Prenatal yoga for labor pain, labor duration, and childbirth-related anxiety: a systematic review and meta-analysis of randomized controlled trials

Prenatal yoga is increasingly used as a non-pharmacological strategy during pregnancy, but its effects on intrapartum pain, labor duration, and childbirth-related anxiety require synthesis in relation to recent randomized evidence and existing reviews. This systematic review and meta-analysis evaluated the effects of prenatal yoga compared with standard care on these outcomes. PubMed, Embase, the Cochrane Library, Web of Science, PEDro, China National Knowledge Infrastructure (CNKI), and Wanfang were searched from inception to July 12, 2025. Randomized controlled trials comparing prenatal yoga, either alone or as the primary intervention combined with routine care, with standard care were included. The primary outcome was labor pain intensity; secondary outcomes were labor duration and childbirth-related anxiety. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled using Review Manager 5.4. Heterogeneity was assessed using Cochran’s Q test and the I² statistic, and exploratory sensitivity analyses were conducted when heterogeneity was substantial. Ten randomized controlled trials involving 1,269 participants were included. In the primary analyses, prenatal yoga was associated with lower labor pain (SMD = -1.35; 95% CI, -1.85 to -0.85; P < 0.00001; I² = 94%), shorter labor duration (SMD = -1.14; 95% CI, -1.74 to -0.53; P = 0.0002; I² = 92%), and lower childbirth-related anxiety (SMD = -1.52; 95% CI, -1.98 to -1.06; P < 0.00001; I² = 85%) compared with standard care. Sensitivity analyses retained statistically significant effects, although the findings should be interpreted cautiously because of clinical and methodological heterogeneity. Certainty of evidence was low for labor pain and very low for labor duration and childbirth-related anxiety. Although the pooled SMDs were large in absolute magnitude, they should not be interpreted as precise estimates of the expected clinical benefit because heterogeneity was substantial to very high, outcome measurement varied across trials, and certainty of evidence was low or very low. Prenatal yoga may reduce labor pain and childbirth-related anxiety compared with standard care. Evidence that prenatal yoga shortens labor duration remains very uncertain because of substantial heterogeneity and inconsistent reporting of labor stages. Prenatal yoga should therefore be considered a potentially beneficial adjunct to standard maternity care rather than evidence for a standardized clinical protocol. PROSPERO CRD420251166137.