Mindfulness Yoga Reduces Depression in At-Risk Pregnant Women

Fran Lowry

August 17, 2012

August 17, 2012 — Mindfulness yoga reduces symptoms of depression and strengthens the mother-baby bond in pregnant women with mental health risks, new research shows.

"Many pregnant women take prenatal hatha yoga, which can help prepare for delivery and make labor less painful by combining physical poses with meditative focus," lead author Maria Muzik, MD, director of the Parent-Infant Wellness Program in Women's and Infants Mental Health at the University of Michigan in Ann Arbor, told Medscape Medical News.

Dr. Maria Muzik

"Our mindfulness yoga classes differ from typical prenatal hatha yoga classes by highlighting mindfulness practice, with targeted instructions, reminders, and readings," Dr. Muzik said.

The study was published online July 14 in Complementary Therapies in Clinical Practice.

Visualization, Relaxation

Many pregnant women are reluctant to initiate drug therapy for depression and anxiety during pregnancy because of concerns about harm to the unborn baby or to initiate psychotherapy because of a reluctance to work through past or present conflicts in therapy during a vulnerable time, she said.

However, untreated depression bears many health risks for both mother and unborn child, such as poor weight gain, preeclampsia, premature labor, and trouble bonding with the unborn baby.

In this study, the researchers recruited 18 pregnant women at high risk for depression to take part in a 10-week mindfulness yoga program. The women were 12 to 26 weeks' pregnant and had elevated scores of greater than 9 on the Edinburgh Postnatal Depression Screen at study entry.

In addition to the baseline diagnostic assessment, the women completed self-ratings on depression, mindfulness, and maternal-fetal attachment before and after mindfulness yoga.

"The instructors consciously made it a part of class to continually remind women to focus inward toward the sensations of their body, listen to the feedback of their body during asana, and be aware of how their bodies are changing to support their growing baby," Dr. Muzik explained. "Participants were taught mindfulness techniques, including breathing, guided visualization, and relaxation."

A significant aspect of the intervention was being "mindful" of the baby to sense its unique persona, which facilitates the attachment process, she added.

Each session lasted 90 minutes and focused on a variety of poses, all taught specifically for the pregnant body, with awareness of the baby. The sessions were modified for level of experience or gestational age.

Promotion of Child Well-Being

The researchers found that after 10 weeks, participants in the mindfulness yoga intervention became significantly less depressed and showed significant improvement in mother-baby attachment and mindfulness skills.

Before the yoga program, the mean maternal Beck Depression Inventory (BDI) score was 13.95; after the intervention, it was 9.63 (P = .025). The mean Maternal-Fetal Attachment Scale (MFAS) score before the intervention was 83.56, and after the intervention it was 95.50 (P = .01).

Overall, the women felt that mindfulness yoga was a helpful coping strategy and benefited their child as well. One mother commented: "Yoga helped me to cope with a high-risk pregnancy — and my son is the most calm and gentlest of souls. The stress reduction really helps the baby, too."

They also benefited from the social support of the other mothers, Dr. Muzik said.

"Our work provides promising first evidence that mindfulness yoga may improve depression symptoms, promote a mindful stance towards pregnancy, and enhance a mother's attachment towards her child, which in turn is a long-term gain promoting child well-being," she said.

Mindfulness yoga would also be something that ob/gyns could recommend to their patients, she added.

"We hope that mindfulness yoga will one day be offered in traditional treatment facilities so that women can attend classes at their obstetrician's or psychiatrist's office."

A Step in the Right Direction

Commenting on the study for Medscape Medical News, Sudeepta Varma, MD, clinical assistant professor of psychiatry at New York University Langone Medical Center in New York City, said the findings offer pregnant women with depression another treatment option.

Pregnant women dealing with depression often find themselves with limited options, with about one half choosing to go off of antidepressant medication during pregnancy, which puts them at high risk for relapse, Dr. Varma said.

"We know that untreated depression has severe consequences in both mom and baby that include poor prenatal care, low birth weight, preeclampsia, IUGR [intrauterine growth restriction], etc.

"Although there were limitations to this study, for example no control group, a relatively small sample size, with a homogeneous group of white, highly educated women from a higher socioeconomic status, this study gives further direction in complementary effective treatments in addition to psychotherapy and medication management," she said.

The study design also offered pregnant women an opportunity to receive social support and to discuss their ailments at the beginning of each session and learn mindfulness skills. All of these are shown to be effective aspects of depression treatment, Dr. Varma noted.

"As a psychiatrist, mom, and practitioner of mindfulness-based stress reduction therapy and yoga, I will definitely be sharing these results with my patients and hope for further research in the area," she said.

Dr. Muzik and Dr. Varma have disclosed no relevant financial relationships.

Complement Ther Clin Pract. Published online July 14, 2012. Abstract

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