Effects of Prenatal Yoga on Stress, Sleep Quality, and Hemoglobin Levels Among Pregnant Women: A Quasi-Experimental Study

Background: Anemia remains an important maternal health concern in Indonesia and may coexist with stress and poor sleep quality. Prenatal yoga combines gentle postural practice with controlled breathing, meditation, and relaxation. This study examined whether participation in a standardized prenatal yoga program was associated with changes in stress, perceived sleep quality, and hemoglobin among pregnant women receiving care at Kademangan Community Health Center, Blitar Regency, Indonesia.. Methods: The study used a nonrandomized quasi-experimental pretest– posttest controlled design involving 60 women in the second or third trimester of pregnancy, with 30 participants in each group. Before group allocation, researchers matched participants by maternal age, parity, BMI, and baseline hemoglobin, then assigned them using a nonrandomized procedure. The intervention consisted of eight 60-minute prenatal yoga sessions over four weeks, while controls received routine antenatal health education. We assessed stress, sleep quality, and hemoglobin levels using the NuPDQ, PSQI, and a validated point-of-care digital hemoglobinometer, respectively. We used paired-sample and independent-sample t-tests, along with MANOVA, for statistical analysis, with a two-sided significance threshold of p < 0.05. Result: Among participants in the intervention group, mean stress scores declined from 12.00 ± 5.00 to 7.27 ± 3.06 (p = 0.001), while mean PSQI scores changed from 10.53 ± 3.48 to 5.27 ± 1.06 (p = 0.001), indicating better perceived sleep quality. Mean hemoglobin changed from 10.45 ± 1.07 g/dL before the intervention to 10.78 ± 1.02 g/dL afterward (p = 0.006). Independent-samples t-tests identified between-group differences in the mean change scores for stress (t = −2.690, p = 0.009), sleep quality (t = −7.271, p = 0.001), and hemoglobin (t = 3.065, p = 0.003). The multivariate comparison also indicated that the combined pattern of change across the three outcomes differed between groups (Wilks’ lambda = 0.491, F = 19.364, p = 0.001). Contribution for Practice: This study contributes evidence that a standardized eight-session prenatal yoga program delivered over four weeks was associated with reduced stress and improved perceived sleep quality among pregnant women. It also provides preliminary evidence of differences in hemoglobin trajectories between groups, which should be interpreted cautiously.