Clinical trial NCT04883541: Effects of Yoga and Meditation on The Birth Process
Official title: Assistant Professor,Faculty of Health Sciences Department of Midwifery, Uskudar University, Istanbul, Turkey
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Birth, First
Labor Pain
State Anxiety
Self Efficacy
Keywords: Labour Preparation Class
Labour Support
Meditation
Pregnancy Yoga
Lead sponsor: Uskudar University
Sponsor class: OTHER
Collaborators: name: Biruni University
First posted: 2021-05-12
Enrollment: 153
Sex: FEMALE
Minimum age (years): 21
Maximum age (years): 35
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: The present study was conducted as a randomized controlled study.
Primary purpose: SUPPORTIVE_CARE

Brief summary: Introduction: Today it is seen that women lose their birthing strength, give the control to healthcare personnel during labour and the rate of c-section or interventional labour is increasing. For this reason, the importance of yoga, meditation and breath awareness practices increases during pregnancy and birth. The study was carried out as a randomized control trial with the purpose of examining the impact of yoga and meditation during pregnancy and labour on the labour process.

Methods: The study was completed with 90 primiparous pregnant women in total, 30 in experimental group and 60 in control group. The data was collected using State Trait Anxiety Inventory, Wijma Delivery Expectancy/Experience Questionnaire A, The Childbirth Self-Efficacy Scale Short Form, Wijma Delivery Expectancy/Experience Questionnaire Version B and Visual Analogue Scale. Pregnant women in experimental group did yoga and meditation for 60 minutes 2 times a week for 10 weeks. Innatal period yoga and meditation practices were continued in experimental group during labour.

Detailed description: METHODS

Study design:

The present study was conducted as a randomized controlled study. The study was conducted on pregnant women who applied to the pregnancy school of an educational and research hospital on the Anatolian side of Istanbul province between October 2016 and May 2018, and who met the criteria for acceptance of the study.

Setting and samples:

All pregnant women attending the pregnancy school, who agreed to participate in the research, and met the research conditions within the study dates constituted the research population. The sampling of the study was created with the simple random method as the experiment and control group with individuals who met the criteria of the study and who were accepted to participate. In this respect, pregnant women, who were primiparous and between 20-36 gestational weeks, who had single fetuses, expected to give birth normally and spontaneously, with no pregnancy complications and systemic disease, and who could speak Turkish, were included in the study. Power Analysis was made by using the G\*Power (v3.1.7) Program to determine the sampling number of the study. According to Cohen's effect size coefficients and other calculations, it was assumed that the evaluations between the two independent groups would have a large impact size (d=0.50). It was also decided that there should be at least 26 people in the groups, and considering that there might be losses in the study process, 30 people were included in the experimental group, and 60 people in the control group, making 90 people in total.

For Randomization, when the experiment and control group were created, support was received from pregnancy school instructors and groups, and pregnant women were determined by using the method of envelope selection. Pregnancy school instructors asked the group volunteering to participate in the study to independently choose one of two blue or red colored envelopes. Those who chose the blue envelope formed the experiment group, and those that chose the red envelope were taken into the control group. The envelope selection process continued until the desired numbers were reached. The researcher was told advised of the groups to which subjects were included by the pregnancy school instructor only after the subjects were chosen.

Eligibility criteria: Inclusion Criteria:

* Pregnant women,
* Primiparous and between 20-36 gestational weeks,
* Single fetuses, expected to give birth normally and spontaneously,
* No pregnancy complications and systemic disease,
* Speak Turkish

Exclusion Criteria:

* Being unable to speak Turkish
* Having a history of serious illness that threatens life or because of these reasons.
* Currently or previously due to a serious mental weakness or illness
* Being diagnosed with a psychiatric diagnosis and being treated for this reason,
* Being multiparous,
* Multiple pregnancies, being in the gestational week less than 20 weeks and greater than 36 weeks,
* Having a diagnosis that constitutes an obstacle to physical activity

Primary outcomes:
measure: Characteristics of Labor (Pregnant)
timeFrame: 16 hours
measure: Comparison of Visual Analog Scale (Pain) Scores of Pregnant Women in Study and Control Group
timeFrame: the 4th hour on average after the birth
Secondary outcomes:
measure: Comparison of WIJMAA and WIJMAB Average Scores of Pregnant Women in the Study and Control Groups
timeFrame: the 4th hour on average after the birth
measure: Comparison of Average Self-sufficiency Scores of Pregnant Women in the Study and Control Groups
timeFrame: the 4th hour on average after the birth
Other outcomes:
Locations:
Study officials:
References:
citation: Dick-Read G. Childbirth Without Fear: The Principles and Practice of Natural Childbirth. Second edition. UK: Pinter & Martin Ltd; 2013. 56-100.
citation: Rathfisch G. Natural Philosophy of Birth. Istanbul: Nobel Medical Bookstores; 2012.
citation: Öner N, LeCompte A. State Trait Anxiety Inventory Handbook, Istanbul; Boğaziçi University Publications;1983.
citation: Lecompte A, Öner N. A study on the adaptation and standardization of the state-trait anxiety inventory to Turkish. IX. National Psychiatry and Neurological Sciences Congress Studies 1975;457-462.
citation: Erkaya R, Karabulutlu Ö, Çalıka YK. Defining childbirth fear and anxiety levels in pregnant women procedia. Social and Behavioral Sciences 2017; 237:1045-1052.
citation: Gönenç İM, Çakırer-Çalbayram N. Contributions of pregnancy school program, opinions of women on the education and their post-education experiences. Journal of Human Sciences 2017; 14(2), 1609-1620. doi:10.14687/jhs.v14i2.4424.
citation: Çiçek Ö, Okumuş H. Doğumda öz-yeterlilik algisi: önemi ve etkileyen faktörler, Self-Efficacy perception at birth: its importance and effective factors. International Refereed Journal Ofgynaecological Diseases And Maternal Child Health 2017; 35-49.
citation: Greathouse, K. The Nightmare of childbirth: the prevalence and predominant predictor variables for tokophobia in American women of childbearing age [PhD dissertation],. The School of Professional Psychology, Chicago; 2014.
citation: Maharana S, Nagarathna R, Padmalatha V, Nagendra HR, Hankey A. The Effect of Integrated Yoga on Labor Outcome: A Randomized Controlled Study. International Journal of Childbirth 2013;(3):165-77. DOI: 10.1891 / 2156-5287.3.3.165.
citation: Karakuş A, Şahin NH. The attitudes of women toward mode delivery after childbirth. International Journal of Nursing and Midwifery 2011; 3(5): 60-65. https://doi.org/10.5897/IJNM.9000042.
citation: Salomonsson B. Fear is in the air : Midwives´ perspectives of fear of childbirth and childbirth self-efficacy and fear of childbirth in nulliparous pregnant women [PhD dissertation], Linköping University Medical Dissertations, Sweden, 2012; ISBN 978-91-7519-780-7 ISSN 0345-0082.
citation: Sercekus P, Baskale H. Effects of antenatal education on fear of childbirth, maternal self-efficacy and parental attachment. Midwifery. 2016 Mar;34:166-172. doi: 10.1016/j.midw.2015.11.016. Epub 2015 Nov 27.
citation: Simkin P, Bolding A. Update on nonpharmacologic approaches to relieve labor pain and prevent suffering. J Midwifery Womens Health. 2004 Nov-Dec;49(6):489-504. doi: 10.1016/j.jmwh.2004.07.007.
citation: Steel A, Adams J, Sibbritt D, Broom A, Frawley J, Gallois C. Relationship between complementary and alternative medicine use and incidence of adverse birth outcomes: an examination of a nationally representative sample of 1835 Australian women. Midwifery. 2014 Dec;30(12):1157-65. doi: 10.1016/j.midw.2014.03.015. Epub 2014 Mar 29.
citation: Polis RL, Gussman D, Kuo YH. Yoga in Pregnancy: An Examination of Maternal and Fetal Responses to 26 Yoga Postures. Obstet Gynecol. 2015 Dec;126(6):1237-1241. doi: 10.1097/AOG.0000000000001137.
citation: Wijma K, Wijma B, Zar M. Psychometric aspects of the W-DEQ; a new questionnaire for the measurement of fear of childbirth. J Psychosom Obstet Gynaecol. 1998 Jun;19(2):84-97. doi: 10.3109/01674829809048501.
citation: Korukcu O, Kukulu K, Firat MZ. The reliability and validity of the Turkish version of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) with pregnant women. J Psychiatr Ment Health Nurs. 2012 Apr;19(3):193-202. doi: 10.1111/j.1365-2850.2011.01694.x. Epub 2012 Jan 20.
citation: Lowe NK. Maternal confidence for labor: development of the Childbirth Self-Efficacy Inventory. Res Nurs Health. 1993 Apr;16(2):141-9. doi: 10.1002/nur.4770160209.
citation: Ip WY, Chan D, Chien WT. Chinese version of the Childbirth Self-efficacy Inventory. J Adv Nurs. 2005 Sep;51(6):625-33. doi: 10.1111/j.1365-2648.2005.03548.x.
citation: Korukcu O, Bulut O, Kukulu K. Psychometric Evaluation of the Wijma Delivery Expectancy/Experience Questionnaire Version B. Health Care Women Int. 2016;37(5):550-67. doi: 10.1080/07399332.2014.943838. Epub 2014 Oct 8.
citation: Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health. 1990 Aug;13(4):227-36. doi: 10.1002/nur.4770130405.
citation: Stoll K, Edmonds JK, Hall WA. Fear of Childbirth and Preference for Cesarean Delivery Among Young American Women Before Childbirth: A Survey Study. Birth. 2015 Sep;42(3):270-6. doi: 10.1111/birt.12178. Epub 2015 Jun 24.
citation: Sydsjo G, Blomberg M, Palmquist S, Angerbjorn L, Bladh M, Josefsson A. Effects of continuous midwifery labour support for women with severe fear of childbirth. BMC Pregnancy Childbirth. 2015 May 15;15:115. doi: 10.1186/s12884-015-0548-6.
citation: Campbell VR, Nolan M. A qualitative study exploring how the aims, language and actions of yoga for pregnancy teachers may impact upon women's self-efficacy for labour and birth. Women Birth. 2016 Feb;29(1):3-11. doi: 10.1016/j.wombi.2015.04.007. Epub 2015 May 29.
citation: Salomonsson B, Gullberg MT, Alehagen S, Wijma K. Self-efficacy beliefs and fear of childbirth in nulliparous women. J Psychosom Obstet Gynaecol. 2013 Sep;34(3):116-21. doi: 10.3109/0167482X.2013.824418.
citation: Narendran S, Nagarathna R, Narendran V, Gunasheela S, Nagendra HR. Efficacy of yoga on pregnancy outcome. J Altern Complement Med. 2005 Apr;11(2):237-44. doi: 10.1089/acm.2005.11.237.
citation: Jiang Q, Wu Z, Zhou L, Dunlop J, Chen P. Effects of yoga intervention during pregnancy: a review for current status. Am J Perinatol. 2015 May;32(6):503-14. doi: 10.1055/s-0034-1396701. Epub 2014 Dec 23.
citation: Cramer H, Frawley J, Steel A, Hall H, Adams J, Broom A, Sibbritt D. Characteristics of women who practice yoga in different locations during pregnancy. BMJ Open. 2015 Aug 21;5(8):e008641. doi: 10.1136/bmjopen-2015-008641.
citation: Sharma M, Branscum P. Yoga interventions in pregnancy: a qualitative review. J Altern Complement Med. 2015 Apr;21(4):208-16. doi: 10.1089/acm.2014.0033. Epub 2015 Feb 24.
citation: Esencan TY, Karabulut Ö, Yıldırım AD, Abbasoğlu DE, Külek H. et. al. Type of delivery, time of ınitial breastfeeding, and skin-to-skin contact of pregnant women participating in childbirth preparation education. Florence Nightingale Journal of Nursing 2018; 26(1), 31-43. https://doi.org/10.26650/FNJN.387192.
citation: Kjergaard H, Wijma K, Dykes AK, Alehagen S. Fear of childbirth in obstetrically low-risk nulliparous women in Sweden and Denmark. Journal of Reproductive and Infant Psychology 2008; 26(4): 340-50.