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Effects of the Mindfulness-Based Childbirth and Parenting (MBCP) Program Among Pregnant Women: A Randomized Controlled Trial

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Abstract

Objectives

To evaluate the efficacy of the Mindfulness-Based Childbirth and Parenting (MBCP) program in improving the mental well-being of pregnant women as compared to an attention-matched active control group (i.e., an Antenatal Childbirth Education and Support program).

Method

This was a two-arm 1:1 randomized controlled trial with 183 pregnant women in Hong Kong. Assessments were conducted at baseline (T1), at the last prenatal session (T2), 6–8 weeks postpartum (T3), and 6 months postpartum (T4). The primary outcome was the Mental Component Score (MCS) of the 12-item Short Form Survey (SF-12) at T4. Secondary outcomes included depressive and anxiety symptoms, stress, catastrophizing thoughts about pain, disordered mother–infant relationships, mindfulness, and clinical outcomes related to childbirth. Analysis of covariance (ANCOVA) was used as the primary analysis based on the intention-to-treat (ITT) principle.

Results

MBCP demonstrated superiority over the control at T4 in improving mental health–related quality of life (increased MCS score), reducing depression symptoms and state anxiety, and increasing mindfulness levels at T2, T3, and T4. No significant differences were shown in other outcomes. No serious adverse events were reported.

Conclusions

MBCP showed positive mental health effects and was perceived as a safe intervention for pregnant women in Hong Kong. Future studies may look into its mechanisms and cost-effectiveness.

Pre registration

Chinese Clinical Trial Registry ChiCTR-TRC-13004070.

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Data Availability

The data has been deposited to CUHK Research Data Repository: https://researchdata.cuhk.edu.hk/dataset.xhtml?persistentId=doi:10.48668/KT1ZZR.

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Acknowledgements

We would like to thank the funding body for the support and express our sincere gratitude to the Department of Obstetrics and Gynaecology, Prince of Wales Hospital, Hospital Authority, Hong Kong, for their tremendous support of study recruitment and implementation. Moreover, we would like to thank the Mindful Birthing and Parenting Foundation MBCP teacher training team, Dr. Helen Ma, Ms. Chan Fung Yi, Ms. Cheung Tang Hung, and Ms. Li Ka Po for their ongoing support. We sincerely thank everyone who joined and contributed to the study, particularly the participants.

Funding

This project was funded by Health and Medical Research Fund, Food and Health Bureau, Hong Kong Government (Reference No. 11120111), following external peer review. However, the funding body has no role in the design, implementation, and writing related to the study.

Author information

Authors and Affiliations

  1. JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China

    Dexing Zhang, Benjamin H. K. Yip, Dicken C. C. Chan, Eric K. P. Lee, Tiffany T. Gao & Samuel Y. S. Wong

  2. CUHK Thomas Jing Mindfulness Centre for Research and Training, Hong Kong SAR, China

    Dexing Zhang, Dicken C. C. Chan, Eric K. P. Lee, Tiffany T. Gao & Samuel Y. S. Wong

  3. Hong Kong SAR, China

    Katrina W. K. Tsang

  4. University of Wisconsin-Madison, Madison, WI, USA

    Larissa G. Duncan

  5. Department of Obstetrics and Gynaecology, Prince of Wales Hospital, Hospital Authority, Hong Kong SAR, China

    Wing Hung Tam, Kit Yee Lam & Wing Hung Tong

  6. Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China

    Wing Hung Tam

  7. Mindful Birthing and Parenting Foundation, Oakland, CA, USA

    Nancy Bardacke

Authors
  1. Dexing Zhang
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  2. Katrina W. K. Tsang
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  3. Larissa G. Duncan
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  4. Benjamin H. K. Yip
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  5. Dicken C. C. Chan
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  6. Eric K. P. Lee
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  7. Tiffany T. Gao
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  8. Wing Hung Tam
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  9. Kit Yee Lam
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  10. Wing Hung Tong
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  11. Nancy Bardacke
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  12. Samuel Y. S. Wong
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Contributions

KWKT, SYSW, TWH, BHKY, and LGD contributed to the conceptualization, funding acquisition, and methodology. KWKT, SYSW, LGD, and NB contributed to the supervision of the overall study and intervention. DZ contributed to the writing (original draft) and methodology. DCCC contributed to the formal analysis and methodology. TTG and DCCC contributed to the investigation and project administration. WHT, KYL, and WHT contributed to project administration. All authors contributed to the writing (review and editing).

Corresponding author

Correspondence to Samuel Y. S. Wong.

Ethics declarations

Ethics

Ethics approval was obtained from the Joint Chinese University of Hong Kong – New Territories East Cluster Clinical Research Ethics Committee (date of approval: 2 October 2013, Reference Number: CRE-2013.463-T). Written informed consent was obtained from all participants.

Conflict of Interest

Nancy Bardacke founded the not-for-profit Mindful Birthing and Parenting Foundation (MBPF) that provides Mindfulness-Based Childbirth and Parenting (MBCP) professional trainings. She receives royalties from the sale of a book and guided audio meditation materials from the MBCP program tested in this study. Larissa Duncan serves as an unpaid board member of the MBPF. The other authors report no conflicts of interest.

Trial Registration

The trial was registered in one of the WHO primary registries: Chinese Clinical Trial Registry before recruitment. Identifier Number: ChiCTR-TRC-13004070. http://www.chictr.org.cn/historyversionpuben.aspx?regno=ChiCTR-TRC-13004070

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Zhang, D., Tsang, K.W.K., Duncan, L.G. et al. Effects of the Mindfulness-Based Childbirth and Parenting (MBCP) Program Among Pregnant Women: A Randomized Controlled Trial. Mindfulness 14, 50–65 (2023). https://doi.org/10.1007/s12671-022-02046-8

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