The Effect of Diaphragmatic Breathing Exercises on Fetal Anxiety and Coping With Prenatal Stres

Introduction Pregnancy is a natural event that many women look forward to have with happiness and excitement, but it can be challenging for some women. In addition to physiological and psychological changes occurring during pregnancy, the readiness for a new life, changes in body image perception, fear of becoming a parent, uncertainties about childbirth, fears about the baby's development and survival can cause stress in pregnant women. Moreover, stressors during pregnancy such as economic problems, epidemics, and natural disasters can contribute to anxiety about both maternal and fetal health and cause significant stress. Stress is commonly observed during pregnancy and ranks high among stressful life events.

The negative effects of stress on human health are well-known. Both maternal and fetal health and their immune responses are sensitive to stress during pregnancy. High cortisol levels can lead to changes in their immune responses, suppressing the immune system and causing complications such as premature birth. Stress during pregnancy has been associated with negative pregnancy outcomes such as spontaneous abortion, pregnancy-induced hypertension, placental abnormalities, difficult labor, operative deliveries, low APGAR score, low birth weight, fetal death, postpartum depression, and long-term health problems such as cerebral palsy, neurodevelopmental delay, vision and hearing problems.

Although many pregnant women are exposed to stress, not all women who experience stress have negative pregnancy outcomes. The positive or negative experiences of pregnant women during pregnancy, their styles of coping with these experiences and stress, and the stressors they are exposed to affect whether the stress will disrupt their body balance and cause negative outcomes such as illness. The style of coping with stress is determinant in adapting to stressful events. Functional styles of coping with stress can reduce negative effects of stress, while ineffective coping styles can increase health risks. Coping styles of pregnant women with stress may vary, including functional coping styles such as having self-confidence, seeking social support, planning, and spiritual readiness and ineffective coping styles such as helplessness and avoidance. Considering the importance of coping with stress, understanding how pregnant women cope with stress and intervening to develop their styles of coping with stress may be useful in reducing stress during pregnancy. Various non-pharmacological methods such as relaxation exercises, yoga, biofeedback, massage therapy, acupuncture, and music therapy may be useful in reducing stress during pregnancy. However, there is no study about the effect of non-pharmacological methods in pregnancy on coping styles with stress. Some studies have reported that diaphragmatic breathing exercises increase quality of life and oxygenation and have a positive effect on anxiety. Therefore, both physical and psychological effects of diaphragmatic breathing exercises in pregnant women may positively affect their styles of coping with stress and reduce fetal anxiety. For this reason, this study aimed to determine the effect of non-pharmacological methods, specifically diaphragmatic breathing exercises, on coping with fetal anxiety and prenatal stress.

Research Hypothesis:

H1. Diaphragmatic breathing exercises performed during pregnancy increase coping with stress and reduce fetal health anxiety.