Yoga-based Meditation as an Adjunct Therapy after Elective Lower Segment Caesarean Section Surgery: A Randomised Controlled Trial Assessing Stress and Wound Healing Outcomes

Introduction: Wound healing following abdominal surgeries such as elective Lower Segment Caesarean Section (LSCS) is a multifactorial process influenced by physiological and psychological factors. Elevated psychological stress adversely affects immune system performance, which can lead to slower tissue regeneration and heightened susceptibility to postoperative complications. Meditation grounded in yoga principles, characterised by controlled breathing and mindful awareness, has been documented to lower stress and inflammation while supporting autonomic nervous system stability. Despite these potential benefits, there is limited clinical evidence evaluating the direct role of yoga-based meditation in improving surgical wound healing. Aim: To evaluate the impact of yoga-based meditation on stress levels and wound healing outcomes in patients after elective LSCS. Materials and Methods: A randomised controlled trial was conducted in July 2022 at the Department of Obstetrics and Gynaecology, Shri B.M Patil Medical College, Hospital and Research Centre, Vijayapura, Karnataka, India. The study included 52 patients undergoing elective LSCS, who were randomly assigned to two groups: an intervention group and a control group. Participants were recruited at the time of admission to the postnatal ward. The intervention group received guided yoga-based meditation for 15 minutes, three times daily, over a period of 14 consecutive days. Meditation sessions focused on breath awareness, relaxation techniques, and mindfulness. The control group received standard postoperative care without meditation. Stress parameters and wound healing outcomes were assessed at baseline and on day 14. The parameters measured included Heart Rate (HR), Heart Rate Variability (HRV), Perceived Stress Score (PSS), and Galvanic Skin Response (GSR). Wound healing was assessed using the Southampton wound grading system. Statistical analysis was performed using International Business Machine (IBM) Statistical Packages of Social Sciences (SPSS) Statistics version 25.0. Between-group comparisons were made using the chi-square test for categorical variables and the Mann-Whitney U test for non parametric continuous variables. A p-value of <0.05 was considered statistically significant. Results: Of the 70 patients enrolled, 52 completed the trial (26 per group). There were no significant baseline differences in age, Body Mass Index (BMI) or parity (p>0.05). After 14 days, the yoga-meditation group showed a greater reduction in resting HR (mean change -14.48% vs -4.02%; p<0.001), a greater increase in HRV (mean change +21.81% vs +8.75%; p<0.001), and a greater reduction in PSS score (-48.2% vs -47.4%; p=0.013) compared with controls. GSR showed a marked increase, indicating enhanced parasympathetic activity. Although both groups achieved 100% Grade 0 healing by day 14 (Southampton Wound Grading System), the meditation group demonstrated a more rapid resolution of early inflammatory signs in the first week. Conclusion: Adjunctive yoga-based meditation significantly attenuates postoperative stress- both physiological and psychological and may accelerate the initial phases of wound healing following elective LSCS. This non invasive, low-cost intervention holds promise for enhancing recovery and patient well-being in the postoperative setting.