A mindfulness and compassion-based intervention applied to

pregnant women and their partners to decrease depression

symptoms during pregnancy and postpartum
Olga 1,2*
Sacristan-Martin ,Carmen Julia Santos Cristina 1
Fernandez-Alonso , 1,
1 3
Fernandez-Arquisola ,Miguel A. Santed , Javier Garcia-Campayo 4
*Correspondence to:olgasacristan @ gmail.com 1 Primary Care Prevention and Health Promotion Research Network (RedIAPP), Valladolid, Spain.,

2 National University of Distance Education (UNED), Madrid, Spain 3Aragon Institute for Health Research (Instituto de Investigacion Sanitaria Aragón,
ID: 1386 Miguel Servet Hospital, Psychiatry Service, Zaragoza, Spain.

Background
Pregnancy and the postpartum period are times of great change for women and their partners, often bringing substantial challenges and
stress. Approximately 10%–20% of women suffer from mood disorders such as depression in the perinatal period, and treatments with
psychoactive drugs are not without risks. Mindfulness and compassion-based educational programs could be efficacious and cost-effective
options for the prevention of perinatal mood disorders. The aim of this study is to assess the efficacy of an adapted Mindfulness-Based
Childbirth and Parenting (MBCP) program that includes compassion training for pregnant women in primary care (PC) settings in the
Spanish National Health System to decrease perinatal depression.
Material and Methods
This was a multicenter randomized controlled trial (RCT) with two parallel groups: (1) adapted Mindfulness Based Childbirth and Parenting
(MBCP) educational course with compassion practices delivered for pregnant women and their partners + TAU; and (2) TAU only, which
consisted of a childbirth education course provided by PC midwives. This protocol has followed the SPIRIT guidelines. The trial registration
number of the study is Clinical Trials.gov NCT03247491.
Participants were 122 pregnant women (61 intervention group, 61 control group) in the second trimester of pregnancy living in the city of
Valladolid (Spain) who were served by the Spanish NHS. They were recruited from 11 PC urban healthcare centers in the city of Valladolid,
Spain through referrals from midwives and obstetricians.
Partners of the expectant women were encouraged to participate in the courses and 60% attended regularly. Participants considered for
inclusion were: (1) women in weeks 6–25 of pregnancy; (2) able to read, write, and understand Spanish;(3)age ≥ 18 years; and(4) who had
signed a written informed consent document following an informed consent procedure. Exclusion criteria were: (1) any diagnosis of disease
that may affect the central nervous system, such as brain pathology or traumatic brain injury; (2) other psychiatric diagnosis or acute
psychiatric illness, such as substance dependence or abuse, a history of schizophrenia or other psychotic or eating disorders; (3) any
medical, infectious, or degenerative disease that may affect mood;(4)presence of delusional ideas, hallucinations, or at risk for suicide; and
(5) currently under psychopharmacological medication or under psychopharmacological treatment. The main outcome that was assessed
was depression, evaluated with the Edinburgh Postnatal Depression Scale (EPDS). Secondary outcomes included self-reported measures
of perceived stress (assessed by the Perceived Stress Scale (PSS);affects (assessed by The Positive and Negative Affect Schedule
(PANAS); mindfulness (assessed by The Five Facet Mindfulness Questionnaire (FFMQ); self-compassion (assessed by The Self-
Compassion Scale (SCS); maternal self-efficacy (assessed by The Parental Evaluation Scale (EEP), and use of health and social services
(assessed by The Client Service Receipt Inventory (CSRI). Participants were assessed at four timepoints: baseline; post-treatment; and at
three and six months after childbirth. Intention-to-treat and per-protocol analyses were carried out using linear regression mixed models.
Results
Although the quantitative results are currently in the process of being analyzed, we already have qualitative results. The satisfaction with the
program has been high and pregnant couples have expressed that learning to manage stress and depression symptoms during pregnancy
and early postpartum has helped them in a high degree with emotional dysregulation and pain perception during childbirth and also during all
the perinatal period, improving the relationship with the partner and with the new-born baby.
Conclusion
Although the study has not yet finished, as it is in the data analysis phase, we already know the high degree of satisfaction of the women and
their partners with the program. Mindfulness, self-compassion, and the normalization attained by sharing common humanity in this stressful
and challenging time in the life of new parents, are key features of this educational program, and have proved to be useful to overcome
important vital changes and to assume with an effective and positive attitude the new parental roles. The high participation rate of the
partners (60%) enabled them to learn tools for their own emotional self-regulation and to help pregnant women during childbirth and
postpartum.

References
Sacristan-Martin, O., Santed, M.A., Garcia-Campayo, J., Duncan, L.G., Bardacke, N., Fernandez-Alonso, C., Garcia-Sacristan, G., Garcia-Sacristan, D., Barcelo-Soler, A., Montero-Marin, J. (2019). A mindfulness and compassion-
based program applied to pregnant women and their partners to decrease depression symptoms during pregnancy and postpartum: study protocol for a randomized controlled trial. Trials, 20:654. doi: 10.1186/s13063-019-3739-z.

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https://doi.org/10.1186/s12884-020-03318-8