The relational dimension in mindfulness intervention effects: results of a randomized controlled trial of mindfulness-based childbirth and parenting.

Prenatal mindfulness training improves relational outcomes only for birthing-people with lower sociodemographic risk but elevated anxiety at baseline, and for those who practice mindfulness more during and after the class. In a randomized controlled trial comparing Mindfulness-Based Childbirth and Parenting (MBCP) with community birthing classes, a main effect favoring MBCP appeared only on parenting stress. Moderation analyses showed significant benefits of MBCP on individual outcomes (dispositional mindfulness, mental health, parenting stress) and relational outcomes (mindfulness in parenting, compassion, bonding with fetus/infant) for higher-risk anxious participants and for those with greater mindfulness practice dosage. The findings clarify that relational benefits depend on baseline risk characteristics and practice engagement, guiding targeted adaptation of mindfulness interventions for diverse families.

Study at a glance

Abstract

Although secular mindfulness interventions draw from contemplative traditions emphasizing relationality, evidence for impacts of such interventions on relational outcomes remains inconsistent. This study was designed to clarify conditions under which mindfulness training can improve relational functioning in a perinatal context where quality of relationship-building carries particularly important consequences for intergenerational health. We used a randomized controlled trial to test effects of prenatal participation in Mindfulness-Based Childbirth and Parenting (MBCP) vs. community birthing classes on trajectories of anxious birthing-people's individual (dispositional mindfulness, mental health, parenting stress) and relational (mindfulness in parenting, compassion, bonding with the fetus/infant) functioning across pre-intervention, post-intervention, and 3-month postnatal follow-up assessments. Multilevel growth curve models examined both main effects of intervention and moderation by participants' baseline risk and mindfulness dosage. We found a main effect favoring MBCP on parenting stress only. Moderation models revealed significant effects of MBCP in predicted directions on both individual and relational outcomes for birthing-people with lower sociodemographic risk but elevated anxiety at baseline, as well as for those who engaged more with mindfulness practice both during and following the class. This study shows relational benefits of prenatal mindfulness training depend on birthing-people's baseline risk characteristics and practice dosage. Insight into sources of differential impact can guide further targeting and adapting mindfulness interventions to better support well-being in diverse families. This study was registered prospectively at ClinicalTrials.gov ID NCT05241600 (protocol identifier 19,461 starting 12/1/2018 at IL site and identifier 19,138 starting 1/26/2022 at PA site).