The Effect of Laughter Yoga and Pilates on Pregnancy in Pregnant Women Receiving Childbirth Preparation Training

Pregnancy, childbirth and the process of becoming a parent are important life events in women's lives. Since birth is an unpredictable and uncontrollable process, this process may be accompanied by stress, fear and anxiety from time to time (Uçar and Gölbaşı, 2015). In addition, pregnancy is a period in which biological, physiological and psychological changes occur in women. In pregnancy, which is a biologically normal process, the woman and the fetus must adapt to this situation in order to protect their health. Although the person experiencing pregnancy is a woman from a physiological point of view, close individuals around the pregnant woman are also involved in the process. In addition to the physiological and psychological changes that occur in the pregnant woman during pregnancy, the pregnant woman's spouse and other family members also experience some psychological and social changes and they need to adapt to these changes (Polat Başpınar, 2021).

The emotional state caused by these changes and the methods of coping with them vary from pregnant to pregnant. While most pregnant women can adapt to these situations brought about by pregnancy, many of them may experience serious problems during this period (Fırat, 2024). Various factors affect women's ability and ability to adapt to changes and challenges in pregnancy. These factors can be classified as personal, social, and pregnancy-related factors (Rockliffe et al., 2021).

Traditional and complementary medicine practices are used to reduce stress during pregnancy, to manage the discomfort experienced during pregnancy and to facilitate the adaptation process. It is increasing in popularity due to the fact that the vast majority of these methods are non-invasive and the awareness of the body-mind-spirit connection in health (Ağapınar Şahin and Bekar, 2023). Massage therapy, acupuncture, relaxation, yoga, homeopathy and aromatherapy are frequently used TTU methods to reduce stress and anxiety during pregnancy. Yoga is a nonpharmacological method that has become very popular recently, which is defined as a mental journey of the individual to his inner world. It reduces the stress caused by pregnancy and helps to reach a more peaceful and fulfilling life. It enables the mother to accept and connect to her body and baby (Şen et al. 2020).

Laughter yoga is an exercise that combines laughter and yoga breathing techniques. In addition, laughter yoga; It is a combination of relaxation technique, flexibility, aerobic exercise, and social interaction (Ağapınar Şahin and Bekar, 2022). Anyone can laugh without humor, jokes, comedy. Laughter sessions are done in a group, in the form of body exercises (Kataria, 2011). Those in the laughter group; As you maintain eye contact and childlike play, the laughter soon becomes real and contagious. In laughter yoga, the prevailing view is that the brain cannot distinguish between real and fake laughter. There is an argument that similar effects will be obtained because the brain cannot make this distinction (Kataria, 2011). Laughter yoga, which is used as a complementary and preventive treatment; Similar to traditional yoga, it is an exercise in which laughter is added to breathing, yoga and stress relief techniques. Laughter has physiological effects such as relaxing muscles, regulating breathing, stimulating circulation, increasing pain threshold and tolerance, reducing stress hormones such as cortisol and epinephrine, increasing the number of antibody-producing cells, and increasing the effectiveness of T cells (Tremayne and Sharma, 2019).

Pilates activates all muscle functions of the body and increases the endurance, flexibility and strength of all body muscles, especially the core area. Pilates is an exercise system that aims to improve dynamic postural control while improving the body's balance system (Srivastava, 2016). Pilates during pregnancy is one of the safe exercise methods that prepares and strengthens expectant mothers for childbirth from the first to the last month of pregnancy. Pilates can be done at least two or three times a week from the onset of pregnancy (Dillard, 2013). Regular exercises performed by the expectant mother play an important role in maintaining the psychological well-being of the mother during pregnancy. Internationally, Pilates is considered an important exercise to improve physical, psychological and motor functions. It supports the protection of self-esteem, self-efficacy and autonomy, a positive pregnancy and easy adaptation to motherhood (WHO, 2016). When examined in the literature, it has been reported that Pilates exercises performed regularly during pregnancy not only have a positive effect on pregnancy complaints and quality of life during pregnancy, but also increase stress management, decrease depression rates, low anxiety levels, and increase self-esteem and body image of pregnant women who exercise regularly (Aktan et al., 2021; Ghandali et al., 2021; Mazzarino et al., 2018). As a result, the aim of the study was to determine the effects of laughter yoga and pilates on pregnancy adjustment, anxiety and prenatal attachment in pregnant women who received childbirth preparation training.