Preventing Postpartum Depression With Mindful Self-Compassion Intervention

Abstract

Mindfulness and self-compassion are reported to have a preventive effects on depression and anxiety disorders. In the present study, we aimed to assess the effect of mindful self-compassion intervention on preventing postpartum depression in a group of symptomatic pregnant women. Participants were screened and assigned to the intervention and control groups randomly. A 6-week Internet-based Mindful Self-Compassion Program was used to train the participants. Multiple scales were used to assess depressive and anxiety symptoms, mindfulness, self-compassion, and mother and infant well-being. All assessments were performed at three time points: baseline, 3 months, and 1 year postpartum. Compared with the control group, the intervention group showed significant improvement in depressive and anxiety behaviors. In addition, the intervention group became more mindful and self-compassionate at 3 months and 1 year postpartum. More importantly, both mothers and infants experienced substantial improvement in well-being. Our findings indicate that mindful self-compassion intervention is effective in preventing postpartum depression and promoting mother and infant well-being.

Impact of maternal mental health interventions on child-related outcomes in low- and middle-income countries: a systematic review and meta-analysis

“…Population: most trials were conducted in upper-middle-income countries (Brazil, Chile, China, Iran, Lebanon, Malaysia, Mexico and South Africa) (Langer et al ., 1998; Bastani et al ., 2006; Aracena et al ., 2009; Carvalho et al ., 2009; Cooper et al ., 2009; Le Roux et al ., 2013; Le Roux et al ., 2014; Rotheram-Borus et al ., 2014a; Rotheram-Borus et al ., 2014b; Tomlinson, 2014; Karamoozian and Askarizadeh, 2015; Murray et al ., 2015; Tomlinson et al ., 2015; Tomlinson et al ., 2016b; Tomlinson et al ., 2016a; Zhao et al ., 2017, Rotheram-Fuller et al ., 2018, Tomlinson et al ., 2018; Mohd Shukri et al ., 2019; Nabulsi et al ., 2019; Rotheram-Borus et al ., 2019; Guo et al ., 2020; Zhao et al ., 2020) followed by lower-middle-income (India, Nigeria and Pakistan) (Rahman et al ., 2008; Tripathy et al ., 2010; Maselko et al ., 2015; Dabas et al ., 2019; Fuhr et al ., 2019; Gureje et al ., 2019; Sikander et al ., 2019; Rajeswari and SanjeevaReddy, 2020), low-income (Pakistan) (Rahman et al ., 2008; Maselko et al ., 2015) and a multi-site trial of lower-middle (Cuba) and upper-middle-income countries (Argentina, Brazil and Mexico) (Villar et al ., 1992) (Table 1). Most trials enrolled pregnant women in their second and/or third trimester (Villar et al ., 1992; Langer et al ., 1998; Bastani et al ., 2006; Rahman et al ., 2008; Aracena et al ., 2009; Cooper et al ., 2009; Le Roux et al ., 2013; Le Roux et al ., 2014; Tomlinson, 2014; Rotheram-Borus et al ., 2014a; Rotheram-Borus et al ., 2014b; Maselko et al ., 2015; Murray et al ., 2015; Tomlinson et al ., 2015; Tomlinson et al ., 2016a; Tomlinson et al ., 2016b; Fuhr et al ., 2019; Gureje et al ., 2019; Kola et al ., 2019; Mohd Shukri et al ., 2019; Oladeji et al ., 2019; Sikander et al ., 2019; Guo et al ., 2020; Rajeswari and SanjeevaReddy,…”

“…Some trials enrolled specific subgroups of pregnant women including adolescents or young adults (Aracena et al ., 2009), low-income (Cooper et al ., 2009; Le Roux et al ., 2013; Le Roux et al ., 2014; Rotheram-Borus et al ., 2014b; Tomlinson, 2014; Murray et al ., 2015; Tomlinson et al ., 2015; Tomlinson et al ., 2016a; Tomlinson et al ., 2016b, Rotheram-Fuller et al ., 2018, Tomlinson et al ., 2018; Rotheram-Borus et al ., 2019), pregnant with a single foetus, no previous vaginal delivery and no evidence of severe obstetric disease (Langer et al ., 1998; Mohd Shukri et al ., 2019), high-risk pregnancies (Zhao et al ., 2017) or HIV-positive (Rotheram-Borus et al ., 2014a). Several trials enrolled subgroups of pregnant women meeting specific mental health criterion including having mild to moderate stress (Rajeswari and SanjeevaReddy, 2020), elevated anxiety or depressive symptoms (Bastani et al ., 2006; Cooper et al ., 2009; Murray et al ., 2015; Guo et al ., 2020) screening positive for depression based on PHQ9 ≥ 10 (Fuhr et al ., 2019), EPDS ≥ 9 (Zhao et al ., 2017; Zhao et al ., 2020), EPDS = 12 (Karamoozian and Askarizadeh, 2015), anxiety based on the Pregnancy-Related Anxiety Questionnaire (PRAQ) (Karamoozian and Askarizadeh, 2015) or DSM-IV-TR criteria for major depressive episode (Rahman et al ., 2008; Maselko et al ., 2015).…”

“…Twelve trials delivered the intervention in hospital- or clinic-based settings by nurse researchers (Bastani et al ., 2006), primary maternal care providers (Gureje et al ., 2019), psychologists (Carvalho et al ., 2009), doulas/midwives/lactation consultants (Langer et al ., 1998; Nabulsi et al ., 2019; Zhao et al ., 2020), peers (Rotheram-Borus et al ., 2014a; Fuhr et al ., 2019; Sikander et al ., 2019) or research staff (Zhao et al ., 2017; Dabas et al ., 2019; Mohd Shukri et al ., 2019; Rajeswari and SanjeevaReddy, 2020). One of these interventions was delivered online (Guo et al ., 2020), and several supplemented in-person activities with audio/video materials (Carvalho et al ., 2009; Dabas et al ., 2019; Mohd Shukri et al ., 2019). One of these clinic-based trials did not specify the provider (Karamoozian and Askarizadeh, 2015).…”

“…MMH components included education surrounding self-esteem and/or problem-solving (Aracena et al ., 2009; Tripathy et al ., 2010; Le Roux et al ., 2013; Le Roux et al ., 2014; Tomlinson, 2014; Rotheram-Borus et al ., 2014b; Tomlinson et al ., 2015; Tomlinson et al ., 2016a; Tomlinson et al ., 2016b; Gureje et al ., 2019; Oladeji et al ., 2019), strengthening social networks (Rotheram-Borus et al ., 2014a, Rotheram-Fuller et al ., 2018, Tomlinson et al ., 2018; Nabulsi et al ., 2019; Rotheram-Borus et al ., 2019), provision of social, psychological and emotional support (Villar et al ., 1992; Cooper et al ., 2009; Tripathy et al ., 2010; Murray et al ., 2015; Nabulsi et al ., 2019), cognitive-behavioural strategies (Le Roux et al ., 2013; Le Roux et al ., 2014; Rotheram-Borus et al ., 2014a; Rotheram-Borus et al ., 2014b; Tomlinson, 2014; Tomlinson et al ., 2015; Karamoozian and Askarizadeh, 2015; Tomlinson et al ., 2016a; Tomlinson et al ., 2016b, Rotheram-Fuller et al ., 2018, Tomlinson et al ., 2018; Fuhr et al ., 2019; Rotheram-Borus et al ., 2019; Sikander et al ., 2019), alcohol use prevention (Le Roux et al ., 2013; Rotheram-Borus et al ., 2014b; Tomlinson, 2014; Rotheram-Borus et al ., 2014a; Tomlinson et al ., 2015, Rotheram-Fuller et al ., 2018, Tomlinson et al ., 2018; Rotheram-Borus et al ., 2019), relaxation techniques (Karamoozian and Askarizadeh, 2015; Dabas et al ., 2019; Mohd Shukri et al ., 2019; Rajeswari and SanjeevaReddy, 2020), mindfulness (Guo et al ., 2020) and psychoeducation (Zhao et al ., 2017; Zhao et al ., 2020). The primary aim of 11 trials was focused specifically on improving MMH via interventions that included relaxation and mindfulness training to reduce anxiety/stress (Bastani et al ., 2006; Rajeswari and SanjeevaReddy, 2020) or depression (Guo et al ., 2020), cognitive-behavioural or problem solving therapy to reduce depressive symptoms (Rahman et al ., 2008; Maselko et al ., 2015; Fuhr et al ., 2019; Gureje et al ., 2019…”

“…Population: most trials were conducted in upper-middle-income countries (Brazil, Chile, China, Iran, Lebanon, Malaysia, Mexico and South Africa) (Langer et al, 1998;Bastani et al, 2006;Aracena et al, 2009;Carvalho et al, 2009;Cooper et al, 2009;Le Roux et al, 2013;Le Roux et al, 2014; Rotheram-Borus et al, 2014a; Rotheram-Borus et al, 2014b; Tomlinson, 2014; Karamoozian and Askarizadeh, 2015;Murray et al, 2015;Tomlinson et al, 2015;Tomlinson et al, 2016b;Tomlinson et al, 2016a;Zhao et al, 2017, Rotheram-Fuller et al, 2018Mohd Shukri et al, 2019;Nabulsi et al, 2019;Rotheram-Borus et al, 2019;Guo et al, 2020;Zhao et al, 2020) followed by lower-middle-income (India, Nigeria and Pakistan) (Rahman et al, 2008;Tripathy et al, 2010;Maselko et al, 2015;Dabas et al, 2019;Fuhr et al, 2019;Gureje et al, 2019;Sikander et al, 2019;Rajeswari and SanjeevaReddy, 2020), low-income (Pakistan) (Rahman et al, 2008;Maselko et al, 2015) and a multi-site trial of lower-middle (Cuba) and upper-middle-income countries (Argentina, Brazil and Mexico) (Villar et al, 1992) (Table 1). Most trials enrolled pregnant women in their second and/or third trimester (Villar et al, 1992; Epidemiology and Psychiatric Sciences Langer et al, 1998;Bastani et al, 2006;Rahman et al, 2008;Aracena et al, 2009;Co...…”