Using Yoga Among Prenatal Women to Reduce Anxiety and Depression
Jaime Umpleby
Background
• Studies show that about half a million women in the United States
experience prenatal and anxiety and depression each year 1
• Anxiety and depression during pregnancy can lead to negative effects
including preeclampsia, preterm labor, low birth weight, and psychological
symptoms5
• Non-pharmacological treatment such as yoga may provide relaxation and
positive effects on prenatal women4
• In prenatal women, how does yoga, compared to standard care, affect
anxiety and depression within two months?
• Current practice should implement yoga as a non- pharmacological
treatment to decrease prenatal anxiety and depression
Synthesis
• CINAHL, Psychinfo, and PubMed were used to access the clinical guideline
and RCTs pertaining to the use of yoga for the reduction of anxiety
• Key search terms included prenatal anxiety, yoga, and randomized
controlled trials
• The publication years searched were 2013-2018
• The clinical guideline recommends that pregnant women should be routinely
screened for depression, and the risks and benefits should be measured
whether to start, continue, or discontinue antidepressants 1
• There is no specific recommendation for the use of non-pharmacological
intervention such as yoga or tai chi to decrease anxiety and depression in
women during pregnancy1
University of South Florida College of Nursing Tampa, Florida
Design
• Design: Pre-post design
• Setting (hospital/unit): Outpatient OBGYN
• Infrastructure to support change: Interdisciplinary healthcare team with
proper knowledge and training on recommending and implementing non-
pharmacological treatment like yoga with prenatal women
• Patient population: Prenatal women
• Data to be collected:
• Edinburgh perinatal depression scale (EPDS)
• Structure clinical interview for depression (SCID)
• Epidemiological studies-depression scale (CES-D)
• State-trait anxiety inventory (STAI).
• Data collection dates: 14-week pilot study
• Pre-intervention: Baseline anxiety and depression scores using the
STAI and either the EPDS, SCID, or CES-D
• Post-intervention: Anxiety and depression using the STAI and either
the EDPS, SCID, or CES-D scores after using yoga as a non-
pharmacological treatment
Framework
• Use of a Model for Evidence-Based Practice Change6
• Step 1: Prenatal anxiety and depression can lead to adverse
outcomes in pregnancy and the mother’s mental health4 (Background
information completed in June 2018)
• Step 2: Evidence from randomized controlled trials collected
(Completed June-July 2018)
• Step 3: The research synthesized showed that using yoga significantly
reduced anxiety and depression in prenatal women 3 (Completed June-
July 2018)
• Step 4: Propose the use of non-pharmacological treatment such as
yoga during pregnancy (Completed July 2018)
• Step 5: Implement a 14 week pilot study in an outpatient OBGYN
facility (Completed by December 2018)
• Step 6: Integrate the use of yoga as a non-pharmacological treatment
method for all prenatal women to reduce prenatal anxiety and
depression (Beginning January 2019)
Data Analysis
• Goal: Prenatal anxiety and depression will decrease after
• The state-trait anxiety inventory, epidemiological studies-depression scale, structure clinical
interview for depression, and the Edinburgh perinatal depression scale will be used to gather data
related to anxiety and depression levels
• Nurses will collect data throughout the pregnancy
Evaluation
• Strengths of project
• The randomized controlled trials support change in practice
• The intervention of yoga is safe for the participants
• Education on the non-pharmacological intervention of yoga is readily accessible and simple for
the healthcare team to learn
• Limitations of project
• Patients may be hesitant to participate in the pilot study
• Nurses may be unwilling to take on the extra workload of learning and implementing the
intervention
• Future implications of project for practice
• An overall more pleasant pregnancy experience for women
• Better pregnancy experiences with decrease prenatal depression and anxiety may increase
patient satisfaction scores
• Decreased prenatal anxiety and depression may decrease negative effects on the mother and
baby
• The non-pharmacological treatment of yoga is safe for pregnant women and implementing this
intervention may result in less psychotherapeutic and pharmacological treatment needed for
prenatal anxiety and depression
• Strategies to promote staff engagement
• Education to the healthcare team regarding yoga as a beneficial non-pharmacological
treatment method
• Staff forums for the healthcare team to express concerns
• Potential bonuses for the staff included in the 14 week pilot study
References
1. Kim, D.R., O’Reardon, J.P., & Epperson, C.N. (2014). Guidelines for the management of
depression during pregnancy. Curr Psychiatry Rep, 12(4), 279-281. doi:
10.1007/s11920.010.0114x
2. Davis, K., Goodman, S.H., Leiferman, J., Taylor, M., & Dimidjian, S. (2015). A randomized
controlled trial of yoga for pregnant women with symptoms of depression and anxiety.
Complementary Therapies In Clinical Practice, 21(3), 166-172. doi:10.1016/j.ctcp.2015.06.005
3. Field, T., Diego, M., Delgado, J., & Medina, L. (2013). Tai chi/yoga reduces prenatal depression,
anxiety, and sleep disturbances. Complementary Therapies In Clinical Practice, 19(1), 6-10.
doi:10.1016/j.ctcp.2012.10.001
4. Newham, J., Wittkowski, A., Hurley, J., Aplin, J., & Westwood, M. (2014). Effects of antenatal yoga
on maternal anxiety and depression: A randomized controlled trial. Depression And Anxiety,
31(8), 631-640. doi:10.1002/da.22268
5. Satyapriya, M., Nagarathna, R., Padmalatha, V., & Nagendra, H. (2013). Effect of integrated yoga
on anxiety, depression & well being in normal pregnancy. Complementary Therapies In Clinical
Practice, 19(4), 230-236. doi: 10.1016/j.ctcp.2013.06.003
6. Larrabee, J.H. (2009). Nurse to nurse: Practice. New York: McGraw-Hill