Effect of Nurse-Delivered Mindfulness-Based Stress Reduction on Postpartum Depression among Primiparous Women: A Randomized Controlled Trial

Abstract

Background: Postpartum depression affects 10-20% of new mothers. Non-pharmacological interventions are preferred by breastfeeding mothers, yet evidence for mindfulness-based approaches remains limited. Objective: To evaluate nurse-delivered Mindfulness-Based Stress Reduction on depressive symptoms and stress biomarkers among primiparous mothers with elevated PPD risk. Methods: Single-center parallel RCT (n = 90). Mindfulness-Based Stress Reduction group (n = 45): eight 90-minute weekly sessions; Control (n = 45): standard postpartum care. Primary: EPDS at 12 weeks. Secondary: salivary cortisol, GAD-7, SF-12. Analysis: LMM, ITT. Results: Mindfulness-Based Stress Reduction achieved clinically significant EPDS reduction (14.2→7.4 vs 14.5→11.8; difference: -4.1; 95% CI: -5.8 to -2.4; p < .001; d = 1.12). The 4.1-point improvement approximates the clinical efficacy of first-line antidepressants, supporting MBSR as a viable alternative for breastfeeding mothers. Cortisol decreased more in MBSR (d = 0.89). Depression history mothers showed larger effects (d = 1.45; interaction p = .024). Remission rate: 82.2% vs 37.8% (NNT = 2.3). Conclusion: Nurse-delivered MBSR significantly reduces PPD symptoms and stress biomarkers. Findings support MBSR as a first-line non-pharmacological intervention.