The effect of prenatal education on fear of childbirth, pain intensity during labour and childbirth experience: a scoping review using systematic approach and meta-analysis

Abstract

Background Antenatal education provides parents with strategies for pregnancy, childbirth, and parenthood. There is not enough evidence of the positive effect of prenatal education on childbirth and maternal outcomes. The present scoping review using a systematic approach, evaluates the effectiveness of prenatal education on fear of childbirth, pain intensity during labour, childbirth experience, and postpartum psychological health. Methods We used Google Scholar and systematically reviewed databases such as PubMed, Web of Science, Cochrane, Scopus, and SID (Scientific Information Database). Randomized controlled and quasi-experimental trials examining the effect of structured antenatal education and routine prenatal care compared to routine prenatal care were reviewed. The participants included pregnant women preferring a normal vaginal delivery and had no history of maternal or foetal problems. The outcomes considered in this study included fear of childbirth, pain intensity during labour, childbirth experience (as primary outcomes) and postpartum psychological health (as secondary outcomes). The grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the quality of evidence. Results Overall, 3242 studies were examined, of which 18 were qualified for the final analysis. The meta-analysis showed that providing prenatal education and routine care compared to only routine care may decrease the fear of childbirth, postpartum depression, and pain intensity during labour. However, we found no study examining the outcome of the childbirth experience. In addition, the inconsistency of included studies prevented conducting a meta-analysis on the rest of the outcomes. Conclusions Our investigations showed that there are very few or no studies on the effect of prenatal education on outcomes such as childbirth experience, postpartum anxiety, and maternal attachment, and the existing studies on the effect of prenatal education on outcomes such as the fear of childbirth, postpartum depression, and pain intensity during labour lack sufficient quality to make definitive conclusions. Therefore, high-quality, randomized trials with a more extensive sample size are suggested to provide clear reports to make definitive decisions. Prospero ID CRD42022376895.

Cultural adaptation, validation and evaluation of the psychometric properties of Childbirth Experience Questionnaire version 2.0 in the Spanish context

“…However, in our opinion, they should be considered different constructs, so they should be measured with different instruments. Moreover, there are certain fears and concerns in women that may be directly related to previous experiences [ 15 , 16 , 67 ]. This is a possible explanation for the behaviour of the item.…”

“…In contrast, negative experiences during childbirth can increase the incidence of postpartum depression, instil fear of future childbirth, reluctance to have children in the future, influence the choice of caesarean section over vaginal delivery, and lead to poor outcomes in breastfeeding [ 5 , 12 – 15 ]. The close relationship between having had a previous negative experience and the fear of childbirth is well-known [ 15 – 19 ].…”

Comparison of different interventions for the reduction of labor pain: A systematic review and network meta-analysis

“…Childbirth pain is regarded as one of the most intense and demanding experiences for many women. [ 1 , 2 ] This demanding process induces significant physiological changes in mothers, [ 2 , 3 ] leading to increased oxygen consumption, blood pressure, cardiac output, and impacting their psychodynamic behavior. [ 3 , 4 ] Furthermore, uncontrolled pain during childbirth is linked to higher rates of cesarean sections and adverse outcomes for newborns, including an increased incidence of fetal hypoxemia.…”

Co-design and refinement of an optimised antenatal education session to better inform women and prepare them for labour and birth

“…2 ANE contributes to practical preparation, but it can contribute to a woman/pregnant person’s expectations and experience of labour and birth and consequently their psychosocial outcomes. 3…”

“…2 ANE contributes to practical preparation, but it can contribute to a woman/pregnant person's expectations and experience of labour and birth and consequently their psychosocial outcomes. 3 When considering what is important to them about birth, women prioritise the physiological birth of a healthy baby. However, when things do not go according to their plan, they wish to retain a sense of personal achievement and control through active decision-making.…”