Jennifer Vanderlaan1, Tricia Gatlin2, Jay Shen3. 1. University of Nevada Las Vegas School of Nursing, 4505 S. Maryland Parkway, 89154-3018, 702-895-3082, Las Vegas, NV, USA. jennifer.vanderlaan@unlv.edu. 2. Dean, Wegmans School of Nursing, St. John Fisher College, 3690 East Avenue, 14618, Rochester, NY, USA. 3. University of Nevada Las Vegas School of Public Health, 4700 S. Maryland Pkwy, 89119, Las Vegas, NV, USA.
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.
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.
Authors: Erin Hetherington; Sheila McDonald; Tyler Williamson; Scott B Patten; Suzanne C Tough Journal: J Epidemiol Community Health Date: 2018-06-19 Impact factor: 3.710
Authors: Summer Sherburne Hawkins; Ariel Dora Stern; Christopher F Baum; Matthew W Gillman Journal: Arch Dis Child Fetal Neonatal Ed Date: 2013-11-25 Impact factor: 5.747