Antenatal education and breastfeeding in a cohort of primiparas.

AIMS: To assess the association between attendance at antenatal education sessions and breastfeeding during the first year of life. BACKGROUND: Although there is evidence that antenatal education encourages breastfeeding, the size and duration of its effect remain unclear. DESIGN: A prospective cohort study. METHODS: The study was conducted in Bizkaia (North of Spain) between May 2005-June 2007 with a consecutive sample of 614 primiparas. Women were classified into three groups according to whether they had received antenatal education and, if so, how many classes (0, 1-4, or 5 or more). Telephone interviews at 1·5, 3, 6 and 12 months were used to estimate the risk of cessation of any breastfeeding and to compare the groups with Cox proportional hazards regression models adjusted for potential confounders. FINDINGS: Initially, 90% of women breastfed their infants, with no differences between the groups. During the first month, the risk of cessation of any breastfeeding was three times as high among non-attendees and twice as high among women who attended 1-4 classes compared with those who attended 5 or more classes. The risk was, however, similar in the three groups from the end of first month onwards. CONCLUSION: The results suggest that though antenatal education may be associated with higher rates of breastfeeding in our setting this is only the case for the first month after the birth. Further research is necessary to optimize this beneficial effect to achieve long-term continuation of breastfeeding.

The benefits of antenatal education for the childbirth process in Spain.

BACKGROUND: Childbirth has changed dramatically over the past 40 years, although antenatal education (AE) has not. This education has been shown to be beneficial in some countries but not in others. OBJECTIVE: The objective of this study was to assess the benefits of AE during the childbirth process, controlling for the possible confounding effects of other variables and involving a comprehensive assessment of the birth process. METHOD: A prospective observational study was conducted in Bizkaia, Spain, to follow 616 low-risk pregnant nulliparous women aged 18-42 years until childbirth. Women who had attended different numbers of AE sessions were compared in terms of the following: whether they arrived at hospital in established labor, whether they received epidural anesthesia before the active phase of the birth, length of the first and second stages (i.e., dilation and delivery), anxiety (Hospital Anxiety and Depression Scale), type of birth, perineal injury, satisfaction with the experience, and the 5-minute Apgar score. Results were adjusted by age, nationality, educational level, social class, personality, and the hospital where the birth occurred. RESULTS: Spanish women who had attended AE classes experienced less anxiety during birth than those who had not (Hospital Anxiety and Depression Scale score adjusted difference = -1.5, 95% confidence interval = -0.1 to -3.0), whereas the opposite was found for immigrant women (adjusted difference = 2.4; 95% confidence interval = -0.6 to 5.4; AE x Nationality interaction, p = .02). No dose-response relationship was found between AE and anxiety, and no benefits were seen for the other variables. DISCUSSION: Antenatal education is not found to be associated with benefits during childbirth. Subsequent research should be focused on redesigning and assessing AE in light of the current needs of women.