Effects of an 8-week birth preparation intervention on women's mental well-being

INTERVENTION: The intervention group undergoes an eight‐week psychological birth preparation program, which is provided via an online application with the name MyDoula. The program contains daily morning mindfulness exercises, evening meditations and two units per week, each including psychoeducation and an exercise part (e.g. reflection exercises run via chatbot). The app use was self‐guided. Participants randomized to the control group receive Treatment as Usual (TAU)/no treatment. CONDITION: Mental health in pregnant women ; Mental and Behavioural Disorders PRIMARY OUTCOME: ; 1. Negative birth expectations measured using the Wijma Delivery Expectations (W‐DEQ) questionnaire at baseline and after 8 weeks; 2. Support within the relationship measured using the “Relationship Assessment Scale” questionnaire at baseline; 3. Depression Scores are measured using the “Edinburgh Depression Scale” questionnaire at baseline and 8 weeks later; 4. Support within relationships measured using the “Social support instrument” questionnaire at baseline; 5. Mother‐Child‐Bonding measured using the “Maternal antenatal attachment scale” questionnaire at baseline and 8 weeks later; 6. Mental Wellbeing measured using the “Mental Wellbeing Scale” questionnaire at baseline and 8 weeks later; 7. Mindfulness measured using the “Frankfurter Fragebogen Achtsamkeit (FFA)” questionnaire at baseline and 8 weeks later; 8. Birth mindset measured using the “Mindset and Birth” questionnaire at baseline; INCLUSION CRITERIA: Pregnant women between the 20.1 and 27.0 week of pregnancy SECONDARY OUTCOME: ; 1. Dyadic coping mechanisms of participants measured using two items of the dyadic coping inventory (DCI) at baseline; 2. Quality of current relationship measured using the relationship assessment scale (RAS) at baseline; 3. Social support measured using the social support instrument (ESSI) at baseline; 4. Prenatal mother‐child bonding measured using the Maternal antenatal attachment scale (MAAS) at baseline and 8 weeks after baseline; 5. Mental wellbeing measured using the Warwick‐Edinburgh Mental Wellbeing Scale (WEMWBS) at baseline and 8 weeks after baseline; 6. Mindfulness measured using the Frankfurter Fragebogen Achtsamkeit (FFA) at baseline and 8 weeks after baseline; 7. Birthyear, sex, gender, German spoken and understood as native language, graduation, professional qualification, employment, professional position, management position, salary, number of persons in household, persons under 14 in household, marital status, taking psychotropic drugs (exclusion criteria), having psychotherapy (exclusion criteria), having a psychological diagnosis (exclusion criteria), having biological children, type of previous birth(s), type of previous negative birth experiences, abortion, miscarriage, pregnancy week, single/multiple pregnancy, planned pregnancy, worries about high/size of baby, complications during pregnancy, diseases regarding the unborn child, medical risk during pregnancy, worries/fears, main care person, satisfaction with pregnancy care, planned caesarian section (CS) and reasons, trauma, carrying out mindfulness exercises regularly, regular use of other pregnancy apps, using a birth preparation course, use of health apps, using online/offline offers regarding mental health, using online/offline offers regarding mindfulness measured using a Likert scale questionnaire at baseline; 8. Pregnancy week, worries about high/size of the unborn baby, complications during pregnancy, diseases regarding the unborn child, medical risk during pregnancy, worries/fears, and planned CS measured using a Likert scale questionnaire at 8 weeks after baseline; 9. A possible stressful event during pregnancy measured using a Likert scale questionnaire at 8 weeks after baseline; 10. Stress tracking measured daily using a Likert scale questionnaire from baseline until 8 weeks after baseline;