Mindfulness-Based Childbirth and Parenting Education: Promoting Family Mindfulness During the Perinatal Period

Larissa G Duncan, Nancy Bardacke, Larissa G Duncan, Nancy Bardacke

Abstract

We present the conceptual and empirical foundation and curriculum content of the Mindfulness-Based Childbirth and Parenting (MBCP) program and the results of a pilot study of n = 27 pregnant women participating in MBCP during their third trimester of pregnancy. MBCP is a formal adaptation of the Mindfulness-Based Stress Reduction program and was developed and refined over the course of 11 years of clinical practice with 59 groups of expectant couples. MBCP is designed to promote family health and well-being through the practice of mindfulness during pregnancy, childbirth, and early parenting. Quantitative results from the current study include statistically significant increases in mindfulness and positive affect, and decreases in pregnancy anxiety, depression, and negative affect from pre- to post-test (p < .05). Effect sizes for changes in key hypothesized intervention mediators were large (d > .70), suggesting that MBCP is achieving its intended effects on maternal well-being during pregnancy. Qualitative reports from participants expand upon the quantitative findings, with the majority of participants reporting perceived benefits of using mindfulness practices during the perinatal period and early parenting. Our future research will involve conducting a randomized controlled trial of MBCP to test effects on psychophysiological stress mechanisms and to examine effects on birth outcomes, family relationship quality, and child development outcomes.

References

    1. Astin JA. Stress reduction through mindfulness meditation: Effects on psychological symptomology, sense of control, and spiritual experiences. Psychotherapy and Psychosomatics. 1997;66:97–106. doi: 10.1159/000289116.
    1. Austin MP, Leader L. Maternal stress and obstetric and infant outcomes: Epidemiological findings and neuroendocrine mechanisms. Australia New Zealand Journal of Obstetrics and Gynaecology. 2000;40:331–337. doi: 10.1111/j.1479-828X.2000.tb03344.x.
    1. Austin MP, Leader LR, Reilly N. Prenatal stress, the hypothalamic-pituitary-adrenal axis, and fetal and infant neurobehaviour. Early Human Development. 2005;81:917–926. doi: 10.1016/j.earlhumdev.2005.07.005.
    1. Baer RA. Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice. 2003;10:125–143. doi: 10.1093/clipsy/bpg015.
    1. Baer RA, Smith GT, Allen KB. Assessment of mindfulness by self-report: The Kentucky inventory of mindfulness skills. Assessment of Mindfulness. 2004;11:191–206.
    1. Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L. Using self-report assessment methods to explore facets of mindfulness. Assessment. 2006;13:27–45. doi: 10.1177/1073191105283504.
    1. Baer RA, Smith GT, Lykins E, Button D, Krietemeyer J, Sauer S, et al. Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment. 2008;15:329–342 . doi: 10.1177/1073191107313003.
    1. Beddoe AE, Lee KA. Mind-body interventions during pregnancy. Journal of Obstetric, Gynecological, and Obstetric Nursing. 2008;37:165–175.
    1. Bergman K, Sarkar P, O’Connor TG, Modi N, Glover V. Maternal stress during pregnancy predicts cognitive ability and fearfulness in infancy. Journal of the American Academy of Child and Adolescent Psychiatry. 2007;6:1454–1463. doi: 10.1097/chi.0b013e31814a62f6.
    1. Benner P. The tradition and skill of interpretive phenomenology in studying health, illness and caring practices. In: Benner P, editor. Interpretive phenomenology. Thousand Oaks, CA: Sage; 1994. pp. 99–127.
    1. Brown KW, Ryan RM. The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology. 2003;84:822–848. doi: 10.1037/0022-3514.84.4.822.
    1. Brown KW, Ryan RM. Perils and promise in defining and measuring mindfulness: Observations from experience. Clinical Psychology: Science and Practice. 2004;11:242–248. doi: 10.1093/clipsy/bph078.
    1. Brown KW, Ryan RM, Creswell JD. Mindfulness: Theoretical foundations and evidence for its salutary effects. Psychological Inquiry. 2007;18(4):211–237.
    1. Brown KW, Ryan RM, Creswell JD. Addressing fundamental questions about mindfulness. Psychological Inquiry. 2007;18:272–281.
    1. Carson JW, Carson KM, Gil KM, Baucom DH. Mindfulness-based relationship enhancement. Behavior Therapy. 2004;35:471–494. doi: 10.1016/S0005-7894(04)80028-5.
    1. Carson JW, Carson KM, Gil KM, Baucom DH. Mindfulness-based relationship enhancement in couples. In: Baer RA, editor. Mindfulness-based treatment approaches: Clinician’s guide to evidence base and applications. Amsterdam: Elsevier; 2006. pp. 309–331.
    1. Cohen, S. (1988). Perceived stress in a probability sample of the United States. In S. Spacapan, & S. Oskamp (Eds.), The social psychology of health. The Claremont Symposium on Applied Social Psychology (pp. 31–67). Thousand Oaks, CA: Sage Publications.
    1. Davidson RJ, Kabat-Zinn J, Schumacher J, Rosenkranz M, Muller D, Santorelli S, et al. Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine. 2003;65:564–570. doi: 10.1097/01.PSY.0000077505.67574.E3.
    1. Dawe S, Harnett P. Reducing potential for child abuse among methadone- maintained parents: Results from a randomized controlled trial. Journal of Substance Abuse Treatment. 2007;32:381–390. doi: 10.1016/j.jsat.2006.10.003.
    1. Deater-Deckard K. Parenting stress. New Haven, CT: Yale University Press; 2004.
    1. Duncan LG, Coatsworth JD, Greenberg MT. A model of mindful parenting: Implications for parent–child relationships and prevention research. Clinical Child and Family Psychology Review. 2009;12:255–270. doi: 10.1007/s10567-009-0046-3.
    1. Dunkel Schetter C. Stress processes in pregnancy and preterm birth. Current Directions in Psychological Science. 2009;18:205–209. doi: 10.1111/j.1467-8721.2009.01637.x.
    1. Elder GH. The life course and human development. In: Damon W, Lerner RM, editors. Handbook of child psychology: Volume I: Theoretical models of human development. 5. Hoboken, NJ: John Wiley & Sons; 1998. pp. 939–991.
    1. Feinberg ME, Kan ML. Establishing family foundations: Intervention effects on coparenting, parent/infant well-being, and parent–child relations. Journal of Family Psychology. 2008;22:253–263. doi: 10.1037/0893-3200.22.2.253.
    1. Folkman S. Positive psychological states and coping with severe stress. Social Science and Medicine. 1997;45:1207–1221. doi: 10.1016/S0277-9536(97)00040-3.
    1. Folkman S, Lazarus RS. Coping as a mediator of emotion. Journal of Personality and Social Psychology. 1988;54:466–475. doi: 10.1037/0022-3514.54.3.466.
    1. Fredrickson BL, Cohn MA, Coffey K, Pek J, Finkel SM. Open hearts build lives: Positive emotions, induced through meditation, build consequential personal resources. Journal of Personality and Social Psychology. 2008;95:1045–1062. doi: 10.1037/a0013262.
    1. Goldstein J. One dharma: The emerging western Buddhism. San Francisco: Harper San Francisco; 2002.
    1. Hogue CJ, Bremner JD. Stress model for research into preterm delivery among black women. American Journal of Obstetrics and Gynecology. 2005;192(5 Suppl):S47–S55. doi: 10.1016/j.ajog.2005.01.073.
    1. Holzman C, Bullen B, Fisher R, The MSU Prematurity Group Rethinking the concept of risk factors for preterm delivery: Antecedents, markers and mediators. Prenatal and Neonatal Medicine. 1998;3:47–52.
    1. Institute of Medicine . Preterm birth. Washington, D.C.: The National Academies Press; 2007.
    1. Izard CE. Human emotions. New York: Plenum; 1977.
    1. Kabat-Zinn J. Full catastrophe living: Using the wisdom of your mind to face stress, pain and illness. New York: Dell Publishing; 1990.
    1. Kabat-Zinn J. Wherever you go there you are: Mindfulness meditation in everyday life. New York: Hyperion; 1994.
    1. Kabat-Zinn J. Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice. 2003;10:144–156. doi: 10.1093/clipsy/bpg016.
    1. Kabat-Zinn M, Kabat-Zinn J. Everyday blessings: The inner work of mindful parenting. New York: Hyperion; 1997.
    1. Lazar S. Mindfulness research. In: Germer CK, Siegel RD, Fulton PR, editors. Mindfulness and psychotherapy. New York: Guilford Press; 2005. pp. 220–238.
    1. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984.
    1. Lederman SA, Rauh V, Weiss L, Stein JL, Hoepner LA, Becker M, Perera FP. The effects of the world trade center event on birth outcomes among term deliveries at three lower Manhattan hospitals. Environmental Health Perspectives. 2004;112:1772–1778.
    1. Leung S, Arthur DG, Martinson I. Stress in women with postpartum depression: a phenomenological study. Journal of Advanced Nursing. 2005;51:353–360. doi: 10.1111/j.1365-2648.2005.03506.x.
    1. Levin JS. The factor structure of the pregnancy anxiety scale. Journal of Health and Social Behavior. 1991;32:368–381. doi: 10.2307/2137104.
    1. Livingston JC, Maxwell BD, Sibai BM. Chronic hypertension in pregnancy. Minerva Ginecologica. 2003;55:1–13.
    1. Lockwood CJ. Stress associated preterm delivery: The role of corticotropin-releasing hormone. American Journal of Obstetrics and Gynecology. 1999;180(1 Pt 3):S264–S266. doi: 10.1016/S0002-9378(99)70713-1.
    1. Lupien SJ, McEwen BS, Gunnar MR, Heim C. Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nature Reviews Neuroscience. 2009;10:434–445. doi: 10.1038/nrn2639.
    1. Ma SH, Teasdale JD. Mindfulness-based cognitive therapy for depression: Replication and exploration of different relapse prevention effects. Journal of Consulting and Clinical Psychology. 2004;72:31–40. doi: 10.1037/0022-006X.72.1.31.
    1. MacQueen KM, McLellan E, Kay K, Milstein B. Codebook development for team-based qualitative analysis. Cultural Anthropology Methods. 1998;10:31–36.
    1. Maier KJ, Waldstein SR, et al. Relation of cognitive appraisal to cardiovascular reactivity, affect, and task engagement. Annals of Behavioral Medicine. 2003;26:32–41. doi: 10.1207/S15324796ABM2601_05.
    1. Miller RL, Pallant JF, Negri LM. Anxiety and stress in the postpartum: is there more to postnatal distress than depression? BMC Psychiatry. 2006;6:12. doi: 10.1186/1471-244X-6-12.
    1. Misra DP, O’Campo P, Strobino D. Testing a sociomedical model for preterm delivery. Pediatric and Perinatal Epidemiology. 2001;15(2):110–122. doi: 10.1046/j.1365-3016.2001.00333.x.
    1. Olds DL, Kitzman H, Hanks C, Cole R, Anson E, Sidora-Arceleo K, et al. Effects of nurse home visiting on maternal and child functioning: Age-9 follow-up of a randomized trial. Pediatrics. 2007;120:832–845. doi: 10.1542/peds.2006-2111.
    1. Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Journal of Applied Psychological Measurement. 1977;1:385–401. doi: 10.1177/014662167700100306.
    1. Rich-Edwards JW, Grizzard TA. Psychosocial stress and neuroendocrine mechanisms in preterm delivery. American Journal of Obstetrics and Gynecology. 2005;192(5 Suppl):S30–S35. doi: 10.1016/j.ajog.2005.01.072.
    1. Ruiz RJ, Avant KC. Effects of maternal prenatal stress on infant outcomes: a synthesis of the literature. ANS Advanced Nursing Science. 2005;28:345–355.
    1. Salzberg S. Lovingkindness: The revolutionary art of happiness. Boston, MA: Shambhala; 1995.
    1. Schulkin J. Corticotropin-releasing hormone signals adversity in both the placenta and the brain: Regulation by glucocorticoids and allostatic overload. Journal of Endocrinology. 1999;161:349–356. doi: 10.1677/joe.0.1610349.
    1. Segal ZV, Williams JMG, Teasdale JD. Mindfulness-based cognitive therapy for depression. New York: The Guilford Press; 2002.
    1. Shapiro SL, Schwartz GE, Bonner G. Effects of mindfulness-based stress reduction on medical and premedical students. Journal of Behavioral Medicine. 1998;139:267–274.
    1. Singh NN, Lancioni GE, Winton ASW, Fisher BC, Wahler RG, McAleavey K, et al. Mindful parenting decreases aggression, noncompliance, and self-injury in children with autism. Journal of Emotional and Behavioral Disorders. 2006;14:169–177. doi: 10.1177/10634266060140030401.
    1. Singh NN, Lancioni GE, Winton ASW, Singh J, Curtis WJ, Wahler RG, McAleavey K. Mindful parenting decreases aggression and increases social behavior in children with developmental disabilities. Behavior Modification. 2007;31:749–771. doi: 10.1177/0145445507300924.
    1. Singh NN, Lancioni GE, Winton ASW, Wahler RG, Singh J, Sage M. Mindful caregiving increases happiness among individuals with profound multiple disabilities. Research in Developmental Disabilities. 2004;25:207–218. doi: 10.1016/j.ridd.2003.05.001.
    1. Speca M, Carlson LE, Goodey E, Angen M. A randomized, wait-list controlled trial: The effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosomatic Medicine. 2000;62:613–622.
    1. Stein JA, Lu MC, Gelberg L. Severity of homelessness and adverse birth outcomes. Health Psychology. 2000;19:524–534. doi: 10.1037/0278-6133.19.6.524.
    1. Teasdale JD, Moore RG, Hayhurst H, Pope M, Williams S, Segal ZV. Metacognitive awareness and prevention of relapse in depression: Empirical evidence. Journal of Consulting and Clinical Psychology. 2002;70:275–287. doi: 10.1037/0022-006X.70.2.275.
    1. Vieten C, Astin J. Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: Results of a pilot study. Archives of Women’s Mental Health. 2008;11:67–74. doi: 10.1007/s00737-008-0214-3.
    1. Wadhwa PD, Culhane JF, Rauh V, Barva SS. Stress and preterm birth: Neuroendocrine, immuno/inflammatory, and vascular mechanisms. Maternal and Child Health Journal. 2001;5:119–125. doi: 10.1023/A:1011353216619.
    1. Wallace BA, Shapiro SL. Mental balance and well-being: Building bridges between Buddhism and Western psychology. American Psychologist. 2006;61:690–701. doi: 10.1037/0003-066X.61.7.690.
    1. Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology. 1988;54:1063–1070. doi: 10.1037/0022-3514.54.6.1063.
    1. Webster-Stratton, C. (2005). The incredible years: A training series for the prevention and treatment of conduct problems in young children. In E. D. Hibbs, & R. J. Mcmahon (Eds.), Preventing childhood and adolescent disorders: Empirically-based strategies for clinical practice (pp. 507–555).
    1. Williams KA, Kolar MM, Reger BE, Pearson JC. Evaluation of a wellness-based mindfulness stress reduction intervention: A controlled trial. American Journal of Health Promotion. 2001;15:422–432.
    1. Witkiewitz K, Marlatt GA, Walker DD. Mindfulness-based relapse prevention for alcohol use disorders: The meditative tortoise wins the race. Journal of Cognitive Psychotherapy. 2005;19:221–228. doi: 10.1891/jcop.2005.19.3.211.

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