Van der Meulen R T, Veringa-Skiba I K, Van Steensel F J A, Bögels S M, De Bruin E I
University of Amsterdam, Research Institute of Child Development and Education (RICDE), Nieuwe Achtergracht 127, 1018 WS, Amsterdam, the Netherlands; UvA minds, Academic Treatment Center, Banstraat 29, 1071 JW Amsterdam, the Netherlands.
University of Amsterdam, Research Institute of Child Development and Education (RICDE), Nieuwe Achtergracht 127, 1018 WS, Amsterdam, the Netherlands.
Midwifery. 2023 Jan;116:103545. doi: 10.1016/j.midw.2022.103545. Epub 2022 Nov 5.
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.
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.
The courses were provided by trained midwives.
Participants included 141 pregnant women and 120 partners.
MBCP comprised a nine-weekly three-hour session mindfulness group course for pregnant couples; ECAU consisted of two 90-minute individual couple consultation sessions.
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.
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.
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.
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.
基于正念的分娩与育儿课程（MBCP）可减轻母亲对分娩的预期恐惧（FOC），减少分娩期间非紧急产科干预，并可能改善高FOC女性的分娩结局（Veringa-Skiba等人，2022年）。本研究的目的是比较MBCP与强化常规护理（ECAU）对高FOC孕妇及其伴侣的短期和长期心理健康、怀孕及分娩体验的影响。
参与者被随机分配到MBCP组或ECAU组，并在干预前（T1）、干预后立即（T2）、分娩后两到四周（T3）和分娩后16 - 20周（T4）完成问卷调查。进行了意向性分析和符合方案分析。
课程由经过培训的助产士提供。
参与者包括141名孕妇和120名伴侣。
MBCP包括为孕妇夫妇开设的为期九周、每周三小时的正念小组课程；ECAU包括两次90分钟的夫妻个体咨询课程。
心理健康测量包括压力、抑郁、焦虑和疲劳等指标。怀孕及分娩体验测量涉及孕期的愉悦感、对分娩的恐惧、分娩疼痛及对分娩的满意度。
在所有分娩女性总体中，未发现MBCP组和ECAU组之间存在差异。然而，在T3时，参与MBCP且开始分娩的女性相比ECAU组报告了更好的分娩体验。关于伴侣总体组，在T4时仅发现MBCP组和ECAU组之间存在一处差异；MBCP组的伴侣报告疲劳感增加。然而，在伴侣风险组（即干预前心理健康水平较低的伴侣）中，MBCP组的伴侣在T2和T3时的心理健康状况比ECAU组更好。
MBCP和ECAU在心理健康、分娩及怀孕体验方面显示出相似的效果。然而，对于正在分娩的女性，MBCP在获得更好的分娩体验方面似乎优于ECAU；对于有心理问题风险的伴侣，MBCP在提高其心理健康水平方面更具优势。
MBCP仅对经历自然分娩（开始分娩）的女性的分娩体验产生积极影响。将有心理问题风险的伴侣纳入MBCP可能是明智的。
