Abstract
Background/Objectives: Antenatal depression and perceived stress are prevalent mental health challenges faced by pregnant women, and they are associated with male child preference. This study aimed to assess the feasibility of a modified mindfulness training program for reducing antenatal depression and perceived stress levels among expectant mothers with a male child preference at a public sector tertiary care hospital in Karachi, Pakistan. Material and Methods: The present feasibility trial was conducted among expectant mothers with antenatal depression and perceived stress with a male child preference using the ADAPT-ITT framework. Assessments of the needs and experiences of the new target population were carried out through an exploratory and descriptive qualitative study. In-depth interviews were conducted using a semi-structured interview guide and analyzed using a thematic analysis process. Repeated-measures MANOVA was employed to investigate the effect of time on antenatal depression and perceived stress scores in the feasibility of the intervention. Results: Five major themes emerged from the qualitative data. A significant influence of time was established on the antenatal depression scores, with perceived scores of F (2, 326) = 21.244, p < 0.001, and F (2, 326) = 310.748, p < 0.001. The antenatal depression scores significantly decreased from pre-intervention to post-intervention (mean difference = 4.00, p < 0.001), and there was a slightly significant decline from post-intervention to follow-up (mean difference = 1.167, p = 0.001). The perceived stress scores were significantly reduced from pre-intervention to post-intervention (mean difference = 10.214, p < 0.001), and there was a minor but significant decline from post-intervention to follow-up (mean difference = 0.333, p = 0.043). Conclusions: This study concludes that the modified mindfulness training program is a culturally suitable, contextually relevant intervention in the context of Pakistan and it significantly reduced antenatal depression and perceived stress in expectant mothers with a male child preference. The modified mindfulness training program was modified in accordance with the context of Islamic teaching regarding health-promoting lifestyles and religious spirituality.