Can Pre-Birth Classes Benefit Labor?
Recent findings cast doubt over the effectiveness of antenatal (pre-birth) relaxation classes as preparation for childbirth. A team of researchers led by clinical psychologist Dr. Malin Bergstrom at the Karolinska Institute in Sweden looked at the effects of natural childbirth preparation on epidural use, childbirth experience and parental stress among 1,087 first-time mothers and 1,064 first-time fathers.
The parents received four two-hour sessions of either “psychoprophylactic” training (relaxation, breathing and psychological coping techniques) or standard antenatal education during the third trimester of pregnancy, and one followup session after delivery. The standard care group were given information about childbirth and parenting based on the standard Swedish antenatal education program.
Dr. Bergstrom explains, “The general aim of antenatal education is to prepare partners for childbirth and the transition into parenthood. In this randomized controlled multicenter trial, conducted at 15 antenatal clinics in Sweden, we compared two models of antenatal education with the same structure but with different content.”
The epidural rate was the same (52 percent) in both groups, as was the spontaneous vaginal birth rate (66 percent), report the team in BJOG: An International Journal of Obstetrics and Gynaecology. The cesarean section rate was slightly lower in the “natural” group, at 20 percent versus 21.5 percent in the standard group. But the use of instruments such as forceps and ventouse during delivery was two percent higher in the “natural” group, 14 percent versus 12 percent in the standard group.
The researchers add, “There were no statistically significant differences in the experience of childbirth or parental stress between the randomized groups, either in women or men. Natural childbirth preparation including training in breathing and relaxation did not decrease the use of epidural analgesia during labor, nor did it improve the birth experience or affect parental stress in early parenthood (measured at three months),” they conclude.
Journal editor, Professor Philip Steer, commented, “The findings of this study are contrary to what many of us would expect. The lack of benefit from psychoprophylactic techniques is disappointing, and suggests that parents’ experience of childbirth is affected more by their personality and previous psychological orientation than by the relatively limited training that is possible during pregnancy.
“An alternative view is that standard antenatal classes are ‘good enough’ and therefore represent an effective use of limited resources.”
Effectiveness of Pre-Birth Education
A study by the same team at the Karolinska Institute measured 1,197 first-time mothers’ opinions on antenatal (pre-birth) childbirth and parenthood education. The study also compared experiences of labor and breastfeeding between participants and non-participants.