Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK.
Lancashire and South Cumbria NHS Foundation Trust, Blackpool, UK.
BMC Pregnancy Childbirth. 2023 Jul 27;23(1):543. doi: 10.1186/s12884-023-05846-5.
Antenatal preparation is commonly offered to women in pregnancy in the United Kingdom, but the content is highly variable, with some programmes orientated towards 'normal birth', whilst others may incorporate information about complications and procedures (broader focus). However, the impact of this variability on birth experience has not been explored. We examined the relationship between the content of antenatal preparation received and birth experience, taking into account obstetric complications and procedures. As birth experience can have a profound impact on a mother's postnatal well-being, we also investigated associations with mothers' postnatal mood and anxiety.
N = 253 first-time mothers completed a cross-sectional survey measuring demographic and clinical factors, antenatal preparation content (categorised as normality-focused or broader-focused), obstetric complications and procedures experienced, birth experience (measured using three separate indices; the Childbirth Experience Questionnaire, emotional experiences, and presence/absence of birth trauma), postnatal depression and anxiety, and qualitative information on how the COVID-19 pandemic had affected birth experience.
Regarding birth experience, receiving more broader-focused preparation was associated with a more positive birth experience irrespective of complications/procedures experienced, while receiving only normality-focused preparation was beneficial in the context of fewer complications/procedures. Regarding birth trauma, receiving more broader-focused preparation was associated with lower likelihood of reporting birth as traumatic only in the context of more complications/procedures. Degree of normality-focused preparation was unrelated to experience of birth trauma. Lastly, while more complications/procedures were associated with greater anxiety and low mood, only greater normality-focused preparation was linked with better postnatal mental health.
Antenatal preparation including both normality- and broader-focused information is positively related to women's birth experience. While normality-focused preparation seems most beneficial if fewer complications/procedures are experienced, broader-focused preparation may be most beneficial in the context of a greater number of complications/procedures. As complications/procedures are often unpredictable, offering broader-focused preparation routinely is likely to benefit women's birth experience. This antenatal preparation should be freely available and easily accessible.
在英国，孕妇通常会接受产前准备，但内容差异很大，有些课程以“正常分娩”为导向，而另一些课程可能包含有关并发症和程序的信息（更广泛的重点）。然而，这种变异性对分娩体验的影响尚未得到探索。我们研究了接受的产前准备内容与分娩体验之间的关系，同时考虑了产科并发症和程序。由于分娩体验会对母亲的产后幸福感产生深远影响，我们还调查了与母亲产后情绪和焦虑的关联。
253 名初产妇完成了一项横断面调查，调查测量了人口统计学和临床因素、产前准备内容（分为以正常为重点或更广泛为重点）、经历的产科并发症和程序、分娩体验（使用三个单独的指标测量；分娩体验问卷、情绪体验以及是否存在分娩创伤）、产后抑郁和焦虑，以及 COVID-19 大流行如何影响分娩体验的定性信息。
就分娩体验而言，接受更多的广泛重点准备与更积极的分娩体验相关，无论是否经历并发症/程序，而仅接受正常重点准备在并发症/程序较少的情况下是有益的。至于分娩创伤，仅在经历更多并发症/程序的情况下，接受更多的广泛重点准备与报告分娩创伤的可能性较低相关。正常重点准备的程度与分娩创伤的经历无关。最后，虽然更多的并发症/程序与更大的焦虑和情绪低落有关，但只有更多的正常重点准备与更好的产后心理健康有关。
包括正常和更广泛重点信息的产前准备与女性的分娩体验呈正相关。虽然在经历较少并发症/程序的情况下，正常重点准备似乎最有益，但在更多并发症/程序的情况下，广泛重点准备可能最有益。由于并发症/程序往往是不可预测的，因此定期提供广泛重点准备可能会使女性受益于分娩体验。这种产前准备应该是免费和易于获得的。
