Examining the birth experiences of women with and without prenatal education: A qualitative study

Meryem Metinoğlu 1 * , Aylin Yalçın Irmak 1, Ülfiye Çelikkalp 2
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1 Nursing Department, School of Health, Namik Kemal University, Tekirdag, Turkey
2 Department of Public Health, School of Medicine, Trakya University, Edirne, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 18, Issue 1, pp. 57-63. https://doi.org/10.23950/jcmk/9657
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ABSTRACT

Aim: This qualitative study examines the intrapartum experiences of nulliparous Turkish women who participated childbirth education classes and only engaged in routine prenatal care.
Material and methods: The study was conducted in a Family Health Center in primary health care service in a metropolitan city in Turkey between October 2015 and June 2016. Women engaged in routine prenatal care (RPC group) (n=17) and women participating in childbirth education classes (CEC group) (n=14) at the maternity unit were included in the study via a purposive sampling method. Data were collected in semi-structured one-on-one interviews with participants. Data were collected by The Socio-Demographic and Obstetric Information Form and The Semi-Structured Interview Form. Number, percentage, mean and standard deviation were used to evaluate descriptive data.
Results: The average age of the 31 women participating was 29.33±3.75. Within the sample population, majority had an education level of university (67.74%) and a nuclear family structure (90.32%). There was no significant difference (p>.05) between the socio-demographic characteristics of both groups. Of the women participating in CEC, 92.8% in the lithotomy position; none of them received anesthesia. Within this group, 50% received no intervention during labor, while 42.86% received fundal pressure, and episiotomy was applied to 21.43% of participants. All women engaged only in RPC had their birth in the lithotomy position, and 11.76% of them received epidural anesthesia. Interventions applied included episiotomy (76.47%), induced labor (70.59%), fundal pressure (58.82%), continuous Non Stress Test (NST) (58.82%), continuous intravenous infusion (52.94%), and enema (47.05%). The statements analyzed were classified under four themes: (1) satisfaction, (2) compliance with birthing positions, (3) intrinsic concentration and (4) participant control of decision-making.
Conclusion: The childbirth education classes group reported that was implemented the less intrapartum intervention, greater satisfaction, fewer distractions, greater participation in active decision-making, and a greater tendency to use non-pharmacological methods. In contrast, the routine prenatal care group mostly reported passive participation, difficulty in pain and contraction control, and greater dissatisfaction.
Keywords: birth, childbirth, labor, natural childbirth, qualitative research

CITATION

Metinoğlu M, Yalçın Irmak A, Çelikkalp Ü. Examining the birth experiences of women with and without prenatal education: A qualitative study. J CLIN MED KAZ. 2021;18(1):57-63. https://doi.org/10.23950/jcmk/9657

REFERENCES

  • Dinç H, Yazıcı S, Yılmaz T, Günaydın S. Pregnancy education. Journal of Health Sciences and Professions. 2015; 1(1):68-76. doi:10.17681/hsp.99216.
  • Esencan TY, Karabulut Ö, Yıldırım AD, Abbasoğlu DE, Külek H, Şimşek Ç, Kılıçcı Ç. Delivery type, first breastfeeding time and skin-to-skin contact preferences of pregnant women who have been trained for childbirth. Florence Nightingale Nursing Journal. 2018; 26(1):31-43. doi:10.26650/FNJN.387192.
  • Serçekuş P, Yenal K. Development of childbirth education classes in Turkey. Turkey Clinics Journal of Obstetric- Women’s Health and Diseases Nursing-Special Topics; 2015; 1(1):33-35. doi:10.1016/j.midw.2015.11.016.
  • Turkey Demographic and Health Survey TDHS-2013. Retrieved from http://www.hips.hacettepe.edu.tr/tnsa2013/rapor/TNSA_2013_ana_rapor.pdf, on April 20, 2018.
  • Turkey Demographic and Health Survey TDHS-2018. Retrieved from http://www.hips.hacettepe.edu.tr/tnsa2018/rapor/TNSA2018_ana_Rapor.pdf, on September 5, 2020.
  • Bergström M, Kieler H, Waldenström U. Psychoprophylaxis during labor: associations with labor-related outcomes and experience of childbirth. Acta Obstet Gynecol. 2010; 89:794–800. doi:10.3109/00016341003694978.
  • Cantone D, Lombardi A, Assunto DA, Piccolo M, Rizzo N, Pelullo CP, Attena F. A standardized antenatal class reduces the rate of cesarean section in southern Italy: A retrospective cohort study. Medicine. 2018; 97(16). doi:10.1097/MD.0000000000010456
  • Miquelutti MA, Cecatti JG, Makuch MY. Evaluation of a birth preparation program on lumbopelvic pain, urinary incontinence, anxiety and exercise: a randomized controlled trial. BMC Pregnancy Childbirth. 2013; 13(1):154. doi:10.1186/1471-2393-13-154.
  • Hong K, Hwang H, Han H, Chae J, Choi J, Jeong Y, Lee KJ. Perspectives on antenatal education associated with pregnancy outcomes: Systematic review and meta-analysis. Women and Birth. 2020. doi.org/10.1016/j.wombi.2020.04.002.
  • Serçekuş P, Başkale H. Effects of antenatal education on fear of childbirth, maternal self efficacy and parental attachment. Midwifery. 2016; 34:166-172. doi:10.1016/j.midw.2015.11.016.
  • Toohill J, Fenwick J, Gamble J, Creedy DK, Buist A, Turkstra E, Ryding EL. A randomized controlled trial of a psycho-education intervention by midwives in reducing childbirth fear in pregnant women. Birth. 2014; 41(4):384–394. doi:10.1111/birt.12136.
  • Artieta-Pinedo I, Paz-Pascual C, Grandes G, Remiro-Fernandezdegamboa G, Odriozola-Hermosilla I, Bacigalupe A, Payo J. The benefits of antenatal education for the childbirth process in Spain. Nursing Research. 2010; 59(3):194-202. doi:10.1097/NNR.0b013e3181dbbb4e.
  • Smarandache A, Kim THM, Bohr Y, Tamim H. Predictors of a negative labour and birth experience based on a national survey of Canadian women. BMC Pregnancy and Childbirth. 2016; 16(1):114. doi:10.1186/s12884-016-0903-2
  • Gagnon AJ, Sandall J. Individual or group antenatal education for childbirth or parenthood or both. Cochrane. 2007; 3:5-24. doi:10.1002/14651858.CD002869.pub2.
  • Lally JE, Murtagh MJ, Macphail S, Thomson R. More in hope than expectation: a systematic review of women's expectations and experience of pain relief in labour. BMC Med. 2008; 6(7):1-29. doi:10.1186/1741-7015-6-7.
  • McCrea BH, Wright ME. Satisfaction in childbirth and perceptions of personal control in pain relief during labour. Journal of Advanced Nursing. 1999; 29(4):877–884. doi:10.1046/j.1365-2648.1999.00961.x.
  • Ferguson S, Davis D, Browne J. Does antenatal education affect labour and birth? A structured review of the literature. Women Birth. 2013; 26(1):e5-e8. doi:http://dx.doi.org/10.1016/j.wombi.2012.09.003.
  • Patriajati S, and Sriatmi A. Determinants of Mothers’participation In Antenatal Classes. Jurnal Administrasi Kesehatan Indonesia. 2019; 7(2):139-146. doi:10.20473/jaki.v7i2.2019.139-146
  • Rassin M, Klug E, Nathanzon H, Kan A, Silner D. Cultural differences in child delivery: comparisons between Jewish and Arab women in Israel. Int Nurs Rev. 2009; 56(1):123-130. doi:10.1111/j.1466-7657.2008.00681.x.
  • Kömürcü, N., Berkiten Ergin, A. (2008). Labor pain and management. Istanbul: Bedray Press Publishing Ltd. Şti.
  • Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006; 3:77–100. doi:10.1191/1478088706qp063oa
  • Miquelutti MA, Cecatti JG, Makuch MY. Antenatal education and the birthing experience of Brazilian women: a qualitative study. BMC Pregnancy Childbirth. 2013b; 13(1):171. doi:10.1186/1471-2393-13-171.
  • Nahaee J, Mohammad-Alizadeh-Charandabi S, Abbas-Alizadeh F, Martin CR, Martin CJH, Mirghafourvand M, Hassankhani H. Pre-and during-labour predictors of low birth satisfaction among Iranian women: a prospective analytical study. BMC Pregnancy and Childbirth. 2020; 20(1):1-11. doi:10.1186/s12884-020-03105-5
  • Hassanzadeh R, Abbas-Alizadeh F, Meedya S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M. Assessment of childbirth preparation classes: a parallel convergent mixed study. Reproductive health. 2019; 16(1):1-7. doi:10.1186/s12978-019-0826-2
  • Jaddoe VW. Antenatal education programmes: Do they work? Lancet. 2009; 374(9693):863-864. doi:10.1016/S0140-6736(09)61610-X.
  • Malata A, Hauck Y, Monterosso L, McCaul K. Development and evaluation of a childbirth education programme for Malawian women. J Adv Nurs. 2007; 60(1):67–78. doi:10.1111/j.1365-2648.2007.04380.x.
  • Afshar Y, Wang ET, Mei J, Esakoff TF, Pisarska MD, Gregory KD. Childbirth education class and birth plans are associated with a vaginal delivery. Birth. 2017; 44(1):29-34. doi:10.1111/birt.12263
  • Maimburg RD, Vaeth M, Dürr J, Hvidman L, Olsen J. Randomised trial of structured antenatal training sessions to improve the birth process. BJOG. 2010; 117(8):921–928. doi:10.1111/j.1471-0528.2010.02584.x.
  • Fabian HM, Radestad IJ, Waldestro U. Childbirth and parenthood education classes in Sweden. Women’s opinion and possible outcomes. Acta Obstet Gynecol Scand. 2005; 84(5):436–443. doi:10.1111/j.0001-6349.2005.00732.x.
  • Bertucci V, Boffo M, Mannarini S, Serena A, Saccardi C, Cosmi E, Andrisani A, Ambrosini G. Assessing the perception of the childbirth experience in Italian women: a contribution to the adaptation of the Childbirth Perception Questionnaire. Midwifery. 2012; 28(2):265–274. doi:http://dx.doi.org/10.1016/j.midw.2011.02.009.
  • Mohammad K, Gamble J, Creedy DK. Prevalence and factors associated with the development of antenatal and postnatal depression among Jordanian women. Midwifery. 2011; 27(6):238–245. doi: 10.1016/j.midw.2010.10.008.
  • Bazant ES, Koenig M. Women’s satisfaction with delivery care in Nairobi’s informal settlements. Int J Qual Health Care. 2009; 21(2):79–86. doi:https://doi.org/10.1093/intqhc/mzn058.
  • Bryanton J, Gagnon AJ, Johnston C, Hatem M. Predictors of women's perceptions of the childbirth experience. JOGNN. 2008; 37(1):24–34. doi:10.1111/j.1552-6909.2007.00203.x.
  • Caughey AB, Cheyney M. Home and birth center birth in the United States: time for greater collaboration across models of care. Obstetrics & Gynecology. 2019; 133(5):1033-1050. doi: 10.1097/AOG.0000000000003215
  • Lowe NK. The nature of labor pain. Am J Obstet Gynecol. 2009; 186(5):16–24. doi: http://dx.doi.org/10.1016/S0002-9378(02)70179-8.
  • Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Libr. 2011; 16(2):1-15. doi:10.1002/14651858.CD003766.pub3.
  • Stapleton LRT, Schetter CD, Westling E, Rini C, Glynn LM, Hobel CJ, Sandman C. Perceived partner support in pregnancy predicts lower maternal and infant distress. J Fam Psychol. 2012; 26(3): 453–463. doi:http://dx.doi.org/10.1037/a0028332.
  • World Health Organization (WHO) Reproductive Health Library. (2014, Jul 4). Recommendations for augmentation of labour. Retrived December 1, 2020, from http://apps.who.int/rhl/pregnancy_childbirth/childbirth/routine_care/cd000330/en/WHO.
  • Vural G, Erenel AŞ. Why Has Medicalization of Birth Increased or Decreased?. Journal of Hacettepe University Faculty of Nursing. 2017; 4(2).
  • Serhatlioğlu SG, Karahan N. Birth Satisfaction and Affecting Factors. International Refereed Journal Of Gynaecological Diseases And Maternal Child Health. 2018. Doi: 10.17367/Jacsd.2018.1.8.
  • Cheung W, Ip WY, Chan D. Maternal anxiety and feelings of control during labour: A study of Chinese first-time pregnant women. Midwifery. 2007; 23:123–30. doi:http://dx.doi.org/10.1016/j.midw.2006.05.001.
  • Çoker H. Natural birth. Istanbul, Inkılap Bookstore. 2015; 51-56.