An evaluation of consumer perspectives of childbirth and parenting education

Information giving and education in pregnancy: a review of qualitative studies

Studies of childbirth education have universally failed to take into account the quality of the education provided to women and their families and whether its style of delivery meets women's preferences and needs. The present study sought to determine which educational approaches are most welcomed by women and most helpful to them in learning about labor, birth, and early parenting. A systematic survey of peer-reviewed studies on antenatal education, published in English from 1996-2006 and which sought women's views and experiences, was conducted. Findings confirm women's preference for a small-group learning environment in which they can talk to each other as well as the educator and can relate information to their individual circumstances.

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."

Childbirth education outcomes: an integrative review of the literature

The purpose of this literature review was to identify and describe recent empirical studies of childbirth education outcomes and to identify areas for further study. The search produced 63 studies; only 12 met the inclusion criteria. The literature demonstrated inconclusive evidence regarding the effectiveness of childbirth education. None of the studies used a theoretical framework that proposed multiple factors, as opposed to childbirth education alone, that impact the outcomes. Health-focused versus illness-focused outcomes were also addressed.

Evaluating the effect of childbirth education class: a mixed-method study

AIM

To examine Chinese women's satisfaction with and the perceived effect of childbirth education class on their labour experience.

BACKGROUND

Attending childbirth education classes is a common activity for pregnant women. Nonetheless, evidence reveals that evaluation of the effects of childbirth education classes is inconsistent. Moreover, women's perceived effect of these classes has not been systematically examined.

METHODS

This two-phase study adopted a mixed-method design with Donadedian's model as the theoretical framework. In Phase One, a random sample of 40 Chinese women was invited to complete a questionnaire after attending a childbirth education class. The questionnaire was focused on their satisfaction with specific aspects of the class. Descriptive statistics were performed to summarize participants' response. In Phase Two, six of the original 40 women were purposely selected for a semi-structured interview pertaining to the perceived effect of the childbirth education class on their labour experience. Thematic analysis was conducted on the interview data.

FINDINGS

The participants expressed overall satisfaction with the class. The area that satisfied them the most was the performance of the midwife. The areas that satisfied them the least were the date, length, size and time of the class. Three themes emerged from the interview data, namely, 'learning about labour', 'contributing to a smooth labour process' and 'coping with uncertainty and handling anxiety.

CONCLUSION

This study supports using a mixed-method approach to evaluate client education activity, and highlights the importance of cultivating positive coping measures among the Chinese women after attending childbirth education class when facing childbirth-related anxiety.

A qualitative study exploring the support needs of first-time mothers on their journey towards intuitive parenting

OBJECTIVE

to gain an understanding of the experiences of first-time mothers in the early weeks of motherhood in order to elicit what areas of support these women find empowering in easing their adjustment.

DESIGN

a grounded theory approach was used. Data were collected through individual in-depth interviews.

SETTING

an area in the South of England with maternity services provided by a consultant obstetric unit and four midwife-led centres.

PARTICIPANTS

eight primiparous women aged 20-39 years, who had given birth normally at term to a healthy baby.

FINDINGS

five categories 'expert to novice', 'losing touch', 'perceiving expertise', 'restoring balance' and 'falling into place' revealed a journey women travelled as they left behind their comfortable, controlled lives in which they were 'experts' and faced the unknown world of motherhood. Eventually, practice, support and knowledge shared with peers facilitated proficiency and intuitive mothering. Throughout this transition, the overriding concern of the mothers was to develop confidence and skills to give optimal care to their baby. 'Doing it right' emerged as the core category.

IMPLICATIONS FOR PRACTICE

an understanding of the factors women considered to be supportive or inhibitive in easing their adjustment to motherhood might enable midwives to move beyond more traditional forms of postnatal care to explore innovative ways of providing and facilitating access to supportive resources.

Childbirth and parenthood education classes in Sweden. Women's opinion and possible outcomes

OBJECTIVE

To investigate first-time mothers' views about antenatal childbirth and parenthood education and their contact with other class participants after birth, and to compare participants and non-participants with respect to the use of pain relief, experience of pain, mode of delivery, childbirth overall, duration of breastfeeding, and assessment of parental skills.

METHODS

A national cohort of 1197 Swedish-speaking women completed three questionnaires: during early pregnancy, 2 months, and 1 year after giving birth.

RESULTS

Seventy-four percent of first-time mothers stated that antenatal education helped prepare them for childbirth, and 40% for early parenthood. One year after giving birth, 58% of the mothers had met with other class participants. These outcomes were associated with the number of class sessions. When controlling for the selection of women into participants and non-participants, no statistical differences were found concerning memory of labor pain, mode of delivery, overall birth experience, duration of breastfeeding, and assessment of parental skills. However, participants had a higher rate of epidural analgesia. Mothers who were young, single, with low level of education, living in a small city, and smokers were less likely to find the classes helpful.

CONCLUSION

Participation in childbirth and parenthood education classes did not seem to affect first-time mothers' experience of childbirth and assessment of parental skills, but expanded their social network of new parents. The higher epidural rate suggests that participation in classes made women more aware of pain relief techniques available, rather than improving their own coping with pain. More research should focus on current forms of antenatal education, with special focus on women of low socioeconomic status.

Congratulations you're a mother: a strategy for enhancing postnatal education for first-time mothers investigated through an action research cycle

The transition to motherhood is a time of great change and an experience for which many women do not feel adequately prepared. This study sought to benefit women in the transition to motherhood by enhancing the postnatal teaching offered to first-time mothers in hospital following childbirth. The study followed an action research cycle to design, implement and evaluate an educational resource for first-time mothers during the immediate postnatal period. Methods for collecting data included focus groups and an anonymous self-completed questionnaire. The research was undertaken at a suburban public hospital in Adelaide. The findings showed that both midwives and first-time mothers considered lack of time as a significant factor in giving and receiving postnatal education. It was also found that the provision of relevant information was important. The study identified that specific information relating to baby-care and self-care are primary educational needs for first-time mothers. The resource, "Congratulations You're a Mother" was developed in response to these findings and was found to be beneficial in providing postnatal education. The study provides a platform for further investigation of postnatal education using larger samples in the broader context of Australian society.

Chinese women's perceptions of the effectiveness of antenatal education in the preparation for motherhood

AIM OF THE STUDY

This was an exploratory descriptive study using mixed methodology to investigate Hong Kong Chinese women's perceptions of the effectiveness of antenatal education in their preparation for motherhood.

DESIGN

In the first phase, the structure and process of five antenatal classes on the topic of motherhood were observed using an observation guide. In the second phase 11 women who had attended the antenatal classes were interviewed in two focus groups, using a semi-structured interview guide.

FINDINGS

In respect to the structure of the classes women revealed that large class sizes and the didactic mode of teaching inhibited learning. While they were satisfied with the date and time of antenatal classes, and the information about self and baby care being provided, they felt unprepared for the demands of motherhood. Further themes identified from the analysis were: anticipating personal needs for antenatal preparation for motherhood, unrealistic preparation for breastfeeding problems, inadequate preparation for baby care, unfulfilled informational needs and conflicting advice from antenatal educators.

CONCLUSION

The conclusion highlights Chinese culturally specific changes needed in the content and mode of antenatal education. In addition, recommendations are made for antenatal educators to work within a framework of adult Chinese learning styles in order to meet the educational needs of Chinese women.

Is there a 'typical' consumer of obstetric services?

Each user of the maternity services will have a different service experience. The experience will vary depending on the place of birth, type of antenatal care, delivery and postnatal support. However, to be effective service providers, the provision ought to be responsive to the needs of the consumers. This paper considers the development of the maternity services, reflecting on the current environment in which the provision is delivered and attempts to characterise users of the provision to facilitate an understanding of consumer needs. This research considered primigravidae and multiparous users of the maternity provision and explored their access to information and their use of information with particular consideration of their referent groups. This study produced interesting results, not least that both primigravidae and multiparous users are prepared to abdicate responsibility for some aspects of their decision-making to medical professionals. Sub-categorisations of primigravida and multipara users and various socio-economic groups were also constructed.

Aims, processes and problems of antenatal education as identified by three groups of childbirth teachers

OBJECTIVE

To establish whether variations exist in the philosophy and approach of three groups of childbirth teachers working in different organisations in the UK.

PARTICIPANTS

Two midwifery Parentcraft Sisters working in the UK maternity services, three National Childbirth Trust Antenatal Teachers and two Active Birth Teachers working in the voluntary sector, and two Midwife Teachers.

METHOD

Semi-structured interviews were tape-recorded, transcribed and analysed using a grounded theory approach to identify common categories.

FINDINGS

All three groups of teachers identified similar aims for antenatal education, with the need to build clients' confidence in their ability to give birth and care for their babies as the most important. However, the process by which the various teachers attempted to realise their aims appeared to be very different.

IMPLICATIONS FOR PRACTICE

In order to ensure the prioritization of antenatal education with purchasers and providers, childbirth teachers need to define more clearly the criteria by which it can be audited.

A comparison of attenders at antenatal classes in the voluntary and statutory sectors: education and organisational implications

OBJECTIVE

this study sought to identify whether differences existed in the demographic details of clients attending each of three types of antenatal classes: those provided at a large inner city hospital, and those provided in the voluntary sector by National Childbirth Trust (NCT) and Active Birth teachers. The aim was to establish whether there is an overlap in provision of antenatal education which might warrant a rationalisation of services.

DESIGN

a survey was conducted using questionnaires which asked for basic demographic details.

SETTING

the questionnaires were distributed at antenatal classes held in the hospital and in the venues used by the lay teachers (generally their homes).

PARTICIPANTS

these included 78 primiparae attending 'couples' classes at the hospital, 36 primiparae attending NCT classes and 25 primiparae attending Active Birth classes.

FINDINGS

the women in the three groups were largely similar in terms of being older than the national average for childbearing women, middle-class and affluent as measured by car-ownership. Women from social classes 4 and 5 and very young women were almost entirely unrepresented. Twenty-three per cent of hospital class attenders, 61% of NCT attenders and 48% of Active Birth attenders were also going to a second set of antenatal classes, suggesting a considerable duplication of effort on behalf of childbirth educators.

KEY CONCLUSIONS

liaison between the voluntary and statutory sectors could lead to a more rational deployment of childbirth educators for the group of women currently attending antenatal classes, thus freeing midwives for one-to-one information giving or alternative educational provision for women who do not now attend formal classes and who may be considered at risk.