Date of Award


Degree Name

Doctor of Philosophy



First Advisor

Dr. Amy E. Naugle

Second Advisor

Dr. Scott T. Gaynor

Third Advisor

Dr. Richard Spates

Fourth Advisor

Dr. Mary Ann Stark


This study investigated the effects of mindfulness training on obstetric outcomes and maternal satisfaction with childbirth. We were interested in whether mindfulness training was more effective than a control group receiving psychoeducation on stress reduction. The goal of the intervention group was to increase participants' moment-to-moment awareness of thoughts, feelings, and body sensations during childbirth so that they would respond to these experiences rather than react to them in an automatic manner. These strategies were hypothesized to help a laboring woman minimize fear or anxiety associated with pain and complications and be more adaptive to whatever circumstances arose. Repeated measures ANOVA procedures examined significant group x time effects across relevant dependent measures. Independent samples t test investigated significant effects between groups on maternal satisfaction and to determine whether practice effects affected outcomes. Also, Fisher's Exact Probability Test examined group differences on obstetric outcomes. Effect sizes were calculated for change scores from pretreatment to postpartum using Hedges g. The hypotheses of this study were partially supported. Participants had an increase in mindfulness skills from time 1 to time 2 only for the observe scale of the KIMS. Effect sizes for change scores from pretreatment to postpartum ranged from small to large for the four KIMS scales, suggesting that the mindfulness intervention was more effective at increasing mindfulness. There was a significant decrease in both fear of childbirth and trait anxiety at postpartum. Moderate effect size for change scores (trait) and small effect size for change scores (state) favored the stress-management group. No significant differences were noted for maternal satisfaction with childbirth or obstetric outcomes. Practice effects showed that participants with high practice scores in the stress-management group had significantly higher state anxiety scores pretreatment compared to those with low practice scores, and participants with high practice scores in the mindfulness group had significantly less fear of childbirth postpartum compared to participants with low practice scores. The lack of significant results were surprising given high treatment adherence ratings and prior research showing MBSR to be effective with various conditions, including pain and anxiety. There may be several explanations for these results.

Access Setting

Dissertation-Open Access