Effectiveness of prenatal yoga on pregnant women's anxiety and duration of labour

Diyan Indrayani; Titi Legiati; Chris Sriyanti

doi:10.4081/hls.2023.11763

Authors

Diyan Indrayani
diyan.indrayani@gmail.com
Midwifery Departement, Ministry of Health Bandung Health Polytechnic, Bandung, Indonesia.
Titi Legiati Midwifery Departement, Ministry of Health Bandung Health Polytechnic, Bandung, Indonesia.
Chris Sriyanti Midwifery Departement, Ministry of Health Bandung Health Polytechnic, Bandung, Indonesia.

The birth process involves physical and psychological mechanisms. Anxiety creates physical and psychological tension, interfering with the birth process. The study aimed to analyze the effectiveness of Yoga on pregnant women's an’iety and labor duration. This study used an experimental design with a Randomized Controlled Trial (RCT) involving 60 pregnant women divided into two groups: Yoga and walking (30 participants each). The variables studied were pregnant women's anxiety and the duration of labor. The sampling technique was conducted using block randomization. Data were analyzed using the Independent T-test. The Yoga group attended 30-minute sessions twice weekly, while the walking group engaged in the same frequency and duration of walking until giving birth. Anxiety levels were measured using the Hamilton Anxiety Rating Scale (HARS) before and one month after the intervention in both groups. The duration of labor was measured using partographs and medical records during delivery for both groups. Data were analyzed using the Shapiro-Wilk test and independent t-test. Pregnant women in both the Yoga and walking groups experienced reduced anxiety scores, with a decrease of 11.6%, and statistically significant p-values of <0.05. The duration of labor was significantly shorter in the Yoga group (mean: 2.65 hours, SD: 1.01) compared to the walking group (mean: 4.01 hours, SD: 2.54), with a mean difference of 1.36 hours and a p-value of <0.05. Prenatal Yoga in the third trimester reduces pregnant women's an’iety and shortens the duration of labor. It can be suggested as an alternative exercise for pregnant women to improve maternal health during pregnancy and childbirth.

Anggreni D, Notobroto HB, Soedirham O. Determinant factors of early marriage in developing countries: a literature review. J Public Health Afr 2023;14:2543. DOI: https://doi.org/10.4081/jphia.2023.2543

Silmi MA, Achmad GNV, Puspitasari HP. Validation of stress assessment instruments related to the COVID-19 pandemic in pregnant women. Pharm Educ 2022;22:129–31. DOI: https://doi.org/10.46542/pe.2022.222.129131

Budiman MEA, Sari SNJ, Kusumawardani W, Sutopo D. Strategy Intervention to Prevent and Reduce Postpartum Depression: A Systematic. J Ners 2019;14. DOI: https://doi.org/10.20473/jn.v14i3.17149

King TL, Brucker MC, Osborne K, Jevitt CM. Varney’s Midwifery. 6th ed. Jones & Bartlett Learning; 2019.

Diana R, Chistianti DF, Anwar F, Kusuma R, Rachmayanti RD, Khomsan A. Food suggestions, meal frequency, and dietary diversity among pregnant women: A quantitative study in Madura. Futur Food J Food Agric Soc 2020;8:1–12. DOI: https://doi.org/10.1155/2019/2647230

Herawati C, Suwandono A, Putra ST, Rahmi FL, Syukur MA, Sakti H, et al. Effect of psychoeducation-modification on the improvement of spiritual response, perception stigma, anxiety level and cortisol levels among lepers. Indian J Public Heal Res Dev 2019;10:1873–8. DOI: https://doi.org/10.5958/0976-5506.2019.03826.9

Akinloye O, Obikoya O, Jegede A, et al. Cortisol plays central role in biochemical changes during pregnancy. Int J Med Biomed Res 2013;2:3–12. DOI: https://doi.org/10.14194/ijmbr.212

Rumaseuw R, Berliana SMM, Nursalam N, et al. Factors Affecting Husband Participation in Antenatal Care Attendance and Delivery. In: M.A. R, editor. 3rd International Conference on Tropical and Coastal Region Eco Development 2017 [Internet]. Badan Pusat Statistik, Supiori District of Papua Province, Indonesia: Institute of Physics Publishing; 2018. Available from: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85043685035&doi=10.1088%2F1755-1315%2F116%2F1%2F012012&partnerID=40&md5=8ddc4c8cf33a374c97a6f6db26d49fb8

Diana S, Wahyuni CU, Prasetyo B. Maternal complications and risk factors for mortality. J Public Health Res 2020;9:195–8. DOI: https://doi.org/10.4081/jphr.2020.1842

Yunitasari E, Matos F, Zulkarnain H, et al. Pregnant woman awareness of obstetric danger signs in developing country: systematic review. BMC Pregnancy Childbirth 2023;23:357. DOI: https://doi.org/10.1186/s12884-023-05674-7

Warburton DER, Nicol CW, Bredin SSD. Health benefits of physical activity: the evidence. C Can Med Assoc J 2006;174:801–9. DOI: https://doi.org/10.1503/cmaj.051351

Kwon R, Kasper K, London S, Haas DM. A systematic review: The effects of yoga on pregnancy. Eur J Obstet Gynecol Reprod Biol 2020;250:171–7. DOI: https://doi.org/10.1016/j.ejogrb.2020.03.044

Albers LL, Anderson D, Cragin L, et al. The relationship of ambulation in labor to operative delivery. J Nurse Midwifery 1997;42:4–8. DOI: https://doi.org/10.1016/S0091-2182(96)00100-0

Nur A, Kusnanto K, Amin M, et al. The Effect of Combination Pranayama Yoga and Endurance Training Exercise on Peak Expiratory Flow (PEF) in Adult Asthmatic Patients. J Keperawatan Padjadjaran 2020;8:136–49. DOI: https://doi.org/10.24198/jkp.v8i2.1350

Shivakumar G, Brandon AR, Snell PG, et al. Antenatal depression: a rationale for studying exercise. Depress Anxiety 2011;28:234–42. DOI: https://doi.org/10.1002/da.20777

Mohyadin E, Ghorashi Z, Molamomanaei Z. The effect of practicing yoga during pregnancy on labor stages length, anxiety and pain: a randomized controlled trial. J Complement Integr Med 2020;18:413–7. DOI: https://doi.org/10.1515/jcim-2019-0291

Bolanthakodi C, Raghunandan C, Saili A, et al. Prenatal Yoga: Effects on Alleviation of Labor Pain and Birth Outcomes. J Altern Complement Med 2018;24:1181–8. DOI: https://doi.org/10.1089/acm.2018.0079

Ding W-E, Tan K-A, Fam J-Y, et al. Psychometric evaluation of the Malay version of the multidimensional Beck Youth Inventories-2 (BYI-2 Malay): Measuring self-concept, anxiety, depression, anger, and disruptive behaviour among adolescents in sheltered homes. Pertanika J Soc Sci Humanit 2021;29:249–65. DOI: https://doi.org/10.47836/pjssh.29.1.15

Bailey R, Sweeney R. Principles and strategies of inclusive physical activity: a European Delphi study. J Public Heal 2022; https://doi.org/10.1007/s10389-022-01770-8 DOI: https://doi.org/10.1007/s10389-022-01770-8

Patel G, Lokhande JN, Pathak Y V. Importance of Integrative Health Sciences in Antiaging Nutraceutical Development. In: Nutraceuticals for Aging and Anti-Aging: Basic Understanding and Clinical Evidence. Indus Extracts, Carson, CA, United States: CRC Press; 2021. p. 27–34. DOI: https://doi.org/10.1201/9781003110866-2

Dwi S, Putri Y, Handayani S, et al. Social support with anxiety of pregnant mothers in trimester iii facing labor in the time of the covid-19 pandemic in 2022. J Aisyah J Ilmu Kesehat 2022;7:349–54. DOI: https://doi.org/10.30604/jika.v7iS2.1547

Rong L, Dai L-J, Ouyang Y-Q. The effectiveness of prenatal yoga on delivery outcomes: A meta-analysis. Complement Ther Clin Pract 2020;39:101157. DOI: https://doi.org/10.1016/j.ctcp.2020.101157

Gong H, Ni C, Shen X, et al. Yoga for prenatal depression: a systematic review and meta-analysis. BMC Psychiatry 2015;15:14. DOI: https://doi.org/10.1186/s12888-015-0393-1

Kusaka M, Matsuzaki M, Shiraishi M, Haruna M. Immediate stress reduction effects of yoga during pregnancy: One group pre-post test. Women Birth 2016;29:e82–8. DOI: https://doi.org/10.1016/j.wombi.2016.04.003

Laksono AD, Wulandari RD, Rukmini R. The determinant of healthcare childbirth among young people in Indonesia. J Public Health Res 2021;10:28–34. DOI: https://doi.org/10.4081/jphr.2021.1890

Putri AMS, Mahindra MP, Mapindra MP, et al. Effectiveness of Participation in Pregnancy Classes to Reduce the Incidence of Obstetric Labor Complications and Cesarean Section. Indones J Obstet Gynecol 2022;10:229–34. DOI: https://doi.org/10.32771/inajog.v10i4.1548

Yudhawati R, Mariani Rasjid HS. Effect of yoga on FEV1, 6-minute walk distance (6-MWD) and quality of life in patients with COPD group B. Adv Respir Med 2019;87:261–8. DOI: https://doi.org/10.5603/ARM.2019.0047

Curtis K, Weinrib A, Katz J. Systematic review of yoga for pregnant women: current status and future directions. Evid Based Complement Alternat Med 2012;2012:715942. DOI: https://doi.org/10.1155/2012/715942

Dewi ES. Pengaruh Kombinasi Yoga Prenatal dan Senam Hamil terhadap Perubahan Kadar Kortisol dan Lama Persalinan Kala I. J Ilm Bidan 2016;1:7–13.

Rahayu NI, Amalia TP, Damayanti I. Effect of Yoga Physical Activity on Increasing Self-Control and Quality of Life. KEMAS J Kesehat Masy 2020;15(3). DOI: https://doi.org/10.15294/kemas.v15i3.22740

Dewi KI, Andriani M. The level of nutritional adequacy, physical activities, and body endurance. Int J Pharm Res 2020;12:1480–4. DOI: https://doi.org/10.31838/ijpr/2020.12.04.208

Curzik D, Jokic-Begic N. Anxiety sensitivity and anxiety as correlates of expected, experienced and recalled labor pain. J Psychosom Obstet Gynaecol 2011;32:198–203. DOI: https://doi.org/10.3109/0167482X.2011.626093

Rusmita E. Pengaruh Senam Hamil Yoga Terhadap Persalinan Di Rsia Limijati Bandung. J Ilmu Keperawatan 2015;III:80–6.

Masoudi Z, M A. The effects of decreasing maternal anxiety on fetal oxygenation and nucleated red blood cells count in the cord blood. Iran J Pediatr 2014;24:285-92.

Udayani W, Amin M, Makhfudli. The Effect of Combination of Buteyko Breathing Technique and Walking Exercise on Forced Peak Expiratory Flow In Adult Asthmatic Patients. J Keperawatan Padjadjaran 2019;7:190–9. DOI: https://doi.org/10.24198/jkp.v7i2.1193

Renuka K, Devi MA. Yoga in pregnancy. Pondicherry J Nurs 2020;13:96–100. DOI: https://doi.org/10.5005/jp-journals-10084-12158

Pratiwi IN, Pradanie R, Setyawati N, Ramoo V. Factors associated with behavior of reducing anxiety in pregnant women during COVID-19 pandemic. J Public Heal Emerg 2023;7:18. DOI: https://doi.org/10.21037/jphe-22-60

Campbell V, Nolan M. “It definitely made a difference”: A grounded theory study of yoga for pregnancy and women’s self-efficacy for labour. Midwifery 2019;68:74–83. DOI: https://doi.org/10.1016/j.midw.2018.10.005

Yekefallah L, Namdar P, Dehghankar L, et al. The effect of yoga on the delivery and neonatal outcomes in nulliparous pregnant women in Iran: a clinical trial study. BMC Pregnancy Childbirth 2021;21:351. DOI: https://doi.org/10.1186/s12884-021-03794-6

Suananda Y. Prenatal-postnatal yoga. Jakarta: PT Kompas Media Nusantara; 2018.

Japutra A, Tjiptono F, Setyawan A, Permana IBGA, Widaharthana IPE. Life events, philosophy, spirituality and gastronomy experience. Int J Contemp Hosp Manag 2022;34:3210–29. DOI: https://doi.org/10.1108/IJCHM-09-2021-1196

Siccardi M, Valle C, Angius V, Di Matteo F. Estimating the Mobility of the Michaelis Sacral Rhombus in Pregnant Women. Cureus 2020;12:e7116. DOI: https://doi.org/10.7759/cureus.7116

Lawrence A, Lewis L, Hofmeyr GJ, et al. Maternal positions and mobility during first stage labour. Cochrane Database Syst Rev 2009;2:CD003934. DOI: https://doi.org/10.1002/14651858.CD003934.pub2

Indrayani, D., Legiati, T., & Sriyanti, C. (2023). Effectiveness of prenatal yoga on pregnant women’s anxiety and duration of labour. Healthcare in Low-Resource Settings, 11(2). https://doi.org/10.4081/hls.2023.11763