Mindfulness, Optimism and Resilience for Perinatal Health and Empowerment (MORPHE) Trial

Traumatic birth experience (TBE) is an underappreciated risk for postpartum post-traumatic stress disorder (p-PTSD), depression and anxiety, which contribute to significant social, medical, and economic burden. We urgently need innovative, wholistic, strengths-based approaches to care for pregnant women with clear mechanisms of impact. Dispositional optimism (DO) is a resilience factor by which we can move the needle on maternal health, and has been associated with wide-ranging mental health benefits, including prevention and treatment of PTSD in non-pregnant populations. Mindfulness interventions show promise in improving DO and thus may be a transdiagnostic approach to bolstering resilience and positively impact health. However, this approach has not been utilized in a perinatal population. In this project, we propose a randomized clinical trial comparing use of an existing, perinatal mindfulness phone application (Expectful) to routine care for pregnant women with low DO. 100 participants will be randomized in order to assess 1) feasibility and acceptability of the digital mindfulness intervention, 2) impact of Expectful on DO, TBE and p-PTSD, and 3) explore perspectives on the role of optimism and other resilience mechanisms in pregnancy experience and outcomes. Results from this trial will support a planned type II hybrid implementation-effectiveness randomized trial to reduce TBE and p-PTSD via improvements in DO.