Cross-sectional survey of antenatal education attendance among nulliparous pregnant women in Sydney, Australia.

BACKGROUND: Antenatal education aims to provide expectant parents with strategies for dealing with pregnancy, childbirth and parenthood and may have the potential to reduce obstetric intervention and fear of childbirth. We aimed to investigate antenatal education attendance, reasons for and barriers to attending, and techniques taught and used to manage labour. METHODS: Antenatal and postnatal surveys were conducted among nulliparous women with a singleton pregnancy at two maternity hospitals in Sydney, Australia in 2018. Classes were classified into psychoprophylaxis, birth and parenting, other, or no classes. Reasons for and barriers to attendance, demographic characteristics, and techniques taught and used in labour were compared by class type, using Pearson's Chi Squared tests of independence. FINDINGS: 724 women were surveyed antenatally. The main reasons for attending classes were to better manage the birth (86 %), feel more secure in baby care (71 %) and as a parent (60 %); although this differed by class type. Reasons for not attending classes included being too busy (33 %) and cost (27 %). Epidural, breathing techniques, massage and nitrous oxide were the most common techniques taught. Women who attended psychoprophylaxis classes used a wider range of pain relief techniques in labour. Women found antenatal classes useful preparation for birth (94 %) and parenting (74 %). Women surveyed postnatally wanted more information on baby care/sleeping and breastfeeding. CONCLUSION: The majority of women found antenatal education useful and utilised techniques taught. Education providers should ensure breastfeeding and infant care information is provided, and barriers to attendance such as times and cost should be addressed.

Birth outcomes by type of attendance at antenatal education: An observational study.

BACKGROUND: Antenatal education aims to prepare expectant parents for pregnancy, birth, and parenthood. Studies have reported antenatal education teaching breathing and relaxation methods for pain relief, termed psychoprophylaxis, is associated with reduction in caesarean section rates compared with general birth and parenting classes. Given the rising rates of caesarean section, we aimed to determine whether there was a difference in mode of birth in women based on the type of antenatal education attended. MATERIALS AND METHODS: A cross-sectional antenatal survey of nulliparous women ≥28 weeks gestation with a singleton pregnancy was conducted in two maternity hospitals in Sydney, Australia in 2018. Women were asked what type of antenatal education they attended and sent a follow-up survey post-birth. Hospital birth data were also obtained. Education was classified into four groups: psychoprophylaxis, birth and parenting, other, or none. RESULTS: Five hundred and five women with birth data were included. A higher proportion of women who attended psychoprophylaxis education had a vaginal birth (instrumental/spontaneous) (79%) compared with women who attended birth and parenting, other or no education (69%, 67%, 60%, respectively P = 0.045). After adjusting for maternal characteristics, birth and hospital factors, the association was attenuated (odds ratio 2.03; 95% CI 0.93-4.43). CONCLUSIONS: Women who attended psychoprophylaxis couple-based education had a trend toward higher rates of vaginal birth. Randomised trials comparing different types of antenatal education are required to determine whether psychoprophylaxis education can reduce caesarean section rates and improve other birth outcomes.

Randomised-controlled trial of two antenatal education programmes.

OBJECTIVE: to determine whether a new antenatal education programme with increased parenting content could improve parenting outcomes for women compared with a regular antenatal education programme. DESIGN: a randomised-controlled trial. Data were collected through self-report surveys. SETTING: specialist referral maternity hospital in Sydney, Australia. PARTICIPANTS: 170 women birthing at the hospital. Ninety-one women attended the new programme and 79 the regular programme. INTERVENTION: a new antenatal education programme ('Having a Baby' programme) developed from needs assessment data collected from expectant and new parents. One important feature of the programme was the recognition that pregnancy, labour, birth and early parenting were a microcosm of the childbearing experience, rather than separate topics. MEASURES: the primary outcome measure was perceived maternal parenting self-efficacy. Worry about the baby, and perceived parenting knowledge, were secondary outcome measures. They were measured before the programme and after birth. Birth outcomes were also recorded. FINDINGS: the postnatal perceived maternal parenting self-efficacy scores of women who attended the 'Having a Baby' programme were significantly higher than those who attended the regular programme. Perceived parenting knowledge scores of women who attended the 'Having a Baby' programme were also significantly higher than those who attended the regular programme. Worry scores were lower but they did not reach statistical significant. Birth outcomes were similar. IMPLICATIONS FOR PRACTICE: the 'Having a Baby' programme improved maternal self-efficacy and parenting knowledge. Parenting programmes that continue in the early postnatal period may be beneficial.

Effective antenatal education: strategies recommended by expectant and new parents.

Antenatal education is a crucial component of antenatal care, yet practice and research demonstrate that women and men now seek far more than the traditional approach of a birth and parenting program attended in the final weeks of pregnancy. Indeed, women and men participating in this study recommended a range of strategies to be provided during the childbearing year, comparable to a "menu in a restaurant." Their strategies included three program types: "Hearing Detail and Asking Questions," "Learning and Discussing," and "Sharing and Supporting Each Other." The characteristics of each type of program are identified in this article. The actual learning methods the study participants recommended to be incorporated into the programs were "Time to Catch Up and Focus," "Seeing and Hearing the Real Experience," "Practicing," and "Discovering."

Antenatal education as perceived by health professionals.

This article aims to identify the learning needs of expectant and new parents for antenatal education as perceived by health professionals. In Australia, antenatal education programs are predominantly designed by health professionals, and recent research has challenged the efficacy of this approach. The data collected from 73 health professionals, reported here, demonstrates that their perceptions of the concerns and interests of expectant and new parents were divided into three interrelated categories: "need to know...what's happening," "they won't listen," and "balanced information." The health professional ideas for improving antenatal education were limited and identified a reluctance to change practice.

The concerns and interests of expectant and new parents: assessing learning needs.

Antenatal education is an important component of antenatal care in the developed world, but research indicates that it may not be meeting consumer needs. This article provides an overview of a needs assessment that aimed to determine the concerns and interests of expectant and new parents and how they prefer to learn during the periods of pregnancy and the early weeks of parenthood. The findings could be used to develop an innovative approach to antenatal education in order to prepare expectant and new parents for the birth experience and the early weeks of parenthood. The current study's results identified that expectant and new parents' concerns and interests during pregnancy, childbirth, and new parenting fall within five interrelated conceptual areas: 1) perceiving achievement or failure; 2) taking on "risk"; 3) riding an emotional "roller coaster" of joy, anxiety, and uncertainty; 4) needing to "know...what is normal"; and 5) needing help to "perform well."