Antenatal Education Systematic Review
Antenatal education programms
In pregnant women, how does group antenatal education compare to no antenatal education or individual antenatal education for improving outcomes of childbirth and parenting?
In pregnant women, how does group antenatal education compare to no antenatal education or individual antenatal education for improving outcomes of childbirth and parenting?
Antenatal education programs are key in improving maternal health all over the world. They have been widely embraced in most developed countries where antenatal education programs are routinely provided as part of antenatal care. They are associated with benefit such as increased knowledge of labor and childbirth, parent-child attachment, reduced anxiety and depression, and increased knowledge of parenthood. They often involve several scheduled sessions with a facilitator or care provider (often a trained patient educator, midwife, or general practitioner) that last about 1 -- 2 hours and focus on different aspects of labor, childbirth, and parenthood. These programs are often provided in groups meeting about seven (7) to ten (10) times for sessions running for 60 to 90 minutes on average over the course of the woman's pregnancy. All antenatal care that is provided in group-based settings is integrated with other antenatal care assessments such as information, peer support, and education.
Methods
The current systematic review compares the effectiveness of group-based antenatal education and no antenatal education or individual antenatal education on labor, childbirth, and parenthood outcomes. A systematic search of electronic databases was conducted. The identified studies were used to understand the effectiveness and cost-effectiveness of group-based antenatal education programs.
Results
The review identified five (5) randomized controlled trials conducted in different settings focusing on different aspects of antenatal care. The review highlights the paucity of research on effectiveness of antenatal education in developing countries. The identified studies provide low quality evidence that is at low risk of bias of the effectiveness of group-based antenatal education programs in promoting good labor, childbirth, and parenthood outcomes.
Discussion and conclusion
The limited evidence available suggests little to no difference in labor, birth, and parenthood outcomes though women in group-based antenatal education were more likely to initiate breastfeeding earlier than the comparator groups. There were no studies of the cost-effectiveness of group-based antenatal education programs. Therefore, the review could not highlight any significant differences in costs for the intervention and control.
Table of Contents
Abstract 4
Table of contents .. 5
Table of figures 10
Glossary of terms . 11
Chapter 1:
Introduction
Rationale and justification of the review
Introduction
Justification for antenatal education classes
Background
Antenatal education in developing countries and emerging economies
Research questions
Objectives of the review
Summary of chapter 1
Chapter 2:
Methods
Introduction
Literature Search Strategy
Searching other resources
Eligibility criteria
Types of studies and participants
Interventions
Outcome measures
Data collection and analysis
Data extraction and management
Assessment of risk of bias
Data analysis
Summary of chapter 2
Chapter 3:
Results
Introduction
Effectiveness of antenatal education
Benediktsson 2013
Bergstrom 2009
Corwin 1999
Mehdizadeh 2005
Ickovics 2007
Cost-effectiveness
Summary of chapter 3
Chapter 4:
Discussion
Introduction
Impact on childbirth outcomes
Health behaviors during pregnancy
Psychological outcomes
Attachment with the newborn baby
Participative forms of learning
Preparing for parenthood before childbirth
Stakeholder involvement and perspectives
Fathers
High-risk groups
Multicultural families
Agreement and disagreement with other reviews
Summary of chapter 4
Chapter 5:
Conclusion
Introduction
Review of evidence
Implications for policy
Implications for practice
Direction of future research
Reflection
Description
Feeling
Evaluation
Analysis
Action plan
Summary of chapter 5
Table 1: Characteristics of included studies
Table 2: Risk of bias analysis of included studies
Table 3: Characteristics of excluded studies
Table 4: Eligibility form for judging inclusion and exclusion of studies
Table 5: Risk of bias assessment tool
Table of figures
Figure 1: Study flow diagram
Glossary of terms
Antenatal
Occurring...
Recently, policy documents in various countries have been reviewed to pave way for antenatal education programs National Childbirth Trust, 2007.
These policy documents emphasize the fact that antenatal education programs play a key role in preparing the mother and the family generally for childbirth, improving the expectant mother's confidence and self-esteem, and preparing them for care and feeding of the newborn. In addition to these, the antenatal education programs also help to increase the overall experience during pregnancy and childbirth Singh and Newburn, 2000(, Schneider, 2001)
These programs have become common in many developed countries but developing countries have lagged behind in their adoption of antenatal education programs. The major reason why developed countries have been faster in adopting education programs is because they recognize the importance of preparing expectant families for pregnancy, labor, childbirth, and care of the newborn baby. In particular, they recognize the significance of expectant women achieving the best physical and psychological health during the period of pregnancy Svensson et al., 2006.
They also see the importance of accessing good social support through attending the sessions with a member of family or a friend for support Robertson et al., 2009
( ADDIN EN.CITE, Lumbiganon et al., 2011)
1.1.2 Justification for antenatal education classes
I am currently working as a staff nurse in the Obstetrics and Gynecology ward at the Jeddah Branch of King Faisal Specialist Hospital and Research Centre in Saudi Arabia. The King Faisal Specialist Hospital in Saudi Arabia delivers the highest level of specialized healthcare within an integrated clinical practice and research setting. The hospital delivers 24-hour emergency care, dentistry services, medical oncology, cardiovascular, short-stay surgery services, as well as ophthalmology services. Despite the healthcare services delivered by the hospital, the King Faisal Specialist Hospital does not have antenatal education programs to educate pregnant women to prepare for childbirth and parenthood. Moreover, the hospital does not have a program to educate and equip clinical nurse specialists specializing in patient education to provide antenatal education to pregnant women.
Importantly, I have gained knowledge about the prenatal education in the UK and this has influenced my decision to choose antenatal education programs as the topic of my dissertation. Typically, there is a large difference between antenatal practice in the UK and Saudi Arabia. In the UK, antenatal education programs are offered free of charge to all pregnant women. These programs assist pregnant women to get a greater understanding of how they should prepare for childbirth and impart knowledge on the other aspects of parenthood such as breastfeeding. The antenatal education program that I attended in the UK assisted me to prepare for childbirth. The program also assisted me to manage my pregnancy effectively. While pregnant women with a supportive person are allowed to receive antenatal education in the UK, the issue is different in Saudi Arabia. Islam in Saudi Arabia forbids male and female individuals from being in the same location. Therefore, it is difficult for the mother to be accompanied by their spouse during antenatal education classes.
1.2 Background
Antenatal education is founded on the premise of using physical and psychological education methods to help mothers understand changes during pregnancy and understand how they can prevent and reduce pain and discomfort associated with pregnancy and childbirth Billingham, 2011
( ADDIN EN.CITE, Bergstrom et al., 2013, Artieta-Pinedo et al., 2010, Artieta-Pinedo et al., 2013)
. Recently, in developed countries, antenatal education classes have featured in policy documents. These emphasize their impact on preparing the mother for childbirth, improving behaviors of mothers and others such as the father and other family members during pregnancy, increasing self-esteem and confidence during pregnancy, and preparing the mother for feeding and providing care for the baby throughout infancy Ferguson et al., 2012
( ADDIN EN.CITE, Schachman et al., 2004)
Antenatal education, often referred to as childbirth education or prenatal education, offers a wide range of information for mothers to identify and prevent complications, ensure the well-being of the mother and their baby during the pregnancy period and after childbirth. As argued by Redman et al., 1991
(Brixval et al. (2014)
, antenatal education classes are mainly provided because scholars associate these with the importance of preparing mothers for labor, childbirth, and postnatal care. The authors posit that there is great…
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In light of the evidence in this literature review then it is of great import that monitoring of the health of pregnant women is vital in reference to LBW infants not only in the sense of present terms but as well to lifelong health considerations for the LBW infant which is probably why stated further is: "Given the relative neglect that mothers and newborns have suffered, their centrality to