Feasibility and Acceptability of Alternate Nostril Breathing to Reduce Stress in Pregnant Women Survivors of Intimate Partner Violence: A Mixed Methods Study

Abstract

Intimate partner violence (IPV) is a pervasive and insidious problem that results in considerable deleterious effects to the physical and psychological health of women, as well as their children. When women exposed to IPV are pregnant, it also results in poor pregnancy and birth outcomes for themselves and their fetuses. Evidence suggests that these impacts result due to toxic stress experienced by women exposed to IPV. Alternate nostril breathing (ANB), a slow yogic breathing technique, has demonstrated effectiveness in reducing stress in various populations, including women who were pregnant, but had not experienced IPV, and women who experienced IPV, but were not pregnant. This dissertation study aimed to determine the feasibility and acceptability of an intervention of ANB to reduce stress in pregnant survivors of IPV. Mitigating the stress of these women could potentially be an initial step in improving their pregnancy and birth outcomes. This mixed methods dissertation study initially was conducted in a face-to-face format, and included collection of salivary C-reactive protein (CRP) pre- and post-intervention in order to assess convergence or divergence with results from pre- and posttest scores on the perceived stress scale (PSS-10), in addition to thematic analysis of post-intervention interview data. Due to the onset of the COVID-19 pandemic, the study had to be revised to a completely online format. This was performed using the research electronic data capture (REDCap) program. CRP could no longer be collected in an online format. Conducting an interventional study with a highly vulnerable population (pregnant women exposed to IPV) during a pandemic proved to present considerable challenges to enrollment and retention. This dissertation describes the study and examines potential methods to improve recruitment, enrollment, and retention of a highly vulnerable population.