Pregnancy is a time of excitement, anticipation and transition. You may envision the child that you are going to have or the parent that you are going to be. You may attempt to plan and prepare. You may feel well-supported or lost and overwhelmed. Stress and perinatal mood disturbances are common and can begin any time during or after pregnancy. Pregnancy can be a time of emotional vulnerability due to the many biological and hormonal changes happening in the body. For this reason and others, many of the women that I work with experience stress and anxiety during pregnancy and following pregnancy. Mindfulness is a powerful coping tool that can help alleviate stress and anxiety in the general population and for mothers during pregnancy. But how does mindfulness work? What evidence is there that mindfulness can be used during pregnancy?
Mindfulness and other mind-body interventions are effective in reducing stress and improving overall mood. Recently, I read a study about the positive effects of mindfulness-based interventions during pregnancy to reduce women’s stress and mood disturbances. Vieten Astin (2008) studied women in their second and third trimesters (12 to 30 weeks gestation) that reported “mood concerns” during their pregnancy. Participants were recruited through physicians’ offices, childbirth education classes, advertisements and flyers. An intervention was developed to train pregnant women in Mindful Motherhood, an intervention incorporating approaches in both mindfulness and Acceptance and Commitment Therapy (ACT). Eligible participants were randomized and placed in a wait-list controlled group and experimental group. Participants in the experimental group were provided with weekly readings, guided meditations and group training facilitated by a licensed clinical psychologist and prenatal yoga instructor. Astin (2008) found that the women who participated in the mindfulness training had a significant decline in anxiety and depression when compared to those who did not receive the mindfulness intervention
A stable and positive mood during pregnancy is important to reduce stress, anxiety and depression in mothers. Further, mood can be highly influential in the outcomes for both mother and infant. Implementing the techniques of mindfulness may be key in helping women navigate the many (emotional) challenges of pregnancy.
Mindfulness can be a way for pregnant women to connect with their minds and bodies and improve stress. While more mindfulness-based interventions provided during pregnancy holds promise for the pregnant population, it is also a push for new coping skills to be researched and implemented during pregnancy to reduce the negative affects of pregnancy-related stress and mood disturbances.
At the hospital where I work, I run an antepartum high-risk program for pregnant patients who are hospitalized. The reasons for hospitalizations vary drastically, but the anxiety around anticipation and the baby's well-being are similar. Being hospitalized during a pregnancy can at the very least be stressful for women who are away from family and the comforts of home and at the very worst trigger perinatal depression and anxiety.
I had one patient named "M". M was pregnant with her first child. Due to complications in the pregnancy, she required a long inpatient hospitalization with continuous fetal monitoring and extensive lab work. The patient had a difficult time adjusting to the hospital setting. During one conversation, M shared her great fear of needles. At this time, M had been pricked, poked and prodded every day during her hospitalization. Being fearful of needles was causing even more stress and anxiety. We discussed how M could reduce her anxiety by practicing mindfulness. I educated her on the benefits of mindfulness and guided her through some mindfulness exercises. I came in every day so we could practice mindfulness together. By focusing her mind, M was able to reduce anxiety and fear around needles. M was grateful and found mindfulness to be very beneficial. After she delivered a her baby girl, M shared with me that she used mindfulness during her delivery. She reported that focusing her mind helped her to stay present and focused. For her, mindfulness had really worked!
Some ideas for practicing mindfulness from DBT Skills Training Handouts and Worksheets, Second Edition, by Marsha M. Linehan. Copyright 2015 by Marsha M. Linehan
Stone flake on the lake.
Imagine that you are by a clear blue lake on a beautiful sunny day. Then imagine that you are a small flake of stone, flat and light. Imagine that you have been tossed out onto the lake and are now gently, slowly, floating through the calm, clear blue water to the lake’s smooth, sandy bottom.
• Notice what you see, what you feel as you float down, perhaps in slow circles, floating toward the bottom. As you reach the bottom of the lake, settle your attention there within yourself.
• Notice the serenity of the lake; become aware of the calmness and quiet deep within.
• As you reach the center of your self, settle your attention there.
Breathing “Wise” in, “Mind” out.
Using breath as an anchor can be helpful to center the mind and reconnect with the body. Find a comfortable seated position and begin to focus on your breath. Breathing in, say to yourself, “Wise”; breathing out, say “Mind.”
•Focus your entire attention on the word “wise,” then, focus it again entirely on the word “mind.”
• Continue until you sense that you have settled into Wise Mind.
•Focus on your breath and let go of distracting thoughts and feelings.
Vieten, C. Astin, J. (2008). Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: Results of a pilot study. Archives of Women's Mental Health; 11(1): 67-74. 10.1007/s00737-008-0214-3. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18317710
Linehan, M. (2015). DBT skills training manual. 2nd Edition. Guilford Press: New York, New York.