Alternate Nostril Breathing to Reduce Stress: An Option for Pregnant Women Survivors of Intimate Partner Violence?

J Holist Nurs. 2021 Dec;39(4):393-415. doi: 10.1177/0898010120983659. Epub 2021 Jan 18.


Background: Stress resulting from intimate partner violence (IPV) on pregnant women causes and sustains poor health and contributes to poor pregnancy and birth outcomes. Appropriate interventions to reduce stress in this population of women are warranted.

Objective: To present a systematic review and the state of the science of evidence on alternate nostril breathing (ANB) as a holistic intervention for stress reduction for pregnant survivors of IPV, framed by complex adaptive systems theory and psychoneuroimmunology.

Data sources: Eight databases and reference lists of potential articles.

Study eligibility criteria: Randomized controlled trials published between January 2013 and July 2019.

Participants: Adults.

Intervention: ANB.

Study appraisal and synthesis method: PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.

Results: ANB is effective in reducing stress, as measured by psychological and biological indicators.

Limitations: Studies were limited in ethnic and gender diversity, most of the populations being Asian Indian and predominately male.

Conclusions: Use of ANB as a safe and effective holistic intervention for stress reduction shows promise, but research in pregnant survivors of IPV is limited.

Implications: Stress reduction benefits may be significant for pregnant survivors of IPV and their fetuses, with minimal risk.

Keywords: alternate nostril breathing; intimate partner violence; pregnancy; psychoneuroimmunology; stress.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Female
  • Humans
  • Intimate Partner Violence*
  • Male
  • Pregnancy
  • Pregnant Women*
  • Survivors