Effects of Laughter Yoga in the Third Trimester

Pregnancy is a physiological process during which a number of biological changes occur in a woman's body. This period represents an important turning point in the lives of women, whose reproductive capacity ensures the continuation of generations. While some women perceive pregnancy as a source of joy and happiness because of the anticipated arrival of a new family member, others may perceive it as a source of worry, anxious anticipation, and stress. In addition to physical and hormonal changes, expectant mothers experience numerous psychological and social changes during pregnancy. A woman's psychological state and experiences may influence the course of pregnancy, while pregnancy itself may also cause significant changes in her psychological state. Women who are unable to adequately adapt to these changes may experience various psychological problems due to pregnancy-related bodily changes and physical complaints, concerns about parenthood, changes in family and social roles, fear of childbirth, unwanted pregnancy and miscarriage, new challenges and needs arising from pregnancy, concerns and worries about the baby, parenting stress, low self-esteem, a persistent tendency toward negative thinking, lack of social support and social isolation, marital and partner-related problems, domestic violence, adverse life experiences, alcohol and tobacco use during pregnancy, chronic diseases, inadequate weight gain during pregnancy, exposure to sexual abuse, employment-related issues, and financial concerns. If these psychological problems arising during pregnancy are not resolved, emotional distress may continue to increase, potentially leading to stress and depression Symptoms of brain fog, such as forgetfulness and absent-mindedness, may occur once or twice during pregnancy or may persist throughout pregnancy. Brain fog may become more pronounced during periods of fatigue or irregular sleep, such as in the early or late stages of pregnancy. Studies conducted among pregnant women have shown that fluctuations in progesterone and estrogen during pregnancy may lead to impairments in attention, memory, and executive functioning because the brain is sensitive to changes in hormone levels. Laughter yoga (Laughter Therapy/Laughter Yoga), developed by Dr. Kataria, is a therapeutic method that combines yogic breathing techniques with laughter exercises. A systematic review reported that laughter yoga physiologically increases oxygenation, relaxes muscles, stimulates circulation and the immune system, increases endorphin release and thereby enhances the pain threshold and pain tolerance, strengthens mental functioning by reducing stress hormone levels, decreases depression and anxiety, improves sleep quality, and promotes psychological well-being by enhancing interpersonal relationships and social interaction. The literature highlights the positive physiological, psychological, and social effects of laughter on health. Although laughter yoga has increasingly been used in healthcare in recent years, positive outcomes have been reported across different age groups and health conditions. Laughter yoga performed with pregnant women has been reported to reduce the frequency of pregnancy-related symptoms and increase psychological well-being and prenatal attachment levels. However, no studies examining its effects on the outcomes addressed in the present study were identified in the literature. Therefore, this study aims to determine the effects of laughter yoga on perceived stress, psychosocial health, and brain fog among pregnant women in the third trimester. Keywords: laughter, pregnancy, stress, psychosocial health, brain fog

Inclusion Criteria: * Being 18 years of age or older * Having no communication barriers * Applying for antenatal education during the study period * Volunteering to participate in the study * Being in the third trimester of pregnancy * Having no condition that would prevent participation in laughter yoga sessions Exclusion Criteria: * Refusing to participate in the study * Providing incomplete responses or failing to answer the questions in the questionnaire * Having a high-risk pregnancy * Having a multiple pregnancy (e.g., twins)