Mindfulness-based classes help fight depression during pregnancy, postpartum period

A group-based mindfulness intervention during pregnancy appears to favourably affect the well-being of women, with the benefit persisting through the postpartum period, as shown in a recent study.

In a cohort of 162 racially and ethnically diverse women in the lower-income group, attending psychosocial intervention classes for 8 weeks helped reduce the symptoms of prenatal and postpartum depression.

Compared with the women who received standard care, those who underwent the intervention had significantly lower depressive symptoms through 8 years of follow-up. The likelihood of having moderate or higher depressive symptoms was lower in the psychosocial intervention group at all time points, except at the 6-year assessment. At year 8, only 12 percent of women in the intervention group reported moderate or more severe depressive symptoms as opposed to 25 percent of women in the standard care group. [J Consult Clin Psychol 2022;doi:10.1037/ccp0000776]

“This dramatic demonstration of both short-term reduction of depressive symptoms and long-term prevention of more severe maternal depression, even during the pandemic, is remarkable, even to us researchers,” according to Dr Elissa Epel from the University of California – San Francisco (UCSF), US, a study co-author and the one who led the psychosocial intervention.

“It's likely that the effects of increased stress resilience in these women is having pervasive effects on their own health and their children. We would never have known about the durability of these changes if [the women] had not [been] followed … for 8 years. We already know pregnancy is a critical period and the lesson here is that we need to heavily invest in pregnancy wellness interventions,” Epel pointed out.

The 8-week intervention classes consisted of 2-hour-per-week sessions joined by groups of 8–10 pregnant women. During the sessions, the women were guided through mindfulness-based stress reduction exercises, including mindful breathing, movement, and eating. In addition to the classes, the women had two phone sessions and a postpartum “booster” group session with their babies.

All women in the study, both in the intervention and the standard care groups, completed a series of questionnaires that assessed depressive symptoms at different time points: before the study began and at year 1, 2, 3–4, 5, 6, and 8 thereafter.

A mindful pregnancy

“Mindfulness practice is known to help alleviate stress in many situations and can meaningfully affect coping and health, and it seems here that it was particularly powerful during pregnancy, with enduring effects,” said the senior author of the study Dr Nicki Bush, professor of paediatrics and psychiatry at the UCSF.

Bush believes that the community connections and social support fostered during the wellness classes had been therapeutic as well.

“Given the economic and social burden of maternal depression and its potential impact on offspring, our findings suggest a meaningful benefit of a modest investment [in wellness classes] during pregnancy that supports well-being across two generations,” added Dr Danielle Roubinov, the first author of the study and assistant professor of psychiatry at the UCSF.

Roubinov noted that the benefit is especially remarkable given that the study population involved expectant mothers who “are systemically exposed to factors that put them at risk for depression, such as racism and economic hardship.”

“Also, the final years of the study were during the COVID-19 pandemic, when depression rates were higher for everyone, and the burden placed on communities of colour was even greater. Even so, the treatment effects held up,” Roubinov said.

The researchers shared that they are currently collecting additional data aimed at shedding light on the potential mechanisms (eg, changes in coping and stress reactivity, nutrition, and exercise) underlying the long-term effect of the mindfulness-based intervention.

Being low cost and involving relatively short time commitment, the mindfulness-based class is expected to be easily scaled up to larger groups of pregnant women, especially those of colour and have lower incomes.

“It’s critical to have interventions that meet the needs of lower-income, Black, Indigenous, and people of colour, who are especially likely to experience the stress of social inequities,” according to Roubinov. “We're excited to see how these results can be scaled to reach more women and a more diverse pool of women.”