Effect of Stress Ball Application On Anxiety Levels of Pregnant Women During Non-Stress Test: Randomized Controlled Experimental Study.

Background: This randomized controlled trial was designed to assess the efficacy of stress ball application on stress levels of pregnant women during non-stress tests. Methods: The study included 80 primiparous pregnant women (n = 40 in the experimental group and n = 40 in the control group) and was carried out in a state hospital's non-stress test room. Data for the study were gathered using Individual Description Form, and the State Anxiety Inventory (STAI). Results: Both groups are independent and homogeneous in terms of the sociodemographic and obstetric characteristics of pregnant women (P > .05). While there was no statistically significant difference between the STAI-1 score averages of the experimental and control groups in the pre-test of the research (P > .05), in the post-test of the research, it was determined that the STAI-2 average score of the women in the experimental group was significantly lower than the women in the control group (P < .001). In the intra-group comparison, while there was a statistically significant difference between the STAI-1 and STAI-2 score averages in the experimental group (P < .001), no statistically significant difference was detected between the STAI-1 and STAI-2 score averages in the control group (P = .696). Conclusion: In this study, the use of a stress ball during the non-stress test is effective in reducing anxiety levels in pregnant women.

Who is most vulnerable? Factors associated with presenting to antenatal care without a male partner in Northern Tanzania.

OBJECTIVE: Male engagement in pregnancy care can be beneficial for maternal and child health outcomes. In Tanzania, pregnant women are strongly encouraged to present to their first antenatal care (ANC) appointment with a male partner, where they jointly test for HIV. For some, this presents a barrier to ANC attendance. The objectives of this study were to identify factors associated with presenting to ANC with a male partner using a cross-sectional design and to assess whether women presenting without partners had significantly delayed presentation. METHODS: Pregnant women (n = 1007) attending a first ANC appointment in Moshi, Tanzania were surveyed. Questions captured sociodemographic characteristics and measures of psychosocial constructs. RESULTS: Just over half (54%) of women presented to care with a male partner. Women were more likely to present with a male partner if they were younger than 25 years old, married, Muslim, attending ANC for their first pregnancy, and testing for HIV for the first time. Women presenting to ANC with a male partner were significantly more likely to attend ANC earlier in their pregnancy than those presenting without male partners. CONCLUSION: Policy change allowing women to present to care with other supportive family members could promote earlier presentation to first ANC. Unmarried women may be at a disadvantage in presenting to ANC when policies mandate attendance with a male partner. Male partners of multiparous women should be encouraged to provide pregnancy support even after first pregnancies, and a wholistic emphasis (beyond HIV testing) on first ANC could encourage male engagement beyond the initial appointment.

Exploring the healthcare needs and experiences of pregnant women with congenital heart disease: A qualitative study.

PROBLEM: Little is known regarding the healthcare needs and experiences of pregnant women with congenital heart disease (CHD) during pregnancy. BACKGROUND: Congenital heart diseases are the most common birth anomalies, and they embrace a wide range of defects ranging from mild to complex and life-threatening defects. Pregnancy carries many physiological and psychological changes that affect pregnant woman with CHD and need special attention and consideration. AIM: To explore the healthcare needs and experiences of Jordanian women with CHD during pregnancy. METHODS: A descriptive phenomenological design was used. Utilising purposive sampling, 15 participants were recruited. Data was collected using individualised semi-structured interviews. Interviews were recorded and transcribed verbatim. Data were analyzed using Colaizzi's method. FINDINGS: Three themes were identified: a) A broad spectrum of health needs during pregnancy, b) not being cared for, c) and the healthcare journey: Challenges and recommendations. Findings revealed that pregnancy in women with CHD is associated with many challenges and needs, and the lived healthcare experiences are mostly negative. DISCUSSION: This study addresses the healthcare needs and experiences of pregnant women with CHD during pregnancy. Our findings shed light on healthcare needs explored hidden aspects of the experiences of this vulnerable population and gave them the chance to make their voices heard. CONCLUSION: The study concluded that pregnant women with CHD experience hardship associated with negative challenges and personal suffering. The findings highlight the importance of the basic values and the need for a holistic approach and effective teamwork to minimise suffering among pregnant women with CHD.

Promovendo saúde por meio da música na maternidade: percepções de gestantes e puérperas / Promoting health through music in motherhood: perceptions of pregnant and puerperal women / Promoviendo la salud a través de la música en la maternidad: percepciones de las mujeres embarazadas y puérperas

Objetivo: compreender as percepções de gestantes e puérperas sobre o uso da música como tecnologia de cuidado para promoção da saúde. Método: estudo qualitativo, fundamentado nos pressupostos da promoção da saúde, realizado com sete gestantes e oito puérperas internadas na maternidade de um hospital público de Santa Catarina. Realizou-se entrevistas semiestruturadas, entre setembro de 2021 e fevereiro de 2022, após aprovação do Comitê de Ética em Pesquisa. Os dados foram analisados por meio da análise de conteúdo. Resultados: a música na maternidade diminui o estresse e a tristeza. Alem disso, proporciona distração, alegria, animação, resgate de lembranças, momento especial, gratidão e tranquilidade para as mulheres hospitalizadas e para os seus bebês. Considerações finais: para as gestantes e puérperas, a música tem a capacidade de promover a saúde, sendo uma tecnologia de cuidado que deveria estar presente em todas as maternidades do Brasil(AU)

Objective: to understand the perceptions of pregnant and postpartum women about the use of music as a care technology for health promotion. Method: qualitative research, based on the assumptions of health promotion, carried out with seven pregnant women and eight postpartum women admitted to the maternity ward of a public hospital in Santa Catarina. Semi-structured interviews were carried out between September 2021 and February 2022, after approval by the Research Ethics Committee. Data were analyzed using content analysis. Results: music in the maternity ward reduces stress and sadness. In addition, it provides distraction, joy, animation, recall of memories, a special moment, gratitude and tranquility for hospitalized women and their babies. Final considerations: for pregnant and postpartum women, music has the ability to promote health, being a care technology that should be present in all maternity hospitals in Brazil(AU)

Objetivo: comprender las percepciones de embarazadas y puérperas sobre el uso de la música como tecnología de cuidado para la promoción de la salud. Método: estudio cualitativo, basado en los supuestos de la promoción de la salud, realizado junto a siete mujeres embarazadas y ocho puérperas internadas en la maternidad de un hospital público de Santa Catarina. Las entrevistas semiestructuradas se realizaron entre septiembre de 2021 y febrero de 2022, previa aprobación del Comité de Ética en Investigación. Los datos se analizaron mediante análisis de contenido. Resultados: la música en la sala de maternidad reduce el estrés y la tristeza. Además, brinda distracción, alegría, animación, recuperación de recuerdos, momento especial, gratitud y tranquilidad para las mujeres hospitalizadas y sus bebés. Consideraciones finales: para las mujeres embarazadas y puérperas, la música tiene la capacidad de promover la salud, siendo una tecnología de atención que debe estar presente en todas las maternidades de Brasil(AU)

The effect of an adapted Mindfulness-Based Stress Reduction program on mental health, maternal bonding and birth outcomes in psychosocially vulnerable pregnant women: a study protocol for a randomized controlled trial in a Danish hospital-based outpatient setting.

BACKGROUND: Stress and mental disorders in pregnancy can adversely affect the developing fetus. Women with a preconception history of mental disorders or of psychosocial vulnerabilities are at increased risk of experiencing perinatal stress or mental health problems. Mindfulness-Based-Stress-Reduction (MBSR) is an acceptable intervention for pregnant women and has a growing evidence-base with meta-analyses consistently pointing to reductions in symptoms of stress, anxiety and depression. This study protocol aim to address the need for a wider array of evidence-based and non-pharmacological options during pregnancy to reduce stress and improve mental health in a psychosocially highly vulnerable group of women. METHODS: Pregnant women with a preconception history of mental disorders or psychosocial vulnerabilities (n = 240) will be recruited from an obstetric ambulatory clinic at Copenhagen University Hospital, Hvidovre, Denmark. Recruitment for the study began in March 2022 and will continue until the desired number of participants is reached. Consenting pregnant women will be randomized to one of two study arms, an adapted MBSR program as add on to usual care or usual care alone. The primary outcome is mental wellbeing at nine months post-randomization. Secondary and exploratory outcomes include stress, anxiety, depression, and maternal antenatal attachment, experience of childbirth, delivery and mode of delivery. Mindfulness and self-compassion are examined as possible mediators of the effect on outcomes. DISCUSSION: Teaching the skills of mindfulness meditation to a psychosocially vulnerable group of pregnant women could prove a viable and non-pharmacological approach to improve mental health and wellbeing during pregnancy, reduce stress and support the transition to parenthood. Mindfulness-Based Stress Reduction does not target a particular group, and results from the study is thus of potential relevance for pregnant women in general as a means of reducing stress and improving perinatal mental health and wellbeing. TRIAL REGISTRATION: ClinicalTrials.gov: NCT05300646 . Registered March 29, 2022.

The effect of emotional freedom technique and music applied to pregnant women who experienced prenatal loss on psychological growth, well-being, and cortisol level: A randomized controlled trial.

INTRODUCTION: Research has shown that application of emotional freedom technique and music ensures psychological growth, increases well-being, and decreases cortisol level. PURPOSE: In the study, it was aimed to determine the effect of EFT and music applied to pregnant women who had experienced prenatal loss on their psychological growth, well-being, and cortisol level. METHODS: The study was conducted as a randomized controlled trial in a city hospital in eastern Türkiye with 159 pregnant women, 53 of whom were in the EFT, 53 in the music group, and 53 in the control group. The study data were collected through Subjective Units of Disturbance Scale (SUDS), Subjective Units of Experience (SUE) Scale, Post Traumatic Growth Inventory (PTGI), and WHO-5 Well-Being Index, and saliva samples were taken for cortisol evaluation. EFT was applied to the women two times every other week; the women in the music group listened to music two times every other week. Throughout the week following the first intervention, the women continued the interventions at home. RESULTS: It was determined that EFT and music significantly decreased the participants' subjective anxiety and salivary cortisol median scores, the lowest anxiety was in the EFT group, and PTGI and WHO-5 Well-Being Index mean scores increased (p < 0.005). Further analyses showed that EFT was more effective in terms of increasing well-being than music (p < 0.001; a > b > c). It was determined that the anxiety levels and salivary cortisol median values of the control group were statistically significantly higher compared to the EFT and music groups (p < 0.001). CONCLUSION: It was found that EFT and music applied to the women who had experienced prenatal loss decreased anxiety, ensured psychological growth, improved well-being, and decreased salivary cortisol level.

Contextualizing the experiences of Black pregnant women during the COVID-19 pandemic: 'It's been a lonely ride'.

The emergence of the COVID-19 pandemic significantly changed the prenatal care experience, specifically regarding medical appointments and social opportunities. It is critical to capture this change through the narratives of pregnant people, particularly those of marginalized populations, whose voices may often be underrepresented in the literature. This mixed-methods paper summarizes the experiences of 40 pregnant Black/African American (AA) women during the COVID-19 pandemic. A cross-sectional, online survey was administered between 2020 and 2021 to assess prenatal health and the impacts of the COVID-19 pandemic on patients' pregnancy experience. Coping behaviors during the pandemic were self-reported using the COPE-IS. Univariate analyses were conducted. An additional analysis of participants (n = 4) was explored through a week-long qualitative exercise using a photo documentation procedure. Photo-Elicitation Interviews (PEI) were conducted to capture and center their pandemic pregnancy experiences. Sources of stress during the pandemic varied, with the most common being financial concerns (n = 19, 47.5%). Over half of the sample (n = 18, 54.5%) self-reported increases in their positive coping behaviors during the pandemic, such as communicating with friends and family, talking to healthcare providers, listening to music, and engaging in spiritual practices-such as prayer. The four PEI study participants reflected on the impacts of social distancing on their prenatal experience and mentioned hospital and provider-related weariness due to their race. The findings of this study suggest that during the COVID-19 pandemic, Black/AA pregnant women in Charlotte, NC used social support, mindfulness practices, self-advocacy, and health literacy to navigate challenges present during their prenatal health experience. This paper highlights the personal, social, and structural experiences of pregnant women during a public health crisis so that responsive and effective programs or policies can be planned in the future.

Effects of mindfulness-based childbirth education on prenatal anxiety: A quasi-experimental study.

Pregnancy and childbirth represent a sequence of challenging events, and adaptive coping strategies are necessary to maintain emotional wellbeing. The present study aimed to assess the effectiveness of applying a mindfulness-based intervention (MBI) for pregnant Saudi women with anxiety in the third trimester. A quasi-experimental, within- and between-subject design was used for this study. Data were collected at two points between February and August 2021 from 88 participants using the Pregnancy-Related Anxiety Questionnaire and the Five Facet Mindfulness Questionnaire. A large, statistically significant reduction was observed in the mean scores of participants' anxiety post-intervention. Furthermore, the anxiety level in the intervention group was very low post-intervention compared to that in the control group. Level of education and spontaneous or medically necessary abortion significantly influenced participants' anxiety. The MBI sessions helped nulliparous women experience less anxiety during pregnancy. Healthcare providers' awareness about the importance of incorporating mindfulness in childbirth education should be increased. Future research should examine the long-term effects of mindfulness-based techniques on maternal health.

Perinatal Understanding of Mindful Awareness for Sleep (PUMAS): A single-arm proof-of-concept clinical trial of a mindfulness-based intervention for DSM-5 insomnia disorder during pregnancy.

OBJECTIVES: Cognitive-behavioral therapy is effective for prenatal insomnia, but unresolved cognitive arousal limits patient outcomes. Therapies aimed at reducing cognitive arousal may benefit pregnant women with insomnia. This proof-of-concept trial evaluated Perinatal Understanding of Mindful Awareness for Sleep (PUMAS, which combines mindfulness with behavioral sleep strategies) on insomnia, depression, and cognitive arousal. METHODS: A single-arm trial of 12 pregnant women with DSM-5 insomnia disorder (n = 5/12 with comorbid depression) who received six sessions of PUMAS delivered individually via telemedicine. Pretreatment and posttreatment outcomes included the insomnia severity index (ISI), Edinburgh postnatal depression scale (EPDS), pre-sleep arousal scale's cognitive factor (PSASC; nocturnal cognitive arousal), perinatal-focused rumination (appended to PSASC), and Glasgow sleep effort scale. RESULTS: Eleven of 12 patients completed all sessions. Intent-to-treat analyses revealed a 10.83-point reduction in ISI (Cohen's dz = 3.05), resulting in 83.3% insomnia remission. PUMAS produced large reductions in EPDS (Cohen's dz = 2.76 in depressed group), resulting in all five baseline depressed patients remitting from depression. PUMAS produced large reductions in nocturnal cognitive arousal, perinatal-focused rumination, and sleep effort (all Cohen's dzs>2.00). Patients were highly satisfied with PUMAS and identified the telemedicine format and meditation app as positive features of its delivery. Patients rated sleep restriction and guided meditations as the most helpful treatment components. CONCLUSION: Prenatal insomnia patients were highly engaged in PUMAS, which produced large acute reductions in insomnia, depression, and cognitive arousal. These findings support the concept and feasibility of PUMAS for pregnant women with insomnia who present with or without comorbid depression. GOV ID: NCT04443959.

Racial and ethnic differences in perinatal depression and anxiety.

BACKGROUND: Findings on racial and ethnic differences in perinatal depression/anxiety are mixed. METHODS: We assessed racial and ethnic differences in depression, anxiety, and comorbid depression/anxiety diagnoses in the year before, during, and the year after pregnancy (n = 116,449) and depression severity during (n = 72,475) and in the year after (n = 71,243) pregnancy among patients in a large, integrated healthcare delivery system. RESULTS: Compared to Non-Hispanic White individuals, Asian individuals had lower risk of perinatal depression and anxiety (e.g., depression during pregnancy relative risk [RR] = 0.35, 95 % confidence interval [CI]:0.33-0.38) and postpartum moderate/severe (RR = 0.63, 95 % CI:0.60-0.67) and severe (RR = 0.66, 95 CI:0.61-0.71) depression but higher risk of moderate/severe depression during pregnancy (RR = 1.18, 95 % CI:1.11-1.25). Non-Hispanic Black individuals had higher risk of perinatal depression, comorbid depression/anxiety, and moderate/severe and severe depression (e.g., depression diagnoses during pregnancy RR = 1.35, 95 % CI:1.26-1.44). Hispanic individuals had lower risk of depression during pregnancy and perinatal anxiety (e.g., depression during pregnancy RR = 0.86, 95 % CI:0.82-0.90) but higher risk of postpartum depression (RR = 1.14, 95 % CI:1.09-1.20) and moderate/severe and severe depression during and after pregnancy (e.g., severe depression during pregnancy RR = 1.59, 95 % CI:1.45-1.75). LIMITATIONS: Information on depression severity was unavailable for some pregnancies. Findings may not generalize to individuals without insurance or outside of Northern California. CONCLUSIONS: Non-Hispanic Black individuals of reproductive age should be targeted with prevention and intervention efforts aimed at reducing and treating depression and anxiety. Asian and Hispanic individuals of reproductive age should be targeted with campaigns to destigmatize mental health disorders and demystify treatments and systematically screened for depression/anxiety.

The effectiveness of mindfulness-based interventions on self-efficacy and fear of childbirth in pregnant women: A systematic review and meta-analyses.

BACKGROUND: Mindfulness-based interventions are a relatively new and potentially useful psychological approach in prenatal care. This study aimed to determine the effect of mindfulness-based programs on pregnant women's fear of childbirth FOC and self-efficacy. METHODS: The systematic search of PubMed, Scopus, Web of Science, Cochrane Library, Google Scholar, SID, and Magiran databases began on 11 November 2021 and ended on 17 December 2021 to obtain studies published in English and Persian without date constraints. Another search was conducted in March 2023. The Cochrane handbook tool was used to evaluate selected studies and their risk of bias. RESULTS: From a total of 316 records obtained, after removing duplicate items, 16 full texts were evaluated for eligibility; and finally, 10 studies were included in the study and meta-analysis. Based on the results of meta-analyses, mindfulness-based exercises may improve childbirth self-efficacy (SMD = 1.34, 95 % CI: 0.39 to 2.30; P < 0.00001; 5 studies, 304 women; low-certainty evidence) and probably reduce the level of FOC (SMD = -0.71, 95 % CI: -1.14 to -0.27; P = 0.001; 5 studies, 424 women; moderate-certainty evidence) in the intervention group compared to the control group. LIMITATIONS: Different duration of interventions across studies, different gestational ages at the time of enrollment, and large heterogeneity in the meta-analysis of results were the limitations of this study. CONCLUSION: Mindfulness-based interventions probably reduce FOC and may promote self-efficacy. More randomized controlled trials with stronger designs and adequate power samples are required to verify the effectiveness of mindfulness-based interventions, especially on self-efficacy in pregnant women. PROSPERO ID: CRD42021294056.

Benefits of Mindfulness Training on the Mental Health of Women During Pregnancy and Early Motherhood: A Randomized Controlled Trial.

Objective: This study aimed to evaluate the effects of a mindfulness-based psychosomatic intervention on depression, anxiety, fear of childbirth (FOC), and life satisfaction of pregnant women in China. Methods: Women experiencing first-time pregnancy ( n = 104) were randomly allocated to the intervention group or a parallel active control group. We collected data at baseline (T0), post-intervention (T1), 3 days after delivery (T2), and 42 days after delivery (T3). The participants completed questionnaires for the assessment of the levels of depression, anxiety, FOC, life satisfaction, and mindfulness. Differences between the two groups and changes within the same group were analyzed at four time points using repeated-measures analysis of variance. Results: Compared with the active control group, the intervention group reported lower depression levels at T2 ( P = 0.038) and T3 ( P = 0.013); reduced anxiety at T1 ( P = 0.001) and T2 ( P = 0.003); reduced FOC at T1 ( P < 0.001) and T2 ( P = 0.04); increased life satisfaction at T1 ( P < 0.001) and T3 ( P = 0.015); and increased mindfulness at T1 ( P = 0.01) and T2 ( P = 0.006). Conclusion: The mindfulness-based psychosomatic intervention effectively increased life satisfaction and reduced perinatal depression, anxiety, and FOC.

Autonomic function and inflammation in pregnant women participating in a randomized controlled study of Mindfulness Based Childbirth and Parenting.

BACKGROUND: Pregnancy and childbirth are significant events in many women's lives, and the prevalence of depressive symptoms increases during this vulnerable period. Apart from well documented cognitive, affective, and somatic symptoms, stress and depression are associated with physiological changes, such as reduced heart-rate variability (HRV) and activation of the inflammatory response system. Mindfulness Based Interventions may potentially have an effect on both HRV, inflammatory biomarkers, and self-assessed mental health. Therefore, the aim of this study was to assess the effects of a Mindfulness Childbirth and Parenting (MBCP) intervention on HRV, serum inflammatory marker levels, through an RCT study design with an active control group. METHODS: This study is a sub-study of a larger RCT, where significant intervention effects were found on perinatal depression (PND) and perceived stress. Participants were recruited through eight maternity health clinics in Stockholm, Sweden. In this sub-study, we included altogether 80 women with increased risk for PND, and blood samples and HRV measures were available from 60 of the participants (26 in the intervention and 34 in the control group). RESULTS: Participants who received MBCP reported a significantly larger reduction in perceived stress and a significantly larger increase in mindfulness, compared to participants who received the active control treatment. However, in this sub-study, the intervention had no significant effect on PND, inflammatory serum markers or measures of HRV. CONCLUSIONS: No significant differences were found regarding changes in HRV measures and biomarkers of inflammation, larger studies may be needed in the future. TRIAL REGISTRATION: ClinicalTrials.gov ID:  NCT02441595 . Registered 12 May 2015 - Retrospectively registered.

Creative arts intervention in support of women experiencing a high-risk pregnancy: A qualitative descriptive thematic analysis.

BACKGROUND: Mental illness can have negative effects on both the pregnant woman and her unborn child. Studies that use the creative arts as interventions have proven to be beneficial to women's antenatal mental health and wellbeing, however, these studies are limited and emergent. Music, drawing and narrative (MDN) is an established music therapy intervention, stemming from guided imagery and music (GIM), that has the potential to support positive mental health and wellbeing. Yet, to date, there have been limited studies on the use of this form of therapy with inpatient antenatal women. AIM: To describe antenatal inpatient women's experiences of participating in a MDN session. METHODS: Qualitative data were collected from a sample of 12 inpatient pregnant women who participated in MDN group sessions of drawing to music. Post intervention interviews explored the mental and emotional health of participants. A thematic analysis of the transcribed interview data was performed. FINDINGS: Through reflection women were supported to acknowledge both the positives and difficulties of pregnancy as well as establish meaningful connections through shared experience. These thematic findings highlighted that MDN enabled this group of pregnant women to better communicate their feelings, validate emotions, engage in positive distractions, develop greater connections, improve optimism, experience calmness, and learn from others. CONCLUSION: This project demonstrates that MDN may offer a viable method for supporting women experiencing high risk pregnancies.

Model of care matters: An integrative review.

BACKGROUND: Pregnant women are entitled to quality care during pregnancy. Some health districts offer a variety of maternity care models but, not all women are aware of what is available and there is limited research on the experiences of women within their chosen or allocated model of care. AIM: The aim of this integrative review is to explore the available literature on women's experiences of the model of care accessed during pregnancy. METHOD: A database search of CINAHL, MEDLINE, SCOPUS, OVID, JBI and Cochrane Database was conducted to identify original research articles published in English between 2011 and 2021. In total, 20 articles met the inclusion criteria. FINDINGS: The included papers came from nine different countries and reported on eight different models of care. Following analysis of the articles one overarching theme 'Model of care matters', and six sub themes were identified: 1.'Choosing a model', 2.'Learning about pregnancy and birth', 3.'Being known', 4.'Making social and emotional connections', 5.'Receiving enabling or disabling care' and 6.'Integrated care is best'. Some women disclosed that they had no choice in the model they were allocated, while others stated they were not provided with information about all available models of care. CONCLUSION: A lack of integrated care between medical and midwifery models led to feelings of dissatisfaction and distress during pregnancy. Positive experiences were reported when women developed a connection with the care provider. The development of a well-informed decision aid could alleviate deficits of information, and clarify the subtle differences that occur within various models.

High Risk-pregnant Women's Experiences of Risk Management: A Qualitative Study.

Background: Maternal and fetal morbidity and mortality depend on identifying of pregnancy risks and risk management. There is a dearth of information about the experiences of high-risk pregnant mothers in self-mitigation of the risk in the socio-cultural setting of Iran. This research was conducted to explore the risk management experiences of high-risk pregnant mothers. Methods: This Qualitative study was conducted in educational hospitals in Mashhad, Iran, from July 2018 to December 2020. The purposive sampling method was used to recruit the participants based on medical or obstetric high-risk conditions in pregnancy. Qualitative data were obtained from in-depth and semi-structured 29 interviews. Mothers' experiences of pregnancy in a risky condition were asked, and the interview continued until data saturation. Data were analyzed using the MAXQDA 10 software and the Elo and Kyngäs method. Results: Maternal experiences for risk management in pregnancy were formed by nine sub-categories and three categories: the excitement of emotion including: "feeling worry and despair", "gladness in the shadow of hope and optimism", "momentary shocking and excitement", and "inactivity and helplessness"; self-contemplation including: "active analysis of the ways of moderating the risk", "cognitive denial", and "ignoring the risk"; and witnessed action including: "problem-focused and rational actions", and "avoidance and inefficient engagements". Conclusion: Risk management experiences of pregnant women with high-risk pregnancies include a wide range of positive and negative feelings, effective and ineffective thoughts, and behaviors. Mutual collaboration between mothers and midwives/obstetricians by providing high-quality risk management counseling can lead to choosing effective risk management strategies.

Prenatal stress self-help mindfulness intervention via social media: a randomized controlled trial.

BACKGROUND: Prenatal stress is a pressing issue. However, there is a lack of robust evidence for psychosocial interventions to manage this problem. AIMS: This study aimed to examine the effectiveness of a mindfulness-based intervention on reducing prenatal stress compared to participation in health education groups. METHODS: A randomized controlled trial was conducted in a prenatal clinic of comprehensive tertiary care from April to October 2017. A total of 108 pregnant women were randomly assigned to an intervention or a control group. Participants completed self-report measures of depression, anxiety, perceived stress, fatigue, positive and negative affect, and mindfulness before, immediately after, and 15 weeks after the 4-week intervention period. Generalized estimating equations were used to analyze the intervention outcomes. RESULTS: The results supported greater improvement in terms of perceived stress (Wald χ2=26.94, p<0.001), fatigue (Wald χ2=17.61, p<0.001), positive affect (Wald χ2=9.03, p = 0.011), negative affect (Wald χ2=11.37, p = 0.003), and mindfulness (Wald χ2=24.97, p<0.001) in the intervention group than in the control group. CONCLUSIONS: The self-help mindfulness intervention decreased prenatal stress and negative affect and improved positive affect and mindfulness.

The Effects of Listening to Lullabies and Self-selected Music on Distress and Maternal Attachment in Pregnant Women: A Randomized Controlled Study.

Context: Pregnant women may experience distress as a result of physical and psychosocial changes, and this distress affects the development of maternal attachment negatively. During pregnancy care and follow-up, reducing women's pregnancy-related distress and improving maternal attachment are important. Objective: To compare the effects of listening to lullabies and self-selected music in reducing distress and increasing maternal attachment in pregnant women. Design: This study is a randomized controlled trial. It was conducted using power analysis for a type-I error rate of α = 0.05, type-II error rate of ß = 0.20, representative power of 0.64, and effect size of 0.81. Setting: The study took place at a secondary care hospital in a provincial center in Turkey. Participants: The participants were 120 pregnant women who came to the outpatient clinic for pregnancy follow-ups between June 2021 and October 2021. Intervention: The participants were allocated to one of three groups, with 40 women in each. For 30 minutes every day, for two weeks, the lullaby group (LG) only listened to lullaby records at home, and the multi-music group (MG) listened to self-selected music from different records; the control group (CG) did not listen to any music. Outcome Measures: The Prenatal Distress Questionnaire and the Maternal Antenatal Attachment Scale were used to collect data. Results: Prenatal distress levels were lower in the intervention groups than in the CG (P < .01), and they were lower in the MG than in the LG (P < .05). Antenatal attachment levels were higher in the intervention groups than in the CG (P < .01), and they were higher in the LG than in the MG (P < .05). Conclusions: For pregnant women, listening to self-selected music was more effective in reducing distress, whereas listening to lullabies selected by the researcher was more effective in increasing attachment. ClinicalTrials.gov ID number: NCT05228392.

The impact of midwifery continuity of care on maternal mental health: A narrative systematic review.

BACKGROUND: Systematic reviews have shown that midwifery continuity of care programs lead to improvements in birth outcomes for women and babies, but no reviews have focused specifically on the impact of midwifery continuity of care on maternal mental health outcomes. OBJECTIVE: To systematically review the available evidence on the impact of midwifery continuity of care on maternal mental health during the perinatal period. METHOD: A systematic search of published literature available through to March 2021 was conducted. A narrative approach was used to examine and synthesise the literature. RESULTS: The search yielded eight articles that were grouped based on the mental health conditions they examined: fear of birth, anxiety, and depression. Findings indicate that midwifery continuity of care leads to improvements in maternal anxiety/worry and depression during the perinatal period. CONCLUSION: There is preliminary evidence showing that midwifery continuity of care is beneficial in reducing anxiety/worry and depression in pregnant women during the antenatal period. As the evidence stands, midwifery continuity of care may be a preventative intervention to reduce maternal anxiety/worry and depression during the perinatal period.

Mindfulness-based childbirth and parenting for pregnant women with high fear of childbirth and their partners: outcomes of a randomized controlled trial assessing short- and longer-term effects on psychological well-being, birth and pregnancy experience.

OBJECTIVES: Mindfulness-Based Childbirth and Parenting (MBCP) reduces mothers' anticipated fear of childbirth (FOC), nonurgent obstetric interventions during childbirth and may improve childbirth outcomes in women with high FOC (Veringa-Skiba et al, 2022). The aim of this study was to examine the short- and longer-term outcomes of MBCP on psychological well-being, pregnancy and birth experience, as compared to enhanced care-as-usual (ECAU), in pregnant women with high FOC and their partners. DESIGN: Participants were randomly assigned to MBCP or ECAU and completed questionnaires preintervention (T1), immediately after intervention (T2), two to four weeks after childbirth (T3) and 16-20 weeks after childbirth (T4). Both intention-to-treat and per-protocol analyses were conducted. SETTING: The courses were provided by trained midwives. PARTICIPANTS: Participants included 141 pregnant women and 120 partners. INTERVENTION: MBCP comprised a nine-weekly three-hour session mindfulness group course for pregnant couples; ECAU consisted of two 90-minute individual couple consultation sessions. MEASUREMENTS: Measures of psychological well-being included measures like stress, depression, anxiety and fatigue. Measures of pregnancy and birth experience concerned experiencing uplifts during pregnancy, experienced fear of childbirth, labour pain and satisfaction with childbirth. FINDINGS: No differences between MBCP and ECAU in the total group of birthing women were found. However, women with (at least an onset of) labour that participated in MBCP reported a better birth experience compared to ECAU at T3. Concerning the total partner group only one difference between MBCP and ECAU was found at T4; MBCP partners reported an increase in fatigue. However, in the partner risk group (i.e., partners with lower psychological well-being before intervention) partners experienced better psychological well-being at T2 and T3 after MBCP than ECAU. KEY CONCLUSIONS: MBCP and ECAU demonstrate similar effects on psychological well-being, birth and pregnancy experience. However, MBCP appears superior to ECAU for labouring women in having a better childbirth experience and for partners at risk for psychological complaints in increasing their psychological well-being. IMPLICATIONS FOR PRACTICE: MBCP only positively affects the childbirth experience of those who experience (onset of) natural birth. It might be advisable to include partners at risk for psychological complaints in the MBCP.