Study of childbirth education classes and evaluation of their effectiveness

BACKGROUND: Childbirth education classes are antenatal support services offered to pregnant women or to the couple, aimed at increasing their knowledge regarding pregnancy, labour, delivery, breastfeeding, parenthood and newborn care. OBJECTIVE: The aim was to evaluate the effectiveness of Birthing Classes through the analysis of the occurrence of C-section, epidural analgesia, behavior during labor and delivery of the women who participated to the course as compared to those who did not attend it. Moreover, the level of satisfaction of pregnant women who attended the course was measured with a questionnaire of 20 items handed out after the delivery. METHODS: To measure the satisfaction level of pregnant women, in the period from February 2017 to October 2017, a questionnaire of 20 items was used. In order to analyze the results of the births the medical records were consulted. RESULTS: In the period of time going from February 2017 to October 2017 there were 147 women who have delivered and who have filled in the questionnaire. According to the multivariable analysis, there were no differences in the frequency of C-sections between the two groups (OR=0.8, 95%CI=0.3-1.7, p=0.503), whereas the frequency of epidural analgesia was lower in women who attended the Birthing Class (OR=0.3, 95%CI=0.1-0.9, p=0.036). We also observed that women who attended the Birthing Class: 1) had a higher likelihood of using breathing techniques during the labor (OR=5.5, 95%CI=1.5-20.0, p=0.009); 2) had a higher likelihood of taking advantage of the visualization exercises during the labor (OR=2.5, 95%CI=1.1-6.0, p=0.039). There was no other relevant difference between the two groups. DISCUSSION: The benefits of perinatal education are difficult to evaluate systematically, and further research would be required to determine real effects and agree upon reliable indicators of effectiveness. CONCLUSIONS: This study identified several positive factors that confirm the results of other studies indicating that antenatal classes are effective for women giving birth for the first time/nulliparous women, based on an analysis of childbirth outcomes, in order to improve maternal and neonatal health.