Abstract
Objective
To determine if childbirth education is associated with improved outcomes for national maternal child health goals in the United States.
Methods
This was a secondary analysis of PRAMS data. The sample was limited to survey respondents who answered a question “During your most recent pregnancy, did you take a class or classes to prepare for childbirth and learn what to expect during labor and delivery?” The outcomes included nine national objectives from Title V and Healthy People. Logistic regression models were built with control for characteristics associated with attending childbirth education. Odds ratios were converted to adjusted risk ratios for interpretation. Stratification by maternal race/ethnicity and use of Medicaid identified opportunities for improvement in childbirth education.
Results
Of the 2,256 eligible respondents, 936 (41.5%) attended childbirth education. Attending childbirth education was associated with reduced likelihood of primary cesarean (ARR 0.79), increased attendance at postpartum visit (ARR 1.06), use of birth control (ARR 1.07), safe infant sleep (Back to Sleep ARR 1.04; Sleep on Own 1.12), and breastfeeding (Ever breastfeed ARR 1.08; still breastfeeding ARR 1.15). No association was found for LARC use or postpartum depression. Not all benefits of childbirth education were apparent for all racial/ethnic groups, nor for those with Medicaid insurance.
Conclusions for practice
Childbirth education is a community intervention that may help achieve population maternal and child health goals.
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Acknowledgements
This work uses data collected by the Prams Working Group at the United States Centers for Disease Control and Prevention.
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J.V., T.G., and J.S. contributed to the design of the study, interpretation of results, and writing of the manuscript. J.V. performed the analysis.
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Vanderlaan, J., Gatlin, T. & Shen, J. Outcomes of Childbirth Education in PRAMS, Phase 8. Matern Child Health J 27, 82–91 (2023). https://doi.org/10.1007/s10995-022-03494-3
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DOI: https://doi.org/10.1007/s10995-022-03494-3