An investigation of dispositional mindfulness and mood during pregnancy.

BACKGROUND: Mindfulness courses are being offered to numerous groups and while a large body of research has investigated links between dispositional mindfulness and mood, few studies have reported this relationship during pregnancy. The aim of this study was to investigate this relationship in pregnant women to offer insight into whether an intervention which may plausibly increase dispositional mindfulness would be beneficial for this population. METHODS: A cross-sectional analysis was conducted to explore potential relationships between measures of mindfulness and general and pregnancy-specific mood. A sample of pregnant women (n = 363) was recruited using online advertising and community-based recruitment and asked to complete a number of questionnaires online. RESULTS: Overall, higher levels of mindfulness were associated with improved levels of general and pregnancy-related mood in pregnant women. Controlling for general stress and anxiety, higher scores for mindfulness in (psychologically) healthy women were associated with lower levels of pregnancy-related depression, distress and labour worry but this relationship was not apparent in those with current mental health problems. In participants without children, higher mindfulness levels were related to lower levels of pregnancy-related distress. CONCLUSIONS: These results suggest a promising relationship between dispositional mindfulness and mood though it varies depending on background and current problems. More research is needed, but this paper represents a first step in examining the potential of mindfulness courses for pregnant women. Increasing mindfulness, and therefore completing mindfulness-based courses, is potentially beneficial for improvements in mood during pregnancy.

Mindfulness for pregnancy: A randomised controlled study of online mindfulness during pregnancy.

OBJECTIVE: Prenatal depression, stress and anxiety are significant predictors of postnatal depression and also have a direct negative impact on the family. Helpful psychological interventions during pregnancy are scarce and expensive, and usually only available for a small percentage of those suffering or deemed to be at risk. The aim of this study was to evaluate the potential of an online mindfulness course for expectant mothers. DESIGN: A randomised study was conducted to explore differences between control and active participants allocated to take an online mindfulness course, offered free to research participants, or wait. SETTING: The course provided was online and already available but given to study participants for free. Measures were also taken online using a secure site to collect the data. PARTICIPANTS: 185 mothers were recruited and randomised to the online course (n = 107) or a waitlist control (n = 78), with 72 completers at post-course (n = 22 active, n = 50 control) and 48 completers at postnatal follow-up (n = 16 active and n = 32 control). INTERVENTION: The online mindfulness course is available at www.bemindfulonline.com and comprises a four-week, condensed version of an eight-week mindfulness course, with videos and written instructions for guided meditation and other mindfulness-based exercises. MEASUREMENTS AND FINDINGS: A number of psychological well-being measurements were taken including stress, anxiety, depression and pregnancy-specific measure such as labour worry. Intention to treat analysis (baseline carried forwards) showed no group difference in stress from pre to post intervention or control. KEY CONCLUSIONS: Results indicated that the course was potentially beneficial for those who completed it, but levels of drop out from the course were very high. IMPLICATIONS FOR PRACTICE: Although outcomes for mothers completing the intervention were improved relative to a waitlist control, high rates of drop out indicate that the online course has low completion rates for pregnant women in its current format.

An evaluation of mindfulness-based childbirth and parenting courses for pregnant women and prospective fathers/partners within the UK NHS (MBCP-4-NHS).

An evaluation of mindfulness-based childbirth and parenting courses for pregnant women and prospective fathers/partners within the UK NHS (MBCP-4-NHS). OBJECTIVE: To explore the usefulness within the National Health Service (NHS) of a brief (four week, ten hour) course based upon the Mindfulness Based Childbirth and Parenting (MBCP) programme (Duncan and Bardacke, 2010) described here as MBCP-4-NHS. BACKGROUND: The National Maternity Review (2016) and report of The Independent Mental Health Taskforce to the NHS (2016a, 2016b) in England highlight the need for significant investment into perinatal mental health services, with the Government pledging funding to improve such services through a range of measures. Whilst the field of mindfulness during the perinatal period is in need of well controlled trials and studies exploring the mechanisms of action (Hall et al., 2016) the limited research to date supports the potential for mindfulness based interventions in pregnancy and the need for further scientific study in this area (Dhillon et al., 2017; Shi and Macbeth, 2017). Particularly because it may broaden women's repertoire of coping strategies with the potential to improve the developmental trajectory of both parents and infants (Dunn et al., 2012; Duncan and Bardacke, 2010; Vieten and Astin, 2008). However, most of the studies to date have involved lengthy courses of around 8-9 weeks (24 h) duration, which may not be feasible or economical within a UK NHS setting and therefore, would be unlikely to be adopted as routine practice. DESIGN: An initial pilot study to discover if MBCP-4-NHS is acceptable and feasible within NHS maternity services, comparing maternal and paternal pre and post intervention self-report measures of mental health to begin to explore the effectiveness of this intervention. SETTING: NHS antenatal education classes held in children's centres for expectant parents across Oxfordshire. PARTICIPANTS: All expectant parents receiving Oxfordshire maternity services between October 2014 and January 2015 were invited to self-refer into the intervention, of which 155 individuals (86 women and 69 men) took part. INTERVENTION: 'MBCP-4-NHS' - A brief (four week, ten hour) course developed from the nine week Mindfulness Based Childbirth and Parenting (MBCP) intervention. MEASURES: Self-report measures of mental health including low mood/depression, mindfulness, stress, anxiety, pregnancy related distress and experiences. FINDINGS: The results showed a significant increase in both maternal and paternal mental health with women demonstrating a significant improvement in symptoms of stress, anxiety, depression, pregnancy-related distress, labour worry and positive and negative pregnancy experiences; and men improving significantly in symptoms of anxiety, depression and showing a trend for improvement in self-reported symptoms of perceived stress. CONCLUSIONS: This is a promising antenatal intervention that can be feasibly implemented within NHS which might have the potential to impact upon parental mental health and, therefore, possibly also the health of next generation. However, caution is needed interpreting these findings given that this study did not include an active control group. IMPLICATIONS FOR PRACTICE: This research provides a clear rationale and justification for a large randomised control trial of this intervention within the NHS, which should include a more diverse population, across multiple centres and should explore both the potential health benefits for parents and infants/children as well as potential economic costs/benefits.