A controlled study of the effect of prepared childbirth classes on obstetric outcomes.

After the development and initiation of prepared childbirth classes in a large, inner-city hospital, a case-controlled study was designed to assess their impact on obstetric outcomes. Prepared couples were matched with nonattenders on six variables: race, patient status (clinic or private), parity, marital status, age, and socioeconomic status. Statistically significant differences between the groups were found. Prepared couples were more likely to receive little or no pain medication and less conduction anesthesia than controls. Consequently, 79 percent of their deliveries were spontaneous, compared to 51 percent for controls (P less than 0.001). Despite the increased pushing ability of the class attenders, over 80 percent of women in both groups had an episiotomy, which was, in turn, significantly associated with a second-, third-, or fourth-degree laceration, thus bringing into question its routine use. Further studies to identify additional factors associated with positive obstetric outcomes are warranted.