Antenatal Education Research Articles

Multicomponent perinatal breastfeeding support in women with BMI >25: The Latch On multi-centre randomised trial.

To investigate the effectiveness of a multicomponent breastfeeding support intervention on breastfeeding prevalence at 3 months among women with a body mass index (BMI) >25 kg/m2. Multicentre multicomponent randomised controlled trial. Four maternity centres in Ireland. A total of 225 primiparous women and their nominated support partners. Participants were aged 18 years and over, with BMI ≥25 kg/m2, carrying a singleton pregnancy and without contraindication for breastfeeding. The intervention included an antenatal group breastfeeding education session for participants and their support partners, followed by a planned postnatal breastfeeding assessment and telephone support for up to 6 weeks by a lactation consultant. Any breastfeeding at 3 months postpartum. Any breastfeeding prevalence was 68.7% (n = 68) in the intervention group and 62.1% (n = 59) in the control group at 3 months postpartum (odds ratio 1.33, 95% confidence interval 0.72-2.46, p = 0.36). Any and exclusive breastfeeding rates did not significantly differ at any other time point. More women in the control group accessed support from private lactation consultants (intervention 23.5% [n = 12], control 45.3% [n = 24], p = 0.02). The control group had higher than expected breastfeeding rates, and the study found no evidence of effect on the primary outcome. Providing comprehensive education and support for women intending to breastfeed remains of paramount importance.

Implementation of Online Antenatal Classes and Education of First-Time Mothers During the COVID-19 Pandemic: The Experience of a Tertiary University Hospital in Nothern Greece

Implementation of Online Antenatal Classes and Education of First-Time Mothers During the COVID-19 Pandemic: The Experience of a Tertiary University Hospital in Nothern Greece

Respectful maternity care at caesarean delivery: Experiences of mothers in a primary referral hospital in Ghana

AbstractBackgroundRespectful, dignified care is a human right for all women that impacts skilled birth attendance and outcomes. This study aimed to assess the prevalence of respectful maternity care (RMC) provided at caesarean deliveries in a Ghanaian referral hospital and determine associated factors influencing care provision. We sought to elucidate RMC prevalence and drivers specific to the caesarean experience, to promote rights‐based, patient‐centred caesarean delivery care.MethodsA cross‐sectional study was conducted from June to November 2022, among women who delivered via caesarean section at the hospital. Interviews of participants were conducted using structured questionnaires, capturing respondents' sociodemographic and obstetric features and perceptions of RMC. Quantitative data were summarised using means, medians, frequencies and proportions. Bivariable and multivariable logistic regression models were employed to determine factors associated with RMC at 95% confidence interval (CI) and a p < 0.05.ResultsA total of 308 women were included in the study. The mean age of mothers was 29.9 (±6.8) years. Of the mothers, 67.9% (95% CI: 62.3, 73.0) received RMC and 32.1% reported disrespectful and abusive care. Several factors were associated with higher likelihood of receiving RMC at caesarean delivery, including being married, adjusted odds ratio (aOR) 2.45 (95% CI: 1.17, 5.12), having average monthly income between Ghana cedis 501 and 1500, aOR = 1.94 (95% CI: 1.07, 3.50), having a previous delivery history of spontaneous vaginal delivery only, aOR 2.04 (95% CI: 1.02, 4.08) and receiving anaesthesia from a male anaesthetist, aOR 2.04 (95% CI: 1.22, 3.42).ConclusionThough the majority of women at caesarean delivery received RMC, close to one‐third may attribute a negative caesarean birth experience to disrespectful care. Respectful and abusive‐free care at service delivery should thus be emphasised for healthcare givers and form part of antenatal education.

Information seeking behavior on hepatitis B virus, and its associated factors among pregnant women at teaching and specialized hospitals, Northwest Ethiopia: A cross-sectional study.

Hepatitis B virus (HBV) infection continues to be a major public health issue worldwide. Health information-seeking behavior is critical to obtain information about health, diseases such as the Hepatitis B virus, health risks, and health promotion and it has become a major concern of health policymakers. However, there is little evidence of information-seeking behavior on the Hepatitis B virus in Ethiopia. So, this study aimed to assess Hepatitis B virus information-seeking behavior and its associated factors among pregnant women at teaching and Specialized Hospitals, in Northwest Ethiopia. An institution-based cross-sectional study was conducted among pregnant women at teaching and specialized hospitals, in Northwest Ethiopia from May 01 to June 01, 2022. A total of 423 participants were selected using a systematic random sampling method. The data was collected through an interview-administered questionnaire by kobo-collect software. Then export into SPSS version 20 for analysis. Descriptive statistics, bi-variable, and multivariable logistic regression analyses were done to identify factors associated with Hepatitis B virus information-seeking behavior. The proportion of information-seeking behavior on the Hepatitis B virus among pregnant women was 40.5% (CI = 35.7, 45.6). Education(diploma and above) [AOR = 3.3, 95% CI (1.31, 8.16)], more than one ANC visit [AOR = 5.99, 95% CI (3.20, 12.31)], smart-phone ownership [AOR = 4.1, 95%CI (1.35, 12.31)], internet access [AOR = 5.1, 95%CI (1.35, 15.60)], perceived susceptibility [AOR = 2.7, 95%CI (1.38, 5.31)], perceived severity [AOR = 3.7, 95%CI (2.06, 6.55)], and self-efficacy [AOR = 1.9, 95%CI (1.03, 3.73)] were factors influencing information seeking on Hepatitis B virus. The overall proportion of information-seeking behavior on HBV among pregnant women was low. To improve information-seeking behavior on HBV among pregnant women we should connect the women to the internet and technology. Creating women's awareness about the Hepatitis B virus severity and their venerability and increasing their antenatal care (ANC) visits, self-efficacy, internet access, and women's education can improve information seeking about the Hepatitis B virus.

Effect of Peanut Ball Exercise on Fear of Labour among Primigravida Mother

Background: Fear of giving birth is the primary factor that has reduced the preference for natural birth. Thesudden rise in the percentage of C-sections has harmed women’s pregnancy and new-born health.Purpose: To evaluate the effectiveness of peanut ball exercise on reducing fear among primigravida mothers.Materials and Methods: Thirty participants were randomly assigned to experimental (peanut ball exercise,antenatal exercise, antenatal education) and conventional (Antenatal exercises) groups. The fear of childbirthquestionnaire (FCQ) was used to evaluate the pre-test the same test used to determine post-treatment values after12 weeks of the treatment.Results: A significant difference was observed between the experimental and control groups (P =0.0001). peanutball exercise and antenatal education were effective in mothers with a fear of childbirth.Conclusion: Peanut ball training is effective in mothers with a fear of childbirth.

Pre-eclampsia training needs of midwives in a Ghanaian tertiary hospital: A cross-sectional study

AimThis study aimed to assess the specific clinical and non-clinical training needs of midwives and determine their preferred approach to enhancing performance. BackgroundPre-eclampsia remains one of the leading causes of maternal deaths in low and middle-income countries. Pre-eclampsia-related deaths may be due to reduced midwifery knowledge and inadequate management. Therefore, a training needs assessment is vital in identifying gaps in practice, especially, in poorly resourced settings for maximal use of training resources. DesignA hospital-based cross-sectional study. SettingThe largest tertiary hospital in Ghana. MethodsAn online version of the validated WHO Hennessy-Hicks Training Needs Analysis questionnaire was used to assess midwives’ training needs on the management of pre-eclampsia. The tool has good psychometric properties and was used to assess 1) midwives’ confidence in performing tasks, 2) the importance of the task to their role and 3) their preferred performance improvement approach. Data analysis adhered to the guidelines specified in the Hennessy-Hicks Training Needs Analysis Questionnaire and the priority training requirements of the midwives were assessed through descriptive statistics and a series of independent t-tests. ResultsAmong the 250 midwives who responded, most possessed 1–5 years of experience (74.7 %). All 28 tasks were viewed by midwives as essential responsibilities in pre-eclampsia management. Midwives had the greatest need for training in research/audit and clinical skills domains respectively (p < 0.001, 95 % confidence interval: 1.08–1.47, Cohen’s-D = 1.27; and p < 0.001, 95 % confidence interval: 0.69–1.06, Cohen’s-D = 0.87). The foremost primary training necessity, as recognised by midwives, was undertaking health promotion activities, including antenatal health education (MD= 0.43, 95 % confidence interval: 0.29–0.57). Training courses were identified as the preferred approach to address training needs and improve overall proficiency. ConclusionMidwives in Ghana require comprehensive training covering research and clinical-based competencies to improve pre-eclampsia management. Considering the pivotal role of Ghanaian midwives in safeguarding maternal well-being, there is a compelling need to enhance the calibre of midwifery services. These findings can guide stakeholders in countries with comparable healthcare contexts in creating effective, resource-efficient training programs that avoid counterproductivity, ultimately supporting national initiatives to enhance pre-eclampsia management and the quality of care.

Assessing the influence of forest therapy on maternal health: a medical perspective and recommendations

Background: The health promoting benefits of greenness exposure were addressed before, during, and after pregnancy. Addressing the low-birth-rate issue of Korea, this review focuses on forest-based interventions to assess the mental and physical health of pregnant women in green environments, both nationally and internationally. It also proposes the utilization of green environmental resources as a strategy to improve maternal health and address the low-birth-rate issue.Current Concepts: Keyword search was done using PubMed, Web of Science, and Research Information Sharing Service (RISS) databases manually for references of retrieved papers until September 2023. Keywords included forest, greenness, and antenatal education. Of 107 potentially relevant papers related to prenatal education in forest or green environments, 12 papers were finally analyzed (comprising six domestic and 6 international academic journals). Overall, these papers showed at least moderate levels of bias. This review explored the influence of green spaces, forest activities, and psychological wellbeing on pregnant women. When analyzing pregnancy outcomes about green environments, differences between domestic and international studies became evident due to age, location, sample size, study design, and female participation rates.Discussion and Conclusion: The primary assessment tools focused on mental health, stress levels, quality of life, and overall psychological wellbeing. Domestic studies emphasized stress, anxiety, life satisfaction, inner peace, and maternal identity during pregnancy, while international research underscored the positive impact of green environments on pregnancy outcomes.

Improving breastfeeding among adolescent mothers: a prospective cohort.

Exclusive breastfeeding is recommended for the first six months, and mother's age impact early weaning. Educational support and relevant information can increase breastfeeding rates. To determine whether antenatal education enhances the maintenance, intention, and confidence in breastfeeding among adolescents. A prospective cohort study involving primiparous adolescents who gave birth at the Woman's Hospital (CAISM), Universidade Estadual de Campinas, Brazil. Adolescent mothers were categorized into two groups based on the location of prenatal care: those at the Woman's Hospital (WH) who received antenatal education, and at the Primary Care (PC) who did not receive antenatal education. All adolescents received breastfeeding orientation during their postpartum hospital stay. The groups were compared using the Student's t-test, Mann-Whitney U test, and chi-squared test. Log-binomial models were used to compare the groups at different time intervals. The study included 132 adolescents: 59 in the WH group and 73 in the PC group. Six months postpartum, adolescents in the WH group demonstrated higher engagement in breastfeeding (P < 0.005) and exclusive breastfeeding (P = 0.04) than PC group. PC group showed greater lack of confidence in breastfeeding (P = 0.02) and felt less prepared (P = 0.01). Notably, all WH adolescents reported a stronger desire to breastfeed after antenatal education. Antenatal education significantly improves the maintenance, intention, and confidence of breastfeeding among adolescents. This education approach can be implemented across all healthcare levels and should be made accessible to all women throughout the pregnancy and postpartum period.

ANTENATAL EDUCATION STRATEGIES DESIGNED TO SUPPORT MOBILITY IN LABOUR: A SCOPING REVIEW PROTOCOL

Empowering women for labour mobility is acknowledged as a component of good midwifery care, yet challenges persist in hospital settings. While the benefits of antenatal education are recognised as supporting labour mobility, specific details and correlations with outcomes remain deficient. A comprehensive synthesis of interventions empowering women for labour mobility is lacking. This study aims to map strategies in antenatal education for labour mobility, utilising JBI methodology. The review will centre on antenatal education, highlighting crucial information for strategies to enhance women’s decision-making and childbirth self-efficacy, fostering labour mobility and upright positions during labour.

Women's empowerment for active labor: A qualitative study with nurse-midwives in antenatal education for childbirth.

Recognizing the positive impact of movement and positions on labor progression and maternal and neonatal outcomes, there is a strong recommendation to empower women for active labor during antenatal education. This study investigates nurse-midwives' interventions in empowering women for active labor, during antenatal education within primary healthcare settings. A qualitative descriptive study was conducted in Primary Healthcare Units that provide antenatal education for childbirth in Portugal. Semi-structured interviews were conducted with 10 nurse-midwives between August and October 2023. Content analysis, utilizing NVIVO software, was employed for data analysis, and the study adhered to the COREQ reporting guidelines. Six themes emerged: 1) Perspective of nurse-midwives and contextual influences; 2) Assessment of women's needs; 3) Enhancing women's knowledge; 4) Enhancing women's capabilities; 5) Supporting women in decision-making; and 6) Nurse-midwives' perspective on intervention outcomes. It is necessary to create environments conducive to knowledge and skill acquisition and invest in developing body awareness and its impact on labor progression. Encouraging women's involvement in decision-making is crucial, especially in less flexible hospital environments. This study highlighted the value nurse-midwives place on empowering women for active labor. Interventions featured sharing evidence-based practices and birth stories to foster reflection, emphasizing pelvic mobility training and partner involvement. Reflective practices could enable women to explore options and communicate effectively with healthcare professionals during labor.

Effectiveness of Childbirth Self-Efficacy Enhancing Classes on Labor Length and Outcomes among Egyptian Primiparous Women: A Quasi-Experimental Study.

Childbirth self-efficacy has repeatedly been shown to raise satisfaction with childbirth, reduce the need for analgesic, and promote the use of different childbirth alternatives. However, the measures to improve the childbirth self-efficacy had rarely been investigated among Egyptian primiparous women. The aim of this study is to evaluate the effectiveness of childbirth self-efficacy enhancing classes on labor length and outcomes among Egyptian primiparous women. A quasi-experimental research approach was carried out on prospective, consecutive sample of 148 pregnant women at the end of pregnancy. A prenatal education study group (n = 74) and a control group receiving standard antenatal care (n = 74) make up the first and second groups, respectively. Between October 2021 and October 2022, the study was conducted at the antenatal clinic. The following four tools were employed to fulfill the study's objective: A structured interviewing form, a childbirth self-efficacy inventory, a follow-up checklist for monitoring maternal and neonatal outcomes during labor, and three antenatal education sessions to boost childbirth self-efficacy are all examples of tools that can be used. All statistical analyses were performed using SPSS for windows version 20.0. Approximately 68.9% of women in the experimental group gave birth vaginally, compared to 29.7% of those in the control group with (p = .001), according to the study's findings. In the experimental group, regular labor took an average of 8 to 12 h, but it took more than 12 h in the control group. Birth weight (>3000g) in the experimental group compared to (2000-3000 g) in the control group, as well as the Apgar score at 1 min and 5 min, were highly statistically significance between two groups with (p = .001). The means±SD of the childbirth self-efficacy result scores were better in the study group than in control groups regarding length of delivery and vaginal delivery (248.2 ± 19.4 versus 144.6 ± 21.6 and 250.1 ± 18.2 versus 137.9 ± 21.5, respectively). According to the findings of this study, antenatal education classes have a real chance of assisting primiparous women in increasing their childbirth self-efficacy and improving maternal and neonatal outcomes.

Mothers working to prevent early stillbirth study (MiNESS 20–28): a case–control study protocol

IntroductionIn the UK, 1600 babies die every year before, during or immediately after birth at 20–28 weeks’ gestation. This bereavement has a similar impact on parental physical and psychological well-being...

Proportion and risk factors of low birth weight among neonates delivered at Omdurman Maternity Hospital, Sudan.

Low birth weight (LBW) is a major predictor of child mortality and morbidity. The objectives of this study are to determine the proportion and risk factors of LBW. A matched case-control study was conducted at Omdurman Maternity Hospital, Sudan. The study population consisted of all babies delivered in August 2016 excluding stillbirths, multiple births, and babies with insufficient data. All LBW neonates were selected using total coverage sampling as cases and matched on babies' gender with randomly selected normal birth weights as controls. The sample size was 350 babies; 175 test cases and 175 control cases. Data were collected from hospital records and six risk factors were tested: mother age, parity, gravidity, mode of delivery, hypertensive disorders, and diabetes mellitus. The proportion of LBW was 10.8% of the total number of delivered neonates which is 2,938. The bivariate analysis identified that younger mother age (p = 0.03) and hypertension (p = 0.02) were significantly associated with LBW while other factors were found statistically insignificant. Multivariable conditional logistic regression revealed that hypertensive disorders in pregnancy increase the risk for LBW almost three times [Adjusted OR = 2.98 (95% CI: 1.23-7.22), p = 0.02]. We found that hypertension is an independent risk factor for LBW. The proportion of LBWcan be reduced if hypertension is controlled by providing simple measures like proper antenatal care and health education for pregnant women.

Lipid-focused dietary education intervention in pregnant women: study protocol for an open-label, parallel, randomised, intervention study addressing adverse pregnancy outcomes in China

IntroductionThe incidence of infants who are large-for-gestational-age (LGA) is on the rise in China, and its detrimental effects on health have received increasing attention. Diet-based interventions have the potential to...

Factors affecting poor sleep quality in last trimester pregnant women: a cross-sectional research from Turkey.

The aim of the study was to determine the factors affecting poor sleep quality in the last trimester pregnant women. A cross-sectional study was conducted at a tertiary care maternity hospital in Ankara, Turkey. The research was conducted between May and September 2019 with 570 pregnant women in the last trimester. The data were collected through the Personal Information Form, Pittsburgh Sleep Quality Index, International Physical Activity Questionnaire Short Form, Restless Legs Syndrome Form, Brief Fatigue Inventory, and Perceived Stress Scale. The mean Pittsburgh Sleep Quality Index score of the pregnant women was 5.98±3.31, and 48.9% of them were found to have over five Pittsburgh Sleep Quality Index scores. Hemoglobin levels, income perceptions, smoking habits, attending pregnant schools, experiencing leg pains or cramping, experiencing back, waist, or neck pains, Restless Legs Syndrome, fatigue levels, and perceived stress levels of the pregnant women were found to be important determinants of sleep quality (p<0.05). According to the findings, increasing hemogram levels, attending antenatal education programs, and improving the ability of pregnant women to manage stress are opportunities to improve sleep quality during pregnancy. Careful evaluation of pregnant women in terms of insomnia and affecting factors can be suggested during antenatal follow-up.

Efficacy of Educational Intervention on Decision Conflict

Background Decision conflict usually occurs from poor patient involvement in decision making which may cause regrets about the options that were chosen. Health professionals should impart antenatal education to enhance a mother’s belief about her birthing. Objective To assess the effect of supportive educational intervention on decision conflict among primipara mothers with a fear of childbirth (FOC). Methods An randomized controlled trial (RCT) was conducted on 205 primipara mothers with an FOC attending Gynae OPD. At 24–28 weeks of pregnancy, mothers were screened for FOC WDEQ-A and then randomly allocated to the experimental (103) and control group (102) and assessed for decision conflict by using a decisional conflict scale. The experimental group was given Supportive educational intervention. At 37–38 weeks of pregnancy, both groups were again assessed for decision conflict. Three participants from the experimental and two from the control group were lost to follow up and the final post-test was completed by 200 participants. Data analysis was done by calculating frequency, mean, standard deviation, Fisher Exact test, chi-square, t-test and F-test using SPSS version 18. Results There was a significantly lower post-intervention decision conflict score in the experimental group as compared to the control group ( p &lt; .001). No difference was observed in the pre-test score in both groups. Conclusion Supportive educational intervention was effective in primipara mothers for reducing decision conflict. Improving antenatal emotional well-being will lead to a positive childbirth experience with better perinatal outcomes.

Pelvic organ prolapse: Women’s experiences of Accessing Care & Recommendations for improvement

Up to 50% of women will develop pelvic organ prolapse (POP) over their lifetime. Symptoms include pain, bulge, urinary, bowel and sexual symptoms affecting all aspects of a woman’s life.Many women with POP symptoms present initially to primary care settings. Research has shown these interactions are often unsatisfactory, with women reporting their health care professional (HCP) trivialized their symptoms or appeared to have poor knowledge about pelvic floor dysfunction (PFD).Aim The aim of this qualitative study was to explore experiences of younger women seeking treatment for POP and their recommendations for improvements.Methods Ethics approval was obtained (LS-21-01-Carroll-Ful). Women with POP were recruited from an online support group (n = 930 members). Inclusion criteria: adult women, diagnosed with POP and aware of their POP stage. Following informed consent, a demographic questionnaire, interview questions and the Central Sensitization Inventory (CSI) were forwarded. Semi-structured zoom audio-recorded interviews were conducted. Thematic analysis was undertaken; transcripts coded, and themes identified.Results Fourteen women aged 32–41, parity 1–3, with POP Grade 1–3 participated. Many women reported HCPs as dismissive or not appreciative of the impact of their condition. Others described interactions with HCPs who they felt listened, understood the impact of their POP, gave simple explanations, a positive prognosis and outlined a realistic treatment plan.Current antenatal education, post-partum care and primary HCP screening for PFD were identified by women as deficient. Many highlighted delays in accessing specialist care for POP. Women made several recommendations for improvements to the current model of care.Conclusions Increased focus on person-centred care, particularly emotional support, information and education may improve younger women’s experiences when seeking care for POP.

Enhancing antenatal education in Pakistan: an audit and recommendations

BackgroundAntenatal Education equips parents with knowledge for safe maternal health and infant care. It also reduces fear and anxiety during childbirth. ANE curriculum can vary according to country and institute. It can include classes focusing on childbirth, pain relief techniques, mode of birth, parenting, breastfeeding, breathing techniques, etc. Although ANE is widely practiced in developed countries, there is no standard program in developing countries like Pakistan. This study aims to improve antenatal education at a tertiary care hospital in Karachi, Pakistan potentially proposing an upgraded curriculum as a national standard.MethodsThis multiphase study used mix-method design was conducted in the Obstetrics and Gynaecology Department of a tertiary care hospital of Karachi, Pakistan from 2019 to 2021. Phase 1 of the study included reviewing and comparing the hospital’s antenatal curriculum with existing literature, followed by Phase 2, which was a desk review of attendance and patient feedback. The 3rd phase involved IDIs (in depth interviews) from health care workers (Obstetrics experts) to understand their perspectives regarding the ANE and the conducted classes. For phase one, gaps were identified and reported theoretically. For phase two, the annual attendance was recorded and participants’ satisfaction with the classes assessed. Qualitative data from phase 2 and 3 was converted into themes and sub-themes.ResultsThe audit showed a decline in the attendance of antenatal classes due to the pandemic and consequent shift to online sessions. The low attendance in online courses could be attributed to various factors. Patient feedback was generally positive, with a majority expressing high satisfaction levels. Expert feedback highlighted the need for additional topics such as mental health and COVID in pregnancy, as well as fathers' involvement. The curriculum was updated to include these topics and made more interactive with printed handouts for parents.ConclusionA standardized antenatal education covering various topics surrounding pregnancy, childbirth, and postnatal care must be available to parents nationwide.

Fear of childbirth in nulliparous and multiparous women in Australia

Background/Aims Although maternity care in developed countries is safe, fear of childbirth is a common problem. There is limited research in this area on nulliparous and multiparous women. The aim of this study was to compare fear of childbirth, its risk factors and birth outcomes between Australian nulliparous and multiparous women. Methods In this prospective cohort study, 141 nulliparous women and 212 multiparous women were recruited from antenatal clinics. Data were collected using standardised questionnaires and analysed. Results A third of nulliparous (33%) and multiparous women (31%) feared childbirth. Nulliparous women with high–severe fear were more likely to have a lower family income, attend antenatal education classes, undergo assisted conception and report higher levels of depression, anxiety and stress. They also had greater odds of prelabour cervical ripening, oxytocin for induction or augmentation of labour, instrumental birth, episiotomy and greater volume of blood loss during birth than multiparous women. Conclusions To empower and support women with fear of childbirth, their unique needs must be recognised. A assistance in coping with fear and anxiety must be made available to contribute to a positive pregnancy experience and birth outcome.

Application of Team-Based Flipped Classroom and Traditional Learning on the Antenatal Education Center Course

Application of Team-Based Flipped Classroom and Traditional Learning on the Antenatal Education Center Course