A woman’s pregnancy, starting from conception, up to delivery can be a stressful one due to various physiological, psychological, emotional, superstitious beliefs, economic condition etc. All cultures emphasis the fact that the expectant mother’s well-being is an absolutely necessary condition for the well-being of the baby. It can be a great emotional experience. The physical and psychological aspects cannot be separated. For most women, labour is a time of apprehension, of fear and agony. But, with proper antenatal preparation the majority of women can have a labour that is easy and painless or almost painless and some can actually enjoy the labour and experience a sense of fulfillment.

Pregnancy is not a disease. It is an ideal environment to give new life to the baby. At the time of pregnancy, the mother should be more positive and relaxed. Cognitive behavior therapy helps to organize the thoughts in the positive way. In addition, yoga therapy helps to relax the mind, as well as strengthen the body.

A woman’s pregnancy, starting from conception, up to delivery can be a stressful period due to various reasons such as physiological, psychological, and emotional conditions, coupled with superstitious beliefs, economic conditions, family traditions etc. All cultures emphasize the fact that the expectant mother’s well-being is an absolutely necessary condition for the well-being of the baby. She needs to be enlightened about her fears, encouraged to adopt the right perspective and emboldened to face pregnancy. This is possible by cognitive behavior therapy and yoga therapy.

The review of literature indicates a significant improvement in the well-being of pregnant women after implementing a suitable intervention programme. Biernacka et al. [1] conducted the study on Occupation-related psychosocial factors in pregnancy and risk of pre-term delivery. The study concluded that the obtained data indicate the need to evaluate stress at work in groups of occupationally active pregnant women as well as to select more thoroughly work posts for this group of employees. It is studied that the pregnant women’s experiences of psychological distress. This study focused on exploring pregnant women’s experiences of antenatal depression and anxiety. The study concluded that mild-moderate psychological distress that is insufficient for referral to the mental health services may be significant for some women in pregnancy.

For conducting the intervention program, the meeting held with the gynecologist and the administration of the concerned hospital marked the initial procedures, in which, the therapist presented the significance and necessity of the intervention program. The gynecologist and management showed keen interest in the area and granted permission to conduct the intervention program for pregnant women. Primi gravidas (undergoing first pregnancy) with normal, healthy conditions pregnant women were selected. The life partners were also requested to participate for cognitive behavior therapy in hospital to enhance understanding and training in the intervention program. The participants seemed curious about the program and showed interest when the highlights of the program were discussed. Timings and dates were decided depending on their availability.

The investigation adopted an experimental design, described as “Pre- Post Experimental design with Control Group”. The sample was a group of primi gravidas (women undergoing first pregnancy) from third month till the date of delivery. Hence purposive sampling method was adopted. Of the 450 pregnant women who attended the counselling session and answered the scale 290 had a high score in perceived the well-being and 160 pregnant women had a low score in perceived the well-being. The samples with high scored in perceived well-being were excluded in this study. So, the investigator selected only 160 pregnant women who had a low score in the perceived well-being of pregnant women. Out of 160, 106 pregnant women gave willingness and they formed the “experimental and control group,” during the intervention program. The intervention program was administered to 106 samples. In experimental group, there were comprised of 20 samples that were willing to participate in cognitive behavior therapy and yoga therapy. They were formed the group –I. Group –II consist of 15 samples they were given cognitive behavior therapy and 18 samples formed the group-III, they were given yoga therapy. The same number of samples in the respective group was taken as control group.

A scale to measure the perceived Well-being of pregnant woman was constructed by the researcher for the fulfillment of objectives of the study. Birth order, Age group, Religion, Nativity, Qualification, Occupation, Nature of work, Hours of work, Income, Family structure, Number of family members, Consanguinity, Family illness, Physical illness, Period of conception were the demographic details of the sample, which also included. The tool was administered to the experimental and control groups. The tool was in the version of both Tamil and English. There are 72-items related to the Well-being of the pregnant woman. The tool emerged based on the opinion of researchers, academicians, gyneacologist, mothers, pregnant women and other experts in the field of investigation. It has helped to identify the items related to measure the wellbeing of pregnant woman. The scoring for the tool was computed on a 5-point scale ranging from 0-Never, 1-Rarely occurs, 2-Sometimes, 3-Most of the time, 4-Always. There were 72-items related to the Well-being of the pregnant woman. Cronbach’s alpha reliability 0.59, parallel form method of reliability 0.61, split-half method reliability is 0.62. Content validity was established with the opinion of experts in the field of investigation. Correlation of coefficient was found to be 0.81 between the English and Tamil version.

The intervention programme was intended to provide a holistic approach to improve the wellbeing of pregnant women. The intervention pragramme was implemented for a period of 8 months and the following sessions were allotted for the intervention program and each session being conducted for 2 hours during weekdays.

Cognitive behavior therapy and yoga therapy-25 sessions

Cognitive behavior therapy- 10 sessions

Yoga therapy- 15 sessions

Dobson, Master et al, Beck 1995 [2,3] model for helping pregnant women, the current researcher devised an innovative, intentional, empirical model appreciated by the hospital and the gynecologist readily referred pregnant women for the intervention

Iyenkars [4] model for helping pregnant women, the current researcher devised an innovative, intentional, empirical model appreciated by the hospital and the gynecologist readily referred pregnant women for the intervention.

Table 1: Cognitive Behavior Therapy for Alliviating the Concerns of Pregnant Women

To maintain structure and facilitate easy administration of the process, the comprehensive programme was divided into five spheres, namely: chanting, pranayama, dynamic breathing exercises, dhyana, yoga nidra.

Table 2: The effect of cognitive behavior therapy and yoga therapy.

Figure 1: The effect of cognitive behavior therapy and yoga therapy

The obtained t value is found to be 0.080. This indicates that there is no significant difference between experimental group -I and control group-I pre-test scores of perceived Well-being of pregnant women among the cognitive behavior therapy with yoga therapy.

Hence, the stated Hypotheses (Ho 2.a.) that,’ There will be no significant difference between experimental group -I and control group-I pre-test scores of perceived Well-being of pregnant women among the cognitive behavior therapy with yoga therapy “is accepted.

A paired sample t-test was conducted to compare scores pre-test and post-test intervention. There was a significant difference in the scores for the pre-test (M=177.35 S.D=14.936) and post test (M=195.62 S.D=18.932) conditions.

From the above table it can be see that a significant difference was found with the pregnant women scoring higher on well-being in the post test compared to the pre-test of experimental group-I, with the t score=3.43, being significant at the 0.01 level.

This result suggest the when the group was subjected to intervention program their scores on well-being improved. Thus the hypothesis (2.b.) stated that,” There will be a significant difference between pre-test and post-test scores of perceived Well-being of pregnant woman among the experimental group-I”is accepted.

The obtained t value is found to be 0.151. This indicates that there is no significance difference pre-test and post-test scores of control group-I of perceived Well-being of pregnant women among the cognitive behavior therapy with yoga therapy.

Hence, the stated Hypotheses (2.c.) that,’ There will be no significant difference between pre-test and post-test scores of perceived Well-being of pregnant women among the cognitive behavior therapy with yoga therapy control group –I, “is accepted.

A paired sample t-test was conducted to compare scores experimental and control group-I post-test scores intervention. There was a significant difference in the scores for the control group-I (M=178.05 S.D=14.365) and experimental group-I (M=195.67 S.D=18.932) post-test intervention.

From the above table it can be see that a significant difference was found with the pregnant women scoring higher on well-being in the experimental group compared to the control group after intervention, with the t score=3.353, being significant at the 0.01 level.

This result suggest the when the group was subjected to intervention programme their scores on well-being improved. Thus the hypothesis (2.d.) stated that,” There will be a significant difference between experimental group-I and control group -I post-test scores of perceived of well-being of pregnant women. ” is accepted.

The same method was adopted in the experimental and control groups II & III.

Table 3: The effect of cognitive behavior therapy

Figure 2: The effect of cognitive behavior therapy

Table 4: The effect of yoga therapy.

Figure 3: The effect of yoga therapy.

At the time of pregnancy, the mother should be more positive and relaxed. Cognitive behavior therapy helps to organize the thoughts in the positive way and yoga therapy helps to relax the mind, as well as strengthen the body. This was possible by giving cognitive behavior therapy and yoga therapy.

In the western countries, the pregnant woman attends counseling sessions along with her husband and gains knowledge regarding the physiological, psychological and emotional changes, gets special attention and knowledge about the economic commitment and tension free delivery which is required for a healthy baby. They are well equipped for a normal labour with proper safety. Whereas, the scenario is entirely different in our country factors like People’s fears, superstitious beliefs and lack of knowledge cause enormous stress for the pregnant women. In order to manage or reduce their physical or mental imbalance, the behavioral intervention program is a boom to the pregnant women. Further, the part of behavioral intervention program of cognitive behavior therapy and yoga therapy can help to alleviate accumulated fears and prepare them for the healthy and safe labor.