Attenders and nonattenders at childbirth education classes in Australia: how do they and their births differ?

This study assessed the associations between attendance at childbirth preparation classes and the health behaviors, birth events, satisfaction with care, and later emotional well-being of women having their first child. A postal survey was conducted of a population-based cohort of 1193 women who gave birth in two weeks in 1989 in Victoria, Australia. The response was 71.4 percent (790/1107). Classes were attended by 245 (83.9%) of 292 primiparous women. Those who did not attend were significantly more likely to be under age 25 years, not to have completed secondary education, to be single, to have a low family income and no health insurance, and to be public hospital clinic patients. Differences between women who attended classes and those who did not, with respect to measures of pain and to the use of procedures, interventions, and pain relief, were rare and minor. No differences occurred between the groups in their satisfaction with the provision of information through pregnancy, birth, and the postnatal period. Only one of five measures of satisfaction with care was less favorable in nonattenders. Attenders were not more confident about looking after their infants at home or less likely to be depressed eight months after birth. Significant differences occurred between the groups on four health behaviors: cigarette smoking, missed antenatal appointments, breastfeeding, and alcohol consumption during pregnancy. Attendance at childbirth preparation classes in Victoria is not associated with differences in birth events, satisfaction with care, or emotional well-being among women having their first child.