Establishing Relevance for Childbirth Education Classes

As I collect data in preparation for writing a lengthy article about pain and pain in childbirth, two comments keep resonating in nearly every evidence-based reference article I read: (1) pain is subjective based a person’s belief and knowledge about pain and (2) pain and pain relief can be affected by education.

Sadly, not all evidence-based reference articles come out and clearly promote attendance at childbirth education classes.  One thing, however, is perfectly clear.  There is a definite and purposeful implication that antenatal education with evidence-based facts about both non-pharmacologic and pharmacologic pain relief plus basic knowledge of the physiological aspects of labor and birth have a direct impact on a person’s pain threshold, tolerance and overall reaction to the pain of labor contractions.

One of the most recent confirmations of the need for evidence-based childbirth education classes comes from the Journal of Education and Health Promotion.  Participants in the study cited expressed a true need for information – the study found that childbirth information received by mothers influenced those mothers’ sense of control and empowerment during the birthing process.  Several other studies reported that most women receive inappropriate or inadequate information about childbirth.  With only an estimated 33% of expectant women attending childbirth education classes, this comment is not surprising.

In the article “Is it realistic? The portrayal of pregnancy and childbirth in the media”, the author finds that while the media does influence who women engage with childbirth, the outcome of that engagement is not always positive.  Normal childbirth is often misrepresented by such television shows as “One Born Every Minute” or “A Baby Story”, which offer the stereotypical, sensational version of birth that entices advertisers and makes money for production through commercials. “The media producer needs a ‘hook’ or plot line to engage the viewer,” Luce et al state.  “Yet women, often unaware of the rate of experiences, continue to watch these programs as birth preparation, as media users actively seek information and entertainment and select from it to satisfy their needs.”

Websites such as the Mayo Clinic recommend attendance in childbirth education classes to demystify the entire birthing process, address fears and discuss options. Countries such as Scotland, who recognize the importance of childbirth education, have created national programs to support professionals to deliver a consistent and evidence-based set of information to all pregnant women and their support persons.  A casual Google search of “childbirth education classes” bring information not only about organizations that have an international reach (such as ICEA www.icea.org ) but also links to childbirth education classes in Japan, the UK, Canada and more.

While a Cochrane review of antenatal education claims that a review of trials found a lack of high-quality evidence and the effects of antenatal education remain largely unknown, the implication for practice is that countless articles call for a better educated expectant client, who knows options and can actively participate in informed decision making. 

The question remains: how can a client obtain the proper evidence-based education and be ready to actively participate in informed decision-making if not for attendance in childbirth education classes?

References:

1. Beigi, N. M. A., Broumandfar, K., Bahadoran, P., & Abedi, H. A. (2010). Women’s experience of pain during childbirth. Iranian Journal of Nursing and Midwifery Research, 15(2), 77–82.
   
2. Free, M. M. (2002). Cross-cultural conceptions of pain and pain control.Proceedings (Baylor University. Medical Center), 15(2), 143–145.
   
3. Haines, H. M., Rubertsson, C., Pallant, J. F., & Hildingsson, I. (2012). The influence of women’s fear, attitudes and beliefs of childbirth on mode and experience of birth. BMC Pregnancy and Childbirth, 12, 55. http://doi.org/10.1186/1471-2393-12-55
   
4. ICEA Position Paper: The Role and Scope of the Childbirth Educator.  Retrieved 3.25.16.
   
5. Iravani, M., Zarean, E., Janghorbani, M., & Bahrami, M. (2015). Women’s needs and expectations during normal labor and delivery. Journal of Education and Health Promotion, 4, 6. http://doi.org/10.4103/2277-9531.151885
   
6. Luce, A., Cash, M., Hundley, V., Cheyne, H., van Teijlingen, E., & Angell, C. (2016). “Is it realistic?” the portrayal of pregnancy and childbirth in the media.BMC Pregnancy and Childbirth, 16, 40. http://doi.org/10.1186/s12884-016-0827-x
   
7. Pirdel, M., & Pirdel, L. (2009). Perceived Environmental Stressors and Pain Perception During Labor Among Primiparous and Multiparous Women. Journal of Reproduction & Infertility, 10(3), 217–223.