinatal depression. Journal of Affective Disorders. 2016;192:56-63. doi: 10.1016/j.jad.2015.12.008
[12] Rallis S, Skouteris H, McCabe M, Milgrom J. A prospective examination of depression, anxiety and stress throughout pregnancy. Women and Birth. 2014;27(4):e36-e42. doi: 10.1016/j.wombi.2014.08.002.
[13] Song Y, Lindquist R. Effects of mindfulness-based stress reduction on depression, anxiety, stress and mindfulness in Korean nursing students. Nurse education today. 2015;35(1):86-90. doi: 10.1016/j.nedt.2014.06.010.
[14] Geng F, Liu X, Liang Y, Shi X, Chen S, Fan F. Prospective associations between sleep problems and subtypes of anxiety symptoms among disaster-exposed adolescents. Sleep Medicine. 2018;50:7-13. doi: 10.1016/j.sleep.2018.05.017.
[15] Nelson DB, Lepore SJ. The role of stress, depression, and violence on unintended pregnancy among young urban women. Journal of women's health. 2013;22(8):673-80. doi: 10.1089/jwh.2012.4133.
[16] Maxson P, Miranda ML. Pregnancy intention, demographic differences, and psychosocial health. Journal of Women's Health. 2011;20(8):1215-23. doi: 10.1089/jwh.2010.2379.
[17] Christensen AL, Stuart EA, Perry DF, Le H-N. Unintended pregnancy and perinatal depression trajectories in low-income, high-risk Hispanic immigrants. Prevention science. 2011;12(3):289-99. doi: 10.1007/s11121-011-0213-x.
[18] Bahk J, Yun S-C, Kim Y-m, Khang Y-H. Impact of unintended pregnancy on maternal mental health: a causal analysis using follow up data of the Panel Study on Korean Children (PSKC). BMC Pregnancy and Childbirth. 2015;15(1):85. doi: 10.1186/s12884-015-0505-4.
[19] Van der Riet P, Rossiter R, Kirby D, Dluzewska T, Harmon C. Piloting a stress management and mindfulness program for undergraduate nursing students: Student feedback and lessons learned. Nurse Education Today. 2015;35(1):44-9. doi: 10.1016/j.nedt.2014.05.003.
[20] Dobkin PL, Zhao Q. Increased mindfulness–The active component of the mindfulness-based stress reduction program. Complementary Therapies in Clinical Practice. 2011;17(1):22-7. doi: 10.1016/j.ctcp.2010.03.002.
[21] Beddoe AE, Yang C-PP, Kennedy HP, Weiss SJ, Lee KA. The effects of mindfulness-based yoga during pregnancy on maternal psychological and physical distress. Journal of Obstetric, Gynecologic & Neonatal Nursing. 2009;38(3):310-9. doi: 10.1111/j.1552-6909.2009.01023.x.
[22] Guardino CM, Dunkel Schetter C, Bower JE, Lu MC, Smalley SL. Randomised controlled pilot trial of mindfulness training for stress reduction during pregnancy. Psychology & health. 2014;29(3):334-49. doi:10.1093/scan/nsu075
[23] Hosseini Shahidi L, Moghimian M, Tavakkoli Zadeh J. The comparison of depression in wanted and unwanted pregnancies. J Gonabad Univ Med Sci Health Serv. 2002;8(2):90-5(in persian).
[24] Guth S, Wood S, Ivanova M, Hudziak JJ. Mindfulness training in pregnancy, and postpartum internalizing symptoms. Journal of The American Academy of Child & Adolescent Psychiatry. 2017;56(10):S180. https://doi.org/10.1016/j.jaac.2017.09.09225.
[25] Setterberg S, Nissen E, Jonas W, Niemi M. Perinatal stress, anxiety, and depression: Effects of a MBCP intervention on mother-infant interaction. European Psychiatry. 2017;41:S30-S1. https://doi.org/10.1016/j.eurpsy.2017.01.149
[26] Li J, Long L, Liu Y, He W, Li M. Effects of a mindfulness-based intervention on fertility quality of life and pregnancy rates among women subjected to first in vitro fertilization treatment. Behaviour Research and Therapy. 2016;77:96-104. doi: 10.1016/j.brat.2015.12.010.
[27] Krusche A, Dymond M, Murphy SE, Crane C. Mindfulness for pregnancy: A randomised controlled study of online mindfulness during pregnancy. Midwifery. 2018;65:51-7. doi: 10.1016/j.midw.2018.07.005.
[28] Goodman JH, Guarino A, Chenausky K, Klein L, Prager J, Petersen R, Forget A, Freeman M. CALM Pregnancy: results of a pilot study of mindfulness-based cognitive therapy for perinatal anxiety. Archives of women's mental health. 2014;17(5):373-87. doi: 10.1007/s00737-013-0402-7.
[29] Nyklíček I, Truijens SE, Spek V, Pop VJ. Mindfulness skills during pregnancy: Prospective associations with mother's mood and neonatal birth weight. Journal of Psychosomatic Research. 2018;107:14-9. doi: 10.1016/j.jpsychores.2018.01.012.
[30] Hicks LM, Dayton CJ, Victor BG. Depressive and trauma symptoms in expectant, risk-exposed, mothers and fathers: Is mindfulness a buffer? Journal of Affective Disorders. 2018;238:179-86. . doi:10.1016/j.jad.2018.05.044