Relationship Between Mindfulness and Posttraumatic Stress in Women Who Experienced Stillbirth

J Obstet Gynecol Neonatal Nurs. 2018 Nov;47(6):760-770. doi: 10.1016/j.jogn.2018.09.002. Epub 2018 Oct 5.


Objective: To explore the potential factors that mediate the relationship between mindfulness and symptoms of posttraumatic stress (PTS) in women who experienced stillbirth.

Design: A cross-sectional analysis of baseline data before women's participation in an online mindfulness intervention (i.e., online yoga).

Setting: This was a national study, and women participated in their own homes.

Participants: Women who experienced stillbirth (N = 74) within the past 2 years and resided in the United States.

Methods: Women were recruited nationally, primarily through social media. Participants (N = 74) completed baseline assessments (self-report mental and physical health surveys) via a Web-based survey tool. We conducted an exploratory factor analysis of the COPE Inventory subscales to reduce the number of variables before entry into a mediation model. We then tested the mediation effects of sleep quality, self-esteem, resilience, and maladaptive coping on the relationship between mindfulness and PTS symptoms.

Results: Through the exploratory factor analysis we identified a two-factor solution. The first factor included nine subscales that represented adaptive coping strategies, and the second factor included five subscales that represented maladaptive coping strategies. Results from multiple mediation analysis suggested that mindfulness had a significant inverse relationship to PTS symptoms mediated by sleep quality.

Conclusion: Mindfulness practices may have potential benefits for grieving women after stillbirth. Evidence-based approaches to improve sleep quality also may be important to reduce PTS symptoms in women after stillbirth.

Keywords: PTSD; grief; mindfulness; perinatal death; stillbirth.

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Cross-Sectional Studies
  • Depression* / diagnosis
  • Depression* / etiology
  • Depression* / therapy
  • Female
  • Grief
  • Humans
  • Mental Status Schedule
  • Mindfulness / methods*
  • Outcome Assessment, Health Care
  • Pregnancy
  • Resilience, Psychological
  • Sleep Hygiene
  • Stillbirth* / epidemiology
  • Stillbirth* / psychology
  • Stress Disorders, Post-Traumatic* / etiology
  • Stress Disorders, Post-Traumatic* / physiopathology
  • Stress Disorders, Post-Traumatic* / psychology
  • Stress Disorders, Post-Traumatic* / therapy