Effect of birth plans integrated into childbirth preparation classes on maternal and neonatal outcomes of Iranian women: A randomized controlled trial

Frontiers in Global Women's Health

Global Women's Health

Ehsan Kazemnejad Leyli¹  Parvin Abedi²  Zaynab Mohaghegh³  Mojgan Javadnoori⁴  Simin Montazeri⁴  Mahin Najafian⁵  Shahla Bakhtiari⁶ 

[1] Department of Biostatistics, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran;Department of Midwifery, Menopause Andropause Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran;Department of Midwifery, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran;Department of Midwifery, Reproductive Health Promotion Research Center, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran;Department of Obstetrics and Gynecology, School of Medicine, Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran;Midwifery Department, Rosie Hospital, Cambridge University Hospitals NHS, Cambridge, United Kingdom;

关键词: birth plans;    prenatal education;    natural childbirth;    maternal outcomes;    neonatal outcomes;   

DOI  :  10.3389/fgwh.2023.1120335

 received in 2022-12-09, accepted in 2023-03-22,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundInvolvement of women in the decision-making process during childbirth plays an important role in their physical and psychosocial preparation. A birth plan allows the woman to express her expectations and facilitates her participation in her own care. The present study is the first to assess the implementation of birth plans integrated into childbirth preparation classes in Tehran, Iran.MethodsThis study is a randomized controlled clinical trial performed on 300 pregnant women at 32–33 weeks of gestation referring to four public health centers in Tehran, Iran. The participants were randomly allocated into intervention and control groups using block randomization method. A training session on the items of the birth plan checklist was held in the fifth session of childbirth preparation classes for the participants in the intervention group. Accordingly, a birth plan was prepared according to the requests of mothers. The birth plan was implemented after the women were admitted to the maternity ward. The primary outcomes were frequency of vaginal birth, mean duration of labor stages, and mean score of childbirth satisfaction. We used a checklist of maternal and neonatal outcomes, Mackey's childbirth satisfaction questionnaire, and a partogram form for data collection. Independent t-test, Mann–Whitney U-test, Chi-square test, Fisher's exact test, and logistic regression were used for data analysis.ResultsVaginal birth rates were significantly higher in women who had birth plans compared with those without (81.9% vs. 48.7%, p < 0.001). Also, the lengths of the first and the second stages of labor were significantly shorter in women having a birth plan (p = 0.02). Women in the birth plan group were significantly more satisfied with the process of labor and childbearing (p < 0.001), and started breastfeeding after birth earlier than those in the control group (p < 0.001).ConclusionHaving a birth plan and attending childbirth preparation classes can increase the rate of normal vaginal birth. Also, according to our results, women's participation in the decision- making process and fulfilling their preferences during birth can improve maternal and neonatal outcomes and childbirth satisfaction.Trial registration: IRCT20190415043283N2. 2020-12-07.

【 授权许可】

Unknown   
© 2023 Mohaghegh, Javadnoori, Najafian, Abedi, Kazemnejad Leyli, Montazeri and Bakhtiari.