(1133) Do antenatal childbirth education classes improve birth satisfaction?

Proponents of childbirth education (CBE) encourage attendance to help prepare patients for delivery. However, whether CBE actually improves patients satisfaction is unclear. We investigated whether CBE is associated with birth satisfaction in nulliparous patients.

Study Design:

A secondary analysis of a randomized controlled trial of intrapartum video education in nulliparous term singleton patients with epidural anesthesia who reached active labor. Patients completed a pre-delivery survey assessing participation in childbirth education and a post-delivery Mackey childbirth satisfaction rating scale (MCRS) which assesses overall satisfaction with the birth experience as well as 19 additional questions grouped into 5 domains: global experience, partner support, professional support, neonatal condition, and individual capacity. The primary outcome was “high satisfaction” on the MCRS question: “How satisfied or dissatisfied were you with your childbirth experience?” Secondary outcomes were domain-specific MCRS scores. Maternal demographics and outcomes were compared between patients who did and did not attend antenatal CBE.

Results:

149 patients completed both surveys. Of those 75(50.3%) participated in antenatal CBE classes prior to admission. Patients who attended CBE were older (30.7yrs±5.4 vs 26.1yrs ±5.9, p< 0.01) and more likely white (84% vs 39%, p< 0.01). Patients who attended CBE were less likely to be highly satisfied (68% vs 85%, p< 0.01, OR 0.37[95% CI 0.17-0.83]). When stratified by race, CBE was associated with similar birth satisfaction. The domain scores of professional support and individual capacity were significantly lower in patients who attended CBE, whereas global experience, partner support, and neonatal condition were similar (Table 2).

Conclusion:

Antenatal CBE attendance is associated with lower childbirth satisfaction among nulliparous patients., particularly within the domains of individual capacity and professional support. Although there may be unmeasured factors impacting this, these results highlight the need to align CBE with patient expectations for childbirth.