Table 2 Elements of the adapted MBCP program
Class | Key concepts | Formal mindfulness practices | Interpersonal mindfulness practices | Formal home practices | Informal home practices |
|---|---|---|---|---|---|
1 | Participants learn how present moment awareness during labor and delivery can support the normal physiology of childbirth and may help develop a healthy, compassionate relationship between parent and child and between partners | Raisin meditation Awareness of Breathing meditation | Group sharing about personal and interpersonal changes in pregnancy provides couples the opportunity to normalize the stresses they may be experiencing and start creating a safe and nurturing environment among the participants | 15-min Awareness of Breathing practice with audio recordings | Participants are encouraged to bring present moment awareness to routine activities of daily living, such as walking, taking a shower, driving, brushing their teeth, and preparing meals. This practice begins to set the foundation for a more responsive and less reactive parenting |
2 | Guided reflection about the motivation to participate in the intervention provides expectant parents an opportunity for sharing hopes and fears about pregnancy, childbirth, and parenting The Body Scan is introduced as a tool that helps participants to: • increase body awareness; • learn to be with sensations that are pleasant, unpleasant, and neutral; • experience the impermanence of physical sensations; • notice reactivity regarding thoughts and emotions in relation to physical sensations; • connect with the unborn baby; • begin to develop the skill of uncoupling the sensory component of pain from its emotional and cognitive components | Awareness of Breathing meditation Body Scan Being with Baby practice | Group sharing about guided reflection and group inquiry after Body Scan meditation promotes participant’s feelings of connection and common humanity | Continue Awareness of Breathing 5–10 min every day (with or without audio recordings). 30-min Body Scan with audio recordings | Continue Mindfulness of Routine Activities Practice of Being with Baby throughout the day, using the sensations from the baby’s movements as an opportunity and a reminder to come back to the body and the present moment |
3 | Participants learn - how fearful anticipations of pain may trigger a cascade of adverse stress reactions that can negatively affect the process of childbirth through the mind–body pathways of the neuroendocrine system - how mindfulness supports the normal physiology of labor with an attitude of acceptance and openness - the difference between primary and secondary suffering and how mindfulness helps participants be with the intense physical sensations of childbirth without adding the secondary suffering of reactivity - that moments between contractions can be experienced with equipoise and calm rather than with fear or worry about future pain or negative memories of past pain | Awareness of Breathing Meditation Compassionate Body Scan | Sharing in small groups of three or four about participant’s experiences practicing the Body Scan facilitates participants connecting at deeper levels as a community of practice Large group inquiry to share experiences practicing the Body Scan at home encourages participants to address and normalize common challenges | Continue Awareness of Breathing 5–10 min every day (with or without audio recordings) 30-min Body Scan with audio recordings | Continue Mindfulness of Routine Activities Continue Being with Baby practice Pleasant Events Calendar |
4 | Mindful Yoga adapted to pregnancy is introduced for the first time Noticing sensations of stretching and contracting and paying attention to the times of ease between poses prepares participants for noticing sensations of contracting and the moments of ease between contractions during childbirth Phrases from Loving-kindness practice during ice pain practice are also introduced. This practice may be especially useful for partners, who can sometimes experience empathic distress and feel helpless to alleviate their pregnant partner’s pain during labor | Sitting Meditation Yoga Practice Pain Practice with ice cubes to induce unpleasant sensations. A variety of mindfulness practices are offered, including - Breath awareness - Focusing attention directly on the unpleasant physical sensations - Moving awareness back and forth between sensations in the hand and the breath - Counting breaths - Turning up the corners of the mouth - Visualizing an image of a baby - Abiding in a safe place - Practicing a Body Scan between “ice sensations.” - Expanding awareness to the body as a whole, noticing where painful sensations are not present and how much of the body is not in pain | Large group inquiry and small group sharing about pleasant events in daily life during the week. Partners are also taught the pain practices in order to let them understand from their own experience how to offer labor support with calm and ease | Continue Awareness of Breathing practice 5–10 min every day Alternate yoga with the Body Scan Participants are encouraged to do at least one sequence of pain practices for 20–30 min, alternating 1-min holding ice using a variety of options with 1.5 min of Awareness of Breathing between the “ice contractions” | Continue Being with Baby practice Continue Mindfulness of Routine Activities, bringing awareness directly to any stress reactions (the contractions of life) experienced during the week Informal Pain Practice: Bring attention to any physical discomforts such as back pain, sciatica, shortness of breath, or heartburn. Practice being with whatever sensations are present, even if they are unpleasant or challenging Unpleasant Events Calendar |
5 | During the ice practice, both partners receive instruction for using mindful, compassionate touch and also experiment with various postures that might be used during labor, such as child’s pose, side lying, gently rocking side to side or back and forth while standing or sitting These practices may be very beneficial for partners for supporting pregnant women during childbirth contractions | Sitting Meditation, including sound as an object of awareness Mindful Yoga 3 Step Breathing Space Pain Practice 2: Working with partners using compassionate touch | Small and large group inquiry about participants’ experiences with mindfulness and compassion practices and the observations regarding pleasant and unpleasant experiences from the home practice of keeping the pleasant and unpleasant events calendars. Exploration of topics such as reacting or responding, desire and attachment, aversion and resistance and their relationship to secondary suffering in childbirth, parenting, and any experience in life | Continue Awareness of Breathing practice 5–10 min every day Continue to alternate yoga with the Body Scan Participants are encouraged to do at least one sequence of pain practices for 20–30 min, adding compassionate touch practices with their partner, making sure each of them has a turn being touched and touching and discovering what is useful for them | Continue Being with Baby practice. Continue Mindfulness of Routine Activities. Continue informal pain practice when physical discomforts arise in everyday life. Mindful Pooping for both expectant parents. 3 Step Breathing Space several times each day |
6 | Introduction to vocalizing low-pitched sounds as a way to focus attention and to work with intense body sensations during the ice practice Couples are encouraged to use all the previous practices they have learned in classes 4 and 5 to cope with the intense sensations of “ice contractions” | Sitting Meditation, including thoughts, emotions and choiceless awareness Mindful Yoga 3 Step breathing space Pain Practice 3: Full Immersion in very cold water | Teaching about causes and conditions and using mindful awareness for making wise choices in childbirth such as selection of a care provider and place of delivery Participants learn that the future is unknown, and there is no one “correct way” to give birth and that with continued practice they will have a variety of skills to work with pain and whatever may come during the birth process | Alternate sitting meditation with either the Body Scan or yoga One sequence of pain practices for 20–30 min integrating all the tools learned in classes 4, 5, and 6 | Continue Awareness of Breathing practice 5–10 min every day and/or 3 Step Breathing Space Continue Being with Baby practice Continue Mindfulness of Routine Activities, including mindful pooping Continue informal pain practice when physical discomforts arise in daily life |
7 | Participants learn how mindfulness can help them cope with the biological, emotional, and social needs of a newborn and challenges that may appear during the postpartum period. Fears about the future and how to foster happiness and wellbeing in one’s self and one’s partners are addressed in an interpersonal mindful speaking and listening inquiry. A practice of self-compassion is introduced for the first time here | Sitting meditation Mindful Yoga 3 Step Breathing Space Loving-kindness meditation (including baby, oneself, partner, loved ones, all babies, and parents in the room, a neutral person, a difficult person, and finally all beings everywhere) Walking meditation Mindful speaking and listening inquiry Self-compassion meditation | Large group inquiry exploring participants’ experiences of Loving-kindness and self-compassion practices Interpersonal mindful speaking and listening inquiry between partners. This practice promotes an experience of feeling the authentic presence of the other person, of being seen and heard, as a valuable skill for parenting and partnership | Sitting Meditation with audio recordings. Alternate with either the Body Scan or yoga One sequence of pain practices for 20–30 min, integrating all the tools learned in classes 4, 5, and 6 | Continue Awareness of Breathing practice 5–10 min every day. Continue Being with Baby practice. Experiment with adding phrases of Loving-kindness to this practice. Continue Mindfulness of Routine Activities, including mindful pooping. Continue informal pain practice when physical discomforts arise in everyday life Participants are encouraged to begin bringing attention to how they will find support for themselves as a newly birthed family during the early postpartum period 3 Step Breathing Space: several times throughout the day, particularly when feeling stress, as a preparation for postpartum there will probably be less time for formal meditation practice |
8 | Participants learn how the continued practice of mindfulness and compassion skills during postpartum may - promote resonance, attachment and bonding with the baby; - support the normal physiology of breastfeeding; - help to alleviate the stress of sleep deprivation and meeting the needs of a newborn Symptoms of postpartum blues and depression in both women and men are reviewed, including how to obtain help from a health provider if necessary. Course review and closing ceremony | Sitting Meditation, including thoughts, emotions and choiceless awareness Mindful yoga 3-Step Breathing Space Loving-kindness final meditation | Reflections on what participants have learned throughout the program and final sharing with mindful listening and speaking Participants are encouraged to continue their practice and, if possible, to continue to meet after the formal course ends, forming a community of support for sustaining the practice of living and parenting mindfully | Participants are invited to practice meditation for 30 min each day without the audio recordings in the coming weeks They are also encouraged to continue to incorporate Loving-kindness and self-compassion into their formal practice and daily life | Continue Awareness of Breathing 5–10 min every day Continue Being with Baby practice. Experiment with adding phrases of Loving-kindness to this practice Continue Mindfulness of Routine Activities, including mindful pooping Continue informal pain practice when physical discomforts arise in everyday life Pay attention to bringing mindfulness into communication with others (mindful speech) Continue practicing the 3-Step Breathing Space |
9 | The class reunion that takes place 3 months after birth is an opportunity for the new parents to reconnect, to meet each other’s babies, and to reflect on what they learned from their birth experience Participants are invited to share how they are applying mindfulness and compassion skills in parenting, how they are growing together as new parents and to express appreciation to and about their partner and themselves Postpartum blues and depression and challenges in breastfeeding are also addressed, including how to seek help from a health provider if necessary | 10-min practice of sitting meditation with babies 10-min practice of loving kindness meditation and self-compassion meditation with babies | Large group sharing about how they applied mindfulness and compassion practices to their experiences of birth and how they are using these practices to help them cope with postpartum challenges. Participants are again encouraged to continue to meet to support their ongoing use of mindfulness and compassion practice as a foundation for living and parenting mindfully | 3-Step Breathing Space several times a day when possible Self-compassion and loving-kindness practice when possible | Continue informal practice while breastfeeding, taking care of their baby, and doing daily activities Participants are encouraged to do some formal practice or return to formal practice as their babies grow |
10 | This class takes place as a reunion 6 months after giving birth. Participants share how to apply mindfulness and compassion skills to - the challenges of postpartum and breastfeeding; - going back to work; - finding childcare; - adapting to their new roles, including the changes in their relationship as a couple and with their families of origin | 10-min practice of sitting meditation with babies 10-min practice of Loving-kindness meditation and self-compassion meditation with babies | Large group sharing about their experiences of parenting and how they are using mindfulness and compassion practices creatively in this period of their lives | 3-Step Breathing Space several times a day when possible Self-compassion and loving-kindness practice when possible | Continue informal practice while breastfeeding, taking care of the baby, at work and doing daily activities Participants are encouraged to do some formal practice or return to formal practice as their babies grow |