Sweet Expectation and Positive Thinking: The Use of Mandalas in Labor Induction. A Randomized Pilot Clinical Study

Purpose: Labor induction is one of the most common medical interventions in obstetric practice and is often associated with feelings of pressure and lack of control. Mandala coloring or drawing is considered a meditative practice that may help express emotions, calm the mind, and promote awareness. The primary aim of this study was to evaluate the efficacy of Mandala coloring in improving the labor experience in nulliparous women undergoing induction. A secondary aim was to assess its effects on birth outcomes and analgesia requests. Patients and Methods: We conducted a monocentric, parallel-group randomized clinical trial. Patients in the intervention group (Group A; n = 26) received standard induction care plus Mandala coloring materials, while the control group (Group B; n = 26) received standard care only. The primary outcome was measured using the Childbirth Experience Questionnaire (CEQ), a 22-item self-administrated survey useful to asses a woman’s satisfaction with her labor and delivery experience. Secondary outcomes were recorded in a dedicated database. Results: The average CEQ score was 69.31 (SD 5.08) in Group A and 68.84 (SD 8.32) in Group B (P=0.81). Analgesia was requested by 15 women (57.7%) in Group A and 13 (50.0%) in Group B (P=0.33). In Group A, there were 17 spontaneous deliveries (65.4%), 5 operative deliveries (19.2%), and 4 Cesarean sections (15.4%). In Group B, 20 spontaneous deliveries (76.9%), 1 operative delivery (3.8%), and 5 Cesarean sections (19.2%) were observed (P=0.22). Conclusion: The results did not show statistically significant differences between the two groups in terms of the birth experience, obstetric outcomes, and the request for labor analgesia. However, the small difference observed in favor of the experimental group might indicate a positive trend which could become more evident in a study with greater statistical power and warrant further investigation.