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The Effect of Mindfulness-Based Stress Reduction Training Given to Young Girls Experiencing Fear of Childbirth on Fear of Childbirth, Coping Strategies with Stress, and State Anxiety Levels

This study demonstrates that a six-session Mindfulness-Based Stress Reduction (MBSR) training program significantly reduces fear of childbirth and state anxiety while improving stress coping strategies among young girls compared to a control group.

Original authors: HACER UNVER KOCA, FADİME BİÇER ŞAHİN, ZEYNEP UNVER, LALE UNVER AYDIN, FUNDA KAVAK BUDAK

Published 2026-07-08

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CC BY 4.0

Original authors: HACER UNVER KOCA, FADİME BİÇER ŞAHİN, ZEYNEP UNVER, LALE UNVER AYDIN, FUNDA KAVAK BUDAK

Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). ✨ This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer

The Big Picture: Training the Mind Before the Storm

Imagine that childbirth is like a massive, unpredictable storm. For many young women who haven't experienced it yet, the mere thought of this storm creates a heavy fog of fear. They worry about the pain, losing control, or things going wrong. This isn't just "nervousness"; it's a deep-seated anxiety that can make them want to avoid the storm entirely or demand a different, safer path (like a scheduled C-section) just to feel safe.

This study asked a simple question: Can we teach young women a mental "survival kit" to clear that fog before the storm even arrives?

The researchers tested a specific toolkit called Mindfulness-Based Stress Reduction (MBSR). Think of MBSR not as a magic spell that makes the storm disappear, but as a pair of high-tech goggles and a compass. It teaches you how to look at the storm without panicking, how to breathe through the wind, and how to stay steady when everything feels shaky.

The Experiment: Two Groups of Students

The researchers gathered 116 young female university students who admitted they were afraid of childbirth. They split them into two teams:

The Training Team (Experimental Group): These 58 students went through a 6-week course. It was like a "Mind Gym." They met twice a week for 50 minutes.
- What they did: They learned about how birth works, practiced breathing exercises, learned how to relax their muscles, did mindfulness yoga, and practiced meditation. They learned to observe their scary thoughts without letting those thoughts take the wheel.
The Waiting Team (Control Group): These 58 students did nothing special. They just went about their normal lives. This group served as a baseline to see if the fear would go away on its own (spoiler: it didn't).

The Results: The Difference Between the Teams

After the 6 weeks, the researchers checked the "fear meters," "anxiety meters," and "coping meters" for both groups. Here is what happened:

Fear of Childbirth:
- The Waiting Team: Their fear levels stayed exactly the same. The fog remained thick.
- The Training Team: Their fear levels dropped significantly. It's as if the MBSR training acted like a windshield wiper, clearing away the panic. They went from being terrified to being much more calm about the idea of birth.
Anxiety Levels:
- The Waiting Team: Their general anxiety stayed high.
- The Training Team: Their anxiety levels took a nosedive. They felt much more relaxed and less jittery.
Coping Strategies (How they handle stress):
- The Waiting Team: They didn't change how they handled stress.
- The Training Team: They became much better at dealing with problems. They learned two new ways to fight stress:
  1. Problem-Focused: Instead of worrying, they started thinking, "Okay, what is the problem, and what can I actually do about it?"
  2. Emotion-Focused: Instead of getting overwhelmed by feelings, they learned to manage their emotions so they didn't crash.
- The Analogy: Before the training, these students were like sailors trying to steer a ship in a storm by screaming and holding their breath. After the training, they were like skilled captains who knew how to adjust the sails and steer through the waves.

What the Researchers Concluded

The study concluded that giving young women this "Mind Gym" training works. It successfully:

Lowered their fear of childbirth.
Reduced their state of anxiety.
Gave them better tools to handle stress.

The researchers emphasize that this is important because fear of childbirth can lead to difficult births, more medical interventions, and even depression after the baby is born. By teaching these skills before a woman even gets pregnant, we might be able to prevent those future problems.

The Fine Print (Limitations)

The authors were honest about the limits of their study:

The Sample: They only tested university students in one city in Turkey. We don't know if this works for older women, women in different cultures, or women who are already pregnant.
The Time: They only checked the results immediately after the training. They didn't check back in six months or a year to see if the students remembered these skills.
The Scope: The study focused only on "young girls" (students), so we can't say for sure how it affects everyone else.

In short: This paper shows that teaching young women to be mindful—like learning to surf the waves of fear rather than drowning in them—can significantly reduce their terror of childbirth and make them better at handling stress.

Technical Summary: The Effect of Mindfulness-Based Stress Reduction Training on Fear of Childbirth, Coping Strategies, and State Anxiety in Young Girls

Problem Statement
Fear of childbirth (FOC) is a multifaceted psychological condition characterized by anxiety and uncertainty that can adversely affect a young woman's daily life, adaptation to pregnancy, and attitudes toward delivery. While mild fear is considered adaptive, moderate to high levels can become pathological, leading to increased requests for cesarean sections, prolonged labor, and higher risks of postpartum depression and post-traumatic stress disorder. Despite Turkey having the highest cesarean section rates globally, research specifically targeting the pre-pregnancy period in young women is limited. Existing literature predominantly focuses on pregnant women, leaving a gap in understanding how preventive mental health interventions, specifically Mindfulness-Based Stress Reduction (MBSR), can shape the perceptions, coping mechanisms, and anxiety levels of young girls before they conceive.

Methodology
This study employed an experimental design with a pretest-posttest control group structure.

Participants: The sample consisted of 116 female students (58 in the experimental group, 58 in the control group) from the Faculties of Nursing and Health Sciences at İnönü University. Participants were selected via computer-aided simple random sampling and were required to demonstrate fear of childbirth via the Fear of Childbirth Scale. Exclusion criteria included physical or mental health issues hindering training.
Intervention: The experimental group underwent a 6-week MBSR training program, conducted twice weekly for 50 minutes per session. The training was structured into eight sessions covering: preparation, physiology of childbirth, fear definition, stress-coping techniques, breathing exercises, relaxation techniques, mindfulness-based yoga, and mindfulness meditation. The control group received no intervention.
Data Collection: Data were gathered using four instruments: a Participant Information Form, the Pre-pregnancy Fear of Childbirth Scale (Stoll et al., 2016), the State Anxiety Inventory (Spielberger et al., 1970; adapted by Öner and Le Compte, 1983), and the Coping Styles with Stress Scale (Şahin and Durak, 1995).
Analysis: Statistical analysis was performed using SPSS 22.0. Paired-sample t-tests were used for dependent groups, and independent-sample t-tests were used for independent groups, with a significance level set at $p < 0.05$ .

Key Results
The study yielded statistically significant differences between the experimental and control groups following the intervention:

Fear of Childbirth (FOC): The experimental group showed a significant reduction in FOC scores (pre-test: $39.06 \pm 9.20$ ; post-test: $32.62 \pm 8.26$ ; $p < 0.001$ ). In contrast, the control group showed no significant change ( $40.27 \pm 8.92$ to $40.01 \pm 8.89$ ; $p = 0.557$ ).
State Anxiety: The experimental group demonstrated a significant decrease in state anxiety levels (pre-test: $36.53 \pm 11.48$ ; post-test: $27.34 \pm 6.95$ ; $p < 0.001$ ), whereas the control group's scores remained stable.
Coping Strategies: The experimental group exhibited significant improvements in both problem-focused coping (active style) and emotion-focused coping (passive style) scores compared to the control group. Specifically, problem-focused coping increased from $45.18 \pm 6.76$ to $49.67 \pm 4.60$ , and emotion-focused coping increased from $26.36 \pm 6.09$ to $30.91 \pm 7.00$ ( $p < 0.001$ for both). The control group showed no significant changes in coping strategies.

Contributions and Significance
The paper positions itself as one of the first research projects in Turkey to examine the effects of MBSR training specifically on young girls regarding their perception of FOC, stress-coping strategies, and state anxiety. The authors claim that this study contributes to the dissemination of mindfulness-based approaches within preventive mental health services.

The significance of the work lies in its demonstration that MBSR training can effectively:

Reduce fear of childbirth levels in young women prior to pregnancy.
Enhance both problem-focused and emotion-focused coping mechanisms.
Lower state anxiety levels.

The authors argue that adolescence and young adulthood are critical developmental stages for shaping stress-coping skills and cognitive appraisal processes. By intervening during this period, MBSR training may foster psychological resilience that decouples future pregnancy and childbirth from pathological fear. The study suggests that such training should be integrated into health programs, youth counseling centers, and primary healthcare services to support holistic midwifery and nursing care.

Limitations
The authors modestly acknowledge several limitations:

Generalizability: The sample size and the fact that the study was conducted at a single university in one city may limit the applicability of results to diverse socio-cultural backgrounds or the broader population of young women.
Scope: The focus was strictly on "young women" (students), excluding older women or those currently pregnant.
Duration: The impact of the training was measured immediately post-intervention; the study did not include follow-up measurements to assess the long-term sustainability of the improved coping skills or the reduction in fear.