A Shift Toward Childbearing in One-Child Families Through a Mindfulness-Based Stress Reduction Program: A Randomized Controlled Trial
-
Mojgan Malekpoorafshar
,
Parvin Salehinejad
,
Fatemeh Pouya
,
Noshiravan Khezri Moghadam
,
Armita Shahesmaeili
Abstract
Objective: Fertility patterns are a key to the estimation of future population size, but they are restricted by serious indecision. One-child families are one of these patterns that is caused by a set of factors and one of these factors is the fear of re-pregnancy. In this regard, this study aimed to use a mindfulness-based stress reduction (MBSR) program to reduce the fear of women who have been experiencing anxiety after their first pregnancy and delivery.
Materials and methods: This interventional study was conducted on 67 one-child women, who at least 6 years have been passed since the birth of their child and according to the short form of the Pregnancy Related Anxiety Questionnaire (PRAQ-17), have been experienced anxiety. These women were randomly divided into control and intervention groups. For the intervention group, the MBSR program was conducted in 8 sessions, once every week, each session lasting 2.5 hours. At the end of the program, a second PRAQ-17 was completed by both groups.
Results: The findings showed that the MBSR approach in the intervention group significantly decreased the anxiety score in total (p=0.001) and individually in all subcategories.
Conclusion: The MBSR approach can reduce the anxiety of one-child women who have experienced anxiety after their pregnancy and childbirth. Thus, using this method in helping women with pregnancy-related anxiety is recommended to increase the birth rate.
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6. Shojaei J, Erfani A. Trends and Patterns of One-child Families in Iran. Quarterly Journal of Social Sciences Allameh Tabataba’i University 2019; 26: 89-105.
7. Prata N, Tavrow P, Upadhyay U. Women's empowerment related to pregnancy and childbirth: introduction to special issue. BMC pregnancy and childbirth 2017; 17: 352.
8. Ahadi M, Taavoni S, Ghanji T, Hoseini F. Comparison of maternal anxiety between primigravid women and pregnant women with the history of previous fetal or neonatal death. Iran Journal of Nursing 2006; 19: 49-55.
9. Ali NS, Azam IS, Ali BS, Tabbusum G, Moin SS. Frequency and associated factors for anxiety and depression in pregnant women: a hospital-based cross-sectional study. ScientificWorldJournal 2012; 2012: 653098.
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11. Negahban T, Ansari A. Does Fear of Childbirth Predict Emergency Cesarean Section in Primiparous Women? Hayat 2009; 14: 73-81.
12. Priya A, Chaturvedi S, Bhasin SK, Bhatia MS, Radhakrishnan G. Depression, anxiety and stress among pregnant women: A community-based study. Indian J Psychiatry 2018; 60: 151-2.
13. Saisto T, Halmesmaki E. Fear of childbirth: a neglected dilemma. Acta Obstet Gynecol Scand 2003; 82: 201-8.
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15. Yildiz PD, Ayers S, Phillips L. The prevalence of posttraumatic stress disorder in pregnancy and after birth: A systematic review and meta-analysis. J Affect Disord 2017; 208: 634-45.
16. Rogal SS, Poschman K, Belanger K, Howell HB, Smith MV, Medina J, et al. Effects of posttraumatic stress disorder on pregnancy outcomes. J Affect Disord 2007; 102: 137-43.
17. Bhatia MS, Jhanjee A. Tokophobia: A dread of pregnancy. Ind Psychiatry J 2012; 21: 158-9.
18. Karabulutlu O, Calik KY, Akar N. Fear of childbirth and related obstetric variables. Nurs Pract Today 2016; 3: 161-70.
19. Rouhe H, Salmela-Aro K, Toivanen R, Tokola M, Halmesmaki E, Saisto T. Obstetric outcome after intervention for severe fear of childbirth in nulliparous women - randomised trial. BJOG 2013; 120: 75-84.
20. Sjogren B, Thomassen P. Obstetric outcome in 100 women with severe anxiety over childbirth. Acta Obstet Gynecol Scand 1997; 76: 948-52.
21. Shahnazi H, Sabooteh S, Sharifirad G, Mirkarimi K, Hassanzadeh A. The impact of education intervention on the Health Belief Model constructs regarding anxiety of nulliparous pregnant women. J Educ Health Promot 2015; 4: 27.
22. Hayes SC, Hofmann SG. The third wave of cognitive behavioral therapy and the rise of process-based care. World psychiatry 2017; 16: 245-6.
23. Molek-Winiarska D, Zolnierczyk-Zreda D. Application
of mindfulness-based stress reduction to a stress management intervention in a study of a mining sector company. Int J Occup Saf Ergon 2018; 24: 546-56.
24. Romans SE, Seeman MV. Women’s Mental Health. A Life Cycle Approach. Philadelphia: Lippincott Williams and Wilkins, 1st Edition 2006.
25. Fonteyne R, Vervliet B, Hermans D, Baeyens F, Vansteenwegen D. Reducing chronic anxiety by making the threatening event predictable: an experimental approach. Behaviour research and therapy 2009; 47: 830-9.
26. Basu AM, Desai S. Hopes, Dreams and Anxieties: India's One-Child Families. Asian Popul Stud 2016; 12: 4-27.
27. Van den Bergh Bea RH. The influence of maternal emotions during pregnancy on fetal and neonatal behavior. Journal of Pre-and Perinatal Psychology and Health 1990; 5: 119-30.
28. Bahadoran P, Alibeigi M. Stress and anxiety in pregnancy. Iranian journal of Nursing and Midwifery Research 2010;10 (2): 7-12.
29. Karamoozian M, Askarizadeh G, Behroozy N. The Study of psychometric properties of pregnancy related anxiety questionnaire. Journal of Clinical Nursing and Midwifery 2016; 5: 22-34.
30. Ebrahiminejad S, Poursharifi H, Bakhshiour Roodsari A, Zeinodini Z, Noorbakhsh S. The Effectiveness of Mindfulness-Based Cognitive Therapy on Iranian Female Adolescents Suffering From Social Anxiety. Iran Red Crescent Med J 2016; 18: e25116.
31. Arab Ghaeni M, Hashemian K, Mojtabaei M, majd ara E, Aghabeiki A. The effect of mindfulness training (MBSR) on the increasing assertiveness among anxious students. J Urmia Univ Med Sci 2017; 28: 119-29.
32. Salehi F, Pourasghar M, Khalilian A, Shahhosseini Z. Comparison of group cognitive behavioral therapy and interactive lectures in reducing anxiety during pregnancy: A quasi experimental trial. Medicine (Baltimore) 2016; 95: e5224.
33. Bergbom I, Modh C, Lundgren I, Lindwall L. First-time pregnant women's experiences of their body in early pregnancy. Scand J Caring Sci 2017; 31: 579-86.
34. Machira K, Palamuleni M. Women's perspectives on quality of maternal health care services in Malawi. Int
J Womens Health 2018; 10: 25-34.
35. Parswani MJ, Sharma MP, Iyengar S. Mindfulness-based stress reduction program in coronary heart disease:
A randomized control trial. Int J Yoga 2013; 6: 111-7.
36. Teasdale JD, Segal ZV, Williams JM, Ridgeway VA, Soulsby JM, Lau MA. Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. J Consult Clin Psychol 2000; 68: 615-23.
37. Schwarze MJ. Assessing the effectiveness of mindfulness-based cognitive therapy in individual sessions in reducing self-reported stress and increasing self-reported mindfulness levels of a nursing student. Nurs. 2011:1-115.
38. Kabat-Zinn J. Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology Science and Practice 2003; 10: 144–56.
39. Jahangirpour M, Musavi SV, Khosrojavid M, Salari A, Rezaei S. The effectiveness of group mindfulness training on depression, hostility and anxiety in individuals with coronary heart disease. Studies in Medical Sciences 2013; 24: 730-9.
40. Mitmansgruber H, Beck TN, Schubler G. ‘‘Mindful helpers”: Experiential avoidance, meta-emotions, and emotion regulation in paramedics. J. Res. Personal 2008; 42: 1358-63.
41. Serpa JG, Taylor SL, Tillisch K. Mindfulness-based stress reduction (MBSR) reduces anxiety, depression, and suicidal ideation in veterans. Med Care 2014; 52: S19-24.
42. Thomas JE, Wuyek LA. Minding the children with mindfulness: A Buddhist approach to promoting well-being in children. In: Springer, New York, NY, 2008.
43. Bayrampour N, Nourizadeh R, Mirghafourvand M, Mehrabi E, Mousavi S. Psychometric Properties of the Pregnancy-Related Anxiety Questionnaire-Revised2 Among Iranian Women. Crescent Journal of Medical and Biological Sciences 2019; 6: 369–74.
44. Abdi F, Navidpour F, Dolatian M. A Literature Review of PregnancyWorries and Stress Scales. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES2018; 12: e14581.
45. Aksoy Derya Y, Altiparmak S, AkÇa E, GÖkbulut N, Yilmaz AN. Pregnancy and birth planning during COVID-19: The effects of tele-education offered to pregnant women on prenatal distress and pregnancy-related anxiety. Midwifery 2021; 92: 102877.
46. Zarenejad M, Yazdkhasti M, Rahimzadeh M, Mehdizadeh Tourzani Z, Esmaelzadeh-Saeieh S. The effect of mindfulness-based stress reduction on maternal anxiety and self-efficacy: A randomized controlled trial. Brain Behav 2020; 10: e01561.
47. Byrne J, Hauck Y, Fisher C, Bayes S, Schutze R. Effectiveness of a Mindfulness-Based Childbirth Education pilot study on maternal self-efficacy and fear of childbirth. J Midwifery Womens Health 2014; 59: 192-7.
48. Zonuzi A, Satarzadeh N, Zamanzadeh V. Recognition of experienced psychologic varieties in wowen’s sexual relationship after childbirth. Journal of Inflammatory Diseases 2008; 12: 38-44.
49. Erfani A. Curbing family planning in Iran: an appraisal of Bill 446. J Fam Plann Reprod Health Care 2015; 41: 317-8.
2. Saberi T, Ehsanpour S, Mahaki B, Kohan S. Comparison of the Relationship between Women' Empowerment and Fertility between Single-child and Multi-child Families. Iran J Nurs Midwifery Res 2018; 23: 131-5.
3. Firouzbakht M, Tirgar A, Hajian-Tilaki K, Ebadi A, Bakouei F, Nikpour M, et al. Social capital and fertility behaviors among female workers in healthcare settings: study protocol of a sequential explanatory mixed methods study. Reprod Health 2018; 15: 67.
4. Vollset SE, Goren E, Yuan CW, Cao J, Smith AE, Hsiao T, et al. Fertility, mortality, migration, and population scenarios for 195 countries and territories from 2017 to 2100: a forecasting analysis for the Global Burden of Disease Study. Lancet 2020; 396: 1285-306.
5. Shamsabadi N, Khajevand A, Hasanzadeh R. Effect of cognitive-behavioral based stress management on anxiety reduction of pregnant women. Journal of Research Development in Nursing and Midwifery 2016; 12: 19-29.
6. Shojaei J, Erfani A. Trends and Patterns of One-child Families in Iran. Quarterly Journal of Social Sciences Allameh Tabataba’i University 2019; 26: 89-105.
7. Prata N, Tavrow P, Upadhyay U. Women's empowerment related to pregnancy and childbirth: introduction to special issue. BMC pregnancy and childbirth 2017; 17: 352.
8. Ahadi M, Taavoni S, Ghanji T, Hoseini F. Comparison of maternal anxiety between primigravid women and pregnant women with the history of previous fetal or neonatal death. Iran Journal of Nursing 2006; 19: 49-55.
9. Ali NS, Azam IS, Ali BS, Tabbusum G, Moin SS. Frequency and associated factors for anxiety and depression in pregnant women: a hospital-based cross-sectional study. ScientificWorldJournal 2012; 2012: 653098.
10. Mosalanefad L, Kheshti A, Gholami A. The assessing mental health in pregnane psychopathologic factors in Jahrom. Pars Jahrom University of Medical Sciencs 2007; 5: 23-9.
11. Negahban T, Ansari A. Does Fear of Childbirth Predict Emergency Cesarean Section in Primiparous Women? Hayat 2009; 14: 73-81.
12. Priya A, Chaturvedi S, Bhasin SK, Bhatia MS, Radhakrishnan G. Depression, anxiety and stress among pregnant women: A community-based study. Indian J Psychiatry 2018; 60: 151-2.
13. Saisto T, Halmesmaki E. Fear of childbirth: a neglected dilemma. Acta Obstet Gynecol Scand 2003; 82: 201-8.
14. Viswasam K, Eslick GD, Starcevic V. Prevalence, onset and course of anxiety disorders during pregnancy: A systematic review and meta analysis. J Affect Disord 2019; 255: 27-40.
15. Yildiz PD, Ayers S, Phillips L. The prevalence of posttraumatic stress disorder in pregnancy and after birth: A systematic review and meta-analysis. J Affect Disord 2017; 208: 634-45.
16. Rogal SS, Poschman K, Belanger K, Howell HB, Smith MV, Medina J, et al. Effects of posttraumatic stress disorder on pregnancy outcomes. J Affect Disord 2007; 102: 137-43.
17. Bhatia MS, Jhanjee A. Tokophobia: A dread of pregnancy. Ind Psychiatry J 2012; 21: 158-9.
18. Karabulutlu O, Calik KY, Akar N. Fear of childbirth and related obstetric variables. Nurs Pract Today 2016; 3: 161-70.
19. Rouhe H, Salmela-Aro K, Toivanen R, Tokola M, Halmesmaki E, Saisto T. Obstetric outcome after intervention for severe fear of childbirth in nulliparous women - randomised trial. BJOG 2013; 120: 75-84.
20. Sjogren B, Thomassen P. Obstetric outcome in 100 women with severe anxiety over childbirth. Acta Obstet Gynecol Scand 1997; 76: 948-52.
21. Shahnazi H, Sabooteh S, Sharifirad G, Mirkarimi K, Hassanzadeh A. The impact of education intervention on the Health Belief Model constructs regarding anxiety of nulliparous pregnant women. J Educ Health Promot 2015; 4: 27.
22. Hayes SC, Hofmann SG. The third wave of cognitive behavioral therapy and the rise of process-based care. World psychiatry 2017; 16: 245-6.
23. Molek-Winiarska D, Zolnierczyk-Zreda D. Application
of mindfulness-based stress reduction to a stress management intervention in a study of a mining sector company. Int J Occup Saf Ergon 2018; 24: 546-56.
24. Romans SE, Seeman MV. Women’s Mental Health. A Life Cycle Approach. Philadelphia: Lippincott Williams and Wilkins, 1st Edition 2006.
25. Fonteyne R, Vervliet B, Hermans D, Baeyens F, Vansteenwegen D. Reducing chronic anxiety by making the threatening event predictable: an experimental approach. Behaviour research and therapy 2009; 47: 830-9.
26. Basu AM, Desai S. Hopes, Dreams and Anxieties: India's One-Child Families. Asian Popul Stud 2016; 12: 4-27.
27. Van den Bergh Bea RH. The influence of maternal emotions during pregnancy on fetal and neonatal behavior. Journal of Pre-and Perinatal Psychology and Health 1990; 5: 119-30.
28. Bahadoran P, Alibeigi M. Stress and anxiety in pregnancy. Iranian journal of Nursing and Midwifery Research 2010;10 (2): 7-12.
29. Karamoozian M, Askarizadeh G, Behroozy N. The Study of psychometric properties of pregnancy related anxiety questionnaire. Journal of Clinical Nursing and Midwifery 2016; 5: 22-34.
30. Ebrahiminejad S, Poursharifi H, Bakhshiour Roodsari A, Zeinodini Z, Noorbakhsh S. The Effectiveness of Mindfulness-Based Cognitive Therapy on Iranian Female Adolescents Suffering From Social Anxiety. Iran Red Crescent Med J 2016; 18: e25116.
31. Arab Ghaeni M, Hashemian K, Mojtabaei M, majd ara E, Aghabeiki A. The effect of mindfulness training (MBSR) on the increasing assertiveness among anxious students. J Urmia Univ Med Sci 2017; 28: 119-29.
32. Salehi F, Pourasghar M, Khalilian A, Shahhosseini Z. Comparison of group cognitive behavioral therapy and interactive lectures in reducing anxiety during pregnancy: A quasi experimental trial. Medicine (Baltimore) 2016; 95: e5224.
33. Bergbom I, Modh C, Lundgren I, Lindwall L. First-time pregnant women's experiences of their body in early pregnancy. Scand J Caring Sci 2017; 31: 579-86.
34. Machira K, Palamuleni M. Women's perspectives on quality of maternal health care services in Malawi. Int
J Womens Health 2018; 10: 25-34.
35. Parswani MJ, Sharma MP, Iyengar S. Mindfulness-based stress reduction program in coronary heart disease:
A randomized control trial. Int J Yoga 2013; 6: 111-7.
36. Teasdale JD, Segal ZV, Williams JM, Ridgeway VA, Soulsby JM, Lau MA. Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. J Consult Clin Psychol 2000; 68: 615-23.
37. Schwarze MJ. Assessing the effectiveness of mindfulness-based cognitive therapy in individual sessions in reducing self-reported stress and increasing self-reported mindfulness levels of a nursing student. Nurs. 2011:1-115.
38. Kabat-Zinn J. Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology Science and Practice 2003; 10: 144–56.
39. Jahangirpour M, Musavi SV, Khosrojavid M, Salari A, Rezaei S. The effectiveness of group mindfulness training on depression, hostility and anxiety in individuals with coronary heart disease. Studies in Medical Sciences 2013; 24: 730-9.
40. Mitmansgruber H, Beck TN, Schubler G. ‘‘Mindful helpers”: Experiential avoidance, meta-emotions, and emotion regulation in paramedics. J. Res. Personal 2008; 42: 1358-63.
41. Serpa JG, Taylor SL, Tillisch K. Mindfulness-based stress reduction (MBSR) reduces anxiety, depression, and suicidal ideation in veterans. Med Care 2014; 52: S19-24.
42. Thomas JE, Wuyek LA. Minding the children with mindfulness: A Buddhist approach to promoting well-being in children. In: Springer, New York, NY, 2008.
43. Bayrampour N, Nourizadeh R, Mirghafourvand M, Mehrabi E, Mousavi S. Psychometric Properties of the Pregnancy-Related Anxiety Questionnaire-Revised2 Among Iranian Women. Crescent Journal of Medical and Biological Sciences 2019; 6: 369–74.
44. Abdi F, Navidpour F, Dolatian M. A Literature Review of PregnancyWorries and Stress Scales. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES2018; 12: e14581.
45. Aksoy Derya Y, Altiparmak S, AkÇa E, GÖkbulut N, Yilmaz AN. Pregnancy and birth planning during COVID-19: The effects of tele-education offered to pregnant women on prenatal distress and pregnancy-related anxiety. Midwifery 2021; 92: 102877.
46. Zarenejad M, Yazdkhasti M, Rahimzadeh M, Mehdizadeh Tourzani Z, Esmaelzadeh-Saeieh S. The effect of mindfulness-based stress reduction on maternal anxiety and self-efficacy: A randomized controlled trial. Brain Behav 2020; 10: e01561.
47. Byrne J, Hauck Y, Fisher C, Bayes S, Schutze R. Effectiveness of a Mindfulness-Based Childbirth Education pilot study on maternal self-efficacy and fear of childbirth. J Midwifery Womens Health 2014; 59: 192-7.
48. Zonuzi A, Satarzadeh N, Zamanzadeh V. Recognition of experienced psychologic varieties in wowen’s sexual relationship after childbirth. Journal of Inflammatory Diseases 2008; 12: 38-44.
49. Erfani A. Curbing family planning in Iran: an appraisal of Bill 446. J Fam Plann Reprod Health Care 2015; 41: 317-8.
| Files | ||
| Issue | Vol 15, No 1 (March 2021) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/jfrh.v15i1.6070 | |
| Keywords | ||
| Reproductive Behavior Fear Pregnancy Anxiety Mindfulness | ||
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How to Cite
1.
Malekpoorafshar M, Salehinejad P, Pouya F, Khezri Moghadam N, Shahesmaeili A. A Shift Toward Childbearing in One-Child Families Through a Mindfulness-Based Stress Reduction Program: A Randomized Controlled Trial. J Family Reprod Health. 2021;15(1):19-27.
