Effectiveness of Mindfulness-Based Interventions for Fear of Childbirth Among Pregnant Women Planned for Normal Birth: A Systematic Review and Meta-Analysis.

The review included 15 trials and 1278 participants, which is small for several outcomes. Overall methodological quality was low, and certainty ranged from moderate to very low. Heterogeneity was very high for labour pain intensity (I² 93%). Intervention adherence was variable, with completion rates from 33.3% to 100.0% and attrition up to 62.5%. Only two trials reported fidelity measures, so intervention delivery was not consistently checked. The review reported only caesarean and epidural rates, not reasons for caesarean, preference, timing or amount of epidural. Only English and Chinese studies were included, which may limit generalisability. Publication bias was not assessed because fewer than 10 studies were available for each outcome.

Do not conclude that mindfulness alone reliably prevents caesarean birth or reduces pain relief use. The caesarean finding was RR 0.58 but very low certainty, epidural use was not significant, and many programmes also included childbirth education, coping strategies or emotional support, so the contribution of mindfulness alone cannot be separated.