TABLE 1.

Specific Activities in “Mindful Moms” Intervention

Key aspect	Specific activities
(A) Mindfulness of symptom self-management and motivation for physical activity	At the baseline visit, the nurse and participant: discuss the concepts of self-management and self-awareness of depressive symptoms and brainstorm methods to manage symptoms, using aspects of motivational interviewing, and develop goals related to symptom self-management and physical activity. At weekly check-ins, the nurse and participant: reassess goals, address barriers to class participation and/or home activity.
(B) Mindful physical activity	Weekly group prenatal yoga class: 75 minutes, manualized; taught by experienced prenatal yoga instructors Participants self-assess at the beginning of each class for indicators to cease physical activity, per ACOG guidelines (e.g., new vaginal bleeding, new consistent painful uterine contractions).
(C) Applied self-management skills	Participants are provided with a handbook of yoga poses and suggestions for other safe physical activities (e.g., walking, stair climbing, dancing) in which to engage at home. Participants self-monitor depressive symptoms and document use of self-management activities (e.g., home-based physical activity) in written log.
Excerpt from weekly group prenatal yoga class manual:
Checking-in and brief discussion with group	Week 3 Theme: Meeting the Mood: Brief discussion—What does “meeting the mood” mean to you?
Creation of safe space; empowerment to adapt practice; intention/centering	SAFE SPACE: Reinforce concepts of yoga: an opportunity to connect breathing practices, physical movements, and relaxation to enhance well-being EMPOWERMENT: Reinforce concepts of self-awareness and adapting practice to one’s specific needs, involves an awareness of “now,” letting go of expectation or self-judgment, communication, and permission to modify as needed INTENTION/CENTERING: Our focus this week—Learn to adapt your practice and meet yourself where your mood currently rests, both at home and in class; everyone has a unique experience—you play a role in adapting your yoga practice according to your personal needs and mood; this is an opportunity to become self-aware and self-accepting and develop the practice that is best for you.
Pranayama (breathing practices) and Asana (physical poses)	Reclining “Goddess” pose with self-awareness of breath: 4:4 count (for energizing if feel tired, down, blue); 4:6 count (for relaxing if feel anxious, revved up, hard to relax) Seated poses: neck/shoulder rolls, pelvic rocking, lateral stretch, gentle twist Poses on hands-and-knees: cat/cow, modified push-up to child’s pose Standing poses: mountain pose, sun breaths, short easy warrior flow, partner squats, tree pose, half forward-fold to wall or with partner, hip circles, slow movement to the mat Legs up the wall
Guided Savasana (meditation and relaxation)	❖ Awareness of sensation (guided body scan) ❖ Awareness of breath (guided breathing practice) ❖ Awareness of inner resources (guided meditation)

ACOG = American College of Obstetricians and Gynecologists