When it comes to giving birth, even an expectant mother can’t be sure what to expect. Although labor for some women is relatively short and the extreme pain passes quickly, the equal possibility of having to suffer through a long and excruciating delivery can loom large in the expectant mother’s mind. As a result, many women are fearful of the whole prospect of bringing a child into the world. Many wouldn’t even consider giving birth without pain medication while others would prefer having a Cesarean birth.
Few people know better about how expectant moms, their partners, and their families feel about birth than Nancy Bardacke. A longtime nurse-midwife and mindfulness meditation teacher, Bardacke decided to merge childbirth education with mindfulness practice after attending a Mindfulness-Based Stress Reduction (MBSR) training retreat for health professionals led by Jon Kabat-Zinn several decades ago. In 1998, she gave birth to the Mindfulness-Based Childbirth and Parenting (MBCP) program, and in 2012 her book Mindful Birthing: Training the Mind, Body and Heart for Childbirth and Beyond was published. It became an instant classic that has already been translated into five languages, including Turkish and Romanian. An edition for readers in China, where interest in the program is growing rapidly, will be published in 2018.
Now, the results of a small study add to the growing body of evidence of the effectiveness of bringing mindfulness to expectant women and their partners. The study, published in the journal BMC Pregnancy and Childbirth, shows that mindfulness training that addresses fear and pain during childbirth improves childbirth experiences and lessens depression symptoms both during pregnancy and in the early postpartum period compared with childbirth classes without mindfulness training. There was also a trend toward decreased opioid use during labor in the study group.
The study was conducted by MBCP Faculty Member Larissa Duncan, PhD, who is the Elizabeth C. Davies Chair in Child and Family Well-Being and Associate Professor of Human Development & Family Studies and Family Medicine & Community Health at the University of Wisconsin–Madison. Drawing on the mindfulness practices taught in the 9-week MBCP course Bardacke developed, the study focused on an 18-hour intensive weekend mindfulness workshop, The Mind in Labor, taught by Bardacke to 30 first-time mothers and their partners. Women with no prior formal mindfulness meditation experience were recruited based on their worries about the pain of childbirth.
“Abundant research shows that mindfulness training is effective for working with physical pain. We also know that mindfulness practice can help reduce stress, anxiety, and depression,” Duncan says. “When these are experienced to a high degree before, during, and after having a baby there can be long-lasting negative outcomes for all involved. We ought to do everything we can to reduce stress in the perinatal period by teaching mindfulness as a basic life skill, a skill that can enhance physical and mental well-being during pregnancy and birth and for the parenting journey that lies ahead.”
“By using mindfulness to work with the contractions of labor, noticing that they are temporary and that there are spaces of ease in between, expectant parents learn a skill they can use later in parenting—like working with their experiences of a baby crying or toddler tantrums—with the same present-moment awareness.”
—Nancy Bardacke, nurse-midwife, mindfulness teacher, and creator of the Mindfulness-Based Childbirth and Parenting (MBCP) program
If and when a longer-term study is conducted, Bardacke feels that other beneficial effects could be investigated in greater depth. For example, when fear and anxiety is reduced in childbirth, leading to a healthier and more positive experience of the process overall, it may spur mothers and their partners to have more confidence as they move into the challenges of parenthood. Bardacke notes, “By using mindfulness to work with the contractions of labor, noticing that they are temporary and that there are spaces of ease in between, expectant parents learn a skill they can use later in parenting—like working with their experiences of a baby crying or toddler tantrums—with the same present-moment awareness.”
Echoing what Bardacke says, Duncan adds, “The results of this small study are promising, but now what we need is more robust research to demonstrate the long-term impact of these methods, particularly the potential benefits for parent-child relationships and infant behavioral, neural, and social-emotional development, the underpinnings of which are established in utero. We also need well-trained MBCP Instructors who are able to teach mindfulness to expectant parents.”
“Practicing mindfulness for childbirth is not about natural childbirth,” Bardacke is careful to note, “though it does seem to support the normal physiological process of giving birth. Medications and medical assistance, when used wisely, can be lifesaving and we can be grateful that we have access to them if they are needed.”
However she is the first to point out that in childbirth, as in life, there is a certain irreducible element of uncertainty, and mindfulness doesn’t guarantee a pregnancy or birth without stress or complications, whoever you are and whatever your condition might be. As one of the participants in the MBCP course said after giving birth, “Mindfulness doesn’t give you the birth experience you want, but it gives you a way to fall in love with the birth experience you get.”