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Why take childbirth classes?

Here are some things from medline on childbirth classes. Record from database: MEDLINE Title
The effects of social support on women's health during pregnancy, labor and delivery, and the postpartum period.
Author
Gjerdingen DK; Froberg DG; Fontaine P
Address
Department of Family Practice and Community Health, University of Minnesota, Minneapolis 55103.
Source
Fam Med, 23: 5, 1991 Jul, 370-5
Abstract

This review of the literature on social support and its relationship to maternal health indicates that emotional, tangible, and informational support are positively related to mothers' mental and physical health around the time of childbirth. The importance of various types of support changes with the changing needs of women as they move from pregnancy to labor and delivery, and then to the postpartum period. During pregnancy, emotional and tangible support provided by the spouse and others is related to the expectant mother's mental well-being. In addition, informational support in the form of prenatal classes is related to decreased maternal physical complications during labor and delivery, and to improved physical and mental health postpartum. Mothers who have the support of a companion during labor and delivery experience fewer childbirth complications and less postpartum depression. Mothers' postpartum mental health is related to both the emotional support and practical help (eg, housework and child care activities) provided by the husband and others. Health care providers are in a unique position to educate prospective parents about the importance of social support around the time of childbirth and may play a critical role in mobilizing support systems for new mothers.

Title
Effects of parent training on infant sleeping patterns, parents' stress, and perceived parental competence.
Author
Wolfson A; Lacks P; Futterman A
Address
Fallon Clinic, Worcester, Massachusetts 01605.
Source
J Consult Clin Psychol, 60: 1, 1992 Feb, 41-8
Abstract

First-time parent couples from childbirth classes were randomly assigned to a four-session training group (n = 29) or a control group (n = 31). Members of the training group were taught behavioral strategies to promote healthy, self-sufficient sleep patterns in their infants, whereas the control group received the same amount of personal contact without the behavioral training. Six sleep variables were derived from a daily infant sleep diary completed by parents at two time points. Results show that at age 6-9 weeks, infants in the training group displayed significantly better sleeping patterns than did control infants. Training group parents awakened and responded less often to infant signaling and reported greater parental competence. By contrast, control group parents indicated increased stress over time.

Title
Multidimensional assessment of women's experience of childbirth: relationship to obstetric procedure, antenatal preparation and obstetric history.
Author
Salmon P; Drew NC
Address
Department of Psychology, University College London, U.K.
Source
J Psychosom Res, 36: 4, 1992 May, 317-27
Abstract

Primiparous postnatal patients (N = 110) rated their experience of childbirth on a 20-item questionnaire based on an earlier survey of women's spontaneous descriptions. Principal components analysis of the ratings identified three independent dimensions, describing feelings of fulfillment, distress and difficulty, respectively. Ratings by 104 primiparous antenatal patients in the third trimester yielded similar dimensions. The postnatal sample was divided, in turn, according to obstetric procedure at delivery, antenatal classes attended, whether the present pregnancy was planned and history of previous termination. Their experience of childbirth was compared on each dimension. Forceps and unassisted deliveries were experienced similarly. Caesarian section was a less difficult, but also less fulfilling and more distressing, experience than either of these. Delivery was less distressing in those who attended antenatal classes, but only one type of class was associated with more fulfilling birth. Finally, delivery was more distressing in women whose pregnancy was unplanned, or in whom a previous pregnancy had been terminated. Future controlled investigations will be incomplete unless each of the three dimensions is measured.

Title
Just another day in a woman's life? Part II: Nature and consistency of women's long-term memories of their first birth experiences.
Author
Simkin P
Source
Birth, 19: 2, 1992 Jun, 64-81
Abstract

Twenty women who attended the author's natural childbirth classes between 1968 and 1974 were the informants in this study of long-term memories of their first childbirths. The data from each informant consisted of 1) a labor and birth questionnaire, including an open-ended account of her labor, written shortly after her baby was born; 2) a similar questionnaire and account written in 1988 and 1989; and 3) a transcribed interview during which her memories and perceptions were discussed and any discrepancies between the questionnaires were explored. The questionnaires were compared for consistency of recall, and the interviews consulted for further clarification. Specific memories were excerpted, compared, classified, tabulated, and summarized. Findings were that, years later, women's memories are generally accurate, and many are strikingly vivid, especially of onset of labor; rupture of the membranes; arrival at the hospital; actions of doctors, nurses, and partners; particular interventions; the birth; and first contact with the baby. Most memory lapses or confusion were minor. Evidence of a halo effect was observed as well.

Title
An outcome evaluation of a six-week childbirth education class.
Author
Finks HH; Hill DS; Clark KE
Address
Kent State University School of Nursing, OH.
Source
J Nurs Care Qual, 7: 3, 1993 Apr, 71-81
Abstract


Title
     A comprehensive perinatal education program. 
Author
     Biasella S 
Source
     AWHONNS Clin Issues Perinat Womens Health Nurs, 4: 1, 1993, 5-19 
Abstract

Perinatal education has become a common standard of preparation for expectant families anticipating childbirth and support for new families during the transition into parenthood. Twenty-two series and classes are defined and a topical outline is provided for a specific audience of clients, including infants, preschoolers, expectant parents, new parents, and grandparents.


Title
     The psychoeducational model of prepared childbirth education. 
Author
     Koehn ML 
Source
     AWHONNS Clin Issues Perinat Womens Health Nurs, 4: 1, 1993, 66-71 
Abstract

Prepared, childbirth education classes are designed to teach the expectant mother how to effectively cope with the childbirth experience through active participation, informed decision making, and noninvasive pain management skills. As knowledge and technology increase, it often becomes difficult for the childbirth educator to complete the important task of determining the essential content for each class. The childbirth educator can follow established guidelines for class content with a review the literature or structure the class to meet the needs of the participants. An approach used less often, but a powerful and effective one, is using a conceptual model as a framework for selecting the essential content for classes.

Title What's missing in childbirth classes today. Author Daub C Source Midwifery Today Childbirth Educ, 23, 1992 Autumn, 23 Abstract Abstract not available online.

Title Expectations and experiences of pain in labor: findings from a large prospective study. Author Green JM Source Birth, 20: 2, 1993 Jun, 65-72 Abstract

Data on expectations and experiences of pain in labor are presented from a prospective study of over 700 women who gave birth in six maternity units in southeast England. Most women preferred to keep drug use to a minimum, even though they expected labor to be "quite" or "very" painful. The ideal of avoiding drugs was unrelated to education or social class. Women who preferred to avoid drugs were more likely to do so, and were more satisfied with the birth overall than women who used drugs. In general, women tended to get what they expected. Breathing and relaxation exercises were widely used, and were most successful for those who had expected them to be so. Anxiety about the pain of labor was a strong predictor of negative experiences during labor, lack of satisfaction with the birth, and poor emotional well-being postnatally.

Title
     Attenders and nonattenders at childbirth education classes in
     Australia: how do they and their births differ? [see
     comments] 
Author
     Lumley J; Brown S 
Source
     Birth, 20: 3, 1993 Sep, 123-30 
Abstract

This study assessed the associations between attendance at childbirth preparation classes and the health behaviors, birth events, satisfaction with care, and later emotional well-being of women having their first child. A postal survey was conducted of a population-based cohort of 1193 women who gave birth in two weeks in 1989 in Victoria, Australia. The response was 71.4 percent (790/1107). Classes were attended by 245 (83.9%) of 292 primiparous women. Those who did not attend were significantly more likely to be under age 25 years, not to have completed secondary education, to be single, to have a low family income and no health insurance, and to be public hospital clinic patients. Differences between women who attended classes and those who did not, with respect to measures of pain and to the use of procedures, interventions, and pain relief, were rare and minor. No differences occurred between the groups in their satisfaction with the provision of information through pregnancy, birth, and the postnatal period. Only one of five measures of satisfaction with care was less favorable in nonattenders. Attenders were not more confident about looking after their infants at home or less likely to be depressed eight months after birth. Significant differences occurred between the groups on four health behaviors: cigarette smoking, missed antenatal appointments, breastfeeding, and alcohol consumption during pregnancy. Attendance at childbirth preparation classes in Victoria is not associated with differences in birth events, satisfaction with care, or emotional well-being among women having their first child.

Title
     Paternal perspectives of the childbirth experience. 
Author
     Nichols MR 
Address
     School of Nursing, Georgetown University, Washington, DC. 
Source
     Matern Child Nurs J, 21: 3, 1993 Jul-Sep, 99-108 
Abstract

This study examined the responses given by first-time fathers who were asked to describe their feelings about their childbirth experience. The fathers answered three open-ended questions about their feelings concerning labor and childbirth, and the paternal behaviors believed to be most useful to their wives during labor and delivery. Data from fathers who attended prenatal childbirth education classes were examined separately from fathers who did not attend. The findings indicated that for all fathers, regardless of prenatal preparation, the labor experience evoked generally positive responses in addition to a significant number of negative responses, while perceptions of the birth experience were primarily characterized by positive or very positive feelings. The results also indicated that the fathers perceived that they were most helpful to their partner during labor.


Title
     Expectations, experiences and satisfaction with labour. 
Author
     Slade P; MacPherson SA; Hume A; Maresh M 
Address
     Department of Psychology, University of Sheffield, Western Bank, UK. 
Source
     Br J Clin Psychol, 32 ( Pt 4):1993 Nov, 469-83 
Abstract

Emotional, medical and control aspects of labour were explored in 81 primiparous women. Expectations were assessed antenatally and compared with postnatal reports of experiences. Expectations of positive emotions were significantly greater than experience while negative emotional expectations were paralleled by experience. There was a major discrepancy between expectations and experiences of the occurrence of interventions, with the proportion of women expecting interventions being greatly exceeded by those actually undergoing such experiences. In addition, expectations concerning personal control together with the use and efficacy of breathing and relaxation exercises in labour were elevated in relation to experience. Positive emotional expectations were strong predictors of positive emotional experiences and unrelated to negative emotional expectations. Expectations in general were positively related to experience but the strength of the association was weak. Personal satisfaction (i.e. satisfaction with self) in labour was strongly associated with the ability to control panic and other aspects of personal control. The ability to control panic was mainly influenced by the use of exercises. Attenders and non-attenders at antenatal preparation classes showed no significant differences in their experiences or personal satisfaction levels. Possible explanations for this absence of impact are discussed together with issues concerning the relevance of psychological theory to midwifery practice and the need for greater integration.

Title
     The technocratic body: American childbirth as cultural expression. 
Author
     Davis-Floyd RE 
Address
     Department of Anthropology, University of Texas at Austin 78712. 
Source
     Soc Sci Med, 38: 8, 1994 Apr, 1125-40 
Abstract

The dominant mythology of a culture is often displayed in the rituals with which it surrounds birth. In contemporary Western society, that mythology--the mythology of the technocracy--is enacted through obstetrical procedures, the rituals of hospital birth. This article explores the links between our culture's mythological technocratic model of birth and the body images, individual belief and value systems, and birth choices of forty middle-class women--32 professional women who accept the technocratic paradigm, and eight homebirthers who reject it. The conceptual separation of mother and child is fundamental to technocratic notions of parenthood, and constitutes a logical corollary of the Cartesian mind-body separation that has been fundamental to the development of both industrial society and post-industrial technocracy. The professionals' body images and lifestyles express these principles of separation, while the holistic ideology of the homebirthers stresses mind-body and parent-child integration. The conclusion considers the ideological hegemony of the technocratic paradigm as potential future-shaper.

Title
     Adjustment to new parenthood: attenders versus nonattenders at
     prenatal education classes. 
Author
     Nichols MR 
Source
     Birth, 22: 1, 1995 Mar, 21-6, discussion 27-8 
Abstract

This longitudinal descriptive study compared the adjustment to new parenthood in two groups of first-time mothers and fathers. Participants included 106 married couples, 58 (55%) who attended prenatal childbirth education classes and 48 (45%) who did not. The study variables included prenatal, intrapartal, and new parent experiences. All mothers and fathers completed questionnaires during the last trimester of pregnancy and one month after delivery of a healthy newborn. Fathers were present during labor and birth regardless of prenatal class attendance. The groups differed in maternal age and in maternal and paternal education levels, but did not differ in measures of prenatal attachment, paternal childbirth involvement, childbirth satisfaction, parenting sense of competence, and ease of transition to parenthood. The results suggest the need for further study of the influence of prenatal classes on becoming a new parent, and of the effects of the father's presence during childbirth on birth and new parent experiences.

Title
     Changing American birth through childbirth education. 
Author
     Bradley LP 
Source
     Patient Educ Couns, 25: 1, 1995 Feb, 75-82 
Abstract

Childbirth educators have the opportunity to enable pregnant families to effect changes in obstetric care. Classes aimed at teaching a low-intervention model of birth are considered. Requisite class content is discussed and examples from the author's experience are offered.


Title
     A comparison of attenders at antenatal classes in the voluntary and
     statutory sectors: education and organisational implications. 
Author
     Nolan ML 
Source
     Midwifery, 11: 3, 1995 Sep, 138-45 
Abstract

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.


Title
     Do childbirth classes influence decision making about labor and
     postpartum issues? 
Author
     Handfield B; Bell R 
Source
     Birth, 22: 3, 1995 Sep, 153-60 
Abstract

This study investigated the role of childbirth education for women attending the Royal Women's Hospital Family Birth Center, Melbourne, Australia, in relation to making decisions about breastfeeding, pain medication, and length of hospital stay. Fifty-nine primiparous women completed a questionnaire after delivery about the influence of childbirth education classes on their decisions during pregnancy, birth, and the postnatal period. The results indicated that although the women enjoyed childbirth education classes, the information they received had minimal effect on their decision to breastfeed and the appropriateness of a 24-hour stay. Information gained about the use of pain medication in labor was clearly helpful when women made decisions about pain relief. Educational strategies have failed to address the tendency of nulliparous women to postpone making decisions about the postnatal period such as early discharge, and further investigation on this aspect of a childbirth education program is suggested.