Psychosocial Impact of Childbirth Education – a brief overview.

Home birth vs. hospital birth.  Natural childbirth (physiologic) vs. the medical model.  Many of today’s expectant women, upon learning about childbirth develop an emerging fear of the upcoming event.  Information regarding childbirth is everywhere: the internet, in books, in the care providers’ office, on television.  Sifting through all of the information and misinformation can be a daunting task for anyone, especially the expectant mother.  Some expectant mothers then perceive that they will be “delivered” and that the entire process is out of their hands and they have little to no control over what is happening.

In a 1995 study, Hallgren et al sited that fear seemed to block acquisition of new knowledge.  However, when women embraced education with evidence-based information, childbirth became a good or better experience than they expected.  This makes early and evidence-based childbirth education the key to more positive birth outcome perceptions.  Women need the information that we have.

Choosing place of birth seems to also have an impact on positive birth outcome perceptions.  Overgaard found (as many researchers have) that women have better psychosocial outcomes in freestanding midwifery units (FMU) than in traditional obstetrical units (OU).   Truly individualized care, including the woman’s need for information and being listened to during the birth process showed major significance in outcome perceptions.

It is through education that women find out the myriad of choices that they do have.  And this might very well contribute to fear – fear of making a decision and fear of making the wrong decision.  The medical model of care is quite prevalent in our society and the feeling that the care provider knows best is a recurring theme.  While this theme is not inaccurate in each situation, parents may find that care providers have not been informed regarding the latest evidence/research.  They may be practice as they learned, or as they have traditionally practiced all of the years they have been in practice. 

A vintage childbirth education film, Nan’s Class, makes a strong point that pregnancy is not a condition of illness – it is a condition of health.  Therefore, when women do take childbirth education classes, it is not always about seeking a drug-free or non-interventive birth.  Researchers do find that women describe how childbirth education classes strengthen their relationships with their husbands/partners, increase their confidence in themselves, and empower them to have some grounded control over a situation (with informed decision making)  that was often perceived as out of their control.

Childbirth education is one of the paths in the journey to motherhood.  Outcomes of satisfaction and empowerment are just as valid as physical outcomes, especially in childbirth.  Mastery of informed decision making techniques are also highly valued by mothers who have participated in research regarding effectiveness of childbirth education classes.

So following logic trails, if childbirth education empowers women in their birth experiences (and later as a competent and empowered parent), enriches social relationships, and increases their self-confidence, then childbirth education not only provides information for the moment in time when mothers are in labor, but this impact lasts for years in our society.

References:

1. Chadwick, R. et al. (2013) Negotiating risky bodies: childbirth and constructions of risk.  Health, Risk & Society.
2. Hallgren, A., et al. (1995) Women’s perceptions of childbirth and childbirth education before and after education and birth.  Midwifery. 11(3): 130-7.
3. Kendall-Tackett, K. (2007) The psychological impact of birth experience: an underreported source of trauma in the lives of women. Trauma Psychology Newsletter.
4. http://www.kathleenkendall-tackett.com/tp_birth_exp_2007_fall.pdf
5. Koehn, M. (2008) Contemporary women’s perceptions of childbirth education.  Journal of Perinatal Education 17(1).
6. Koehn, M. (2002) Childbirth education outcomes: an integrative review of the literature. Journal of Perinatal Education. 11(3).
7. Overgaard, C., et al. (2012) The impact of birthplace on women’s birth experiences and perception of care. Social Science & Medicine.