Childbirth education in the 1990s and beyond.

Childbirth education has been evolving for centuries. It has been a part of the experience of pregnancy and birth since the beginning of time, although it did not exist in the formal structure that exists today. It began in response to a need to improve prenatal care and maternal-infant outcomes. It experienced an awakening fueled by the women's movement and the grass roots consumer movement between 1960 and 1980 and had an impact on the development of family-centered maternity care. It has been influenced by institutional control in the 1980s and 1990s. Throughout these decades the goals of childbirth education have changed and evolved. As we near the year 2000, childbirth education approaches a crossroads and faces many challenges for the future. A number of factors will influence the direction that childbirth education takes in the next century. These factors include demographic trends, health care reform, the philosophy of health care providers, goals and responsibilities of consumers, goals of educational programs, consumer access to education programs, the philosophy and role of childbirth educators, research, and standards of practice.