•Antenatal education is a key element of antenatal care, recommended by NICE

•There is no mandated curriculum for NHS antenatal education, and class content and delivery is variable both between and within trusts

•Via surveys and focus groups, parents and midwives told us that an improved antenatal education session was needed

 

To co-design and refine a two-hour antenatal education (ANE) session about labour and birth to adequately prepare pregnant women/birthing-people

 

Methods

This intervention development study can be divided into two parts.

Part 1: Co-design

5 co-design groups grounded in data from prior focus groups (46 women , 21 staff, >1000 survey participants).

 

Part 2: Piloting

The two hour long co-designed antenatal education session was trialed at North Bristol NHS Trust, women were invited to the class in addition to their usual antenatal class.

Participants: Women in their third trimester booked for their antenatal care with North Bristol Trust

 

Part 3: Refining

Feedback on classes from

 

Results

Part 1 Co-Design:

36 parents and maternity staff co-designed the antenatal education session. The concept centred around a river and the multiple currents that can be travelled along to reach the postnatal bay at the end. The manual was designed in a modular fashion (see fig 1 for contents) with midwives encouraged to cover all modules but without a prescriptive order to allow for personal style.

Part 2 Piloting:

Four midwives were trained to deliver the ACE classes and delivered 19 classes to 143 women and 94 birth partners.

Part 3 Refining:

Figure 3 shows the general post class feedback, which was generally positive. Birth partners found the sessions less engaging and useful compared to mothers. 38 changes were recommended 22 by parents, 5 by midwives, 11 by both. These have been included in an updated midwifery manual and a training video has been developed for implementation.

Conclusions and recommendations

The co-designed antenatal education session met the needs of parents, but interestingly the partners did not find the sessions relevant to them. Whilst it seems possible to improve antenatal preparedness for women, more must be done to meet the information needs of partners.