They say pregnancy is one of the happiest times in life. For women who have experienced depression, it can look different. The physical and hormonal changes, disrupted sleep and upheaval in daily life can all happen at once, bringing back depression that had subsided. On October 20, a research team at the University of Colorado Boulder published results in the international journal Lancet Public Health from a trial testing whether a free online mindfulness program, accessed from home, could prevent relapse.
500 Pregnant Women Across All 50 States Took Eight Sessions at Home
The study was led by Sona Dimidjian, director of the Renée Crown Wellness Institute at the University of Colorado Boulder, with Lee Cohen of the Center for Women's Mental Health at Massachusetts General Hospital. A total of 500 pregnant women recruited from all 50 states took part. All had a history of multiple episodes of depression and had recently taken or were currently taking antidepressants, but were not depressed when they entered the study. Their average age was 32, and they were around 11 weeks pregnant.
Half the participants continued their usual care and also used an online program called Mindful Mood Balance for Moms over 12 weeks; the other half received usual care alone. The program consisted of eight web-based mindfulness-based cognitive therapy sessions, with audio-guided practices, videos, and advice from mothers in similar situations and from professionals. Participants learned mindfulness practices they could use while caring for a newborn, how to respond to self-critical thoughts with self-compassion, and how to recognize early signs of depression and make a plan to address them.
By Six Months Postpartum, Relapse Rates Were 44% and 33%
The researchers tracked depression relapse through six months after birth. In the program group, 81 of 249 participants (33%) relapsed, compared with 111 of 251 (44%) in the usual-care group. That translated to a 26% lower risk of relapse in the program group (hazard ratio, 0.74).
Depressive symptoms also declined more during the 12-week program in the program group. But across the full period through six months postpartum, the two groups did not differ significantly in changes in symptoms. In other words, the groups differed in relapse prevention, but the difference in symptom scores did not last after the program ended. The National Institutes of Health and the National Institute of Mental Health funded the study.
This Is Not a Recommendation to Stop Taking Medication
One important point to keep in mind when interpreting these results: About three-quarters of participants in both groups continued taking antidepressants throughout the study. The program was not used instead of medication; it was an added preventive tool alongside usual care and medication treatment. The developers also said the program was designed to prevent relapse, not to treat depression that had already begun during pregnancy or after childbirth. Whether outcomes differ for people who continue medication versus those who reduce it remains a question for future research.
Professor Dimidjian emphasized that pregnant women and new mothers need options. According to the research team, many pregnant women prefer counseling over medication, and about half reduce or stop medication during pregnancy. Cost, transportation and a shortage of specialists can be barriers even for those who want counseling. The team says a free program that people can access from home whenever they choose could help fill that gap. Anyone considering a change to their medication should discuss it with their doctor.
How Meditation Can Complement Medical Care
This study points to the role meditation can play. Mindfulness is not an alternative that displaces doctors or medication; it is taking shape as a daily practice that can help people through the long stretches outside the clinic. Getting to a meditation center can be difficult when pregnancy brings a growing belly and fragmented sleep. Practicing for a few minutes at a time on a phone or laptop while the baby sleeps offers an approach suited to that reality.
The program’s practices, such as self-compassion and recognizing early warning signs, are also skills mothers can use to care for themselves. Expectant mothers with a history of depression may want to work with their health care team to identify in advance the approaches to emotional well-being that suit them. Meditation is not a demand to cope alone; it can help build the capacity to notice and care for your own feelings while receiving support.
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