Childbirth Education Research Articles

Survivors of Placenta Accreta: What Their Blogs Can Tell Us

Prior cesarean birth is the most significant predictor of placenta accreta which can place the woman and her infant’s lives at risk. With the continuing increase in cesarean birth rate, it is essential that childbirth educators inform women of this life-threatening risk. Insightful information from blogs written by survivors of placenta accreta pregnancies can help guide clinical practice and childbirth education. Content analysis of 22 blogs posted on the internet identified seven themes that provide an insider’s view of placenta accreta: the shock of it all, living in constant fear, advocate for yourself to get some sense of control, my mental health is deteriorating, you saved our lives!, recommendations, and posttraumatic growth.

Do women have a choice when it comes to fetal monitoring? Perceptions of information provided and choice of fetal monitoring in Australia: A national survey

IntroIn Australia, little research has examined how women and people participate in decision-making about types of fetal monitoring, or their perceptions of information provided by caregivers. MethodsA national cross-sectional survey, the ‘Women’s experiences Of Monitoring Baby’ (WOMB) Study, explored women’s experiences of intrapartum fetal monitoring. This study reports on selected results. ResultsThere were 861 responses. Of respondents, 20 % reported receiving enough information about types of fetal monitoring from care providers and childbirth education, 35 % recalled being asked for consent, and 34 % were unaware they had a choice in monitoring. Most women (86 %) obtained information via ‘other’ sources or own reading, and where monitoring was discussed, it was most likely a ‘brief discussion’ with a midwife (43 %).Women who were monitored via wired CTG (35 %) were more likely to report facing barriers to choosing their preferred monitoring type, (p<0.001). Wired CTG was significantly associated with hospital type and primiparity and 70 % indicated they would not choose it again (p<0.001). ConclusionWomen did not know they had a choice in the type of intrapartum monitoring received, and felt they had insufficient information to make informed decisions. While monitoring via intermittent doppler and wireless CTG was preferred, women experienced barriers to receiving these, especially in public hospitals in rural/regional areas and private metropolitan hospitals. Antenatal models of care and childbirth education are underutilised avenues for providing information however, it is incumbent on maternity systems to provide adequate information resources, access to equipment and appropriate models of woman-centred and humane care.

EDUCAÇÃO EM SAÚDE E PREVENÇÃO DA DEPRESSÃO PÓS-PARTO: O papel da enfermagem obstétrica

The research addresses the importance of health education and prevention of postpartum depression in the context of obstetric care, highlighting the role of nursing in the care of pregnant and postpartum women. Postpartum depression is a condition that affects many women and can have serious consequences for the mother and the development of the baby. The general objective of the study was to investigate the impact of health education actionscarried out by obstetric nurses in the prevention and management of postpartum depression, focusing on detection strategies, emotional support and educational interventions. The methodology used was a literature review, covering scientific articles published between 2019 and 2024, resulting in 12 articles addressing the role of obstetric nursing in health education and prevention of postpartum depression, in which the inclusion criteria were articles published in Portuguese, and the Inclusion Criterion with the DeCS: Depression. Obstetric Nursing. Health Education. Studies in Portuguese that specifically addressed the role of these professionals in this context were included. The research was conducted through electronic databases such as PubMed, Scopus and VHL, using descriptors related to mental health, childbirth and health education. The results indicate that obstetric nurses play an essential role in raising awareness and supporting women, promoting preventive practices that reduce the incidence of postpartum depression. The implementation of educational and welcoming strategies in the prenatal and postpartum period, associated with continuous emotional support, proved to be effective in improving the mental health of pregnant and postpartum women.

Midwives’ account of virtual reality childbirth education

In Finland, prenatal clinics and birthing hospitals struggle with resources to provide expectant parents with childbirth education (CBE) and a tour of the hospital birthing unit. Not preparing for birth is common, and not knowing how and where to give birth causes parents unnecessary stress during pregnancy. One new possibility to complement CBE is using virtual reality (VR) to deliver content. The aim of this study is to describe midwives' views of the status of parents' preparation for birth and provide information on the VR CBE program's advantages and challenges from the midwife's perspective. The study consisted of two focus group sessions with seven participants. Participants were midwives with experience from a hospital birthing ward and had provided childbirth education. The data was analysed using a thematic content analysis approach. According to the midwives, the parents do not prepare for birth well enough. Preparing for birth affects the parents' knowledge about childbirth, their cooperation with the healthcare personnel, and how they trust the birthing process, themselves, and the healthcare personnel. Preparation can also have adverse effects if the birthing person is trying to give birth with a detailed plan or has false expectations. Parents should focus on knowledge, attitude, and mental and physical exercise in preparing for childbirth. By preparing from trusted sources, parents can make informed decisions. They have the skills to stay calm, relaxed, and open-minded during labour and birth. Physical and mental exercise will help them cope with labour and relax their mind and bodies during birth. Midwives see VR as offering great potential for concrete, realistic, and flexible childbirth education that can address current challenges. They were also worried that VR could replace face-to-face contact. However, since there is minimal such contact in the current CBE, VR could enhance childbirth education and offer a realistic and concrete image of birth and a hospital tour. Midwives want families to prepare better for birth and work on their knowledge, attitude, and exercise. By preparing, parents understand childbirth, trust themselves, the birthing process, and the midwives; cooperation works better. Midwives see VR as an excellent addition to childbirth education by offering realistic and concrete online childbirth education. VR should not replace face-to-face contact.

Childbirth self-efficacy and birth related PTSD symptoms: an online childbirth education randomised controlled trial for mothers

BackgroundThis study evaluated an online childbirth education course on childbirth self-efficacy and, subsequent birth related posttraumatic stress disorder (PTSD) symptoms and mother-infant relationship quality.MethodThree group (intervention, passive control, active control) parallel randomised controlled trial. Groups were assigned using computer generated random allocation. For the passive control group participants were instructed to carry on with whatever they were currently undertaking with their pregnancy, while the active control group were asked to read a booklet comprised of twelve birth stories. The purpose of the active control was to check if the act of having an activity to complete would influence outcomes. For the online course group (intervention) participants were asked to complete the online version of a birthing course designed by She Births®. One hundred and twenty-five women residing in Australia between 12 and 24 weeks pregnant were recruited online. Participants were asked to complete their required activity between 24 and 36 weeks pregnant. Childbirth self-efficacy scores were tested pre and post intervention (time one and time 2), PTSD symptoms and mother-infant relationship quality were tested at six weeks and six months postnatal.ResultsThere was no significant interaction by group for childbirth self-efficacy scores. Mean difference scores at time one (pre-intervention) and time two (post-intervention) for each group indicated a trend in the online group towards higher childbirth self-efficacy compared with the two control groups. The main effect of group on birth related PTSD scores was not statically significant at six weeks postnatal or at six months postnatal. The main effect of group on mother-infant relationship scores was not statically significant at six weeks postnatal or six months postnatal.ConclusionsTrends showed childbirth self-efficacy scores to be higher in the intervention group compared with the two control groups, demonstrating effectiveness for the intervention. Paradoxically, PTSD scores were higher in the intervention group compared with the two control groups and therefore also reported poorer mother-infant relationship quality. External factors may be more important than childbirth self-efficacy highlighting the need for a holistic approach that addresses systemic and socio-political influences to improve communication, autonomy, and respectful maternity care.Trial RegistrationThis trial was retrospectively registered with the Australian New Zealand Clinical Trials Registry number: ACTRN12624000241538 on March 11, 2024.

Dietary patterns of Polish pregnant women in reference to prepregnancy BMI and gestational weight gain.

During the life cycle of a woman, pregnancy is the period when she is most open to changing her behaviour and lifestyle for the benefit of the child's development. Lifestyle changes include also the diet correction. The objective of the study was to assess, through identified dietary patterns, the diets of women in the second and third trimester of pregnancy in relation to their nutritional status before and during pregnancy. The study was conducted among pregnant women, participants of childbirth education classes at the Institute of Mother and Child, based on food frequency questionnaire. The study involved 392 women in the age 19-40 years (first single pregnancy without complications). Dietary patterns were identified using the k-means method, based on groups of products. Three dietary patters were identified in the study group of women: dietary pattern 1 - cereal-milk diet, dietary pattern 2 - vegetable-fruit diet and dietary pattern 3 - cottage cheese-vegetable diet. Dietary pattern 3 occurred in 43.9% of underweight women, in 45.5% of women with normal weight and in 43.1% of women with excess body weight. Dietary pattern 1 occurred in about one third of women and dietary pattern 2 in about 20% in each group. A greater diversity in the frequency of identified dietary patterns was observed in relation to weight gain during pregnancy. The identified dietary patterns differed significantly in terms of the profile of macronutrients, most minerals and vitamins - E, C and B group vitamins. The identified dietary patterns and their energy and nutritional profile indicate the need for monitoring the diets and nutritional education of pregnant women.

Improving Online Childbirth Education: A Role for Active Learning.

Teaching online poses unique challenges for keeping participants engaged. To enhance the effectiveness of virtual childbirth education, this article explores how active learning techniques can guide the design of online prenatal classes. Active learning involves encouraging class participants to process and engage with ideas as the instructor presents them in class, rather than just hearing about concepts through lectures. This article draws from pedagogical literature on active learning and applies its key components to the needs of childbirth instructors in an online setting. Specific recommendations for activities to involve participants and create lasting learning are also provided for synchronous online classes.

The First Baby Study: What women would like to have known about first childbirth. A mixed-methods study.

Although prenatal care providers aim to prepare women for first childbirth, little research has explored retrospectively what birthing people would like to have known before first childbirth. To describe women's reports of what they would like to have known before first childbirth but feel they were not told. This is a secondary analysis of the First Baby Study, a large prospective cohort study conducted in Pennsylvania, USA. Telephone interviews were conducted with 3006 women 1 month after their first childbirth. Women were first asked: "Was there anything that you would have liked to have known before your delivery that you were not told?". If "yes" they were asked a second question: "Please tell me what you would have liked to have known before your delivery". A convergent mixed-methods analysis including descriptive analytics to compare characteristics of women by answers to the first question, and qualitative content analysis of women's open-ended answers to the second question. A total of 441 women (14.7%) reported there was something they would like to have known before their first childbirth. Women described that communication with care providers was their main concern. They would have liked a better understanding of their options before birth, more agency in decision-making, and more information about the topics of their body, their birth, their baby, and what to expect beyond birth. Results highlight important topics for childbirth education, and the impact of gaps in shared decision-making, patient-provider communication, and supportive care practices for first childbirth, especially where women have identified vulnerabilities.

Maternal experiences of women who had received salutary childbirth education: A descriptive qualitative study.

Childbirth education, underpinned by Salutogenesis, presents a paradigm shift in maternal care. There was no present information about the maternal experiences of women who had received Salutary childbirth education. The present study aimed to deeply explore women's pregnancy, birth and postnatal experiences who attended the 'Salutary Childbirth Education Program' and shed light on the mechanisms of Salutogenesis on maternal health promotion. A descriptive qualitative study was conducted with 15 mothers. The study was conducted during April-October 2023. Data were obtained through semi-structured, in-depth individual longitudinal interviews to cover all maternal periods. A thematic analysis was performed. Women stated that they 'acquired normality oriented perspective' which provides 'attribution of positive meanings to the period' and 'freedom from their risk focus concerns'. Women experienced the naturality of the process and were in the flow. They described that they became 'aware of their internal resources', and gained 'skills for the construction of resources' and 'ability to manage the period'. The 'emotional strength' and 'Investment ability for themselves' in addition to obtained autonomy provided them a feeling of strength to actively engage in their experience. This study explores the experiences of women who participated in the Salutary Childbirth Education Program and describes the mechanisms of the program's components on their experiences. By doing so, it aims to enhance understanding of how healthcare professionals can present effective childbirth education through the use of the Salutogenesis Model. The authors would like to acknowledge and thank the women who attended the education program and were willing to interview.

In This Issue—A Champion for Maternal Health

In this column, the editor ofThe Journal of Perinatal Educationdiscusses how a champion for maternal health has supported legislation to improve maternal mortality in one state. The editor also describes the contents of this issue, which offer a broad range of resources, research, and inspiration for childbirth educators in their efforts to promote, support, and protect natural, safe, and healthy birth and postpartum.

An experimental study to assess the effectiveness of video-assisted childbirth education programme on knowledge regarding childbirth among primigravida mothers attending antenatal out patient department of a selected hospital in Bhopal.

Childbirth is a normal physiological process in a woman's life, yet it is a life-changing experience for the primigravida mothers. Boosting confidence regarding pregnancy and childbirth by enhancing knowledge is an important component of care. The aim was to assess the effectiveness of the video-assisted childbirth education programme on the knowledge of the primigravida mothers regarding childbirth. A quantitative research approach with a quasi-experimental non-equivalent control group design was adopted. Non-probability convenient sampling technique was used to select the 60 primigravida mothers who completed 34 weeks of gestation and are attending the Gynaec Outpatient Department (OPD) of a tertiary care hospital in Bhopal. The self-structured knowledge questionnaire was developed. On the first day of contact with the sample, pretest was taken from both groups. A tailor-made video was administered to the experimental group on the same day. Posttest was taken on the seventh day from both groups. Repeated measures analysis of variance (ANOVA) used to determine the effectiveness of video-assisted childbirth education programme revealed a significant interaction between the intervention and time, F (1,58) =29.398, P < .001. The mean difference in knowledge score over time was greater in the experimental group compared to the control group and the difference was statistically significant. The video-assisted childbirth education programme was effective in enhancing the knowledge of primigravida mothers regarding childbirth.

Breastfeeding Education Program Based on Human Caring Theory: Randomized Control Trial.

The aim of the study was determined to examine the effect of breastfeeding education, counseling, and support based on Human Caring Theory on mothers' perceptions of breastfeeding self-efficacy and type of breastfeeding. The randomized controlled prospective study was conducted with 100 Turkish women (intervention: 50; control: 50) between 2019 and 2021 at a university hospital in Izmir. The intervention program included Human Caring Theory-based face-to-face sessions, for 12 hours, asynchronous distance education modules, and telephone support process. Individual asynchronous distance education and telephone support based on Human Caring Theory were provided from the prenatal process to the sixth month postpartum. The control group received two hours of standard breastfeeding training in a childbirth education class. Clinical trial number was received (NCT05246748). Human Caring Theory-based breastfeeding education and support program improved breastfeeding self-efficacy scores of the intervention group (68.88 ± 3.15) compared to the control group (58.08± 9,92). In addition, the breastfeeding duration and exclusively breastfeeding in the intervention group were longer and statistically higher than the control group. Since breastfeeding is an emotional and social interactive process, using the theoretical/philosophical framework based on human care will provide a scientific and holistic perspective. It may be crucial to prefer Human Caring Theory based on routine programs for well-being of breastfeeding rates and successful breastfeeding.

Reflecting on Childbirth Education and Providers

Reflecting on Childbirth Education and Providers

Intervensi Non Farmakologi untuk Menurunkan Kecemasan dan Ketakutan Persalinan pada Trimester III Kehamilan

This study aims to identify non-pharmacological interventions that can reduce anxiety and fear during childbirth in the third trimester of pregnancy. Using the PRISMA method, the research method used is a systematic review through searching 6 (six) databases, namely ProQuest, Scopus, Pubmed, Science Direct, and Taylor &amp; Francis. The results of research from 11 articles included in the analysis show that non-pharmacological interventions that can reduce pregnant women's anxiety levels regarding pregnancy and childbirth are providing education and training in preparation for childbirth carried out face to face (P &lt; 0.001), Iyengar yoga (P &lt; 0 .05), and the application of lavender oil as aromatherapy (P&lt;0.001) as well as mindfulness-based antenatal education (P&lt;0.001). Meanwhile, non-pharmacological interventions that can reduce the level of fear during childbirth are simulation-based childbirth preparation education combined with mindfulness (P&lt;0.01), online-based antenatal education about childbirth preparation (P&lt;0.05), Mindfulness-Based Childbirth and Parenting (MBCP) with a partner (P&lt; 0.05), simulation-based childbirth education (P&lt; 0.05), psychodrama (P&lt; 0.001) and psychotherapy (P&lt; 0.001). In conclusion, non-pharmacological interventions given to pregnant women in the third trimester of pregnancy can reduce the level of anxiety and fear of childbirth. Keywords: Non-Pharmacological Intervention, Anxiety, Pregnancy, Fear of Childbirth

Effectiveness of Childbirth Education and Hypnobirthing Assistance in Improving Labor Outcome

Background: Childbirth education and assistance with hypnobirthing is an autohypnosis technique, namely an effort to instill positive intentions through suggestion into the soul or subconscious mind during pregnancy and preparation for childbirth. This study aims to analyze the effectiveness of childbirth education and assistance with hypnobirthing in improving childbirth outcomes. Subjects dan Methode: The Randomized Controlled Trial (RCT) study was conducted at the Pratama D'Maryam Clinic, Yogyakarta from August to December 2023. A total of 154 pregnant women were selected for this study. Dependent variables are anxiety, depression, complications, and delivery time. The independent variables are childbirth education and assistance with hypnobirthing. Therapy is given 2 times a week with a duration of 3 hours. The study instrument is a questionnaire. Data analysis used Independent T-Test. Results: Providing childbirth education accompanied by assistance with hypnobirthing is effective in reducing anxiety levels in pregnant women (Effect Size= 1.22; p&lt;0.001), reducing depression levels (Effect Size= 1.19; p&lt;0.001), and shortening labor time (Effect Size= 0.08; p = 0.016). Conclusion: Providing childbirth education accompanied by assistance with hypnobirthing is effective in reducing anxiety levels in pregnant women, reducing depression levels, and shortening labor time.

Influence of Integrating Childbirth Preparation Program on Birth Outcomes among Pregnant Women in Western Kenya

Childbirth education and preparation has been fronted as key element in enhancing maternal and neonatal health and preventing some adverse outcomes. There is paucity of literature in Kenyan setting linking maternal childbirth education and maternal and neonatal outcomes. The study aimed to assess the effect of an educational intervention in childbirth and its influence on maternal and neonatal outcomes among expectant women in western Kenya. A Quasi-experimental design was utilised. The health facilities were selected by simple random sampling. Expectant women were enrolled at antenatal care services and allocated to either the control group or the intervention group. Those in the intervention group went through 2 hourly sessions of childbirth preparation teaching twice in the course of the 32nd–35th weeks of gestation. Investigation and assessment on specific maternal and neonatal outcomes was done within 48 hours following delivery. Chi-square and independent t tests were used to determine the statistical difference. More mothers in the control experienced prolonged labour 12% compared to 2.2% in the intervention (P&lt;0.001). Progression failure was high in the control 8.9% compared to 1.1% in the intervention (P=0.001). The control had more cases of augmentation 11% compared to 2.7% in the intervention (P=0.004). Higher APGAR scores were recorded in the intervention group at 1 and 5 minutes compared to the control (P&lt;0.001). Few cases of birth asphyxia were in the intervention 1.6% compared to 5.8% in the control (P&lt;0.001). The intervention program aimed at enhancing childbirth knowledge and improving self- efficacy offered prior to birth was successful in reducing adverse birth outcomes in mothers and their neonates in the intervention group. A program aimed at enhancing women’s’ self- efficacy and improving their knowledge on childbirth should be structured and incorporated in the routine antenatal care to reduce some adverse maternal and neonatal health outcomes associated with fear anxiety and uncertainty related to inadequate childbirth knowledge.

Exploring Healthcare Providers' and Women's Perspectives of Labor Companionship during Childbirth: An Interpretative Phenomenological Analysis Study.

A labor companion of choice during childbirth is crucial for improving women's birth experience and confidence to give birth. Labor companions provide various benefits, including enhanced communication, emotional support, non-pharmacological pain relief, and better healthcare. However, little is known about the supportive actions of labor companions with respect to women's needs during labor and birth, as well as healthcare providers' perceptions of labor companions. Therefore, this study was conducted to explore the perceptions of healthcare providers and women regarding labor companions. The study utilized an interpretative phenomenology research design. Data collection involved conducting semi-structured interviews with 14 participants. The sample consisted of mothers, physicians, and nurses, ensuring a diverse range of perspectives. An interpretative phenomenological analysis was conducted for data analysis. Five themes were identified: (a) impact of companionship, (b) benefits for healthcare providers, (c) companion roles, (d) loneliness and alienation of mothers, and (e) challenges of implementation. The findings indicated that the presence of a companion reduces the need for unnecessary medical interventions and eases the workload of healthcare providers. Without a companion, mothers often feel lonely and disconnected during the birthing process. The presence of companions is often hindered by space limitations in delivery rooms, the absence of clear policies, and lack of childbirth education programs for companions. Clear policies, education programs, and adequate space are essential for implementing and promoting labor companionship during childbirth.

Flipping Childbirth Education.

Since many childbirth education (CBE) courses have moved online, there is a need for a pedagogical design model for online learning. In this study, an online CBE course was flipped, user studies were conducted, and a pedagogical design model was developed. Flipped learning was chosen as it combines asynchronous and synchronous learning activities. The developed model was further strengthened by conducting a pilot study with public health nurses. User data were collected with questionnaires and analyzed using inductive thematic analysis. The results show that in informal learning settings, emphasis should be on which elements are asynchronous or synchronous and mandatory or voluntary. Additionally, time management and interaction between participants and their peers and the instructor should be considered for future training.

High-Risk Pregnancy Follow-Up: What the Childbirth Educator Needs to Know.

Women with a high-risk pregnancy or birth often need additional follow-up care. This article provides a summary of the current recommendations for follow-up after a high-risk pregnancy. It is intended to be a quick read for the busy childbirth educator and includes a table that summarizes the recommendations.

Urban Green Space and Perinatal Health Inequities in the United States: A Literature Review.

Access to urban green space has been linked to positive health outcomes including enhanced perinatal health. The purpose of this article was to review, summarize, and synthesize what is known about the relationship between urban green space and perinatal health and outline implications for practice, policy, education, and research. Nineteen articles were included in this state-of-the-science review. Overall, it was found that limited access to green space is significantly related to adverse birth outcomes. These findings present an important opportunity for childbirth educators and other clinicians involved in the provision of prenatal and reproductive health care. Through education and intervention, poor perinatal outcomes may be mitigated. Clinical screening and education about the importance of access to and use of urban green space during pregnancy should be an essential component of preconception counseling and antenatal screening for at-risk populations. Policy makers should be made aware of these findings so that impactful change can be made in order to reduce disparities and promote health equity.