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Guided Imagery Reduces Maternal Stress from At-Risk Pregnancies

22 Apr

Researchers from the Department of Family and Community Health at Virginia Commonwealth University School of Nursing in Richmond, Virginia, and Norfolk General Hospital in Norfolk, Virginia, conducted a feasibility study examining the impact of guided imagery on maternal stress in at risk, hospitalized pregnant women suffering from conditions such as preterm labor,  hypertension, pre-eclampsia, premature rupture of membranes, incompetent cervix, multiple gestation, and so forth.

The investigators used a repeated-measures, pre-/posttest design. Mean stress and systolic blood pressure measurements were significantly lower after the intervention, as compared to before listening to the guided imagery CD.  Measures were taken on Day one and whatever the last day was – number of days varied and could be from 2 to 10 days.

The guided imagery that was used was described in this way:

The intervention was a 20-minute GI CD prerecorded by the Health & Wellness department ofSentara Healthcare, based on visualization concepts often used in yogic practices.

The Content consisted of key components of GI. The CD begins with a calm soothing voice inviting the listener to assume a comfortable position.

The script then proceeds with a relaxation induction section focusing on muscle relaxation and breathing. For several minutes, the listener is encouraged to imagine walking slowly downstairs and, with each step, becoming more and more relaxed. The narrator encourages the listener to visualize several pleasant scenes using all of the senses. Images such as a garden and a rainbow with a myriad of colors are introduced.

Throughout the CD, positive thoughts and affirmations such as “I am relaxed,” “I am calm,” and “nurturing energy fills me” were included. After the narration, the CD ended with several minutes of quiet harp music.

The content was developed to impart a sense of relaxation, calmness, power, healing, and health to affect health outcomes. It is these images that mediate the communication between perception emotion, and physiological change and may affect a physiological process.


All participants identified benefits derived from the intervention in their logs. Mean stress level immediately after participation in the GI therapy (M = 1.74, SD = 2.23) was statistically significantly lower than the mean level of stress prior to therapy (M = 3.97, SD = 2.78) (Z=−3.54, P < .001;).

Eighty-four percent (84%) of participants had lower stress scores after treatment, whereas the remainder had equivalent pre- and posttest scores.

Posttest mean systolic blood pressure (M = 104, SD = 13.67) was also statistically significantly lower than the mean score prior to participation in relaxation therapy (M = 109, SD = 12.05) (t18 = 2.35, P = .031, with a medium effect-size index, d = 0.5; Table 2). No statistically significant difference was found in pretherapy diastolic blood pressure (M = 64, SD = 8.83) and posttherapy diastolic blood pressure (M = 64, SD = 8.95) (Z=−0.181, P = .856; Table 2).

Sixty-eight percent of participants had lower systolic blood pressures scores, and 53% of participants had lower diastolic blood pressure scores after participation in therapy.

The researchers conclude that this provides preliminary evidence that guided imagery may be effective in reducing maternal stress in hospitalized pregnant women, and supports the feasibility of conducting a randomized clinical trial to further support incorporating this intervention into care. [Ed. Note: The design of this study has a lot of problems with it, so these conclusions need to be heard with caveats to that effect.]

Citation: 
Jallo N, Cozens R, Smith MW, Simpson RI Effects of a guided imagery intervention on stress in hospitalized pregnant women: a pilot study. Holistic Nursing Practice. 2013 May-Jun;27 (3): pages 129-39.

Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award