Effect of Yoga Exercises on Preventing Postpartum Blues in Postpartum Mothers | ||
| Health Education and Health Promotion | ||
| Article 8, Volume 13, Issue 2, 2025, Pages 249-256 PDF (281.15 K) | ||
| DOI: 10.58209/hehp.13.2.249 | ||
| Authors | ||
| M. Sinaga* 1; M.F.A. Tanjung2; E.E.R. Siringoringo2 | ||
| 1Department of Midwifery, Medan Sehati College of Health Sciences, Medan, Indonesia | ||
| 2Department of Midwifery, Sakinah Husada Tanjungbalai College of Health Sciences, Tanjungbalai, Indonesia | ||
| Abstract | ||
| Aims: The postpartum period presents significant physical, emotional, and social challenges for mothers. One common issue is postpartum blues, which can negatively impact maternal well-being. This study aimed to analyze the effect of yoga exercises on preventing postpartum blues in postpartum mothers using family health media as an intervention. Instrument & Methods: This quantitative analytical study with a quasi-experimental approach was conducted on postpartum mothers at the Alisah Clinic, utilizing a total population sampling technique. Data were collected through structured questionnaires and interviews and then analyzed statistically using SEM-PLS to evaluate the relationship between the frequency and duration of yoga practice, family support, and postpartum blues prevention. Findings: The yoga exercises significantly reduced postpartum blues symptoms. A higher frequency and longer duration of yoga sessions contributed to better mental and physical well-being. Additionally, the quality of family health media played a crucial role in enhancing knowledge and promoting behavioral changes that support yoga practice. Family support was found to positively influence the consistency of yoga practice. Conclusion: Yoga exercises, when practiced regularly with adequate duration and supported by quality health media and family involvement, are effective in preventing postpartum blues. | ||
| Keywords | ||
| Exercise; Yoga; Family Health | ||
| Full Text | ||
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Introduction The puerperium is a very important and challenging period for a mother after childbirth. During this time, the mother’s body and mind undergo major changes that require physical and emotional adaptation. Drastic hormonal changes after childbirth can affect a mother’s emotional balance, often leading to feelings of anxiety, stress, and unstable mood swings. In addition to hormonal changes, social and psychological factors also play an important role in the well-being of postpartum mothers [1]. Support from partners, family, and the surrounding environment can greatly affect a mother’s emotional state. A lack of social support is often associated with an increased risk of postpartum blues. Additionally, cultural pressures and societal expectations of the perfect mother can also add to the mental burden for new mothers. This condition often makes mothers feel overwhelmed and less confident in caring for their children. One psychological problem that is quite common during the postpartum period is postpartum blues, which is a mood disorder that generally appears within a few days to weeks after giving birth. This condition is characterized by symptoms such as excessive anxiety, irritability, frequent crying for no apparent reason, fatigue, and a lack of confidence in fulfilling the role of mother. Postpartum blues can be experienced by around 50-80% of postpartum mothers, and although it is temporary, this condition requires special attention. If left untreated, postpartum blues can develop into more serious postpartum depression and impact the mother’s quality of life and emotional relationship with the baby [2]. The impact of postpartum blues is not only limited to the mother but can also affect the development of the child [3]. Mothers who experience postpartum blues tend to have difficulty giving their full attention to their babies, which can impact the quality of the emotional bond between mother and child. In addition, this condition can also cause disturbances in sleep and feeding patterns in infants due to a lack of positive stimulation from the mother. Therefore, the prevention and management of postpartum blues are very important aspects of ensuring the well-being of both mother and baby [4]. Given its considerable impact on maternal well-being and child development, effective prevention efforts are needed to address postpartum blues. One method that can be applied is a physical and psychological approach, such as yoga exercises. Yoga has been shown to help stabilize emotions, reduce stress, and improve the physical well-being of postpartum mothers [5]. Thus, the application of yoga as one of the strategies to prevent postpartum blues is expected to help mothers cope better with the postpartum period, allowing them to fulfill their roles as mothers with more confidence and comfort [4]. Based on data released by the World Health Organization (WHO), around 20% of cases of postpartum blues that are not treated properly develop into postpartum depression [6]. This condition is more common in developing countries, including Indonesia, where a lack of social support and limited knowledge about mental health problems are often causal factors [7]. Riskesdas data for 2023 shows that the prevalence of postpartum depression in Indonesia reached 11.5%, with main risk factors including physical fatigue after giving birth, social pressure, and a lack of support from family or partners [8]. These factors may affect mothers’ ability to adapt to their new roles and negatively impact their mental health. Therefore, it is important for society, especially families and health workers, to find solutions that can prevent or mitigate the problem of postpartum blues, one of which is using yoga exercises as an intervention that can be easily and affordably implemented [9]. Yoga is a physical method that combines various body movements, breathing techniques, and meditation to create a balance between body and mind [10]. This yoga practice is believed to reduce stress, improve sleep quality, increase body flexibility, and strengthen the relationship between mother and baby. According to Gerbarg & Brown, yoga positively lowers cortisol levels, a hormone associated with stress and anxiety [11]. Yoga can also help overcome physical problems that postpartum mothers often face, such as back pain, fatigue, or muscle tension [12]. In terms of mental health, yoga can reduce anxiety and improve maternal emotional well-being [13]. Munns et al. also found that mothers who regularly practiced yoga during the postpartum period reported experiencing a significant reduction in symptoms of depression and anxiety. Therefore, yoga exercises are considered an effective alternative to help postpartum mothers prevent or reduce the symptoms of postpartum blues, as well as to support their physical and mental recovery after giving birth [14]. Research on the relationship between yoga and the mental health of postpartum mothers has been conducted by several previous researchers. Satyapriya et al. in India found that postpartum mothers who participate in a yoga program for six weeks experience a significant reduction in postpartum blues symptoms compared to mothers who did not participate in the yoga program [15]. Similar research by Chuntharapat et al. in Thailand also showed that yoga can reduce anxiety and improve the quality of life of mothers after giving birth [16]. The results of this research indicate that yoga is not only beneficial for physical health but can also support the mental well-being of mothers. However, although these studies show positive results, most were conducted in health centers or with the guidance of yoga instructors, thus paying less attention to affordability and convenience for postpartum mothers who live in areas with limited access to health facilities. This research differs from previous studies, particularly in its approach, which integrates family health media as a tool to facilitate the implementation of yoga at home. In most previous studies, yoga was implemented with the assistance of a direct instructor or in a health center. Meanwhile, this research tested the application of yoga through family health media, such as video tutorials or digital applications that can be accessed by postpartum mothers independently at home. This approach is expected to increase the accessibility of yoga for postpartum mothers who may not have the time or resources to attend scheduled yoga classes. Through family health media, it is hoped that mothers can carry out yoga exercises regularly at home, thereby increasing the likelihood of success in preventing or reducing symptoms of postpartum blues. Even though many studies have discussed the benefits of yoga for postpartum mothers, there is still a gap in the implementation of yoga that can be widely accessed by postpartum mothers at home. Some previous studies were limited to interventions carried out in health centers or with the assistance of professional yoga instructors. This makes it difficult for postpartum mothers who do not have access to these facilities to obtain the same benefits. Additionally, more affordable and practical approaches, such as digital media, have not been widely explored. This gap is the main reason this research was conducted to determine how effective the application of yoga exercises through family health media is in preventing postpartum blues in postpartum mothers. With this approach, it is hoped that mothers can practice yoga easily at home, which will suit their circumstances and needs. The main purpose of this study was to analyze the effect of applying yoga exercises on preventing postpartum blues in postpartum mothers using family health media as a means of intervention. In addition, this study aimed to contribute to the development of an effective and practical family-based intervention model. Through this research, a system was developed that increased mothers’ awareness of the importance of maintaining mental and physical health during the postpartum period and helped them overcome the symptoms of postpartum blues. Thus, the results of this study can serve as a basis for the development of health policies that are more inclusive and pay greater attention to the welfare of postpartum mothers in Indonesia. Instrument and Methods Type of research This research was quantitative with a cross-sectional method, in which, the main goal was to examine a specific population or sample using a structured research instrument. This approach is relevant for evaluating the effect of implementing yoga exercises on preventing postpartum blues because it provides an overview of the relationship between yoga exercise as a health intervention and postpartum blues conditions in postpartum mothers at a single point in time. Research setting The research was carried out at the Alisah Clinic. This health facility is a strategic location because it has a relevant target population; postpartum mothers registered as patients. The selection of this location was based on considerations of accessibility, data availability, and support from the clinic to ensure the smooth running of the research. The research was done from June to July 2024, with activity stages designed systematically. Sample The sampling technique employed was total population sampling, which included all postpartum mothers registered at Alisah Clinic, totaling 80 individuals. Since this study utilized a single intervention group, all participants received treatment in the form of postpartum yoga exercises combined with family health media. This single-group approach enabled researchers to assess changes before and after the intervention within the same group, without making comparisons to a control group. Data collection The data collection was carried out through two main types of data sources, including primary and secondary data. Primary data were obtained directly from respondents through questionnaires and interviews. A questionnaire was designed with 18 statements for each research parameter, using an ordinal scale to measure postpartum mothers’ perceptions and experiences regarding the effect of yoga exercises on preventing postpartum blues. In addition, interviews were conducted directly to explore more in-depth information, such as emotional experiences, levels of family support, and the benefits of yoga exercises according to the respondents’ views. This approach aimed to obtain accurate and comprehensive data and to complement the results of the questionnaire. The validity of the questionnaire was assessed through content validity, which involved seeking opinions from experts (expert judgment), such as supervisors or health practitioners experienced in the fields of postpartum maternal health and postpartum psychology. Each item in the questionnaire was reviewed to ensure that the statements accurately reflect the aspects to be measured, such as the perception of yoga benefits, postpartum blues symptoms, and family support. Meanwhile, secondary data were obtained from patient medical records at the Alisah Clinic. Medical records provided objective data regarding the postpartum mother’s health condition, birth history, and risk factors relevant to postpartum blues. This information helped ensure the validity of the research data and provided a broader context for the analysis. By using a combination of primary and secondary data, it is hoped that this research will provide a comprehensive picture of the effect of yoga exercises in preventing postpartum blues and support more valid and reliable conclusions. Data analysis Data analysis was conducted using SmartPLS software version 4, which is an application based on Partial Least Squares Structural Equation Modeling (PLS-SEM). Findings Most respondents were young mothers, with the majority in the 17-25 age group, followed by those in the 26-35 age group. In terms of education, the respondents predominantly had a diploma or Junior high school background, although a significant portion had lower levels of education, including junior high, elementary, and high school/vocational school (Table 1). Table 1. Demographic characteristics of the subjects obtained from primary data, 2024  Reliability of the research parameters The reliability and construct validity tests indicated that several constructs measured showed varying levels of reliability and validity. The construct “frequency of application of yoga exercises” demonstrated low reliability, with Cronbach’s alpha and composite reliability values below the acceptable threshold, suggesting that this construct may not be reliable for measuring its intended variable. Similarly, “family health media quality” also showed moderate reliability, with an average variance extracted (AVE) slightly below the ideal value, indicating room for improvement. On the other hand, “yoga practice duration” and “level of family support” exhibited better reliability, with acceptable composite reliability and AVE values, supporting their validity as strong indicators in the model. Importantly, the construct “the effect of applying yoga exercises in preventing postpartum blues” exhibited perfect reliability and construct validity, with all indicators at the maximum value, indicating that this construct is highly reliable and valid for measuring the effect of yoga exercises on preventing postpartum blues. These findings highlight that while some constructs require refinement, the research successfully supports the intended goal of examining how yoga exercises can effectively prevent postpartum blues, particularly with the strong performance of the “effect of yoga” construct. This reinforces the research’s focus on the importance of yoga interventions in improving postpartum mental health, aligning with the goal of developing effective family-based health interventions (Table 2). Table 2. Composite reliability and Cronbach’s alpha results  The application of yoga practice had a highly significant effect on preventing postpartum blues in postpartum mothers. The research model used demonstrated excellent predictive ability, with the independent variables explaining most of the variation in the incidence of postpartum blues. The high adjusted R-squared value indicated that the model remained robust even when adjusted for the number of predictors used. This confirms the importance of integrating yoga exercises into postpartum women’s health programs to reduce the risk of postpartum blues (Figure 1).  Figure 1. Regression results on the effect of applying yoga exercises on preventing postpartum blues. Independent and dependent parameters were assessed using the bootstrapping method in SE Mpls to determine the validity and reliability of the research data. This test used T-statistics and p-values, which were later presented as a t-table, to identify valid research data for T-statistic values greater than 1.96 and p-values less than 0.05 (Table 3). Table 3. Bootstrapping method results  All independent parameters significantly influenced the application of yoga exercises in preventing postpartum blues among postpartum mothers. Each parameter showed significant results (high T-statistics and p=0.0001). Among the parameters, “yoga practice duration” demonstrated the strongest influence with the highest original sample value, followed by “regularity of yoga practice,” which also showed a substantial effect. Additionally, “frequency of application of yoga exercises,” “family health media quality,” and “level of family support” all contributed significantly to the overall outcome, with each showing positive relationships with the prevention of postpartum blues. These findings directly align with the research’s goal of evaluating the effectiveness of yoga exercises, particularly through family-based health interventions, in reducing the risk of postpartum blues. Discussion This study aimed to analyze the effect of yoga exercises on preventing postpartum blues in postpartum mothers using family health media as an intervention. The frequency of implementing yoga exercises significantly influenced the parameters analyzed, supporting the importance of consistency in this activity. The results are in line with previous research showing that physical activity carried out regularly, such as yoga, has a significant positive impact on both physical and mental health. Smith et al. revealed that regular yoga contributes to increased body flexibility, reduced stress, and improved sleep quality and concentration [17]. This is in line with our results, where the frequency of applying yoga exercises positively affected physical condition and general well-being. Additionally, Rafika emphasized that the frequency of yoga activities is directly related to the benefits obtained [18]. The more often a person engages in yoga, the greater the positive impact felt in managing stress and improving mental health. These findings support that more frequent application of yoga may provide greater benefits in enhancing quality of life. Thus, our results strengthen previous findings, which show that consistency in practicing yoga exercises significantly improves physical and mental well-being. The frequency of application of “Family Health Media Quality” significantly influenced the analyzed parameters, with results indicating a positive relationship between the quality of media used in the family health context and its impact on health knowledge and behavior. Previous research has confirmed the importance of the quality of health media in influencing health-related decision-making, especially within families. Research by Deepa and Krishna Priya revealed that using quality health media can increase people’s understanding of health issues and promote healthy living behavior [19]. Informative and trustworthy media serve as effective means of providing health education, especially for families that may not have direct access to health services. These findings support our results, demonstrating that the quality of family health media played an important role in improving the understanding and practice of health within families. In addition, research by Li shows that quality health media, especially accurate, easy-to-understand, and trustworthy information, significantly impacts family health knowledge. High-quality media can help families make better health-related decisions, such as adhering to medical recommendations and following a healthy lifestyle. Therefore, this study provides in-depth evidence about the influence of media quality on health behavior in families and supports that family health media quality can improve the quality of life [2]. The duration of yoga practice significantly influenced the analyzed results, with a very high t value. This indicates that the longer the duration of yoga practice, the greater the impact on physical and mental well-being. Previous research has proven that longer durations of yoga practice provide greater benefits, both in terms of improving physical health and managing stress. Research by Cramer et al. shows that a longer duration of yoga practice is directly related to improved body flexibility, muscle strength, and balance [20]. The longer a person practices yoga, the greater the body’s ability to adapt to the yoga movements, thereby improving overall physical health. These findings support the results found in this study, which showed that the duration of yoga practice had a significant positive influence on well-being. Additionally, a survey by Gothe et al. emphasized that longer durations of yoga practice play an important role in reducing stress, anxiety, and depression [21]. Longer durations allow individuals to experience greater psychological benefits, such as increased peace of mind and better emotional management. These results align with the findings of this study, which indicated that the duration of yoga practice played a crucial role in improving mental health and general well-being. Overall, these findings further strengthen the evidence that longer durations of yoga practice have a significant impact on enhancing physical and psychological health, as well as supporting overall quality of life. The level of family support significantly influenced the analyzed parameters, indicating that high family support can improve individual well-being. Previous research has emphasized the importance of family support in enhancing the quality of life, particularly in the context of personal health and happiness. Research by Xu et al. revealed that emotional and practical support from family can help individuals face life challenges, reduce stress levels, and improve mental well-being. This support serves as a source of strength in dealing with difficult situations and enhances overall physical and psychological health. The results of this study align with existing findings, which show that the higher the level of family support, the greater the impact on individual well-being [22]. Research by Aass et al. indicates that family support is not only related to emotional aspects but can also increase motivation to maintain health [23]. Families that support individuals in physical activity or in overcoming health problems play an important role in ensuring the individual’s success in achieving health goals. Thus, this research supports that family support can contribute significantly to improving a person’s quality of life in terms of physical health and mental well-being. Overall, these findings underline the importance of family support in enhancing well-being, both physically and psychologically, and provide evidence that the support offered by the family significantly impacts an individual’s quality of life. The regularity of yoga practice significantly influenced the analyzed parameters, with the t value indicating that consistency in yoga practice greatly impacts physical and mental health. The results of this study are consistent with previous findings, which show that regular yoga practice provides greater benefits than sporadic practice. Research by Sherman et al. confirms that regular yoga can increase physical strength, flexibility, and body balance. They found that individuals who practiced yoga regularly are more likely to experience improvements in overall physical condition. This supports the results of this study, which demonstrated that regular yoga practice greatly influenced physical well-being [24]. Furthermore, Gothe et al. indicate that yoga performed regularly also has a positive impact on mental health by reducing symptoms of anxiety, depression, and stress. Regularity in yoga practice enables individuals to manage their emotions more effectively and achieve a calmer state of mind [21]. These findings align with this research, which shows that regular yoga practice has a positive effect on physical health and plays an important role in improving psychological well-being. Overall, these findings further strengthen the evidence that regular yoga practice significantly impacts physical and mental health, thereby enhancing overall quality of life. It can be concluded that the application of yoga exercises significantly prevented postpartum blues in postpartum mothers. More frequent and longer yoga practice positively impacted the physical and mental well-being of postpartum mothers. The more often postpartum mothers engage in yoga, the greater the benefits they experience in managing stress and improving their mental health. Additionally, the quality of family health media used for education played an important role in increasing health knowledge and behavior, which supports the implementation of yoga exercises. Family support is another crucial factor, as it motivated postpartum mothers to maintain regular yoga practice, thereby enhancing the program’s effectiveness. Regularity in yoga practice also significantly contributed to the prevention of postpartum blues, with families providing positive support that helps sustain consistent practice. Overall, regular yoga practice, adequate duration, quality health media, and family support are effective methods for preventing postpartum blues in postpartum mothers. However, this study has some limitations. The lack of a control group restricts the ability to identify the pure effects of the intervention due to the absence of direct comparators. Additionally, data collected through questionnaires and interviews may contain subjective biases from respondents. The research was also conducted in only one clinic, which means the results cannot necessarily be generalized to the population of postpartum mothers in different regions or social contexts. To enhance the effectiveness of interventions, it is recommended that health workers, particularly midwives, integrate yoga practices and family health media into postpartum mothers’ assistance services. Educational materials should be prepared in language that is simple, engaging, and relevant to the needs of postpartum mothers. Families should be actively involved through education and short training to provide optimal support. Future research is encouraged to utilize a quasi-experimental or experimental design with control groups and to include more sites and participants to strengthen external validity and broaden the application of the results. Conclusion Yoga exercises, when practiced regularly with adequate duration and supported by quality health media and family involvement, are effective in preventing postpartum blues. Acknowledgments: The author expresses praise and gratitude to God Almighty for all His abundant blessings and grace, which enabled the completion of the scientific research titled “The Effect of Applying Yoga Exercises in Preventing Postpartum Blues in Postpartum Mothers: Implementation of Family Health Media.” This scientific research was compiled to fulfill one of the requirements for obtaining the Rank/Group and Position as a Lecturer at Sehati Health Science College. The author fully recognizes that this research could not have been completed without the assistance of various parties, including moral support, material contributions, and intellectual guidance. Ethical Permissions: This research received ethical approval from the Research Ethics Committee of Alisah Clinic, under Number 118/STIKS/VI/2024, dated January 13 – July 18, 2024. Additionally, respondents signed an informed consent form. Conflicts of Interests: The authors reported no conflicts of interests. Authors' Contribution: Sinaga M (First Author), Introduction Writer/Methodologist/Main Researcher (35%); Tanjung MFA (Second Author), Assistant Researcher/Discussion Writer (35%); Siringoringo EER (Third Author), Assistant Researcher/Statistical Analyst (30%) Funding/Support: This research was supported by the Medan Sehati College of Health Sciences Midwifery Study Program, Indonesia. | ||
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