SciTech-15-293 (4)

SciTechnol
The Effect of One Month Yoga Intervention on Perceived Stress and Anxiety in
Pregnant Women
--Manuscript Draft--
Manuscript Number: SciTech-15-293R2
Full Title: The Effect of One Month Yoga Intervention on Perceived Stress and Anxiety in
Pregnant Women
Short Title: The ffect of yoga intervention in pregnant women
Article Type: Research Article
Section/Category: Women's Health, Issues & Care
Keywords: PREGANT WOMEN, STATE ANXIETY, PERCIEVED STRESS, ONE MONTH YOGA,
AUM meditation
Corresponding Author: Rashmi Bapat
INDIA
Corresponding Author Secondary
Information:
Corresponding Author's Institution:
Corresponding Author's Secondary
Institution:
First Author: Rashmi Bapat
First Author Secondary Information:
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Order of Authors Secondary Information:
Manuscript Region of Origin: INDIA
Abstract: The effect of one month yoga intervention on state anxiety and perceived stress in
pregnant women (n=40) was examined. The participants were divided into two groups-
yoga and control group. Yoga group was given one month yoga intervention of āsanas,
relaxation technique, prāṇāyāma, and AUM meditation (thirty minutes) for one hour
every alternate day. Results indicated that yoga intervention based AUM meditation
contributed significantly to reduce the perceived stress and anxiety in pregnant women.
Suggested Reviewers:
Opposed Reviewers:
Response to Reviewers: first of thanks for suggesting the corrections regarding this manuscript. since this was
the first attempt to submit the manuscript definitely it needs the correction in all aspects
and as a author tried to complete as per the viewers suggestion still it lacks some
points like at end why the both tests are used are answered but may not be
satisfactorily as the author was just under learning process.
rest of the points raised in comments were answered and corrected in the present
revised submission.
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INTERVENTION
The Effect of One Month Yoga Intervention on Perceived
Stress and Anxiety in Pregnant Women
Rashmi A Bapat, SonyKumari and H.R.Nagendra
Swami Vivekananda Yoga Anusandhana samsthana University, Bangalore, India.
Address correspondence to Rashmi Bapat, Swami Vivekananda Yoga Research Foundation and University, Banglore-
560011 India.
Email –rashmibapat29@gmail.com
The effect of one month yoga intervention on state anxiety and perceived stress in pregnant women (n=40)
was examined. The participants were divided into two groups- yoga and control group. Yoga group was given
one month yoga intervention of āsanas re a ation te hni e rānāyāma an me itation (thirty
minutes) for one hour every alternate day. Results indicated that yoga intervention based AUM meditation
KEY WORDS: PREGANT WOMEN, STATE ANXIETY, PERCIEVED STRESS, ONE MONTH YOGA,
AUM meditation.
regnancy is a very precious and important event in a woman’s life. It is a state of physiological stress
that necessitates physical, mental and social adaptation. Human pregnancy is the most studied of all
mammalian pregnancies. With recent advances in obstetrics the little life inside the womb can be
visualized from the very first day of fetal life, from the moment of conception until birth. It is indeed artistic,
accurate and awesome; the new life taking shape and becoming active inside the mother to be so vivid and
complex.
Today’s urbanization and hectic life style pattern have increased risk of complications during pregnancy.
Emotional stress among all is found to be more in urbanized population.
It is true that the development of the baby is affected by several maternal as well as several fetal factors.
Hypertension, diabetes, malnutrition, high stress levels in life style can cause harmful effects on the fetus.
Similarly chromosomal abnormalities in embryo and infections in mother can cause several birth defects.
These are prone to several complications in new born period and even later in childhood. Apart from these
psychological stress, fear, anxiety in mother can cause serious problems resulting in poor outcome (2008).
P
Manuscript
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It is now well-recognized that stress causes psycho-neuro-immunological changes in the body leading to
pregnancy complications. It can lead to irregular, in coordinate uterine contractions causing distress ending in
operative surgery. Hypersensitivity of mother leads to intolerance to pain, requiring heavy dosage of pain
killers which are not safe for unborn. Prenatal stress and outcomes—maternal stress and anxiety during
pregnancy has been associated with: Shorter gestation & higher incidence of preterm birth,
Smaller birth weight and length, increased risk of miscarriage. Prospective studies have shown that maternal
stress and anxieties during pregnancy are related to infant outcomes; such as-Temperamental problems and
increased fussiness, Problems with attention, attention regulation, and emotional reactivity, Lower scores on
measures of mental development.
Our ancient teachings and techniques from Yoga and Ayurveda are found to be more effective. There can be
many yogic relaxation techniques that can be used to minimize emotional stress and to create harmonious
environment for coming child. (2002)
An ancient holistic Indian science, yoga, has been used for centuries for stress reduction and health promotion.
Positive effects of integrated yoga modules have been demonstrated in women with high- risk pregnancies
(2008), but no studies have looked the effect of one month yoga intervention based on AUM meditation on
perceived stress and anxiety. The objective of the present study was to assess the effect of one month yoga
intervention AUM based meditation on perceived stress and anxiety in pregnant women.
Material and Methods
A total (n= 40) forty pregnant women receiving antenatal care at various obstetrics units in THANE and
Mumbai, India were selected for yoga intervention. The selected women, who were aged between 25 years to
35 years and between 20th
weeks to 28th
weeks of pregnancy, were randomized to the yoga or control group.
Yoga group (n= 20) twenty and control group (n=20) twenty were divided randomly.
Both the groups were assessed for the pre and post physiological parameters blood pressure, weight, pulse rate
tests and psychological PSS, STAI(form –X) tests. They were not informed about the hypothesis of the study.
Informed consent was obtained from them all.
Measures
The State- Anxiety Inventory (STAI) is a psychological inventory. It was developed by psychologists Charles
Spielberg, R.L. Grouch, and R.E. Lushun in 1964. Their goal in creating the inventory was to create a set of
questions that could be applied towards assessing different types of anxiety. Several items on the STAI were
reversed coded (Items 1, 2, 5, 8, 11, 15, 16, 19, and 20). State Trait Anxiety Inventory (STAI) was used to
assess the anxiety level of the pregnant woman in the initial stage and end stage of both 30 days of control and
30 days of experimental group
The Perceived Stress Scale was developed to measure the degree to which situations in one’s life are
appraised as stressful. This was measured before (1day) yoga intervention and after (30thday)
for both the
groups. It contain 10 questions that would applied towards assessing perceived stress level .several items on

PSS were reverse coded (items 4, 5, 7, 8) High psychological Stress is associated with high blood pressure,
higher BMI, larger waist to hip ratio, shorter Telomere length, higher cortisol levels, suppressed immune
function, decreased sleep, and Increased alcohol consumption.
Procedure
PSS and STAI (form –x) and parameters like blood pressure, weight, pulse rate were assessed before and after
yoga intervention. Yoga intervention includes of AUM meditation sessions 30 minutes and yogic practices, set
of loosening of joints, breathing techniques, asanas, and pranayam alternately one hour for four week.
TABLE 1 Yogic practice.
1.Hasta yam śvasanam (Hands In and Out Breathing- ‘A’kar, ‘U ’kar,’M kar’ chanting)- 1 min
2.Hastavistāra śvasanam (Hands Stretch Breathing-‘A’kar, ‘U ’kar,’M kar’ chanting) - 2 min
3.Ka iparivartana śvsanam (Side Twist Breathing) -1 min
4.Vajrasana -5min
5.Deep Relaxation- 15 min
6.Uttānapādāsana śvasanam (Leg Raise Breathing) -1 min
7.Setubandhāsana śvasanam (Hip Raise Breathing) -1 min
8.Vyāghrāsana śvasanam (Tiger Stretch Breathing) -1 min
9.Quick Relaxation techniocque ( “U”kar chant 5 times)-5min
10.Gulphagūra am (Ankle Rotation) -2 min
11.Jānuphalakākar a am (Kneecap Contraction) -1 min
12.Ardhātitaliāsana (Half Butterfly Exercise) -3 min
13.Poornātitaliāsana (Full Butterfly Exercise) -1 min
AUM meditation is a type of meditation in which the person experience love and peace attune with the fetal
movements, journey within. Everyday life is interaction between the senses and the outer world. It is a
technique for withdrawing the senses from the outer world and bringing them together (fetus and mother,
union with cosmic soul) .The union between you and your bigger self gives the seat for creativity and peace.
Aum meditation decreases oxygen consumption and heart rate and significant decrease in skin resistance level.
It produces a state of alert full rest (1998).
Table 2AUM meditation
1. Opening prayer
Sitting position ; vajrasana,sukhasana,sidhayoni asana
2.PURIFICATION: kapalbhati here avoided. Abdominalbreathing with “U”KARchantings -5times.
3.PREPARATION:
i. Nadishodhan pranayama: 5 rounds ( linear awareness)
ii. Shitali pranayama: 5 rounds ( surface aware ness)
iii. Sitkari pranayama: 5 rounds ( surface awareness)
iv. Brhamari pranayama: 5 rounds((3D-Three dimensional awareness)
4.Dharana:this is holding the same action.one is dharana on rupa “the form”,second is the wave “shabdda”.here our
focuses are evolved focusing on one thought.
(Dharana of chakras:from muladhar to sahastradal chakra)
5. Chanting of chakra mantras and AUM bijamatra repeatedly with the fast speed.
6. Slow down the speed of mantra chanting.
7. MERGING INTO SILENCE.
8. Closing prayer

Result and discussion
Means and SDs, percentage, p value of the Measure of variables by Yoga and Control Groups Before and After
Intervention.
TABLE 3
Yoga( n=20) Control (n=20)
variables pre post % P value pre post % P value
M SD M SD M SD M SD
Wt 60.455 12.75 63.460 11.90 44.51 0.000* 51.1 7.40 54.5 7.59 55.55 0.000*
Sys.B.P 117.3 12.63 114.2 5.67 19.94 0.404 116.2 10.07 114.9 5.2 17.31 0.598
Dia .B.P 77.4 10.59 78.15 7.24 67.30 0.551 75.8 7.40 78.8 8.2 28.15 0.130
PR 76.6 8.82 74.65 8.2 20.7 0.090 73.6 3.96 73.6 3.6 26.4 0.638
PSS 19.85 4.28 17.8 3.22 69.8 0.019* 20.3 4.6 22.0 3.19 88.07 0.107
STAI 46 5.7 43.2 5.66 47.9 0.006* 41.6 6.49 42.7 7.69 61.04 0.123
(*significant)
The performances of the control and yoga intervention groups on the measure of PSS, STAI and other variables are
shown in Table 3. A close perusal ofthescores reveals considerablegainby the intervention group. The mean(M)andSD
value of PSS, STAI, pulse rate (PR), systolic blood pressure (Systolic.B.P.), diastolic blood pressure (Diastolic.B.P.), of yoga
group has reduced whereas in control group value increased. The weight increased both in yoga and control group. The
percentage change of PSS & STAI was significant within the group, whereas control groups shows no
significance expect weight.
TABLE 4 Wilcoxon’s signed Ranked Test
Group PSS STAI
(P)value %change (P)value %change
YOGA 0.019* 69.8 0.006* 47.9
CONTROL 0.107 88.07 0.123 61.04
(*significant)
As the scores were not normally distributed, Wilcoxon’s Signed Rank Test was used. Table 4 shows that, There were
reduced percentage change of PSS& STAI value in yoga group (69.8%,47.9%)compared with control
group(88.7%,61.04%)respectively and p value<.05 of PSS & STAI(0.019&0.006 ) were significant within the
group. This was supporting to the previous studies based on only IAYT intervention given for pregnant
women.
TABLE 5 Mann- Whitney Tests
VARIABLES WT SYS.B.P DIA.B.P PR PSS STAI

PRE 0.021 0.799 0.820 0.718 0.383 0.015
POST 0.013 0.989 0.904 0.314 0.000* 0.602
Table 5 presents the result of Mann Whitney test. Results of Mann Whitney Test shows that there is a significant
change in only the post data PSS value in yoga group rather than control group, the other variables shows no
significant change. On the basis of these results we can conclude that there is a significant difference between Yoga and
Control group (p<.05).
The present study clearly indicates that AUM meditation based one month yoga intervention given during
20th
week to 28th
week of first pregnancy period of the average age group between 30-35years contributed to
better reducing perceived stress and state anxiety (PSS and STAI) levels in pregnant women on Indian
population and also it is safe.
In general the participating reported improvement in alert fullness. In addition they have experienced other
benefits like reduction in blood pressure, clarity in thinking, and relaxed feeling in action. Earlier research on
integrated yoga on Pregnancy experience anxiety, and depression in normal pregnancy State (STAI I)
anxiety (decreased 15.65% in yoga, increased 13.76% in control), (2013) this study lends further support to
previous studies based on IAYT intervention. However, there is need for a more detailed study on diet based yoga
intervention given for pregnant women.
REFERENCES
Babbar, S., Parks-Savage, A. C., & Chauhan, S. P. (2012). Yoga during pregnancy: a review. American journal of
perinatology, 29(6), 459.
Chan, K. P. (2014). Effects of parental meditation on pregnant Chinese women in Hong Kong: A randomized controlled
trial. Journal of Nursing Education and Practice, 5(1), p1.
Chang, S. C., & Chen, C. H. (2005). Effects of music therapy on women's physiologic measures, anxiety, and satisfaction
during cesarean delivery. Research in Nursing & Health, 28(6), 453-461.
Cohen, S; Kamarck T; Mermelstein R (December 1983). A global measure of perceived stress Journal of Health and
Social Behavior 24 (4): 385–396.
Curtis, K., Weinrib, A., & Katz, J. (2012). Systematic review of yoga for pregnant women: current status and future
directions. Evidence-Based Complementary and Alternative Medicine, 2012.
Dr.balaji tambe.(2011). Ayurvedic garbhasanskar the art and science of pregnancy, retrievedfrom
Dr.Guri ashih borkar(1941). garbhasaàskära udayäcyä budhdimäana va ärogyyasampanna santatisäaöhé. sadashiv
peth,puna,411 030.mehata publications.,
Dr.Ulka natu. (2005).Effect of Yogic Practices in Pregnancy Depicted by Doppler Velocimetry studies of Uterine Arteries,
Umbilical Artery and Middle Cerebral Artery of the Fetus retrieved from
Narendran, S., Nagarathna, R., Gunasheela, S., & Nagendra, H. R. (2005). Efficacy of yoga in pregnant women with
abnormal Doppler study of umbilical and uterine arteries. Journal of the Indian Medical Association, 103(1), 12-4.
Narendran.S,Dr.R.Nagarathana,Dr.H R Nagendra.(2008).Garbhopanishad, ,yoga for pregnancy,(pp85-8).SVYP:Banglore-
560019.
Pra na joçé.(1892) Agnipurana.Sadashiv peth,puna411 30: Manohar joshi,prasd publication

PriyaVarta Sharma(2010). çuçruta saàhitäa zuïut s<ihta –vol II.varanasi 001,INDIA: vishawabharati oriental publishers.
Rakhshani, A., Nagarathna, R., Mhaskar, R., Mhaskar, A., Thomas, A., & Gunasheela, S. (2012). The effects of yoga in
prevention of pregnancy complications in high-risk pregnancies: A randomized controlled trial.Preventive medicine, 55(4),
333-340.
Styapriya, M., Nagarathna, R., Padmalatha, V., & Nagendra, H. R. (2013). Effect of integrated yoga on anxiety,
depression & well being in normal pregnancy. Complementary therapies in clinical practice, 19(4), 230-236.
SriPandharinathKashinathThavare.(2001). manuñya yoni präapta jhäalelyä jéväacyä gatéce varëana.InV.G.
Desai(Ed),Shrimadbhagawatmahapurana (pp345-346).gorakhpur-273005: Gitapress
SriSwamiSivananda (2000) BhagavadGitaBySriSwamiSivanand. Shivanandanagar—249 192Distt. Tehri-Garhwal, Uttar
Pradesh, Himalayas, India: DIVINE LIFE SOCIETY.
SRIDEVI, V. GARBHA VIDHYA (Oct2013), WE MAKE BRILLIANT CHILD THROUGH PROPER TRAINING FROM
FOETUS.
Telles, S., Nagarathna, R., & Nagendra, H. R. (1998). Autonomic changes while mentally repeating two syllables-one
meaningful and the other neutral. Indian journal of physiology and pharmacology, 42, 57-63.

(SciTechnol
Pregnant Women
Manuscript Number: SciTech-15-293
Pregnant Women
Short Title:
AUM meditation
INDIA
Information:
Institution:
relaxation technique, prānāyāma, and AUM meditation (thirty minutes) for one hour
Opposed Reviewers:
Manuscript
Click here to download Manuscript: sci tech yoga anc (1).docx

Manuscript
INTERVENTION
The Effect of One Month Yoga Intervention on Perceived Stress and Anxiety in Pregnant
Women
www.scitechnol.org
Rashmi A Bapat, SonyKumari and H.R.Nagendra
Swami Vivekananda Yoga Anusandhana Samsthana University, Bangalore, India.
Address correspondence to Rashmi Bapat, Swami Vivekananda Yoga Research Foundation and University,
Banglore-560011 India.
Was examined. The participants were divided into two groups- yoga and control group. Yoga group was
given one month yoga intervention of āsanas relaxation technique, prānāyāma and AUM meditation
(thirty minutes) for one hour every alternate day. Results indicated that yoga intervention based AUM
meditation contributed significantly to reduce the perceived stress and anxiety in pregnant women.
KEY WORDS: PREGANANT WOMEN, STATE ANXIETY, PERCIEVED STRESS, ONE MONTH
YOGA, AUM meditation.
regnancy is a very precious and important event in a woman’s life. It is a state of physiological
stress that necessitates physical, mental and social adaptation. Human pregnancy is the most studied
of all mammalian pregnancies. With recent advances in obstetrics the little life inside the womb
can be visualized from the very first day of fetal life, from the moment of conception until birth. It is
indeed artistic, accurate and awesome; the new life taking shape and becoming active inside the
mother to be so vivid and complex.
Today’s urbanization and hectic life style pattern have increased risk of complications during pregnancy.
P

pregnancy has been associated with: Shorter gestation & higher incidence of preterm birth,
Smaller birth weight and length, increased risk of miscarriage. Prospective studies have shown that maternal
stress and anxieties during pregnancy are related to infant outcomes; such as-Temperamental problems and
increased fussiness, Problems with attention, attention regulation, and emotional reactivity, Lower scores on
measures of mental development.
An overview of research studies yoga
Narendran et al., 2005 conducted a study focused on the effectiveness of yoga on pregnancy outcomes. It is
hypothesized that stress management in pregnancy using integrated approach of yoga therapy [IAYT]
improves pregnancy outcomes when compared with standard obstetrics management. The sample consists of
169 women in yoga group and 166 women in control group between 18 to 20 weeks of gestation. Yoga
practices include physical postures, breathing and meditation which were practiced for one hour a day from the
date of entry into the study until delivery. The control group walks for thirty minutes twice a day and both the
group received telephone calls and record diary for compliance. The result of the study supported the
hypothesis that the practice of yoga during pregnancy is safe the number of babies with birth weight greater or
equal to 2500grams were higher, preterm labor was significantly lower and pregnancy induced hypertension
was also significantly lower in yoga group. The IAYT practices during pregnancy are safe and improve birth
weight and decreases preterm labor and the risk of pregnancy induced hypertension, with no increased
complications.
Our ancient teachings and techniques from Yoga and Ayurveda are found to be more effective. There can be
many yogic relaxation techniques that can be used to minimize emotional stress and to create harmonious
environment for coming child. (2002)
perceived stress and anxiety. The objective of the present study was to assess the effect of one month yoga
intervention AUM based meditation on perceived stress and anxiety in pregnant women.
A total (n= 40) forty pregnant women receiving antenatal care at various obstetrics units in THANE and
Mumbai, India was selected for yoga intervention. The selected women, who were aged between 25 years to
35 years and between 20 weeks to 28 weeks of pregnancy, as suggested by the text on auyrveda there
we found the development of mind and intellect more during this period of pregnancy
[shrushrut samnhita] and this study area is focused more on mental aspect of the personality,

were randomized to the yoga or control group.
Yoga group (n= 20) twenty and control group (n=20) twenty were divided randomly.
Both the groups were assessed for the pre and post physiological parameters blood pressure, weight, pulse rate
tests and psychological PSS, STAI(form –X) tests. Yoga group practiced meditation, asana, and
pranayama and relaxation while the control group practiced their regular routine with daily 30
minutes walk .They were not informed about the hypothesis of the study. Informed consent was obtained
from them all.
Measures
The State- Anxiety Inventory (STAI) is a psychological inventory. It was developed by psychologists
Charles Spielberg, R.L. Grouch, and R.E. Lushun in 1964. Their goal in creating the inventory was to create
a set of questions that could be applied towards assessing different types of anxiety. Several items on the
STAI were reversed coded (Items 1, 2, 5, 8, 11, 15, 16, 19, and 20). State Trait Anxiety Inventory (STAI)
was used to assess the anxiety level of the pregnant woman in the initial stage and end stage of both 30 days
of control and 30 days of experimental group
The Perceived Stress Scale [PSS] was developed to measure the degree to which situations in one’s
life are appraised as stressful. This was measured before (1day) yoga intervention and after [ 30] last
day for both the groups. It contain 10 questions that would applied towards assessing perceived stress
level .several items on PSS were reverse coded (items 4, 5, 7, 8) High psychological Stress is associated
with high blood pressure, higher BMI, larger waist to hip ratio, shorter Telomere length, higher cortisol
levels, suppressed immune function, decreased sleep, and Increased alcohol consumption.
As this was an interventional study, the participants and trainers could not be blinded, but the team who did the
assessments and the statistician were blinded. The perceived stress scale [PSS] answer sheets were coded and
kept away until the end of the study, and care was taken to prevent the participants from discussing the
techniques used.
Procedure
Yoga intervention. Yoga intervention includes of AUM meditation sessions 30 minutes and yogic practices, set
Of loosening of joints, breathing techniques, asana, and pranayam and relaxation technique alternately one hour for
four week.
1. Hasta yam śvasanam (Hands In and Out Breathing- ‘A’kar, ‘U ’kar,’M kar’ chanting)- 1 min
2.
3. Hastavistāra śvasanam (Hands Stretch Breathing-‘A’kar, ‘U ’kar,’M kar’ chanting) - 2 min
4. Ka iparivartana śvsanam (Side Twist Breathing) -1 min
5. Vajrasana -5min
6. Deep Relaxation- 15 min
7. Uttānapādāsana śvasanam (Leg Raise Breathing) -1 min
8. Setubandhāsana śvasanam (Hip Raise Breathing) -1 min
9. Vyāghrāsana śvasanam (Tiger Stretch Breathing) -1 min
10. Quick Relaxation techniocque (“U”kar chant 5 times)-5min
11. Gulphagūra am (Ankle Rotation) -2 min
12. Jānuphalakākar a am (Kneecap Contraction) -1 min

13. Ardhātitaliāsana (Half Butterfly Exercise) -3 min
Movements, journey within. Everyday life is interaction between the senses and the outer world. It is
a technique for withdrawing the senses from the outer world and bringing them together (fetus and
mother, union with cosmic soul) .The union between you and your bigger self gives the seat for creativity
and peace. Aum meditation decreases oxygen consumption and heart rate and significant decrease in skin
resistance level. It produces a state of alert full rest (1998).
Table 2 AUM meditation
1. Opening prayer
2. PURIFICATION: kapalbhati here avoided. Abdominal breathing with “U”KARchantings -5times.
3.PREPARATION:
I. Nadishodhan pranayama: 5 rounds ( linear awareness)
II Shitali pranayama: 5 rounds ( surface aware ness)
III Sitkari pranayama: 5 rounds ( surface awareness)
IV Brahmari pranayama: 5 rounds((3D-Three dimensional awareness)
4. Dhahran: this is holding the same action. One is Dhahran on rope “the form”, second is the wave
“shabdda”.Here our focuses are evolved focusing on one thought.
(Dhahran of chakras: from muladhar to sahastradal chakra)
5. Chanting of chakra mantras and AUM bij mantra repeatedly with the fast speed.
7. SILENCE.
8. Closing prayer
The outcome measures were PSS and STAI measurements and physiological factors.PSS is valid for use in the Indian
population with reliability of .84. PSS questionnaire was administered before the intervention period and the last day.
Statistical analysis was done with SPSS version 21.0.
Intervention.
TABLE 3
M SD M SD M SD M SD
Wt 60.455 12.75 63.460 11.90 44.51 0.000* 51.1 7.40 54.5 7.59 55.55 0.000*
Sys.B.P 117.3 12.63 114.2 5.67 19.94 0.404 116.2 10.07 114.9 5.2 17.31 0.598
Dia .B.P 77.4 10.59 78.15 7.24 67.30 0.551 75.8 7.40 78.8 8.2 28.15 0.130
PR 76.6 8.82 74.65 8.2 20.7 0.090 73.6 3.96 73.6 3.6 26.4 0.638
PSS 19.85 4.28 17.8 3.22 69.8 0.019* 20.3 4.6 22.0 3.19 88.07 0.107
STAI 46 5.7 43.2 5.66 47.9 0.006* 41.6 6.49 42.7 7.69 61.04 0.123
(*significant)
The performances of the control and yoga intervention groups on the measure of PSS, STAI and other variables
are shown in Table 3. A close perusalofthescoresreveals considerablegainbythe intervention group. The mean (M)
and SD value of PSS, STAI, pulse rate (PR), systolic blood pressure (Systolic.B.P.), diastolic blood pressure

(Diastolic.B.P.), of yoga group has reduced whereas in control group value increased. The weight increased both in
yoga and control group. The percentage change [percentage %=pre-post/pre values] of PSS & STAI was
significant within the group, whereas control groups shows no significance expect weight.
TABLE 4 Wilcoxon’s signed Ranked Test
Group PSS STAI
YOGA 0.019* 69.8 0.006* 47.9
CONTROL 0.107 88.07 0.123 61.04
(*significant)
As the scores were not normally distributed, Wilcoxon’s Signed Rank Test was used. Table 4 shows that, There
were reduced percentage change of PSS& STAI value in yoga group (69.8%,47.9%)compared with
control group(88.7%,61.04%)respectively and p value<.05 of PSS & STAI(0.019&0.006 ) were significant
within the group. This was supporting to the previous studies based on only IAYT intervention given
for pregnant women.
TABLE 5 Mann- WhitneyTests
PRE 0.021 0.799 0.820 0.718 0.383 0.015
POST 0.013 0.989 0.904 0.314 0.000* 0.602
Table 5 presents the result of Mann Whitney test. It has greater efficiency than the t-test on non-normal
distributions, such as a mixture of normal distribution, and it is nearly as efficient as the t-test on normal
distributions. Results of Mann Whitney Test shows that there is a significant change in only the post data PSS
value in yoga group rather than control group, the other variables shows no significant change. On the basis
of these results we can conclude that there is a significant difference between Yoga and Control group (p<.05).
The present study clearly indicates that AUM meditation based one month yoga intervention given
during 20 week to 28 week of first pregnancy period of the average age group between 30-35years
contributed to better reducing perceived stress and state anxiety (PSS and STAI) levels in pregnant
women on Indian population.
In general the participating reported improvement in alert fullness. In addition they have experienced
other benefits like reduction in blood pressure, clarity in thinking, and relaxed feeling in action. Earlier
research on integrated yoga on Pregnancy experience anxiety, and depression in normal pregnancy
State (STAI I) anxiety (decreased 15.65% in yoga, increased 13.76% in control), (2013) this study lends
further support to previous studies based on IAYT intervention. However, there is a limitation of this study
which needs for a more detailed study on diet based yoga intervention given for pregnant women.

REFERENCES
Babar, S., Parks-Savage, A. C., & Chatham, S. P. (2012). Yoga during pregnancy: a review. American
journal of perinatology, 29(6), 459.
Chan, K. P. (2014). Effects of parental meditation on pregnant Chinese women in Hong Kong: A
randomized controlled trial. Journal of Nursing Education and Practice, 5(1), p1.
Chang, S. C., & Chen, C. H. (2005). Effects of music therapy on women's physiologic measures, anxiety,
and satisfaction during cesarean delivery. Research in Nursing & Health, 28(6), 453-461.
Cohen, S; Kamarck T; Mermelstein R (December 1983). A global measure of perceived stress Journal of
Health and Social Behavior 24 (4): 385–396.
Curtis, K., Weinrib, A., & Katz, J. (2012). Systematic review of yoga for pregnant women: current
status and future directions. Evidence-Based Complementary and Alternative Medicine, 2012.
Dr.balaji tambe. (2002). Ayurvedic garbhasanskar the art and science of pregnancy, retrieved from
Dr.Guri shih broker (1941). Garbhasaàskära udayäcyä budhdimäana VA ärogyyasampanna
santatisäaöhé. Sadashiv peth, puna, 411 030.mehata publications.
Dr.Ulka natu. (2005).Effect of Yogic Practices in Pregnancy Depicted by Doppler Velocimetry studies of
Uterine Arteries, Umbilical Artery and Middle Cerebral Artery of the Fetus retrieved from
Narendran, S., Nagarathna, R., Gunasheela, S., & Nagendra, H. R. (2005). Efficacy of yoga in pregnant
women with abnormal Doppler study of umbilical and uterine arteries. Journal of the Indian Medical
Association, 103(1), 12-4. Narendran.S, Dr.R.Nagarathana, Dr.H R Nagendra. (2008).Garbhopanishad, yoga
for pregnancy, (pp85-8).SVYP: Banglore-560019.
Pra Na joçé. (1892) Agnipurana.Sadashiv peth, puna411 30: Menorah josh, prods publication
PriyaVarta Sharma (2010). Cucuta saàhitäa suit s<iota –vole II.varanasi 001, INDIA: vishawabharati oriental
publishers. Rakhshani, A., Nagarathna, R., Masker, R., Masker, A., Thomas, A., & Gunasheela, S. (2012).
The effects of yoga in prevention of pregnancy complications in high-risk pregnancies: A randomized
controlled trial. Preventive medicine, 55(4), 333-340.
Styapriya, M., Nagarathna, R., Padmalatha, V., & Nagendra, H. R. (2013). Effect of integrated yoga
on anxiety, depression & well being in normal pregnancy. Complementary therapies in clinical practice,
19(4), 230-236. SriPandharinathKashinathThavare. (2001). manuñya yoni präapta jhäalelyä jéväacyä gatéce
varëana.InV.G.Desai(Ed), Shrimadbhagawatmahapurana (pp345-346).gorakhpur-273005: Gitapress
SriSwamiSivananda (2000) BhagavadGitaBySriSwamiSivanand. Shivanandanagar—249 192Distt. Tehri-
Garhwal, Uttar Pradesh, Himalayas, India: DIVINE LIFE SOCIETY.
SRIDEVI, V. GARBHA VIDHYA (Oct2013), WE MAKE BRILLIANT CHILD THROUGH PROPER
TRAINING FROM FOETUS.
Telles, S., Nagarathna, R., & Nagendra, H. R. (1998). Autonomic changes while mentally repeating two
syllables-one meaningful and the other neutral. Indian journal of physiology and pharmacology, 42, 57-63.

(SciTechnol
Pregnant Women
Manuscript Number: SciTech-15-293
Pregnant Women
Short Title:
AUM meditation
INDIA
Information:
Institution:
relaxation technique, prānāyāma, and AUM meditation (thirty minutes) for one hour
Opposed Reviewers:
Manuscript
Click here to download Manuscript: sci tech yoga anc.pdf

Manuscript
INTERVENTION
The Effect of One Month Yoga Intervention on Perceived Stress and Anxiety in Pregnant
Women
www.scitechnol.com
Rashmi A Bapat, Sony Kumari and H.R.Nagendra
Swami Vivekananda Yoga Anusandhana Samsthana University, Bangalore, India.
Address correspondence to Rashmi Bapat, Swami Vivekananda Yoga Research Foundation and University,
Banglore-560011 India.
Was examined. The participants were divided into two groups- yoga and control group. Yoga group was
given one month yoga intervention of āsanas relaxation technique, prānāyāma and AUM meditation
(thirty minutes) for one hour every alternate day. Results indicated that yoga intervention based AUM
meditation contributed significantly to reduce the perceived stress and anxiety in pregnant women.
KEY WORDS: PREGANANT WOMEN, STATE ANXIETY, PERCIEVED STRESS, ONE MONTH
YOGA, AUM meditation.
regnancy is a very precious and important event in a woman‘s life. It is a state of physiological
stress that necessitates physical, mental and social adaptation. Human pregnancy is the most studied
of all mammalian pregnancies. With recent advances in obstetrics the little life inside the womb
can be visualized from the very first day of fetal life, from the moment of conception until birth. It is
indeed artistic, accurate and awesome; the new life taking shape and becoming active inside the
mother to be so vivid and complex.
Today‘s urbanization and hectic life style pattern have increased risk of complications during pregnancy.
P

pregnancy has been associated with: Shorter gestation & higher incidence of preterm birth,Smaller birth weight
and length, increased risk of miscarriage. Prospective studies have shown that maternal stress and anxieties
during pregnancy are related to infant outcomes; such as-Temperamental problems and increased fussiness,
Problems with attention, attention regulation, and emotional reactivity, Lower scores on measures of mental
development.
An overview of research studies yoga
Narendran et al., 2005 conducted a study focused on the effectiveness of yoga on pregnancy outcomes. It is
hypothesized that stress management in pregnancy using integrated approach of yoga therapy [IAYT]
improves pregnancy outcomes when compared with standard obstetrics management. The sample consists of
169 women in yoga group and 166 women in control group between 18 to 20 weeks of gestation. Yoga
practices include physical postures, breathing and meditation which were practiced for one hour a day from the
date of entry into the study until delivery. The control group walks for thirty minutes twice a day and both the
group received telephone calls and record diary for compliance. The result of the study supported the
hypothesis that the practice of yoga during pregnancy is safe the number of babies with birth weight greater or
equal to 2500grams were higher, preterm labor was significantly lower and pregnancy induced hypertension
was also significantly lower in yoga group. The IAYT practices during pregnancy are safe and improve birth
weight and decreases preterm labor and the risk of pregnancy induced hypertension, with no increased
complications.
Our ancient teachings and techniques from Yoga and Ayurveda are found to be more effective. There can be many
yogic relaxation techniques that can be used to minimize emotional stress and to create harmonious environment
for coming child. (2002), an ancient holistic Indian science, Yoga, has been used for centuries for stress reduction and
health promotion .Guided relaxation techniques based on Yoga and isometric relaxation have been linked to reduced
sympathetic activity(1999) .The practice of cyclic meditation was found to reduce oxygen consumption and breathing
frequency. (2000), Studies on heart rate variability (HRV) during vipassana (mindfulness) meditation showed a shift
toward vagal dominance in the autonomic balance (2005).
perceived stress and anxiety. The practice of Aum meditation is recommended in all the four Vedas, the
Upanishads (the essence of the Vedas) and the Shrimad Bhagawad Geeta. (B.G 8-12, 13.)Aum helps not only
to attain the ultimate aim of all existence, but helps also at all intermediate levels of growth of all kinds. The

objective of the present study was to assess the effect of one month yoga intervention AUM based
meditation on perceived stress and anxiety in pregnant women.
A total (n= 40) forty pregnant women receiving antenatal care at various obstetrics units in Thane and
Mumbai, India, was selected for yoga intervention. Mumbai, also known as Bombay, is the capital city of
the Indian state of Maharashtra. It is the most populous city in India, the second most populous metropolitan
area in India, and the ninth most populous agglomeration in the world, with an estimated city population of
18.4 million and metropolitan area population of 20.7 million as of 2011. Along with the urban areas,
including the cities of Navi Mumbai, Thane, Kalyan, Dombivali, Mira-bhayandar, and Bhiwandi, it is one of
the most populous urban regions in the world, is the fastest urban city where everyone has to run fast as
their daily routine to meet the day to day needs of family or the business. Even the pregnant women
are not excused for the fast and stress life, some are working or some are house wives. The selected
women between 25 years to 35 years aged and 20th w e e ks to 28th w e e k s of pregnancy. It was found
that the development of mind and intellect is more during this period of pregnancy as
suggested by the text on Ayrvada [Cucuta saàhitäa suit s<iota –vole II.2010] and aum meditation
based on (BhagavadGitaBySriSwamiSivanand.(pp86-87). Since stressed anxiety and perceived stress is the
aspect of mind factor, the sample size were divided randomly into yoga group (n= 20) twenty and control
group (n=20) twenty , assessed for the pre and post physiological parameters blood pressure, weight, pulse
rate tests and psychological PSS, STAI(form –X) tests. Yoga group practiced meditation, asana, and
pranayam and relaxation every three days of week for 30 minutes aum meditation and 30 minutes of
yogic practices while the control group practiced their regular routine with daily 30 minutes walk
for one month.They were not informed about the hypothesis of the study. Informed consent was obtained
from them all.
Measures
The State- Anxiety Inventory (STAI) is a psychological inventory. It was developed by psychologists Charles
Spielberg, R.L. Grouch, and R.E. Lushun in 1964. Their goal in creating the inventory was to create a set of
questions that could be applied towards assessing different types of anxiety. Several items on the STAI were
reversed coded (Items 1, 2, 5, 8, 11, 15, 16, 19, and 20). State Trait Anxiety Inventory (STAI) was used to
assess the anxiety level of the pregnant woman in the initial stage and end stage of both 30 days of control and
30 days of experimental group
The Perceived Stress Scale [PSS] was developed to measure the degree to which situations in one‘s
life are appraised as stressful. This was measured before (1day) yoga intervention and after [ 30] last
day for both the groups. It contain 10 questions that would applied towards assessing perceived stress
level .several items on PSS were reverse coded (items 4, 5, 7, 8) High psychological Stress is associated
with high blood pressure, higher BMI, larger waist to hip ratio, shorter Telomere length, higher cortisol
levels, suppressed immune function, decreased sleep, and Increased alcohol consumption.
As this was an interventional study, the participants and trainers could not be blinded, but the team who did the

assessments and the statistician were blinded. The perceived stress scale [PSS] answer sheets were coded and
kept away until the end of the study, and care was taken to prevent the participants from discussing the
techniques used.
Procedure
Yoga intervention. Yoga intervention includes of AUM meditation sessions 30 minutes and yogic practices, set
of loosening of joints, breathing techniques, asana, and pranayam and relaxation technique alternately one hour for
four week.
1. Hasta yam śvasanam (Hands In and Out Breathing- ‗A‘kar, ‗U ‘kar,‘M kar‘ chanting)- 1 min
2.
3. Hastavistāra śvasanam (Hands Stretch Breathing-„A‟kar, „U ‟kar,‟M kar‟ chanting) - 2 min
4. Ka iparivartana śvsanam (Side Twist Breathing) -1 min
5. Vajrasana -5min
6. Deep Relaxation- 15 min
7. Uttānapādāsana śvasanam (Leg Raise Breathing) -1 min
8. Setubandhāsana śvasanam (Hip Raise Breathing) -1 min
9. Vyāghrāsana śvasanam (Tiger Stretch Breathing) -1 min
10. Quick Relaxation techniocque (―U‖kar chant 5 times)-5min
11. Gulphagūra am (Ankle Rotation) -2 min
12. Jānuphalakākar a am (Kneecap Contraction) -1 min
13. Ardhātitaliāsana (Half Butterfly Exercise) -3 min
Movements, journey within. Everyday life is interaction between the senses and the outer world. It is a
technique for withdrawing the senses from the outer world and bringing them together (fetus and mother,
union with cosmic soul) .The union between you and your bigger self gives the seat for creativity and peace.
Aum meditation decreases oxygen consumption and heart rate and significant decrease in skin resistance level.
It produces a state of alert full rest (1998).

Table 2 AUM meditation
1. Opening prayer
2. PURIFICATION: kapalbhati here avoided. Abdominal breathing with “U”KARchantings -5times.
3.PREPARATION:
I. Nadishodhan pranayama: 5 rounds ( linear awareness)
II Shitali pranayama: 5 rounds ( surface aware ness)
III Sitkari pranayama: 5 rounds ( surface awareness)
IV Brahmari pranayama: 5 rounds((3D-Three dimensional awareness)
4. Dhahran: this is holding the same action. One is Dhahran on rupa ―the form‖, second is the wave
―shabdda‖.Here our focuses are evolved focusing on one thought.
(Dhahran of chakras: from muladhar to sahastradal chakra)
5. Chanting of chakra mantras and AUM bij mantra repeatedly with the fast speed.
7. SILENCE.
8. Closing prayer
The outcome measures were PSS and STAI measurements and physiological factors. Validity of the tests- PSS is
valid for use in the Indian population with reliability of .84. PSS questionnaire was administered before the
intervention period and the last day. Statistical analysis was done with SPSS version 21.0.
Intervention.
TABLE 3
M SD M SD M SD M SD
Wt 60.455 12.75 63.460 11.90 44.51 0.000* 51.1 7.40 54.5 7.59 55.55 0.000*
Sys.B.P 117.3 12.63 114.2 5.67 19.94 0.404 116.2 10.07 114.9 5.2 17.31 0.598
Dia .B.P 77.4 10.59 78.15 7.24 67.30 0.551 75.8 7.40 78.8 8.2 28.15 0.130
PR 76.6 8.82 74.65 8.2 20.7 0.090 73.6 3.96 73.6 3.6 26.4 0.638
PSS 19.85 4.28 17.8 3.22 69.8 0.019* 20.3 4.6 22.0 3.19 88.07 0.107
STAI 46 5.7 43.2 5.66 47.9 0.006* 41.6 6.49 42.7 7.69 61.04 0.123
(*significant)
The performances of the control and yoga intervention groups on the measure of PSS, STAI and other variables are
shown in Table 3. A close perusalofthescoresreveals considerablegainbythe intervention group. The mean (M) and
SD value of PSS, STAI, pulse rate (PR), systolic blood pressure (Systolic.B.P.), diastolic blood pressure (Diastolic.B.P.), of
yoga group has reduced whereas in control group value increased. The weight increased both in yoga and control group.
The percentage change [percentage %=pre-post/pre values] of PSS & STAI was significant within the
group, whereas control groups shows no significance expect weight.

TABLE 4 Wilcoxon‘s signed Ranked Test
Group PSS STAI
YOGA 0.019* 69.8 0.006* 47.9
CONTROL 0.107 88.07 0.123 61.04
(*significant)
As the scores were not normally distributed, Wilcoxon‘s Signed Rank Test was used. Table 4 shows that, There were
reduced percentage change of PSS& STAI value in yoga group (69.8%,47.9%)compared with control
group(88.7%,61.04%)respectively and p value<.05 of PSS & STAI(0.019&0.006 ) were significant within the
group. This was supporting to the previous studies based on only IAYT intervention given for pregnant
women.
TABLE 5 Mann- WhitneyTests
PRE 0.021 0.799 0.820 0.718 0.383 0.015
POST 0.013 0.989 0.904 0.314 0.000* 0.602
Table 5 presents the result of Mann Whitney test. It has greater efficiency than the t-test on non-normal
distributions, such as a mixture of normal distribution, and it is nearly as efficient as the t-test on normal
distributions. Results of Mann Whitney Test shows that there is a significant change in only the post data PSS
value in yoga group rather than control group, the other variables shows no significant change. On the basis of
these results we can conclude that there is a significant difference between Yoga and Control group (p<.05).
The present study clearly indicates that AUM meditation based one month yoga intervention given during
20 week to 28 week of first pregnancy period of the average age group between 30-35years contributed to
better reducing perceived stress and state anxiety (PSS and STAI) levels in pregnant women on Indian
population.
In general the participating reported improvement in alert fullness. In addition they have experienced other
benefits like reduction in blood pressure, clarity in thinking, and relaxed feeling in action. Earlier research on
integrated yoga on Pregnancy experience anxiety, and depression in normal pregnancy State (STAI I)
anxiety (decreased 15.65% in yoga, increased 13.76% in control), (2013) this study lends further support to
previous studies based on IAYT intervention. However, there is a limitation of this study which needs for a
more detailed study on diet based yoga intervention given for pregnant women.

REFERENCES
Babar, S., Parks-Savage, A. C., & Chatham, S. P. (2012). Yoga during pregnancy: a review. American journal
of perinatology, 29(6), 459.
Chan, K. P. (2014). Effects of parental meditation on pregnant Chinese women in Hong Kong: A randomized
controlled trial. Journal of Nursing Education and Practice, 5(1), p1.
Chang, S. C., & Chen, C. H. (2005). Effects of music therapy on women's physiologic measures, anxiety, and
satisfaction during cesarean delivery. Research in Nursing & Health, 28(6), 453-461.
Cohen, S; Kamarck T; Mermelstein R (December 1983). A global measure of perceived stress Journal of
Health and Social Behavior 24 (4): 385–396.
Curtis, K., Weinrib, A., & Katz, J. (2012). Systematic review of yoga for pregnant women: current status
and future directions. Evidence-Based Complementary and Alternative Medicine, 2012.
Dr.balaji tambe. (2002). Ayurvedic garbhasanskar the art and science of pregnancy, retrieved from
Dr.Guri shih broker (1941). Garbhasaàskära udayäcyä budhdimäana VA ärogyyasampanna
santatisäaöhé. Sadashiv peth, puna, 411 030.mehata publications.
Dr.Ulka natu. (2005).Effect of Yogic Practices in Pregnancy Depicted by Doppler Velocimetry studies of
Uterine Arteries, Umbilical Artery and Middle Cerebral Artery of the Fetus retrieved from
Narendran, S., Nagarathna, R., Gunasheela, S., & Nagendra, H. R. (2005). Efficacy of yoga in pregnant
women with abnormal Doppler study of umbilical and uterine arteries. Journal of the Indian Medical
Association, 103(1), 12-4.
Narendran.S, Dr.R.Nagarathana, Dr.H R Nagendra. (2008).Garbhopanishad, yoga for pregnancy, (pp85-
88).SVYP: Banglore-560019.
Pra Na joçé. (1892) Agnipurana.Sadashiv peth, puna411 30: Menorah josh, prods publication
PriyaVarta Sharma (2010). Cucuta saàhitäa suit s<iota –vole II.varanasi 001, INDIA: vishawabharati oriental
publishers.
Rakhshani, A., Nagarathna, R., Masker, R., Masker, A., Thomas, A., & Gunasheela, S. (2012). The effects of
yoga in prevention of pregnancy complications in high-risk pregnancies: A randomized controlled trial.
Preventive medicine, 55(4), 333-340.
Styapriya, M., Nagarathna, R., Padmalatha, V., & Nagendra, H. R. (2013). Effect of integrated yoga
on anxiety, depression & well being in normal pregnancy. Complementary therapies in clinical practice,
19(4), 230-236.
SriPandharinathKashinathThavare. (2001). manuñya yoni präapta jhäalelyä jéväacyä gatéce
varëana.InV.G.Desai(Ed), Shrimadbhagawatmahapurana (pp345-346).gorakhpur-273005: Gitapress
SriSwamiSivananda (2000) BhagavadGitaBySriSwamiSivanand. (Pp86-87). Shivanandanagar—249 192Distt.
Tehri-Garhwal, Uttar Pradesh, Himalayas, India: DIVINE LIFE SOCIETY.
SRIDEVI, V. GARBHA VIDHYA (Oct2013), WE MAKE BRILLIANT CHILD THROUGH PROPER
TRAINING FROM FOETUS.

Telles S, Reddy SK, Nagendra HR. Oxygen consumption and respiration following two yoga relaxation techniques.
Appl Psychophysiol Biofeedback 2000; 25(4):221–7.
Telles, S., Nagarathna, R., & Nagendra, H. R. (1998). Autonomic changes while mentally repeating two
syllables-one meaningful and the other neutral. Indian journal of physiology and pharmacology, 42, 57-63.
Telles S, Mohapatra RS, Naveen KV. Heart rate variability spectrum during Vipassana mindfulness meditation. J
Indian Psychol 2005; 22:215–9.
Vempati RP, Telles S. Yoga based isometric relaxtation versus supine rest: a study of oxygen consumption, breath
rate and volume, and autonomic measures. J Indian Psychol 1999; 17(2):46-2.
Vempati RP, Telles S. Yoga-based guided relaxation reduces sympathetic activity judged from baseline levels.
Psychol Rep 2002; 90(2):487–94.

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