Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2017

Open Access 01-12-2017 | Research article

Framework for the establishment of a feasible, tailored and effective perinatal education programme

Authors: Isabel Artieta-Pinedo, Carmen Paz-Pascual, Gonzalo Grandes, Maite Espinosa

Published in: BMC Pregnancy and Childbirth | Issue 1/2017

Login to get access

Abstract

Background

Antenatal education needs to be renewed and adapted to the needs of women. Objectives: to assess women needs, identify factors that influence the desired outcomes, and propose a framework for developing new perinatal education based on the guidance published by the UK Medical Research Council for the development and evaluation of complex interventions in primary care.

Methods

For this study: (a) four focus group sessions were held from October to November 2010 in Bizkaia (Spain) with 30 women exploring their needs during pregnancy and postpartum; (b) two literature reviews were conducted on women’s needs at these times and theoretical models of healthcare education; and (c) seven discussion and consensus sessions were run with a group of experts composed of midwifes, gynaecologists, paediatricians, and paediatric and postpartum nurses.

Results

Various areas for improvement were identified: needs assessment of each woman/family, consideration of pregnancy and childbirth as normal physiological processes, participation of fathers, establishment of social networks, continuity of postpartum care, better access to and training for midwives, and more flexible format and contents for the programme. We propose a woman-focused framework that includes three exploratory interviews during pregnancy, personalized interventions coordinated between professionals, empowerment to choose the type of birth, and postpartum activities.

Conclusion

New perinatal education should be on-going and focused on each woman. It is necessary to assess the feasibility of implementing this type of programme, depending on the context, professionals’ readiness for change and characteristics of the proposed interventions. Then, its effectiveness and sustainability must be assessed.
Literature
1.
go back to reference Bernard MR, Eymard C. [Trends and current issues in childbirth and parenting education]. Sante Publique. 2012;24(4):283–89.PubMed Bernard MR, Eymard C. [Trends and current issues in childbirth and parenting education]. Sante Publique. 2012;24(4):283–89.PubMed
2.
go back to reference Schrader-McMillan A, Barlow J, Redshaw M. Birth and beyond: a review of evidence about antenatal education. London: DH; 2009. Schrader-McMillan A, Barlow J, Redshaw M. Birth and beyond: a review of evidence about antenatal education. London: DH; 2009.
3.
go back to reference Shaw E, Levitt C, Wong S, Kaczorowski J, The McMaster University Postpartum Research Group. Systematic review of the literature on postpartum care: effectiveness of postpartum support to improve maternal parenting, mental health, quality of life, and physical health. Birth. 2006;33:210–20.CrossRefPubMed Shaw E, Levitt C, Wong S, Kaczorowski J, The McMaster University Postpartum Research Group. Systematic review of the literature on postpartum care: effectiveness of postpartum support to improve maternal parenting, mental health, quality of life, and physical health. Birth. 2006;33:210–20.CrossRefPubMed
4.
go back to reference 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. Nurs Res. 2010;59(3):194–202.CrossRefPubMed 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. Nurs Res. 2010;59(3):194–202.CrossRefPubMed
5.
go back to reference Mehdizadeh A, Roosta F, Chaichian S, Alaghehbandan R. Evaluation of the impact of birth preparation courses on the health of the mother and the newborn. Am J Perinatol. 2005;22(1):7–9.CrossRefPubMed Mehdizadeh A, Roosta F, Chaichian S, Alaghehbandan R. Evaluation of the impact of birth preparation courses on the health of the mother and the newborn. Am J Perinatol. 2005;22(1):7–9.CrossRefPubMed
6.
go back to reference Gagnon AJ, Sandall S. Individual or group antenatal education for childbirth or parenthood, or both, The Cochrane library, vol. Issue 4. Oxford: Update Software; 2007. Gagnon AJ, Sandall S. Individual or group antenatal education for childbirth or parenthood, or both, The Cochrane library, vol. Issue 4. Oxford: Update Software; 2007.
7.
go back to reference Brixval C, Axelsen SF, Andersen SK, Due P, Koushede V. The effect of antenatal education in small classes on obstetric and psycho-social outcomes: a systematic review and meta-analysis protocol. Syst Rev. 2014;3:12.CrossRefPubMedPubMedCentral Brixval C, Axelsen SF, Andersen SK, Due P, Koushede V. The effect of antenatal education in small classes on obstetric and psycho-social outcomes: a systematic review and meta-analysis protocol. Syst Rev. 2014;3:12.CrossRefPubMedPubMedCentral
8.
go back to reference Artieta-Pinedo I, Paz-Pascual C, Grandes G, Bacigalupe A, Payo J, Montoya I. Antenatal education and breastfeeding in a cohort of primiparas. J Adv Nurs. 2013;69(7):1607–27.CrossRefPubMed Artieta-Pinedo I, Paz-Pascual C, Grandes G, Bacigalupe A, Payo J, Montoya I. Antenatal education and breastfeeding in a cohort of primiparas. J Adv Nurs. 2013;69(7):1607–27.CrossRefPubMed
9.
go back to reference Lumbiganon P, Martis R, Laopaiboon M, Festin MR, Ho JJ, Hakimi M. Antenatal breastfeeding education for increasing breastfeeding duration (Protocol). Cochrane Database Syst Rev. 2007; Issue 2. Art. No: CD006425. doi:10.1002/14651858.CD006425. Lumbiganon P, Martis R, Laopaiboon M, Festin MR, Ho JJ, Hakimi M. Antenatal breastfeeding education for increasing breastfeeding duration (Protocol). Cochrane Database Syst Rev. 2007; Issue 2. Art. No: CD006425. doi:10.​1002/​14651858.​CD006425.
10.
11.
go back to reference Billingham K. Preparing for parenthood: the role of antenatal education. Community Pract. 2011;84(5):36–8.PubMed Billingham K. Preparing for parenthood: the role of antenatal education. Community Pract. 2011;84(5):36–8.PubMed
12.
go back to reference Walker DS, Visger JM, Rossie D. Contemporary childbirth education models. J Midwifery Womens Health. 2009;54(6):469–76.CrossRefPubMed Walker DS, Visger JM, Rossie D. Contemporary childbirth education models. J Midwifery Womens Health. 2009;54(6):469–76.CrossRefPubMed
13.
go back to reference Bryanton J, Beck CT, Montelpare W. Postnatal parental education for optimizing infant general health and parent-infant relationships. Cochrane Database Syst Rev. 2013;11:CD004068. Bryanton J, Beck CT, Montelpare W. Postnatal parental education for optimizing infant general health and parent-infant relationships. Cochrane Database Syst Rev. 2013;11:CD004068.
15.
go back to reference Spiby H, Slade P, Escott D, Henderson B, Fraser RB. Selected coping strategies in labor: an investigation of women’s experiences. Birth. 2003;30(3):189–94.CrossRefPubMed Spiby H, Slade P, Escott D, Henderson B, Fraser RB. Selected coping strategies in labor: an investigation of women’s experiences. Birth. 2003;30(3):189–94.CrossRefPubMed
16.
go back to reference Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new medical research council guidance. BMJ. 1655;2008:337. Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new medical research council guidance. BMJ. 1655;2008:337.
17.
go back to reference Forster DA, McLachlan HL, Rayner J, Yelland J, Gold L, Rayner S. The early postnatal period: exploring women’s views, expectations and experiences of care using focus groups in Victoria. Australia. BMC Pregnancy Childbirth. 2008;8:27.CrossRefPubMedPubMedCentral Forster DA, McLachlan HL, Rayner J, Yelland J, Gold L, Rayner S. The early postnatal period: exploring women’s views, expectations and experiences of care using focus groups in Victoria. Australia. BMC Pregnancy Childbirth. 2008;8:27.CrossRefPubMedPubMedCentral
18.
go back to reference Fenwick J, Burns E, Sheehan A, Schmied V. We only talk about breast feeding: a discourse analysis of infant feeding messages in antenatal group-based education. Midwifery. 2013;29(5):425–33.CrossRef Fenwick J, Burns E, Sheehan A, Schmied V. We only talk about breast feeding: a discourse analysis of infant feeding messages in antenatal group-based education. Midwifery. 2013;29(5):425–33.CrossRef
19.
go back to reference Glanz K, Rimer BK, Lewis FM. Health behavior and health education. Theory, research and practice. San Fransisco: Wiley; 2002. Glanz K, Rimer BK, Lewis FM. Health behavior and health education. Theory, research and practice. San Fransisco: Wiley; 2002.
20.
go back to reference Harley K, Eskenazi B. Time in the united states, social support and health behaviors during pregnancy among women of Mexican descent. Soc Sci Med. 2006;62:3048–61.CrossRefPubMedPubMedCentral Harley K, Eskenazi B. Time in the united states, social support and health behaviors during pregnancy among women of Mexican descent. Soc Sci Med. 2006;62:3048–61.CrossRefPubMedPubMedCentral
21.
go back to reference Alvarez Dardet C, Alonso J, Domingo A, Regidor E. La medición de la clase social en ciencias de la salud. Barcelona: SG Editores; 1995. Alvarez Dardet C, Alonso J, Domingo A, Regidor E. La medición de la clase social en ciencias de la salud. Barcelona: SG Editores; 1995.
22.
go back to reference Paz Pascual C, Artieta Pinedo I, Grandes G, Espinosa Cifuentes M, Gaminde Inda I, Payo Gordon J Perceived needs of women regarding maternity. Qualitative study to redesign maternal education]. Aten Primaria. 2016 Mar 31. Spanish Paz Pascual C, Artieta Pinedo I, Grandes G, Espinosa Cifuentes M, Gaminde Inda I, Payo Gordon J Perceived needs of women regarding maternity. Qualitative study to redesign maternal education]. Aten Primaria. 2016 Mar 31. Spanish
23.
go back to reference Patton M. Qualitative research and evaluation methods. 3rd ed. Thousand Oaks: Sage; 2002. Patton M. Qualitative research and evaluation methods. 3rd ed. Thousand Oaks: Sage; 2002.
25.
go back to reference Consonni EB, Calderon I, Consonni M, De Conti M, Prevedel T, Rudge M. A multidisciplinary program of preparation for childbirth and motherhood: maternal anxiety and perinatal outcomes. Reprod Health. 2010;7:28.CrossRefPubMedPubMedCentral Consonni EB, Calderon I, Consonni M, De Conti M, Prevedel T, Rudge M. A multidisciplinary program of preparation for childbirth and motherhood: maternal anxiety and perinatal outcomes. Reprod Health. 2010;7:28.CrossRefPubMedPubMedCentral
26.
go back to reference Li H-T, Lin K-C, Chang S-C, Kao C-H, Liu C-Y, Kuo S-C. A birth education program for expectant fathers in Taiwan: effects on their anxiety. Birth. 2009;36:289–96.CrossRefPubMed Li H-T, Lin K-C, Chang S-C, Kao C-H, Liu C-Y, Kuo S-C. A birth education program for expectant fathers in Taiwan: effects on their anxiety. Birth. 2009;36:289–96.CrossRefPubMed
27.
go back to reference Artieta I, Paz C, Grandes G, Abaunza MP, Ayestaran C, Burgos V, Cabeza I, Espinosa M, Gaminde I, Payo J, Trincado MJ. Rediseño de la educación maternal: propuesta de un marco para la elaboración de un programa de educación para la salud y preparación al nacimiento efectivo y centrado en las necesidades de las mujeres, Informe osteba D-13-07. Investigación comisionada. Vitoria-Gasteiz: Departamento de Salud, Gobierno Vasco; 2013. Artieta I, Paz C, Grandes G, Abaunza MP, Ayestaran C, Burgos V, Cabeza I, Espinosa M, Gaminde I, Payo J, Trincado MJ. Rediseño de la educación maternal: propuesta de un marco para la elaboración de un programa de educación para la salud y preparación al nacimiento efectivo y centrado en las necesidades de las mujeres, Informe osteba D-13-07. Investigación comisionada. Vitoria-Gasteiz: Departamento de Salud, Gobierno Vasco; 2013.
29.
go back to reference Benediktsson I, McDonald SW, Vekved M, McNeil DA, Dolan SM, Tough SC. Comparing centering pregnancy to standard prenatal care plus prenatal education. BMC Pregnancy Childbirth. 2013;13 (Suppl 1):S5.PubMedPubMedCentral Benediktsson I, McDonald SW, Vekved M, McNeil DA, Dolan SM, Tough SC. Comparing centering pregnancy to standard prenatal care plus prenatal education. BMC Pregnancy Childbirth. 2013;13 (Suppl 1):S5.PubMedPubMedCentral
30.
go back to reference Hjelm K, Bard K, Berntorp K, Apelqvist J. Beliefs about health and illness postpartum in women born in Sweden and the middle east. Midwifery. 2009;25(5):564–75.CrossRefPubMed Hjelm K, Bard K, Berntorp K, Apelqvist J. Beliefs about health and illness postpartum in women born in Sweden and the middle east. Midwifery. 2009;25(5):564–75.CrossRefPubMed
31.
go back to reference Ekhtiari YS, Majlessi F, Foroushani AR, Shakibazadeh E. Effect of a self-care educational program based on the health belief model on reducing Low birth weight among pregnant Iranian women. Int J Prev Med. 2014;5(1):76–82.PubMedPubMedCentral Ekhtiari YS, Majlessi F, Foroushani AR, Shakibazadeh E. Effect of a self-care educational program based on the health belief model on reducing Low birth weight among pregnant Iranian women. Int J Prev Med. 2014;5(1):76–82.PubMedPubMedCentral
32.
go back to reference Hebl MR, King E, Glick P, Singletary SL, Kazama S. Hostile and benevolent reactions toward pregnant women: complementary interpersonal punishments and rewards that maintain traditional roles. J Appl Psychol. 2007;92(6):1499–511.CrossRefPubMed Hebl MR, King E, Glick P, Singletary SL, Kazama S. Hostile and benevolent reactions toward pregnant women: complementary interpersonal punishments and rewards that maintain traditional roles. J Appl Psychol. 2007;92(6):1499–511.CrossRefPubMed
35.
go back to reference Lally J, Murtagh M, 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;14:6–7. Lally J, Murtagh M, 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;14:6–7.
38.
39.
go back to reference Cronin C. First-time mothers-identifying their needs, perceptions and experiences. J Clin Nurs. 2003;12:260–7.CrossRefPubMed Cronin C. First-time mothers-identifying their needs, perceptions and experiences. J Clin Nurs. 2003;12:260–7.CrossRefPubMed
40.
go back to reference Singh GK, Kogan MD, Dee DL. Nativity/immigrant status, race/ethnicity, and socioeconomic determinants of breastfeeding initiation and duration in the united states, 2003. Pediatrics. 2007;119 (Suppl 1):38–46.CrossRef Singh GK, Kogan MD, Dee DL. Nativity/immigrant status, race/ethnicity, and socioeconomic determinants of breastfeeding initiation and duration in the united states, 2003. Pediatrics. 2007;119 (Suppl 1):38–46.CrossRef
41.
go back to reference Shia N, Pharm O. An evaluation of male Partners’ perceptions of antenatal classes in a national health service hospital: implications for service provision in London. J Perinat Educ. 2013;22(1):30–8.CrossRefPubMedPubMedCentral Shia N, Pharm O. An evaluation of male Partners’ perceptions of antenatal classes in a national health service hospital: implications for service provision in London. J Perinat Educ. 2013;22(1):30–8.CrossRefPubMedPubMedCentral
42.
43.
46.
go back to reference Hegarty K, Brown S, Gunn J, Forster D, Nagle C, Grant B, Lumley J. Women’s views and outcomes of an educational intervention designed to enhance psychosocial support for women during pregnancy. Birth. 2007;34(2):155–63.CrossRefPubMed Hegarty K, Brown S, Gunn J, Forster D, Nagle C, Grant B, Lumley J. Women’s views and outcomes of an educational intervention designed to enhance psychosocial support for women during pregnancy. Birth. 2007;34(2):155–63.CrossRefPubMed
47.
go back to reference Checa MJ, Prats R, Plasencia A. In: de Salut Publica DG, editor. Educación maternal: preparación para el nacimiento. Barcelona: Generalitat de Catalunya; 2009. Checa MJ, Prats R, Plasencia A. In: de Salut Publica DG, editor. Educación maternal: preparación para el nacimiento. Barcelona: Generalitat de Catalunya; 2009.
49.
go back to reference Downe S, Finlayson K, Tunçalp Ӧ, Gülmezoglu Metin A. What matters to women: a systematic scoping review to identify the processes and outcomes of antenatal care provision that are important to healthy pregnant women. BJOG. 2016;123(4):529–39.CrossRefPubMed Downe S, Finlayson K, Tunçalp Ӧ, Gülmezoglu Metin A. What matters to women: a systematic scoping review to identify the processes and outcomes of antenatal care provision that are important to healthy pregnant women. BJOG. 2016;123(4):529–39.CrossRefPubMed
50.
go back to reference Kearns AD, Caglia JM, Ten Hoope-Bender P, Langer A. Antenatal and postnatal care: a review of innovative models for improving availability, accessibility, acceptability and quality of services in low-resource settings. BJOG. 2016;123(4):540–8.CrossRefPubMed Kearns AD, Caglia JM, Ten Hoope-Bender P, Langer A. Antenatal and postnatal care: a review of innovative models for improving availability, accessibility, acceptability and quality of services in low-resource settings. BJOG. 2016;123(4):540–8.CrossRefPubMed
51.
go back to reference Serçekuş P, Başkale H. Effects of antenatal education on fear of childbirth, maternal self-efficacy and parental attachment. Midwifery. 2016;34:166–72.CrossRefPubMed Serçekuş P, Başkale H. Effects of antenatal education on fear of childbirth, maternal self-efficacy and parental attachment. Midwifery. 2016;34:166–72.CrossRefPubMed
52.
go back to reference Abalos E, Chamillard M, Diaz V, Tuncalp Ӧ, Gülmezoglu AM. Antenatal care for healthy pregnant women: a mapping of interventions from existing guidelines to inform the development of new WHO guidance on antenatal care. BJOG. 2016;123(4):519–28.CrossRefPubMed Abalos E, Chamillard M, Diaz V, Tuncalp Ӧ, Gülmezoglu AM. Antenatal care for healthy pregnant women: a mapping of interventions from existing guidelines to inform the development of new WHO guidance on antenatal care. BJOG. 2016;123(4):519–28.CrossRefPubMed
53.
go back to reference Langley G, Moen R, Nolan K, Nolan T, Norman C, Provost L. The improvement guide: a practical approach to enhancing organizational performance. 2nd ed. San Francisco: Jossey Bass Publishers; 2009. Langley G, Moen R, Nolan K, Nolan T, Norman C, Provost L. The improvement guide: a practical approach to enhancing organizational performance. 2nd ed. San Francisco: Jossey Bass Publishers; 2009.
54.
go back to reference Matone M, O’Reilly ALR, Luan X, Localio R, Rubin DM. Home visitation program effectiveness and the influence of community behavioral norms: a propensity score matched analysis of prenatal smoking cessation. BMC Public Health. 2012;12(1):1016.CrossRefPubMedPubMedCentral Matone M, O’Reilly ALR, Luan X, Localio R, Rubin DM. Home visitation program effectiveness and the influence of community behavioral norms: a propensity score matched analysis of prenatal smoking cessation. BMC Public Health. 2012;12(1):1016.CrossRefPubMedPubMedCentral
55.
go back to reference Curran GM, Bauer M, Mittman B, Pyne JM, Stetler C. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Med Care. 2012;50(3):217–26.CrossRefPubMedPubMedCentral Curran GM, Bauer M, Mittman B, Pyne JM, Stetler C. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Med Care. 2012;50(3):217–26.CrossRefPubMedPubMedCentral
56.
go back to reference Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50.CrossRefPubMedPubMedCentral Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50.CrossRefPubMedPubMedCentral
57.
go back to reference Dzewaltowski DA, Glasgow RE, Klesges LM, Estabrooks PA, Brock E. RE-AIM: evidence-based standards and a Web resource to improve translation of research into practice. Ann Behav Med. 2004;28(2):75–80.CrossRefPubMed Dzewaltowski DA, Glasgow RE, Klesges LM, Estabrooks PA, Brock E. RE-AIM: evidence-based standards and a Web resource to improve translation of research into practice. Ann Behav Med. 2004;28(2):75–80.CrossRefPubMed
Metadata
Title
Framework for the establishment of a feasible, tailored and effective perinatal education programme
Authors
Isabel Artieta-Pinedo
Carmen Paz-Pascual
Gonzalo Grandes
Maite Espinosa
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2017
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-017-1234-7

Other articles of this Issue 1/2017

BMC Pregnancy and Childbirth 1/2017 Go to the issue