"I have changed my mind"

Although the effects of mindfulness-based interventions in stressed adults are well established, research on the effects of these intervnetions in a population of stressed pregnant women is a new domain. The MBCP program is an innovative application of mindfulness for expectant couples designed to ameliorate the impact of stress related to pregnancy, childbirth and early parenting. MBCP seems to be potentially effective in reducing stress, anxiety and negative mood and increasing adaptation to pregnancy, childbirth, early parenting, and overall psychological well-being in new parents as evaluated in two small pilot studies.
The objective of our study is threefold: (a) to investigate whether the MBCP program decreases stress, anxiety and childbirth fear-eliciting beliefs and increases overall psychological well-being, and mindfulness during pregnancy, (b) to test whether these changes mediate perinatal outcome, and (c) to evaluate the cost effectiveness of MBCP.
Study design: A RCT with two study arms: MBCP and SB program: a standardized psycho-education program for couples.
Expectant couples (n = 160) from whom pregnant women have at least moderate levels of stress and/or anxiety at the end of the second trimester of pregnancy.
The MBCP program consists of: a 9-week course with 3 hours per class and a 7 hour silent Retreat Day during end of the second and the third trimester and a Reunion Class after birth.
A series of self-report questionnaires will be used to measure the following outcomes: mental health of both partners (including stress, anxiety, childbirth fear-eliciting beliefs), attitude toward medical interventions in childbirth, experience of pain, perinatal outcomes, breastfeeding, early parenting stress and quality of life. Measurements will be collected at pre and post intervention, about two weeks and three months following childbirth. Dysfunctional childbirth beliefs and mindfulness will be assessed as potential mediators. An economic evaluation will be conducted to assess the cost-effectiveness of MBCP.
This will be one of the first studies to investigate the efficacy of the MBCP program using an active control group. MBCP has a potential to be an effective, non-invasive, and non-medical intervention for pregnant women and their partners, and may become popular from a client’s perspective.

The Mindfulness Based Childbirth and Parenting (MBCP) program is an innovative application of mindfulness for expectant couples designed to ameliorate the impact of stress related to pregnancy, childbirth and early parenting. MBCP seems to be potentially effective in reducing stress, anxiety and negative mood and increasing adaptation to pregnancy, childbirth and early parenting, and psychological well-being in new parents. Since stress, anxiety and depression influence pregnancy, the childbirth process and childbirth outcomes negatively, and general childbirth education seems to be inefficient in preparing expectant mothers for the challenges of childbirth, we propose to examine effects and costs of the MBCP program in a population of stressed pregnant women with their partners.

Data will be collected several time points during the study: at baseline 20-24 weeks pregnancy (T=0), pre intervention at 26-28 weeks pregnancy (T=1), post intervention at 36-38 weeks pregnancy (T=2), following birth at 10-14 day (T=3), and following birth at 12-14 week (T=4).

The American MBCP program is an adaptation of the Mindfulness-Based Stress Reduction (MBSR) program. The MBCP program includes 9-weekly 3 hours sessions and a one day of silent retreat. Different mindfulness meditation instructions are given and practiced in each class and participants are expected to practice mindfulness at home every day during the intervention. The teaching of mindfulness is fully integrated with the knowledge of the psychobiological processes in pregnancy, birth and early, postpartum adjustment and psychobiological needs of the baby.



Control group: The Dutch SamenBevallen (SB) is an official pregnancy course for expectant couples (www.samenbevallen.nl). This program includes 9-weekly classes of about 3 hours each. In the sessions information is provided on life-style issues including eating, physical activity, sleeping patterns, relaxation, pleasurable activities, and unhealthy habits, explicit information on stress and anxiety during pregnancy, the normal course of and health and psychological aspects related to pregnancy, birth and early parenting.