Perinatal Effects of Mindfulness Phone App Use in Pregnancy (PaMPPr Study)
Perinatal Effects of Mindfulness Phone App Use in Pregnancy (PaMPPr Study)
There is evidence to show that mindful meditation has a positive impact on health. To date,
 all the studies done to investigate the effect of mindfulness on pregnancy outcomes have been
 done through a traditional 8-10 weeks mindfulness classroom program with some home practice.
 This time-intensive classroom training may be expensive and not convenient for many busy
 pregnant women. This study will investigate the use of a smartphone app-based intervention to
 determine if it has the potential to make mindfulness training more accessible, acceptable,
 and convenient to a larger number of pregnant women. The use of an app as opposed to
 traditional structured classes may increase a woman's ability and willingness to practice
 mindfulness because the app can be used almost anywhere and at any time. This pilot study
 aims to explore the feasibility and acceptability of a smartphone mindfulness meditation
 application for pregnant women. As well, this study will compare the pregnancy outcomes of
 women who use the app to those women who do not use the app.
This is a randomised controlled trial to study the effect of the use of a mindfulness
 meditation app on pregnancy outcomes. This study will measure how often the app is used, as
 well as indicators of maternal health such as sleep, stress, depression, anxiety and other
 perinatal outcomes (premature delivery, diabetes during pregnancy (gestational diabetes),
 high blood pressure in pregnancy (hypertensive disorders of pregnancy), inadequate growth of
 the baby inside the womb (fetal growth restriction), bleeding in later pregnancy, mode of
 delivery, pain relief during delivery, length of stay for mother and baby in the hospital,
 admission of baby in ICU, pain relief medication requirement after delivery, and
 breastfeeding).

 Participants will be randomly assigned to either group A (the experimental group) or group B
 (the control group). All participants will be given a an actigraph to measure sleep.

 Participants in Group A will be given a free subscription to a mindfulness meditation app for
 six months. They will also be given a general pregnancy sleep leaflet. Participants assigned
 to Group B will be given the general pregnancy sleep leaflet only.

 There will be 3 visits associated with this study. At each of the 3 visits, participants will
 be given four questionnaires to complete - the Pittsburgh Sleep Quality Index, Perceived
 Stress Questionnaire, Beck's Anxiety Inventory, and the Edinburgh Postnatal Depression Scale.
 Participants in Group A will also be asked to complete a fifth survey at their post-partum
 visit. This survey will collect information on how easy it was to use the mindfulness
 meditation app.

 Information on delivery outcomes will also be collected. This information will include things
 such as any complications that occur during delivery, baby's birth weight and Apgar score,
 any complications with baby's health, method of delivery, and pain medications used during
 delivery.
Inclusion Criteria:

 -  Are able to understand and sign this consent form

 -  Have a singleton pregnancy (not having twins)

 -  Are planning to give birth at St. Michael's Hospital

 -  Have access to personal email, a smartphone, and have a data plan

 -  Are able to understand and write English

 -  Are 20-30 weeks into your pregnancy

 Exclusion Criteria:

 -  Are formally practicing a body-mind activity (except yoga) or currently using a
 mindfulness/meditation app

 -  Have a known psychiatric diagnosis or acute psychiatric illness (substance dependence
 or abuse, history of schizophrenia or other psychotic disorders, eating disorders,
 etc.)

 -  Have a mood disorder and/or suicide risk

 -  Have any medical, infectious, or degenerative disease that may affect mood, behavior,
 and stress levels

 -  Have a known fetal anomaly

 -  Have an uncontrolled medical condition that may interfere with sleep or requires
 immediate treatment

 -  Have a comorbid sleep disorder, including obstructive sleep apnea, restless legs
 syndrome, or circadian rhythm sleep disorders

 -  Are using hypnotic or sedating medications, antidepressant or antipsychotic
 medications, or currently under psychopharmacological, behavioral, or psychoanalytic
 treatment

 -  Are a night shift worker