Enhancing Childbirth Satisfaction Through A Brief, Targeted Educational Intervention

Enhancing Childbirth Satisfaction
through a Brief, Targeted

Educational Intervention
Dyan Thompson, BSN, RN, DNP Student
Diane Boyle, PhD, RN, FAAN
Positive Childbirth Satisfaction/Experience
Negative Childbirth Satisfaction/Experience
Background
• Large body of literature reports maternal
dissatisfaction with labor and childbirth experiences
• Promoting maternal childbirth satisfaction
– linked with women accessing relevant information
• make informed choices
• gain confidence
• address fears around childbirth
(Brown & Lumley, 2994; Fisher, Fenwick, & Hauk, 2006; Gibbins & Thompson, 2001; Green & Baston, 2003;
Hodnett, 2002; Slade, MacPherson, Hume, & Maresh, 1993; Wadenstrom, 1999)
Background Continued (Lothian & DeVries, 2010)
• Benefits of Childbirth Education

– Gain confidence
– Address and overcome fears around childbirth
– Greater understanding of options
– Better able to communicate with caregivers
Fear and lack of confidence surrounding childbirth has been

associated with longer labor duration (Adams, Eberhard-Gran, & Eskild, 2012)
Childbirth Class Attendance
(Declercq , Sakala, Corry, & Applebuam, 2006)
• 56% of women expecting 1st baby took

childbirth education classes
• 9% of experienced mothers took classes prior
to most recent birth
New ways to educate women for
childbirth need to be explored
Purpose
The purpose of this descriptive, comparative

study is to explore the effects of a brief, targeted
educational intervention on childbirth
satisfaction.
Specific Aims
– Test the feasibility of implementing a brief (1/2

hour), targeted educational intervention with
women in their 3rd trimester of pregnancy as an
added service to routinely scheduled office visits
– Compare postpartum childbirth satisfaction (two
weeks postpartum) of obstetrical patients who
receive the brief, targeted education session in
their 3rd trimester of care to a group of similar
patients who receive routine obstetrical care
Methods
Participants
– Intervention Group (n=>10)
• Received an additional, brief, targeted educational
session in their 3rd trimester of pregnancy and
completed a childbirth satisfaction survey at two weeks
postpartum
– Comparison Group (n=10)
• Usual care only. Completed a childbirth satisfaction
survey at two weeks postpartum
Inclusion Criteria for Participants
• Third trimester of pregnancy
• Have not taken a childbirth preparation class during
this pregnancy
• Not receiving additional specialty care because of high
risk
• 18-34 years old
• First time or previous pregnancy
• Able to understand and read English
Setting
• A large, multi-site family practice in the

Northern Colorado area. Three clinics will be
used for this study.
Intervention
• A ½ hour targeted prenatal educational session
during the third trimester of care
• Session followed a regularly scheduled prenatal visit
• Tailored to participant’s needs from a list of
educational topics
• Standardized evidence based informational
pamphlets given to the patient
Educational Material
• Designed to provide direct benefit to the

participant
– Provides access to relevant information to make
informed choices, gain confidence, and address
fears around childbirth
– Provides information about evidence based
maternity care practices, pain relief, decision
making during labor, infant and postnatal care,
and breastfeeding
Childbirth Satisfaction Survey
• Survey data was collected over a 2-3 month

period at two-week postpartum visit
– Intervention Group: *21 question survey using a
5-level Likert scale
– Comparison Group: 17 question survey using a 5-
level Likert scale
*Additional 4 questions in the intervention survey focused on the

feasibility of the intervention
Patient Characteristics
Participant Intervention Group Comparative Group
Characteristics
Age Mean = 26.1 years Mean = 27.4 years
Education Some College Some College
Hispanic 28.6% Hispanic 10%

Ethnicity White 71.4% Asian 10%
White 80%
First Delivery Yes = 71.4% Yes = 90%
Previous Childbirth Class No = 86% No = 10%

ANOVA
Satisfaction with Childbirth Experience
Group Mean (SD) F P
Intervention Group 60.57 1.94 .18
(n=7) (0.98)
Comparison Group 57.40

(n=10) (5.91)
Total 58.71
(n=17) (4.75)
Feasibility Survey Questions
• Q1 A ½ hour educational session fit my schedule
• Q2 A ½ hour educational session was adequate for my

educational needs
• Q3 The information given at the educational session

was beneficial to my overall childbirth experience
• Q4 I would recommend the additional education

session to family or friend
Mean Scores for Feasibility Questions
4.1
4
3.9
3.8
3.7
3.6
3.5
3.4
3.3
Q1 Q2 Q3 Q4
Strongly Agree 4
Agree 3
Disagree 2
Strongly Disagree 1
Lessons Learned
• Some patients were eliminated from the intervention

group of this study.
• Placed in childbirth classes
• Developed high risk criteria after intervention was given
• Delivered before intervention was done
• Certain participants were identified by the OB
provider as needing extra support. This may be a
target population to identify and provide extra
services.
Limitations
• Small sample size

• Convenience sample
• Comparison group only
• Not randomized
• Potential bias to survey results due to
participants completing survey in doctors
office
Conclusion
• A brief, targeted educational session provided to women
in their third trimester of care shows promising
effectiveness in enhancing childbirth satisfaction
• The added service of providing a brief, targeted
educational session to a routinely scheduled office visit
shows potential as being feasible in a family care setting
• Further research is needed on this important topic
– Use a larger, random, more diverse sample
– Establish alternative way to collect survey data to avoid
bias
References
• Adams, S., Eberhard-Gran, M., & Eskild, A. (2012). Fear of childbirth and duration
of labour: A study of 2,206 women with intended vaginal delivery. British Journal
of Obstetrics and Gynaecology, 119(10), 1238-1246.
• Alehagen, S. (2001). Fear during labor. Acta Obstetricia et Gynecological
Scandinavica, 80(4), 315-320.
• Brown, S., & Lumley, J. (1994). Satisfaction with care in labor and birth: a survey of
790 Australian women. Birth, 21, 4-13.
• Declercq, E., Sakala, C., Corry, M., & Applebaum, S. (2006). Listening to mothers II:
Report of the second national U.S. survey of women’s childbearing experiences.
New York: Maternity Center Association.
• Fisher, C., Fenwick, J. & Hauck, Y. (2006). How social context impacts on women
fears of childbirth: a Western Australian example. Social Science Medicine, 63, 64-
75.
• Gibbins, J., & Thomson, A. M. (2001). Women’s expectations and experiences of
childbirth. Midwifery, 17, 302-313.
References Continued . . .
• Green, J.M., & Baston, H.A. (2003). Feeling in control during labor: concepts,
correlates, and consequences, Birth, 30, 235-247.
• Hodnett, E. D. (2002). Pain and women’s satisfaction with the experience of
childbirth: a systematic review. American Journal of Obstetrics and Gynecology,
186, 160-172.
• Lothian, J., & DeVries, C. (2010). The official Lamaze guide: giving birth with
confidence. Minneapolis: Meadowbrook Press.
• Slade, P, MacPhersono, S.A., Hume, A., & Maresh,M. (1993). Expectations,
experiences and satisfaction with labour, British Journal of Clinical Psychology, 32,
469-483.
• Waldenstrom, U. (1999). Experience of labour and birth in 1,111 women, Journal
of Psychosomatic Research, 47, 471-482.

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Enhancing Childbirth Satisfaction

through a Brief, Targeted

• Benefits of Childbirth Education

Fear and lack of confidence surrounding childbirth has been

• 56% of women expecting 1st baby took

The purpose of this descriptive, comparative

– Test the feasibility of implementing a brief (1/2

• A large, multi-site family practice in the

• Designed to provide direct benefit to the

• Survey data was collected over a 2-3 month

*Additional 4 questions in the intervention survey focused on the

Education Some College Some College

Hispanic 28.6% Hispanic 10%

First Delivery Yes = 71.4% Yes = 90%

Previous Childbirth Class No = 86% No = 10%

Comparison Group 57.40

• Q2 A ½ hour educational session was adequate for my

• Q3 The information given at the educational session

• Q4 I would recommend the additional education

• Some patients were eliminated from the intervention

• Small sample size

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