Prenatal Breastfeeding Education with or without Hand Expressing Human Milk and Breastfeeding Duration in a Rural Population.

BACKGROUND: The benefits of breastfeeding are well recognized. However, exclusive breastfeeding (EBF) rates are well below the Healthy People 2030 Guidelines, with a rapid drop in exclusive breastfeeding over the first 3 months of life. Although breastfeeding support has increased the initiation of breastfeeding, the role of perinatal interventions, particularly in the context of breastfeeding support, remains a topic of contradiction. METHODS: This observational study was designed to assess the impact of a unique prenatal educational intervention in rural East Texas. The study had two aims: (1) to determine whether the addition of prenatal breastfeeding education increased the rate of exclusive breastfeeding at four time points, and (2) to assess the impact of hand expression education on breastfeeding exclusivity. RESULTS: Differences in breastfeeding behaviors were seen between those who received the education and those who did not for exclusivity and duration of breastfeeding. Participants who received the hand expression education were 1.79 times more likely to continue EBF practices at three months postpartum, 6.27 times more likely to continue EBF practices at six months postpartum, and 3.34 times more likely to continue breastfeeding at twelve months postpartum than those who did not receive any hand expression education. CONCLUSION: This study demonstrates that prenatal education is beneficial for increasing breastfeeding exclusivity and duration and underscores its potential to improve maternal and infant health outcomes. Further research is needed to resolve the ongoing debate and advance our understanding of interventions to increase breastfeeding duration.

Study protocol of a breathing and relaxation intervention included in antenatal education: A randomised controlled trial (BreLax study).

BACKGROUND: Antenatal education is part of antenatal care in many countries. Physical and mental preparation for childbirth and information on pain management are considered key elements of antenatal education classes. Evidence suggests that women who participate in antenatal education classes appear to benefit in terms of self-efficacy and childbirth experience. In particular, women with increased fear of childbirth benefit from trained breathing and relaxation techniques in antenatal education. However, little is known about the effect of breathing and relaxation techniques on the outcomes of healthy pregnant women without fear of childbirth or who do not have medical or obstetric risks, or on neonatal outcomes. OBJECTIVE: The aim of this study is to test whether including a breathing and relaxation technique in an antenatal education class will improve self-efficacy towards birth compared to a standard antenatal education class. METHODS: The study will be a two-armed randomised controlled trial (RCT). Healthy pregnant women between the 12th and 30th week of gestation with singleton low-risk pregnancies and who are receiving routine antenatal care will be recruited in a hospital in Switzerland. All women included will attend an 8-hour antenatal education class. The intervention group will additionally practise a breathing and relaxation technique, receive a handbook to guide their exercise practice at home, and be provided with access to an online brochure with video and audio recordings for guidance. Data on maternal and neonatal outcomes will be collected after recruitment, in the 37th week of pregnancy, and two to four weeks postpartum. DISCUSSION: The effectiveness of including a breathing and relaxation technique in antenatal education classes on women's self-efficacy is discussed as a means to improving women's pregnancy and childbirth outcomes. TRIAL REGISTRATION NUMBER: NCT06003946, SNCTP000005672.

Pregnant women's experiences of online prenatal education in Korea during COVID-19: a phenomenological study.

PURPOSE: This study aimed to explore the significance and insights derived from the experiences of pregnant women in Korea who participated in online prenatal education during the COVID-19 pandemic. METHODS: This study employed the hermeneutic phenomenology framework developed by Colaizzi. It involved 12 pregnant women who participated in online prenatal education provided by public health centers in Chuncheon, Korea. Data collection was achieved through in-depth interviews conducted in Korea from October 2021 to April 2022. RESULTS: In total, 51 significant statements were extracted from the interview data and then categorized into 10 themes. Finally, three categories were formed by merging similar themes. The three basic categories of participants' experiences of online prenatal education were "feeling of safety and comfort in body and mind," "frustrated by a lack of interaction," and "digital education being a double-edged sword." Pregnant women expressed ambivalence regarding the benefits and drawbacks of the online educational experience. They desired more interactive and practical learning opportunities, even as they appreciated the comfort of learning remotely. CONCLUSION: This study revealed the phenomenon of online prenatal education as an advanced form of distance-based prenatal education instead of the traditional in-person classroom. To maximize the educational effectiveness of this new format, public health center policies must address the digital literacy gap and enhance accessibility by leveraging the immersive multimedia experiences that online education offers to pregnant women. We recommend that maternal healthcare providers adopt this innovative approach to prenatal education, utilizing distance education technology to improve participation and promote immersion.

Paternal well-being perception during childbirth: Experience of prepared Chilean fathers after a prenatal education intervention.

OBJECTIVE: To understand the father's lived experience of childbirth as a significant life situation within the well-being concept framework. To understand the father's lived experience of childbirth within the framework of the concept of well-being as a significant life situation. METHOD: Secondary data analysis from a qualitative study about the experience of twelve Chilean fathers who were prepared to actively participate at childbirth from a mixed public-private health system institution between 2016-2017, was carried out. Qualitative data were extracted from transcripts of open interviews with eight of the twelve fathers after childbirth. Data were analyzed using an interpretive-phenomenological approach. RESULTS: Four central themes emerged from data, which were framed and understand within the psychological well-being concept: I. Feeling as a part of the healthcare team; II. Perceiving himself capable of containing and supporting his partner and being a guardian of the process; III. Being committed to being a father from the first moment of contact with the child; IV. Being wrapped in a whirlwind of emotions. CONCLUSION: Father's lived experience at childbirth can be understood considering the psychological well-being concept. Prepared fathers could live the childbirth experience within a state of well-being, focusing on their achievements, commitments, and being satisfied with their roles as father and partner.

Originalarbeiten / Original Article. Chancen und Risiken genderstereotyper Ansprache von Männern im Kontext der Bildungs- und Beratungsarbeit am Beispiel der Geburtsvorbereitung für werdende Väter / Opportunities and Risks of Gender-Stereotypical Approach to Men in the Context of Education and Counselling Work Using the Example of Birth Preparation for Expectant Fathers.

Opportunities and Risks of Gender-Stereotypical Approach to Men in the Context of Education and Counselling Work Using the Example of Birth Preparation for Expectant Fathers At first glance, it seems absurd that families or mothers and fathers become addressees of social work when they decide to have a child. But the legislator has also formulated it: "Mothers and fathers as well as pregnant women and expectant fathers should be offered advice and help in questions of partnership and the development of parental parenting and relationship skills" (§16 paragraph 3 SGB VIII). One can argue that this makes sense, especially in complex and challenging times. Fathers in particular are confronted with an increasing ambivalence between caring father and providing breadwinner. Against the background of crisis-ridden conditions, this ambivalence can be perceived as strenuous living conditions, so that the addressing of social work is justified. Gender-homogeneous psychosocial services for fathersto- be make counselling and educational processes in the sense of helping them to help themselves be used by the addressees. In this article, the gender-stereotypical addressing of men in the context of education and counselling services is presented and discussed using the example of gender-homogeneous birth preparation courses for expectant fathers, on the basis of empirical findings.

Randomized Controlled Trial of Interventions Used by Midwives to Treat Fear of Childbirth.

BACKGROUND: Fear of childbirth affects women worldwide and can have adverse consequences. Midwives have implemented a number of interventions, autonomously or as part of a professional team. However, midwives have been unable to identify the most appropriate intervention for ensuring the reduction or alleviation of this fear to provide the best perinatal outcomes. OBJECTIVE: This study aimed to evaluate the effectiveness of a prenatal educational intervention followed by specific support during childbirth, designed and delivered exclusively by midwives for women with a high fear of childbirth. METHOD: This randomized controlled trial was performed with two arms in two phases: an online prenatal education phase followed by a support phase during childbirth. Participating women with a high fear of childbirth, which was determined using the Wijma Delivery Expectancy Questionnaire A-Spanish version, were assigned to the experimental group or the usual care control group at a 1:1 ratio. RESULTS: Women showed a reduction in fear of childbirth in both phases of the study. According to the intention-to-treat analysis, a significant mean difference was observed in the prenatal stage in favor of the intervention group, and a nonsignificant difference was observed in favor of this same group after delivery. DISCUSSION: The effectiveness of continuous specific prenatal education with preferential support during childbirth by midwives was indicated by improvements in the level of fear of childbirth.

The effect of prenatal education on health anxiety of primigravid women.

BACKGROUND AND AIM: Health anxiety is a mental disorder that characterized by an excessive fear about health and physical symptoms. High anxiety in pregnancy is associated with adverse outcomes. The aim of this study was to investigate the effect of prenatal education on health anxiety of primigravid women. METHODS: The present study was quasi-experimental study. 122 primiparous pregnant women referred to comprehensive health services Shahrekord (A city in the southwest of Iran) clinics in 2019, after receiving consent to participate in the study, randomly divided into two intervention and control groups. The intervention group participated in 8 sessions (1.5-h), once every 2 weeks, from 20 to 37th weeks of gestation. The health anxiety questionnaire was completed on 20th (before the beginning of the courses), 28th and 37th weeks by two groups. Consequences of pregnancy included weight, Apgar score, delivery type, labor time and first breastfeeding time. SPSS version 16 software was used for data analysis. RESULTS: No significant difference was found type of delivery, gestational age, height, weight, head length, Apgar score, duration of hospitalization and first breastfeeding time. The duration of the active and latent phase of labor was significantly lower and the weight of newborn was significantly higher in the intervention group than the control group (P < 0.05). At 37th week, the scores of illness concern, negative consequence and total health anxiety in the intervention group decreased by 3.42, 0.93 and 4.36 respectively and in control group increased by 2.82, 0.03 and 2.86. CONCLUSION: Pregnancy educational courses has positive effects on health anxiety, decrease duration of labor time and increased newborn weight. In order to improve the outcome of pregnancy, educational classes during pregnancy should be considered.

Analysis of the current situation and demand for perinatal education in pregnant women in general grade A tertiary hospitals in China: a cross-sectional survey.

OBJECTIVES: This study aimed to assess the factors influencing pregnant women's participation in perinatal education and their demand for educational courses. DESIGN: A cross-sectional study. SETTING: Tertiary hospital in Suzhou, China, July-September 2022. PARTICIPANTS: Pregnant women from a general grade A tertiary hospital in Suzhou were recruited via online survey invitations during the specified period. MEASURES: A self-designed scale was used to evaluate pregnant women's demand for perinatal education. Multiple response sets were employed for the assessment of multiple-choice items and analyses included frequency and cross-tabulation. Logistic regression analysis was conducted to assess the factors influencing pregnant women's participation in perinatal education. OUTCOME: The primary outcome measured was the demand for perinatal education among pregnant women. RESULTS: A majority (53.8%) of pregnant women expressed a preference for a mixed teaching mode combining online and offline formats. Logistic regression analysis showed that education level significantly influenced pregnant women's participation in online learning. Specifically, women with higher education levels were more likely to participate actively in online courses. Additionally, compared with those with first-born children, pregnant women with second-born children participated less actively in online learning. Pregnant women in their second and third trimesters showed greater engagement in online learning compared with those in their first trimester. CONCLUSIONS: These findings indicate that Chinese pregnant women's preferences for perinatal education are influenced by their educational background, pregnancy history and the mode of teaching employed. The variability in educational needs underscores the importance of regularly updating course content based on participant feedback.

Codesign and refinement of an optimised antenatal education session to better inform women and prepare them for labour and birth.

OBJECTIVE: Our objective was to codesign, implement, evaluate acceptability and refine an optimised antenatal education session to improve birth preparedness. DESIGN: There were four distinct phases: codesign (focus groups and codesign workshops with parents and staff); implementation of intervention; evaluation (interviews, questionnaires, structured feedback forms) and systematic refinement. SETTING: The study was set in a single maternity unit with approximately 5500 births annually. PARTICIPANTS: Postnatal and antenatal women/birthing people and birth partners were invited to participate in the intervention, and midwives were invited to deliver it. Both groups participated in feedback. OUTCOME MEASURES: We report on whether the optimised session is deliverable, acceptable, meets the needs of women/birthing people and partners, and explain how the intervention was refined with input from parents, clinicians and researchers. RESULTS: The codesign was undertaken by 35 women, partners and clinicians. Five midwives were trained and delivered 19 antenatal education (ACE) sessions to 142 women and 94 partners. 121 women and 33 birth partners completed the feedback questionnaire. Women/birthing people (79%) and birth partners (82%) felt more prepared after the class with most participants finding the content very helpful or helpful. Women/birthing people perceived classes were more useful and engaging than their partners. Interviews with 21 parents, a midwife focus group and a structured feedback form resulted in 38 recommended changes: 22 by parents, 5 by midwives and 11 by both. Suggested changes have been incorporated in the training resources to achieve an optimised intervention. CONCLUSIONS: Engaging stakeholders (women and staff) in codesigning an evidence-informed curriculum resulted in an antenatal class designed to improve preparedness for birth, including assisted birth, that is acceptable to women and their birthing partners, and has been refined to address feedback and is deliverable within National Health Service resource constraints. A nationally mandated antenatal education curriculum is needed to ensure parents receive high-quality antenatal education that targets birth preparedness.

Impact of no publicly accessible prenatal education programming on patients and their care providers: a descriptive qualitative study in Nova Scotia, Canada.

OBJECTIVE: Patients in Nova Scotia do not have access to public prenatal education programming. This study aimed to explore whether care providers find patients are uninformed or misinformed, and the impact of that on patients and their care providers with a focus on clinical outcomes, time, resources and informed decision-making. METHODS: Semistructured interviews were conducted with 13 care providers around Halifax and Cape Breton. An interview guide (supplemental) of open-ended questions was used for consistency. A descriptive qualitative approach was employed to describe the contents of the interviews. Each interview was audio-taped and transcribed verbatim by an interdependent transcriber. Transcripts were analysed using established techniques in qualitative descriptive research including coding, grouping, detailing and comparing the data using NVivo V.12 software. A co-coder (SS) independently coded two interviews for inter-rater reliability. RESULTS: The study revealed six themes: (1) concern for a significant population of Nova Scotians experiencing pregnancy, birth and postpartum uninformed and misinformed, (2) consequences for patients who are uninformed and misinformed, (3) more time and resources spent on care for patients who are uninformed or misinformed, (4) patients and their care providers need a publicly available education programme, particularly vulnerable populations, (5) emphasis on programme quality and disappointment with the programme previously been in place and (6) recommendations for an effective prenatal education programme for Nova Scotians. CONCLUSIONS: This study shows care providers believe a public prenatal education programme could improve health literacy in Nova Scotia. Patients are seeking health education, but it is not accessible to all and being uninformed or misinformed negatively impacts patients' experiences and outcomes. This study revealed excess time and resources are being spent on individualised prenatal education by care providers with high individual and system-wide cost and explored the complicated process of providing patient-centred care for people who are uninformed or misinformed.

Cross Sectional Survey of Antenatal Educators' Views About Current Antenatal Education Provision.

OBJECTIVES: Antenatal education (ANE) is part of National Health Service (NHS) care and is recommended by The National Institute for Health and Care Excellence (NICE) to increase birth preparedness and help pregnant women/birthing people develop coping strategies for labour and birth. We aimed to understand antenatal educator views about how current ANE supports preparedness for childbirth, including coping strategy development with the aim of identifying targets for improvement. METHODS: A United Kingdom wide, cross-sectional online survey was conducted between October 2019 and May 2020. Antenatal educators including NHS midwives and private providers were purposively sampled. Counts and percentages were calculated for closed responses and thematic analysis used for open text responses. RESULTS: Ninety-nine participants responded, 62% of these did not believe that ANE prepared women for labour and birth. They identified practical barriers to accessing ANE, particularly for marginalised groups, including financial and language barriers. Educators believe class content is medically focused, and teaching is of variable quality with some midwives being ill-prepared to deliver antenatal education. 55% of antenatal educators believe the opportunity to develop coping strategies varies between location and educators and only those women who can pay for non-NHS classes are able to access all the coping strategies that can support them with labour and birth. CONCLUSIONS FOR PRACTICE: Antenatal educators believe current NHS ANE does not adequately prepare women for labour and birth, leading to disparities in birth preparedness for those who cannot access non-NHS classes. To reduce this healthcare inequality, NHS classes need to be standardised, with training for midwives in delivering ANE enhanced.

Preparing solo mothers for childbirth and parenthood - The importance of being with like-minded women.

OBJECTIVES: Denmark and many high-income countries have seen an increase in the number of single women getting pregnant through medical assisted reproduction (MAR). These women are also named solo mothers. According to the Danish Health Authorities, they should, as all other pregnant women, be offered antenatal education. The aim of this study was to explore solo mothers' needs in order to prepare them for childbirth and parenthood. METHODS: This qualitative study was set to investigate solo mothers' experiences and requirements during pregnancy toprepare them for childbirth and parenting. Semi-structured interviews were conducted by telephone or face-to-face. A systematic text condensation and interpretation was used to analyse data. RESULTS: 38 interviews were conducted before and after pregnancy. Twenty solo mothers participated in the study. Three themes emerged from the analysis: 'Confrontation with the normative pregnancy', 'Mirroring and network' and 'Using formal and informal sources to gain information'. CONCLUSION: The conventional antenatal packages offered by the healthcare system did not meet the solo mothers' needs. The women called for content and information tailored to single parents. Solo mothers may benefit from structured antenatal classes in small groups. Being with like-minded women was essential for preparing for childbirth and parenting.

Antenatal education - Putting research into practice: A guideline review.

PROBLEM: Antenatal care guidelines used in Australia are inconsistent in their recommendations for childbirth and parenting education (CBPE) classes for preparation of women and parents for pregnancy, childbirth, and early parenting. BACKGROUND: Clinical practice guidelines in maternity care are developed to assist healthcare practitioners and consumers to make decisions about appropriate care. The benefit of such guidelines relies on the translation and quality of the evidence contained within them. In the context of antenatal care guidelines, there is a potential evidence-practice gap with regard to CBPE. AIMS: This review aims to appraise the quality of Australian antenatal care guidelines in their recommendations for CBPE for women and partners. METHODS: Publicly available Australian antenatal care guidelines were identified including local health district websites and professional organisations pertaining to maternity care. Guidelines were reviewed independently, and the quality was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. FINDINGS: Five guidelines were included in the review and appraised using AGREE II. With the exception of the Department of Health Pregnancy Care Guidelines, guidelines scored poorly across all six domains. When appraised according to specific CBPE recommendations for rigour of development, presentation, and applicability; all guidelines received low scores. DISCUSSION: Prenatal services remain largely unregulated across the board, with no systematic approach to make recommendations for CBPE and guidelines lacking in rigour with regard to CBPE. CONCLUSION: Within the guidelines reviewed there was a lack of evidence-based recommendations provided for educators or consumers regarding childbirth and parenting education.

Increasing Realism and Variety of Virtual Patient Dialogues for Prenatal Counseling Education Through a Novel Application of ChatGPT: Exploratory Observational Study.

BACKGROUND: Using virtual patients, facilitated by natural language processing, provides a valuable educational experience for learners. Generating a large, varied sample of realistic and appropriate responses for virtual patients is challenging. Artificial intelligence (AI) programs can be a viable source for these responses, but their utility for this purpose has not been explored. OBJECTIVE: In this study, we explored the effectiveness of generative AI (ChatGPT) in developing realistic virtual standardized patient dialogues to teach prenatal counseling skills. METHODS: ChatGPT was prompted to generate a list of common areas of concern and questions that families expecting preterm delivery at 24 weeks gestation might ask during prenatal counseling. ChatGPT was then prompted to generate 2 role-plays with dialogues between a parent expecting a potential preterm delivery at 24 weeks and their counseling physician using each of the example questions. The prompt was repeated for 2 unique role-plays: one parent was characterized as anxious and the other as having low trust in the medical system. Role-play scripts were exported verbatim and independently reviewed by 2 neonatologists with experience in prenatal counseling, using a scale of 1-5 on realism, appropriateness, and utility for virtual standardized patient responses. RESULTS: ChatGPT generated 7 areas of concern, with 35 example questions used to generate role-plays. The 35 role-play transcripts generated 176 unique parent responses (median 5, IQR 4-6, per role-play) with 268 unique sentences. Expert review identified 117 (65%) of the 176 responses as indicating an emotion, either directly or indirectly. Approximately half (98/176, 56%) of the responses had 2 or more sentences, and half (88/176, 50%) included at least 1 question. More than half (104/176, 58%) of the responses from role-played parent characters described a feeling, such as being scared, worried, or concerned. The role-plays of parents with low trust in the medical system generated many unique sentences (n=50). Most of the sentences in the responses were found to be reasonably realistic (214/268, 80%), appropriate for variable prenatal counseling conversation paths (233/268, 87%), and usable without more than a minimal modification in a virtual patient program (169/268, 63%). CONCLUSIONS: Generative AI programs, such as ChatGPT, may provide a viable source of training materials to expand virtual patient programs, with careful attention to the concerns and questions of patients and families. Given the potential for unrealistic or inappropriate statements and questions, an expert should review AI chat outputs before deploying them in an educational program.

Effects of Prenatal Breastfeeding Education on Breastfeeding Duration Beyond 12 Weeks: A Systematic Review.

The proportion of infants in the United States who are breastfed at 1 year remains well below the Healthy People 2030 target. The health implications of suboptimal breastfeeding durations are significant, including increased risk of childhood leukemia and maternal Type 2 diabetes. Prenatal breastfeeding education provides an opportunity to improve breastfeeding self-efficacy among pregnant individuals and to establish their coping skills in case future breastfeeding problems arise. Although prenatal breastfeeding education is known to improve breastfeeding self-efficacy, characteristics of prenatal breastfeeding education interventions that are successful at increasing breastfeeding duration have not been well defined. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Health Action Process Approach, we conducted a systematic review of the literature examining the impact of prenatal breastfeeding education interventions on breastfeeding duration measured at least 12 weeks postpartum. Twenty-one studies were identified. Prenatal breastfeeding education was most likely to increase breastfeeding duration when education interventions integrated psychological components (Health Action Process Approach coping planning) or were paired with in-person postpartum breastfeeding support. Additional research is needed to examine the role of psychological components in breastfeeding education interventions in diverse populations and to determine the specific psychological intervention components with the greatest impact on breastfeeding duration.

Antenatal care of women who use opioids: a qualitative study of practitioners' perceptions of strengths and challenges of current service provision in Scotland.

BACKGROUND: The increasing rise of women using opioids during pregnancy across the world has warranted concern over the access and quality of antenatal care received by this group. Scotland has particularly high levels of opioid use, and correspondingly, pregnancies involving women who use opioids. The purpose of this study was to investigate the different models of antenatal care for women using opioids during pregnancy in three Scottish Health Board Areas, and to explore multi-disciplinary practitioners' perceptions of the strengths and challenges of working with women who use opioids through these specialist services. METHODS: Thirteen semi-structured interviews were conducted with health and social care workers who had experience of providing antenatal and postnatal care to women who use drugs across three Scottish Health Board Areas: NHS Greater Glasgow and Clyde, NHS Lothian, and NHS Tayside. Framework Analysis was used to analyse interview data. The five stages of framework analysis were undertaken: familiarisation, identifying the thematic framework, indexing, charting, and mapping and interpretation. RESULTS: Each area had a specialist antenatal pathway for women who used substances. Pathways varied, with some consisting of specialist midwives, and others comprising a multidisciplinary team (e.g. midwife, mental health nurse, social workers, and an obstetrician). Referral criteria for the specialist service differed between health board areas. These specialised pathways presented several key strengths: continuity of care with one midwife and a strong patient-practitioner relationship; increased number of appointments, support and scans; and highly specialised healthcare professionals with experience of working with substance use. In spite of this, there were a number of limitations to these pathways: a lack of additional psychological support for the mother; some staff not having the skills to engage with the complexity of patients who use substances; and problems with patient engagement. CONCLUSIONS: Across the three areas, there appears to be high-quality multi-disciplinary antenatal services for women who use opioids during pregnancy. However, referral criteria vary and some services appear more comprehensive than others. Further research is needed into the perceptions of women who use opioids on facilitators and barriers to antenatal care, and provision in rural regions of Scotland.

Digital transformation of antenatal education: A descriptive exploratory study of women's experiences of online antenatal education.

PROBLEM: Research on how women experience online antenatal education is currently limited. A more nuanced understanding may assist organisations to tailor future digitalisation that best meets the needs of users. BACKGROUND: COVID-19 emergency measures forced a rapid implementation of online antenatal education. Women are known to enjoy some aspects of online antenatal education, but still desire social interaction. A marked digital divide is evident for more vulnerable populations. AIM: To explore how pregnant women experience an online antenatal education program. METHODS: A descriptive exploratory study was undertaken through collection of two concurrent data-sets. Quantitative data was collected from the online Parent Education Feedback Form (n = 38) Based on the six-stage process of Braun & Clarke, reflexive thematic analysis was used to analyse data sourced from semi-structured interviews with women (n = 5) who had undertaken online antenatal education. FINDINGS: Four themes, and eight associated sub-themes, were identified to better understand how women experience online antenatal education. The four primary themes identified were: Experiential Digital Learning; Desired Journey; Contemporary Representation; and Human Connection in the Digital Age. DISCUSSION: Well-designed digital platforms provide opportunities for interaction, content personalisation and self-tailored approaches in online antenatal education. Women require caregivers who hold specialist digital capabilities. Further research is warranted to better understand how digitalisation of antenatal education impacts women disadvantaged by digital exclusion. CONCLUSION: The digital transformation of antenatal education impacts a vast array of factors in women's experiences during pregnancy. A specialist skill-set from midwives is needed to champion quality antenatal education in the digital age.

Women's experiences of online antenatal education: An integrative literature review.

AIM: To identify what is currently known about how women experience online antenatal education. DESIGN: Integrative literature review. REVIEW METHODS: This integrative review applied the five-stage methodological framework outlined by Whittemore and Knafl (2005), supporting rigour in problem identification, selection and critical appraisal of quality literature, data analysis and synthesis of findings. DATA SOURCES: A literature search was conducted in May/June 2022, utilizing databases including OVID Embase, CINAHL, Joanna Briggs Institute EBP database, Nursing and Allied Health database, Wiley Online Library, Google scholar search engine and related reference lists. The search was limited to English language and primary research articles published in the last 10-year period (2012-2022). RESULTS: 12 articles met inclusion criteria. Three primary themes were identified: Comprehensibility: Looking back - understanding women's needs and preferences; Manageability: In the moment - flexibility versus social connection; and Meaningfulness & sustainability: Looking forward - the future of digital maternity education. CONCLUSION: Findings identified a marked digital divide for women accessing online antenatal education, placing vulnerable women at risk of continuing inequity. E-health literacy frameworks need to be implemented to create genuine accessibility, comprehensibility and cultural responsiveness to best meet the needs of users. IMPLICATIONS FOR THE PROFESSION AND/OR HEALTH CARE CONSUMER: As digital health is an emerging field, there is strong evidence that online antenatal education requires further evaluation to better meet the needs of pregnant women and their support people. Enhancing digital health literacy for health professionals will also promote a greater understanding for how to uphold and support the socio-technical dimensions of online service delivery. PATIENT OR PUBLIC CONTRIBUTION: There were no patient or public contributions as part of this integrative review of the literature.

Sífilis na gestação: conhecimento de gestantes e puérperas / Syphilis in pregnancy: knowledge of pregnant and puerperous women / Sífilis durante el embarazo: conocimientos de las mujeres embarazadas y puérperas

Objetivo: identificar o conhecimento de gestantes e puérperas acerca da sífilis. Método: pesquisa descritiva, com abordagem qualitativa. A coleta de dados ocorreu por meio de instrumento semiestruturado, entre abril a julho de 2021, com 18 gestantes/puérperas com diagnóstico de sífilis na gestação. As respostas foram gravadas e transcritas na íntegra, sendo utilizado para análise a técnica do Discurso do Sujeito Coletivo. Resultados: identificou-se três ideias centrais: 1) Conhecimento sobre a sífilis, 2) Buscando conhecimento sobre a sífilis e 3) Falsa prevenção. O conhecimento das participantes mostrou-se conflitante, pois algumas apresentaram algum conhecimento e outras nenhum, sendo que todas deveriam ter sido orientadas sobre a doença. Considerações finais: identificou-se uma falha no atendimento ofertado nos serviços de saúde. Assim, estratégias voltadas à educação em saúde devem ser incentivadas e implementadas no acompanhamento de pré-natal, ofertando a promoção e prevenção da saúde, a fim de reduzir os casos de sífilis na gestação.

Objective: to identify the knowledge of pregnant and postpartum women about syphilis. Method: descriptive research, with a qualitative approach. Data collection took place using a semi-structured instrument, between April and July 2021, with 18 pregnant/postpartum women diagnosed with syphilis during pregnancy. The responses were recorded and transcribed in full, using the Collective Subject Discourse technique for analysis. Results: three central ideas were identified: 1) Knowledge about syphilis, 2) Seeking knowledge about syphilis and 3) False prevention. The knowledge of the participants was conflicting, as some had some knowledge and others none, and all of them should have been educated about the disease. Final considerations: a flaw in the care offered in health services was identified. Therefore, strategies aimed at health education should be encouraged and implemented in prenatal care, offering health promotion and prevention, in order to reduce cases of syphilis during pregnancy.

Objetivos:identificar el conocimiento de las mujeres embarazadas y puérperas sobre la sífilis. Método: investigación descriptiva, con enfoque cualitativo. La recolección de datos se realizó mediante un instrumento semiestructurado, entre abril y julio de 2021, con 18 mujeres embarazadas/puérperas diagnosticadas con sífilis durante el embarazo. Las respuestas fueron grabadas y transcritas en su totalidad, utilizando para su análisis la técnica del Discurso del Sujeto Colectivo. Resultados: se identificaron tres ideas centrales: 1) Conocimiento sobre sífilis, 2) Búsqueda de conocimiento sobre sífilis y 3) Falsa prevención. El conocimiento de los participantes fue contradictorio, ya que algunos tenían algún conocimiento y otros ninguno, y todos deberían haber sido educados sobre la enfermedad. Consideraciones finales: se identificó una falla en la atención ofrecida en los servicios de salud. Por lo tanto, se deben fomentar e implementar estrategias orientadas a la educación en salud en la atención prenatal, ofreciendo promoción y prevención de la salud, con el fin de reducir los casos de sífilis durante el embarazo.