Guided Imagery Reduces Anxiety During Pregnancy & Labor
Researchers from the Pediatrics Department of Université Laval in Québec, Canada, reviewed the literature to assess the benefits of mind-body interventions during pregnancy for preventing or treating women's anxiety and in influencing perinatal outcomes.
They searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 November 2010), MEDLINE (1950 to 30 November 2010), EMBASE (1974 to 30 November 2010), the National Center for Complementary and Alternative Medicine (NCCAM) (1 December 2010), ClinicalTrials.gov (December 2010) and Current Controlled Trials (1 December 2010), along with reference lists of selected studies and contacting professionals and authors in the field.
For inclusion, studies needed to be randomized controlled trials, involving pregnant women of any age at any time from conception to one month after birth, comparing mind-body interventions with a control group. Mind-body interventions include: autogenic training, biofeedback, hypnotherapy, imagery, meditation, prayer, auto-suggestion, tai-chi and yoga. Control group could include standard care, other pharmacological or non-pharmacological interventions, other types of mind-body interventions or no treatment at all.
Eight trials met the criteria (556 participants), evaluating hypnotherapy (one trial), guided imagery (five trials), autogenic training (one trial) and yoga (one trial). Due to the small number of studies per intervention and to the diversity of outcome measurements, the investigators performed no meta-analysis, and instead reported results individually for each study.
Compared with usual care, in one study (133 women), guided imagery had a positive effect on anxiety during labor, decreased anxiety at the early and middle stages of labor (MD -1.46; 95% CI -2.43 to -0.49; one study, 133 women) and (MD -1.24; 95% CI -2.18 to -0.30). Another study showed that guided imagery had a positive effect on anxiety and depression in the immediate postpartum period. Autogenic training was effective for decreasing women's anxiety before delivering.
The authors conclude that mind-body interventions may benefit women's anxiety during pregnancy. Based on individual studies, there is some evidence for the effectiveness of mind-body interventions and especially guided imagery, for the management of anxiety during pregnancy. The main limitations of the studies were the lack of blinding and insufficient details on the methods used for randomization.
Citation: Marc I, Toureche N, Ernst E, Hodnett ED, Blanchet C, Dodin S, Njoya MM. Mind-body interventions during pregnancy for preventing or treating women's anxiety. Cochrane Database Syst Rev. 2011 Jul 6;(7)