Mindful meditation for epidural catheter placement during labor: a single-center randomized controlled trial

Labor epidural placement can cause significant procedural anxiety for patients. Behavioral interventions, such as mindful meditation, can effectively reduce anxiety, including during pregnancy.

This study aimed to assess the impact of a 10-minute mindful meditation session on anxiety and pain during labor epidural placement.

Pregnant women were recruited and randomized into 2 groups: A 10-minute guided mindful meditation, or a neutral content recording, both delivered via headphones before the epidural procedure as a recording. After the procedure, participants reported their levels of anxiety, pain, and satisfaction. Linear regression analyses were used to evaluate the main effects of the intervention on anxiety, pain, and satisfaction. Additionally, an exploratory post hoc moderation analysis assessed the role of baseline pain catastrophizing and its interaction with the intervention.

A total of 100 participants were included (50 per group). There were no overall main effect of mindful meditation on primary outcomes of anxiety and pain, or secondary outcome of procedural satisfaction, compared to the neutral content recording (P's > .05). Exploratory post hoc analysis indicated a moderation of treatment effect, such that participants with higher baseline pain catastrophizing experienced greater benefits from mindful meditation compared to neutral content on anxiety (b = -0.18, P = .01) and pain (b = -0.14, P = .03).

While no overall group-level effects of mindful meditation were found, exploratory analysis suggested that the intervention may be more beneficial for participants with high baseline pain catastrophizing. Future studies enrolling a larger sample, or enriching for patients with these characteristics are needed to confirm these results.

ClinicalTrials.gov Identifier: NCT04687085 (https://clinicaltrials.gov/ct2/show/NCT04687085).