Preparing For Labor and Delivery – Advice From a Midwife
Pregnancy brings so many valid emotions–joy, fear, anticipation, and excitement among them. It’s normal to feel nervous at the end of pregnancy while waiting for labor to begin.
Fortunately, there are a few things that you can do during pregnancy to help prepare your mind and body.
Balance your nutrition
The Institute of Medicine recommends the following ranges of weight gain during pregnancy, based on maternal pre-pregnancy BMI (1):
- BMI less than 18.5: 28-40 lbs
- BMI 18.5-24.9: 25-35 lbs
- BMI 25-29.9: 15-25 lbs
- BMI 30 or greater: 11-20 lbs
Weight gains that are both lower and higher than recommendations have been associated with adverse pregnancy outcomes, including fetal growth issues and preterm birth (2, 3).
In particular, gaining too much weight during pregnancy increases the risk of having a large-for-gestational-age baby, which is associated with higher rates of cesarean section, delivery complications, newborn complications, and childhood obesity (3, 4).
While a variety of foods can be enjoyed in moderation during pregnancy, there is no need to “eat for two.” Daily calorie needs do not change in the first trimester, and energy requirements increase by just 350-450 kcal/day during the second and third trimesters (5). This can be accomplished by adding in one or two additional snacks, like an apple with 1 ounce of sliced cheddar cheese or a cup of Greek yogurt with berries.
Protein, iron, and folic acid needs increase during pregnancy, so it is more important than ever to choose nutrient-dense options for meals and snacks (5). For example, a handful of walnuts is a great source of protein, folic acid, and omega-3 fatty acids.
A registered dietician (RD) can help you make personalized dietary changes that are in alignment with your health goals.
Strengthen your body
Regular exercise is a vital component of a healthy lifestyle and may be especially beneficial during pregnancy. The U.S. Department of Health and Human Services Physical Activity Guidelines for Americans recommends 150 minutes of moderate-intensity exercise per week (6).
Though more research is needed, some studies have found that exercise in pregnancy is associated with:
- Decreased pregnancy weight gain and associated complications, including gestational diabetes and preeclampsia (7-10)
- Decreased length of active labor (11, 12)
- Increased rate of vaginal delivery and decreased cesarean section (13, 14)
While exercise has important benefits, it is important to ensure that your form is correct. Levels of the hormone relaxin are increased during pregnancy, resulting in the loosening of the joints and soft tissues of your body. This can make pregnant people more susceptible to injuries (15).
The lower back and pelvic floor are common areas of stress, discomfort, and injury during pregnancy. A pelvic floor physical therapist is a specialist that can provide targeted exercises to strengthen your core and pelvic floor, which may:
- Reduce time spent pushing (16)
- Reduce risk of severe vaginal tears (16)
- Prevent/treat urinary and bowel incontinence (17)
>> Read more: Benefits of pelvic floor therapy & How pelvic floor therapy during pregnancy can help
Calm your mind
Beyond the physical work, labor requires mental preparation. Some people find that breathing exercises and mindfulness strategies, such as hypnobirthing, help prepare them to cope with the challenges that labor brings (18).
In particular, mindfulness-based childbirth preparation can help to reduce fear about birth, reduce the use of pain medication during labor, and reduce the risk of postpartum depression (19, 20).
It is equally important to prepare for the postpartum experience. Postpartum depression and postpartum anxiety are real and common disorders. Some studies estimate that as many as 10-20% of new mothers experience postpartum depression and anxiety (21, 22).
There are many risk factors for postpartum mood disorders (23), including:
- Personal history of anxiety or depression
- Complications during pregnancy, labor, or delivery
- Young age
- Lower socioeconomic status
- Minimal social support
- Inadequate nutrition
Mental health therapy is an effective treatment for reducing postpartum mood disorder symptoms, and may even help to prevent postpartum depression (24, 25). People at risk of postpartum mood disorders and people who want to be proactive about prevention may find it helpful to establish counseling with a mental health therapist during pregnancy.
Several complementary therapies including yoga, acupuncture, and music therapy have also demonstrated benefits among people with depression, though more research is needed among pregnant and postpartum people (26-28). These practices are considered safe while pregnant and breastfeeding unless otherwise directed by your healthcare provider.
Medication is sometimes required for the treatment of anxiety and/or depression. Many medications are considered safe for use during pregnancy and breastfeeding. It is important to talk to your healthcare provider about the right option for you.
The bottom line
Though it may seem daunting, there are several steps that you can take to help create a healthy prenatal and postpartum experience. And Zaya is here to help!
References
- Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight Gain During Pregnancy: Reexamining the Guidelines. Rasmussen KM, Yaktine AL, editors. Washington (DC): National Academies Press (US); 2009. PMID: 20669500.
- Rogozińska E, Zamora J, Marlin N, Betrán AP, Astrup A, Bogaerts A, Cecatti JG, Dodd JM, Facchinetti F, Geiker NRW, Haakstad LAH, Hauner H, Jensen DM, Kinnunen TI, Mol BWJ, Owens J, Phelan S, Renault KM, Salvesen KÅ, Shub A, Surita FG, Stafne SN, Teede H, van Poppel MNM, Vinter CA, Khan KS, Thangaratinam S; International Weight Management in Pregnancy (i-WIP) Collaborative Group. Gestational weight gain outside the Institute of Medicine recommendations and adverse pregnancy outcomes: analysis using individual participant data from randomised trials. BMC Pregnancy Childbirth. 2019 Sep 2;19(1):322. doi: 10.1186/s12884-019-2472-7. PMID: 31477075; PMCID: PMC6719382.
- Goldstein RF, Abell SK, Ranasinha S, Misso M, Boyle JA, Black MH, Li N, Hu G, Corrado F, Rode L, Kim YJ, Haugen M, Song WO, Kim MH, Bogaerts A, Devlieger R, Chung JH, Teede HJ. Association of Gestational Weight Gain With Maternal and Infant Outcomes: A Systematic Review and Meta-analysis. JAMA. 2017 Jun 6;317(21):2207-2225. doi: 10.1001/jama.2017.3635. PMID: 28586887; PMCID: PMC5815056.
- Scifres CM. Short- and Long-Term Outcomes Associated with Large for Gestational Age Birth Weight. Obstet Gynecol Clin North Am. 2021 Jun;48(2):325-337. doi: 10.1016/j.ogc.2021.02.005. PMID: 33972069.
- Kominiarek MA, Rajan P. Nutrition Recommendations in Pregnancy and Lactation. Med Clin North Am. 2016;100(6):1199-1215. doi:10.1016/j.mcna.2016.06.004
- U.S. Department of Health and Human Services . Physical activity guidelines for Americans . 2nd ed . Washington, DC : DHHS ; 2018 . Available at: https://health.gov/paguidelines/second-edition/ . Retrieved October 18, 2019.
- Du MC, Ouyang YQ, Nie XF, Huang Y, Redding SR. Effects of physical exercise during pregnancy on maternal and infant outcomes in overweight and obese pregnant women: A meta-analysis. Birth. 2019 Jun;46(2):211-221. doi: 10.1111/birt.12396. Epub 2018 Sep 21. PMID: 30240042.
- Barakat R, Refoyo I, Coteron J, Franco E. Exercise during pregnancy has a preventative effect on excessive maternal weight gain and gestational diabetes. A randomized controlled trial. Braz J Phys Ther. 2019 Mar-Apr;23(2):148-155. doi: 10.1016/j.bjpt.2018.11.005. Epub 2018 Nov 17. PMID: 30470666; PMCID: PMC6428908.
- Ming WK, Ding W, Zhang CJP, Zhong L, Long Y, Li Z, Sun C, Wu Y, Chen H, Chen H, Wang Z. The effect of exercise during pregnancy on gestational diabetes mellitus in normal-weight women: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2018 Nov 12;18(1):440. doi: 10.1186/s12884-018-2068-7. PMID: 30419848; PMCID: PMC6233372.
- Magro-Malosso ER , Saccone G , Di Tommaso M , Roman A , Berghella V . Exercise during pregnancy and risk of gestational hypertensive disorders: a systematic review and meta-analysis . Acta Obstet Gynecol Scand 2017 ; 96 : 921 – 31 .
- Barakat R, Franco E, Perales M, López C, Mottola MF. Exercise during pregnancy is associated with a shorter duration of labor. A randomized clinical trial. Eur J Obstet Gynecol Reprod Biol. 2018 May;224:33-40. doi: 10.1016/j.ejogrb.2018.03.009. Epub 2018 Mar 6. PMID: 29529475.
- Watkins VY, O’Donnell CM, Perez M, Zhao P, England S, Carter EB, Kelly JC, Frolova A, Raghuraman N. The impact of physical activity during pregnancy on labor and delivery. Am J Obstet Gynecol. 2021 Oct;225(4):437.e1-437.e8. doi: 10.1016/j.ajog.2021.05.036. Epub 2021 Jun 1. PMID: 34081895.
- Meander L, Lindqvist M, Mogren I, Sandlund J, West CE, Domellöf M. Physical activity and sedentary time during pregnancy and associations with maternal and fetal health outcomes: an epidemiological study. BMC Pregnancy Childbirth. 2021 Feb 27;21(1):166. doi: 10.1186/s12884-021-03627-6. PMID: 33639879; PMCID: PMC7913456.
- Di Mascio D, Magro-Malosso ER, Saccone G, Marhefka GD, Berghella V. Exercise during pregnancy in normal-weight women and risk of preterm birth: a systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol. 2016 Nov;215(5):561-571. doi: 10.1016/j.ajog.2016.06.014. Epub 2016 Jun 16. PMID: 27319364.
- Exercise During Pregnancy. The American College of Obstetricians and Gynecologists. Last updated March 2022. Accessed May 1, 2022. Accessed from https://www.acog.org/womens-health/faqs/exercise-during-pregnancy
- Sobhgol SS, Smith CA, Dahlen HG. The effect of antenatal pelvic floor muscle exercises on labour and birth outcomes: a systematic review and meta-analysis. Int Urogynecol J. 2020 Nov;31(11):2189-2203. doi: 10.1007/s00192-020-04298-1. Epub 2020 Jun 6. PMID: 32506232.
- Hay-Smith J, Mørkved S, Fairbrother KA, Herbison GP. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD007471. doi: 10.1002/14651858.CD007471. Update in: Cochrane Database Syst Rev. 2012;10:CD007471. PMID: 18843750.
- Finlayson K, Downe S, Hinder S, Carr H, Spiby H, Whorwell P. Unexpected consequences: women’s experiences of a self-hypnosis intervention to help with pain relief during labour. BMC Pregnancy Childbirth. 2015;15:229. Published 2015 Sep 25. doi:10.1186/s12884-015-0659-0
- Veringa-Skiba IK, de Bruin EI, van Steensel FJA, Bögels SM. Fear of childbirth, nonurgent obstetric interventions, and newborn outcomes: A randomized controlled trial comparing mindfulness-based childbirth and parenting with enhanced care as usual. Birth. 2022 Mar;49(1):40-51. doi: 10.1111/birt.12571. Epub 2021 Jul 11. PMID: 34250636.
- Duncan LG, Cohn MA, Chao MT, Cook JG, Riccobono J, Bardacke N. Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison. BMC Pregnancy Childbirth. 2017 May 12;17(1):140. doi: 10.1186/s12884-017-1319-3. PMID: 28499376; PMCID: PMC5427564.
- Shorey S, Chee CYI, Ng ED, Chan YH, Tam WWS, Chong YS. Prevalence and incidence of postpartum depression among healthy mothers: A systematic review and meta-analysis. J Psychiatr Res. 2018 Sep;104:235-248. doi: 10.1016/j.jpsychires.2018.08.001. Epub 2018 Aug 3. PMID: 30114665.
- Wang Z, Liu J, Shuai H, Cai Z, Fu X, Liu Y, Xiao X, Zhang W, Krabbendam E, Liu S, Liu Z, Li Z, Yang BX. Mapping global prevalence of depression among postpartum women. Transl Psychiatry. 2021 Oct 20;11(1):543. doi: 10.1038/s41398-021-01663-6. Erratum in: Transl Psychiatry. 2021 Dec 20;11(1):640. PMID: 34671011; PMCID: PMC8528847.
- Ghaedrahmati M, Kazemi A, Kheirabadi G, Ebrahimi A, Bahrami M. Postpartum depression risk factors: A narrative review. J Educ Health Promot. 2017;6:60. Published 2017 Aug 9. doi:10.4103/jehp.jehp_9_16
- Dennis CL, Hodnett ED. Psychosocial and psychological interventions for treating postpartum depression. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD006116. DOI: 10.1002/14651858.CD006116.pub2. Accessed 02 May 2022.
- Werner E, Miller M, Osborne LM, Kuzava S, Monk C. Preventing postpartum depression: review and recommendations. Arch Womens Ment Health. 2015 Feb;18(1):41-60. doi: 10.1007/s00737-014-0475-y. Epub 2014 Nov 25. PMID: 25422150; PMCID: PMC4308451.
- Cramer H, Lauche R, Klose P, Lange S, Langhorst J, Dobos GJ. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database Syst Rev. 2017 Jan 3;1(1):CD010802. doi: 10.1002/14651858.CD010802.pub2. PMID: 28045199; PMCID: PMC6465041.
- Smith CA, Armour M, Lee MS, Wang LQ, Hay PJ. Acupuncture for depression. Cochrane Database of Systematic Reviews 2018, Issue 3. Art. No.: CD004046. DOI: 10.1002/14651858.CD004046.pub4. Accessed 08 May 2022.
- Tang Q, Huang Z, Zhou H, Ye P. Effects of music therapy on depression: A meta-analysis of randomized controlled trials. PLoS One. 2020 Nov 18;15(11):e0240862. doi: 10.1371/journal.pone.0240862. PMID: 33206656; PMCID: PMC7673528.
Pregnancy brings so many valid emotions–joy, fear, anticipation, and excitement among them. It’s normal to feel nervous at the end of pregnancy while waiting for labor to begin.
Fortunately, there are a few things that you can do during pregnancy to help prepare your mind and body.
Balance your nutrition
The Institute of Medicine recommends the following ranges of weight gain during pregnancy, based on maternal pre-pregnancy BMI (1):
- BMI less than 18.5: 28-40 lbs
- BMI 18.5-24.9: 25-35 lbs
- BMI 25-29.9: 15-25 lbs
- BMI 30 or greater: 11-20 lbs
Weight gains that are both lower and higher than recommendations have been associated with adverse pregnancy outcomes, including fetal growth issues and preterm birth (2, 3).
In particular, gaining too much weight during pregnancy increases the risk of having a large-for-gestational-age baby, which is associated with higher rates of cesarean section, delivery complications, newborn complications, and childhood obesity (3, 4).
While a variety of foods can be enjoyed in moderation during pregnancy, there is no need to “eat for two.” Daily calorie needs do not change in the first trimester, and energy requirements increase by just 350-450 kcal/day during the second and third trimesters (5). This can be accomplished by adding in one or two additional snacks, like an apple with 1 ounce of sliced cheddar cheese or a cup of Greek yogurt with berries.
Protein, iron, and folic acid needs increase during pregnancy, so it is more important than ever to choose nutrient-dense options for meals and snacks (5). For example, a handful of walnuts is a great source of protein, folic acid, and omega-3 fatty acids.
A registered dietician (RD) can help you make personalized dietary changes that are in alignment with your health goals.
Strengthen your body
Regular exercise is a vital component of a healthy lifestyle and may be especially beneficial during pregnancy. The U.S. Department of Health and Human Services Physical Activity Guidelines for Americans recommends 150 minutes of moderate-intensity exercise per week (6).
Though more research is needed, some studies have found that exercise in pregnancy is associated with:
- Decreased pregnancy weight gain and associated complications, including gestational diabetes and preeclampsia (7-10)
- Decreased length of active labor (11, 12)
- Increased rate of vaginal delivery and decreased cesarean section (13, 14)
While exercise has important benefits, it is important to ensure that your form is correct. Levels of the hormone relaxin are increased during pregnancy, resulting in the loosening of the joints and soft tissues of your body. This can make pregnant people more susceptible to injuries (15).
The lower back and pelvic floor are common areas of stress, discomfort, and injury during pregnancy. A pelvic floor physical therapist is a specialist that can provide targeted exercises to strengthen your core and pelvic floor, which may:
- Reduce time spent pushing (16)
- Reduce risk of severe vaginal tears (16)
- Prevent/treat urinary and bowel incontinence (17)
>> Read more: Benefits of pelvic floor therapy & How pelvic floor therapy during pregnancy can help
Calm your mind
Beyond the physical work, labor requires mental preparation. Some people find that breathing exercises and mindfulness strategies, such as hypnobirthing, help prepare them to cope with the challenges that labor brings (18).
In particular, mindfulness-based childbirth preparation can help to reduce fear about birth, reduce the use of pain medication during labor, and reduce the risk of postpartum depression (19, 20).
It is equally important to prepare for the postpartum experience. Postpartum depression and postpartum anxiety are real and common disorders. Some studies estimate that as many as 10-20% of new mothers experience postpartum depression and anxiety (21, 22).
There are many risk factors for postpartum mood disorders (23), including:
- Personal history of anxiety or depression
- Complications during pregnancy, labor, or delivery
- Young age
- Lower socioeconomic status
- Minimal social support
- Inadequate nutrition
Mental health therapy is an effective treatment for reducing postpartum mood disorder symptoms, and may even help to prevent postpartum depression (24, 25). People at risk of postpartum mood disorders and people who want to be proactive about prevention may find it helpful to establish counseling with a mental health therapist during pregnancy.
Several complementary therapies including yoga, acupuncture, and music therapy have also demonstrated benefits among people with depression, though more research is needed among pregnant and postpartum people (26-28). These practices are considered safe while pregnant and breastfeeding unless otherwise directed by your healthcare provider.
Medication is sometimes required for the treatment of anxiety and/or depression. Many medications are considered safe for use during pregnancy and breastfeeding. It is important to talk to your healthcare provider about the right option for you.
The bottom line
Though it may seem daunting, there are several steps that you can take to help create a healthy prenatal and postpartum experience. And Zaya is here to help!
References
- Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight Gain During Pregnancy: Reexamining the Guidelines. Rasmussen KM, Yaktine AL, editors. Washington (DC): National Academies Press (US); 2009. PMID: 20669500.
- Rogozińska E, Zamora J, Marlin N, Betrán AP, Astrup A, Bogaerts A, Cecatti JG, Dodd JM, Facchinetti F, Geiker NRW, Haakstad LAH, Hauner H, Jensen DM, Kinnunen TI, Mol BWJ, Owens J, Phelan S, Renault KM, Salvesen KÅ, Shub A, Surita FG, Stafne SN, Teede H, van Poppel MNM, Vinter CA, Khan KS, Thangaratinam S; International Weight Management in Pregnancy (i-WIP) Collaborative Group. Gestational weight gain outside the Institute of Medicine recommendations and adverse pregnancy outcomes: analysis using individual participant data from randomised trials. BMC Pregnancy Childbirth. 2019 Sep 2;19(1):322. doi: 10.1186/s12884-019-2472-7. PMID: 31477075; PMCID: PMC6719382.
- Goldstein RF, Abell SK, Ranasinha S, Misso M, Boyle JA, Black MH, Li N, Hu G, Corrado F, Rode L, Kim YJ, Haugen M, Song WO, Kim MH, Bogaerts A, Devlieger R, Chung JH, Teede HJ. Association of Gestational Weight Gain With Maternal and Infant Outcomes: A Systematic Review and Meta-analysis. JAMA. 2017 Jun 6;317(21):2207-2225. doi: 10.1001/jama.2017.3635. PMID: 28586887; PMCID: PMC5815056.
- Scifres CM. Short- and Long-Term Outcomes Associated with Large for Gestational Age Birth Weight. Obstet Gynecol Clin North Am. 2021 Jun;48(2):325-337. doi: 10.1016/j.ogc.2021.02.005. PMID: 33972069.
- Kominiarek MA, Rajan P. Nutrition Recommendations in Pregnancy and Lactation. Med Clin North Am. 2016;100(6):1199-1215. doi:10.1016/j.mcna.2016.06.004
- U.S. Department of Health and Human Services . Physical activity guidelines for Americans . 2nd ed . Washington, DC : DHHS ; 2018 . Available at: https://health.gov/paguidelines/second-edition/ . Retrieved October 18, 2019.
- Du MC, Ouyang YQ, Nie XF, Huang Y, Redding SR. Effects of physical exercise during pregnancy on maternal and infant outcomes in overweight and obese pregnant women: A meta-analysis. Birth. 2019 Jun;46(2):211-221. doi: 10.1111/birt.12396. Epub 2018 Sep 21. PMID: 30240042.
- Barakat R, Refoyo I, Coteron J, Franco E. Exercise during pregnancy has a preventative effect on excessive maternal weight gain and gestational diabetes. A randomized controlled trial. Braz J Phys Ther. 2019 Mar-Apr;23(2):148-155. doi: 10.1016/j.bjpt.2018.11.005. Epub 2018 Nov 17. PMID: 30470666; PMCID: PMC6428908.
- Ming WK, Ding W, Zhang CJP, Zhong L, Long Y, Li Z, Sun C, Wu Y, Chen H, Chen H, Wang Z. The effect of exercise during pregnancy on gestational diabetes mellitus in normal-weight women: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2018 Nov 12;18(1):440. doi: 10.1186/s12884-018-2068-7. PMID: 30419848; PMCID: PMC6233372.
- Magro-Malosso ER , Saccone G , Di Tommaso M , Roman A , Berghella V . Exercise during pregnancy and risk of gestational hypertensive disorders: a systematic review and meta-analysis . Acta Obstet Gynecol Scand 2017 ; 96 : 921 – 31 .
- Barakat R, Franco E, Perales M, López C, Mottola MF. Exercise during pregnancy is associated with a shorter duration of labor. A randomized clinical trial. Eur J Obstet Gynecol Reprod Biol. 2018 May;224:33-40. doi: 10.1016/j.ejogrb.2018.03.009. Epub 2018 Mar 6. PMID: 29529475.
- Watkins VY, O’Donnell CM, Perez M, Zhao P, England S, Carter EB, Kelly JC, Frolova A, Raghuraman N. The impact of physical activity during pregnancy on labor and delivery. Am J Obstet Gynecol. 2021 Oct;225(4):437.e1-437.e8. doi: 10.1016/j.ajog.2021.05.036. Epub 2021 Jun 1. PMID: 34081895.
- Meander L, Lindqvist M, Mogren I, Sandlund J, West CE, Domellöf M. Physical activity and sedentary time during pregnancy and associations with maternal and fetal health outcomes: an epidemiological study. BMC Pregnancy Childbirth. 2021 Feb 27;21(1):166. doi: 10.1186/s12884-021-03627-6. PMID: 33639879; PMCID: PMC7913456.
- Di Mascio D, Magro-Malosso ER, Saccone G, Marhefka GD, Berghella V. Exercise during pregnancy in normal-weight women and risk of preterm birth: a systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol. 2016 Nov;215(5):561-571. doi: 10.1016/j.ajog.2016.06.014. Epub 2016 Jun 16. PMID: 27319364.
- Exercise During Pregnancy. The American College of Obstetricians and Gynecologists. Last updated March 2022. Accessed May 1, 2022. Accessed from https://www.acog.org/womens-health/faqs/exercise-during-pregnancy
- Sobhgol SS, Smith CA, Dahlen HG. The effect of antenatal pelvic floor muscle exercises on labour and birth outcomes: a systematic review and meta-analysis. Int Urogynecol J. 2020 Nov;31(11):2189-2203. doi: 10.1007/s00192-020-04298-1. Epub 2020 Jun 6. PMID: 32506232.
- Hay-Smith J, Mørkved S, Fairbrother KA, Herbison GP. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD007471. doi: 10.1002/14651858.CD007471. Update in: Cochrane Database Syst Rev. 2012;10:CD007471. PMID: 18843750.
- Finlayson K, Downe S, Hinder S, Carr H, Spiby H, Whorwell P. Unexpected consequences: women’s experiences of a self-hypnosis intervention to help with pain relief during labour. BMC Pregnancy Childbirth. 2015;15:229. Published 2015 Sep 25. doi:10.1186/s12884-015-0659-0
- Veringa-Skiba IK, de Bruin EI, van Steensel FJA, Bögels SM. Fear of childbirth, nonurgent obstetric interventions, and newborn outcomes: A randomized controlled trial comparing mindfulness-based childbirth and parenting with enhanced care as usual. Birth. 2022 Mar;49(1):40-51. doi: 10.1111/birt.12571. Epub 2021 Jul 11. PMID: 34250636.
- Duncan LG, Cohn MA, Chao MT, Cook JG, Riccobono J, Bardacke N. Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison. BMC Pregnancy Childbirth. 2017 May 12;17(1):140. doi: 10.1186/s12884-017-1319-3. PMID: 28499376; PMCID: PMC5427564.
- Shorey S, Chee CYI, Ng ED, Chan YH, Tam WWS, Chong YS. Prevalence and incidence of postpartum depression among healthy mothers: A systematic review and meta-analysis. J Psychiatr Res. 2018 Sep;104:235-248. doi: 10.1016/j.jpsychires.2018.08.001. Epub 2018 Aug 3. PMID: 30114665.
- Wang Z, Liu J, Shuai H, Cai Z, Fu X, Liu Y, Xiao X, Zhang W, Krabbendam E, Liu S, Liu Z, Li Z, Yang BX. Mapping global prevalence of depression among postpartum women. Transl Psychiatry. 2021 Oct 20;11(1):543. doi: 10.1038/s41398-021-01663-6. Erratum in: Transl Psychiatry. 2021 Dec 20;11(1):640. PMID: 34671011; PMCID: PMC8528847.
- Ghaedrahmati M, Kazemi A, Kheirabadi G, Ebrahimi A, Bahrami M. Postpartum depression risk factors: A narrative review. J Educ Health Promot. 2017;6:60. Published 2017 Aug 9. doi:10.4103/jehp.jehp_9_16
- Dennis CL, Hodnett ED. Psychosocial and psychological interventions for treating postpartum depression. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD006116. DOI: 10.1002/14651858.CD006116.pub2. Accessed 02 May 2022.
- Werner E, Miller M, Osborne LM, Kuzava S, Monk C. Preventing postpartum depression: review and recommendations. Arch Womens Ment Health. 2015 Feb;18(1):41-60. doi: 10.1007/s00737-014-0475-y. Epub 2014 Nov 25. PMID: 25422150; PMCID: PMC4308451.
- Cramer H, Lauche R, Klose P, Lange S, Langhorst J, Dobos GJ. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database Syst Rev. 2017 Jan 3;1(1):CD010802. doi: 10.1002/14651858.CD010802.pub2. PMID: 28045199; PMCID: PMC6465041.
- Smith CA, Armour M, Lee MS, Wang LQ, Hay PJ. Acupuncture for depression. Cochrane Database of Systematic Reviews 2018, Issue 3. Art. No.: CD004046. DOI: 10.1002/14651858.CD004046.pub4. Accessed 08 May 2022.
- Tang Q, Huang Z, Zhou H, Ye P. Effects of music therapy on depression: A meta-analysis of randomized controlled trials. PLoS One. 2020 Nov 18;15(11):e0240862. doi: 10.1371/journal.pone.0240862. PMID: 33206656; PMCID: PMC7673528.