Many expectant mothers worry about the physical pain that accompanies labor and childbirth. New research suggests that including mindfulness skills in childbirth education can help first-time mothers cope with their fears.
The study, published in the journal BMC Pregnancy and Childbirth, also indicates that mindfulness may help decrease women’s symptoms of prenatal and postpartum depression.
Mindfulness, defined as the awareness that arises from paying attention in the present moment, has been shown to help manage chronic pain, depression and anxiety. This study, although small, is one of the first to look at how these skills might benefit pregnant women.
“Fear of the unknown affects everyone, and this may be particularly true for pregnant women,” said Larissa Duncan, lead researcher in the study and an associate professor of human development and family studies at the University of Wisconsin-Madison.
The study included 30 first-time mothers in the third trimester of their pregnancies.
Each woman completed a series of questionnaires: one before the study began, another after completing the course, and a final one after giving birth. Many of the participants indicated concern about the pain of childbirth, while others were afraid of postpartum depression.
“I worry about what could go wrong during labor and delivery,” one participant wrote at the beginning of the study. “I’ve read books, but they scare me. I’m afraid of the pain, and the unknown is frightening.”
One study showed that first-time mothers who fear childbirth were more likely to have longer labor — on average 47 minutes longer — than similar women who weren’t fearful. These kinds of traumatic childbirth experiences can, in turn, increase a new mother’s risk of post-traumatic stress disorder, a serious mental health concern that affects 9 percent of mothers.
While many women take childbirth classes to educate themselves about the birth process, many of these courses do not teach skills for coping with childbirth anxiety. According to Dr. Duncan, in some instances, these classes may even cause women to feel worse.
“Childbirth education that only includes information about labor and delivery may make the fears first-time mothers experience feel closer at hand,” she said.
Curious about whether mindfulness skills could help women manage these anxieties, Dr. Duncan and her colleagues randomly assigned half of the participants to a mindful childbirth workshop called the Mind in Labor. The others were assigned to traditional childbirth classes.
The Mind in Labor is a weekend course developed by Nancy Bardacke, a certified nurse-midwife and mindfulness teacher at the Osher Center for Integrative Medicine at the University of California, San Francisco, Medical Center.
During the course, women are taught how to apply the language of mindfulness to the childbirth process, including how to use mindfulness to cope with pain and fear during labor. Birth partners also learn how to give comfort and support using mindfulness techniques.
“I teach women, and of course their partners, that the painful contractions of labor come and go, moment by moment, and that between the contractions are moments of calm and ease,” Ms. Bardacke said.
She says that the key to managing one’s fears is learning how to stay anchored in the present moment without worrying about the past or the future.
To teach this skill, Ms. Bardacke asks participants to hold ice cubes in their hands while paying attention to their breath. She said that allows them to experience the temporary nature of unpleasant physical sensations.
She also introduces basic mindfulness meditation practices, such as yoga, sitting meditation and walking meditation, as well as informal practices, such as mindful eating.
“Mindfulness practice provides an opportunity for the discovery of previously unrecognized inner resources of strength and resilience,” Ms. Bardacke says. “By the time the workshop is over, women’s confidence levels increase and their fears begin to dissipate. They realize that even if giving birth is hard, it’s something that they can manage, moment by moment.”
After attending the class, study participants said they felt more prepared for impending childbirth, and were less likely to use opioid pain medication during labor.
These women also had lower scores of prenatal and postpartum depression symptoms than those who participated in the traditional childbirth classes. According to the American Psychological Association, biological factors, such as hormonal changes, may affect a mother’s risk of depression. The association also states that women may struggle during the postpartum period as they adjust to their new roles as mothers. The study results suggest that mindfulness skills may help women manage the symptoms of maternal depression by teaching them how to cope with the unknowns of new motherhood.
“Expectant mothers may feel as though they have to control and manage every aspect of the birth experience,” said Carla Naumburg, a mindful parenting expert and clinical social worker in Newton, Mass., who was not involved with the study. “They often worry about the future, and this not only affects childbirth, but it can make parenting more difficult, too.”
Dr. Naumburg said that mindfulness can help women in labor to remain present and responsive to their experience, which can help to ease their physical and emotional suffering.
The researchers said they plan to conduct larger studies to examine how mindfulness may not only prepare expectant couples for navigating childbirth with greater emotional ease, but also help them as they raise children.
“By learning mindfulness skills as part of their childbirth education, expectant mothers can reappraise the impending birth as something they can handle instead of viewing it as something they fear,” Dr. Duncan said.