Mindfulness to reduce fear of labour and postpartum depression

Anxiety about labour – and what might come afterwards – causes stress for expectant mothers and increases risk in childbirth. But there could be a natural solution

Many women feel anxious about giving birth. Fear of the unknown and over-sharing by others (“I felt I was ripped apart,” one mother told my antenatal group) can make labour daunting. Being frightened of childbirth can prolong labour – by an average of 47 minutes, but it feels longer – increase the need for pain relief, make a caesarean section more likely and raise the risk of postpartum depression. Last month, a small, randomised controlled trial added to the evidence that teaching mindfulness to pregnant women could reduce these risks.

Mindfulness is defined as paying attention to the present moment in a purposeful, non-judgmental way. This study, as with previous ones, was small. It included 30 women in the third trimester of pregnancy who were randomly assigned to either mindfulness training or traditional childbirth classes. The lead author, Dr Larissa Duncan, associate professor of human development and family studies at the University of Wisconsin-Madison, said that, given the fairly large body of research showing that mindfulness can reduce depression and anxiety, she hypothesised it would protect the mental health of mothers and fathers.

The trial’s weekend mindfulness programme, set up by midwife Nancy Bardacke, included forced mindfulness meditation – awareness of breathing, the body, walking meditation and yoga. Pregnant women were taught to keep their minds focused on the present moment, rather than worrying about the next contraction or recalling the previous one. Bardacke helped to make this practice real by intermittently giving participants ice cubes to hold, and alternating the experience of unpleasant sensation with calm moments. This trains the mind to be less reactive to stress and pain.

Duncan believes that the benefits extend beyond labour. “By using mindfulness to work with the contractions of labour, noticing they are temporary and there are spaces of ease in between, expectant parents learn a skill they can use later in parenting – working with their experiences of the baby crying or later toddler tantrums, with the same present moment awareness,” she said.

The study showed women in the mindfulness group had lower scores for postnatal depression and were less likely to use opiates during labour, although the evidence comes from small pilot studies. Certainly, mindfulness intuitively sounds helpful – the pain of labour is a means to an end – and building confidence to deal with it is likely to reduce anxiety. This doesn’t, however, mean mindfulness encourages women not to have pain relief in labour.

The main problem is sourcing the courses, although Duncan said there are trained practitioners in the UK, and Bardacke has given training courses in Oxford. You could ask your GP, but practitioners can be found online, although look for evidence of training. There are also books, online resources and apps that can help to teach mindfulness. And mindfulness is not just for giving birth – it can be used throughout life.

Hypnotherapy is also recognised as a helpful method used by many women during labour and child birth – often referred to as ‘Hypnobirthing’. You should always use an Accredited Hypnotherapist – search for a therapist in your area using the National Hypnotherapy Society Accredited Register.