Effectiveness of Mindfulness-Based Interventions for Fear of Childbirth Among Pregnant Women Planned for Normal Birth: A Systematic Review and Meta-Analysis

Abstract

Background: Fear of childbirth is common among pregnant women. Mindfulness-based interventions have been used widely in obstetrics. However, the evidence of the effects on fear of childbirth is controversial. Aims: To evaluate the effects of mindfulness-based interventions on fear of childbirth, pain catastrophising, labour pain intensity, use of pain relief medication, mode of delivery and duration of labour among pregnant women planned for normal delivery. Methods: In this systematic review, 10 databases were searched from inception to 7 November 2024. Randomized controlled trials implementing mindfulness-based interventions for fear of childbirth or related outcomes were included. Two reviewers assessed the methodological quality and certainty of evidence independently. Standardized mean difference (SMD), risk ratio (RR), and 95% confidence intervals (CI) were used to evaluate effect sizes. Results: A total of 16 studies from 15 trials were included. Based on very low to moderate certainty of evidence, mindfulness-based interventions were effective in decreasing fear of childbirth both immediately post-intervention and within 6-week postpartum (SMD: −0.72; 95% CI −0.89, −0.55; SMD: −0.63; 95% CI −0.91, −0.35, respectively), labour pain intensity (SMD: −1.22; 95% CI −2.07, −0.37), caesarean section rate (RR: 0.58; 95% CI 0.36, 0.93), and total duration of labour (SMD: −1.03; 95% CI −1.34, −0.72), and improving mindfulness level both immediately post-intervention and within six-week postpartum (SMD: 0.48; 95% CI 0.31, 0.66; SMD: 0.50; 95% CI 0.27, 0.73, respectively), but had no significant effect on pain catastrophising (SMD: −0.36; 95% CI −0.72, 0.01) and epidural analgesia use rate (RR: 0.77; 95% CI 0.57, 1.03). Linking Evidence to Action: Mindfulness-based interventions have potential effects on reducing fear of childbirth and promoting labour-related outcomes. These interventions might be an effective approach in obstetrics clinical practice to enhance the pregnancy and labour experiences among pregnant women. Trial Registration: PROSPERO registration number: CRD42024610793.