None listed
Conditions
Brief summary
In Australia, antenatal education programs are mostly unregulated and educators do not require formal qualifications that ensure evidence-based teaching (Downer, Young et al. 2020). In a climate where birth interventions are increasing (AIHW 2018), antenatal education can play a role in helping women to make evidence-based decisions about labour and birth that may improve outcomes for themselves and their baby. Randomised control trials (RCTs) of antenatal education interventions are diverse, and largely weakened by low numbers and poor design. The strongest suggestion so far that antenatal education can improve birth outcomes was an RCT of 176 births in Sydney, Australia where women undergoing a an antenatal program based on the SheBirths® course, compared to controls, had 65% less epidural anaesthesia, 44% less caesarean sections and 50% less medical augmentation/induction (Levett, 2016). In order to make generalisations about the impact of this antenatal education course, the results need to be replicated in other populations. The proposed project will be an open-label, assessor-blind RCT of the online, self-administered adaptation of SheBirths® antenatal education program in Port Macquarie and Coffs Harbour Base Hospitals.
Interventions
The intervention arm (50% of participants) will undertake an integrative antenatal education course delivered online.
Potential participants will recruited via an advertisement for the trial in the antenatal clinic. A QR code will direct them to a website where they will consent and register with the following details: due date of the baby, maternal age and the last 3 digits of the mothers mobile phone number
Participants in the intervention arm will be given a link to an online course via emai
The intervention arm (50% of participants) will undertake an integrative antenatal education course delivered online. Potential participants will recruited via an advertisement for the trial in the antenatal clinic. A QR code will direct them to a website where they will consent and register with the following details: due date of the baby, maternal age and the last 3 digits of the mothers mobile phone number Participants in the intervention arm will be given a link to an online course via email and asked to complete the 4 core modules (roughly 10 hrs) of the course in their own time, at any location, prior to birth. For both the intervention and control arms, the trial is offered not as a replacement to usual care (such as public group antenatal classes) but IN ADDITION to whatever usual care the participants would have otherwise undertaken. This is all that participants in the intervention arm are required to do. Participants randomised to the control arm of the study will not undertake any activity other than usual care. Details of the degree of completion of the course will be collected by the online course administrator and sent to the research team to monitor adherence. Non-completion will require data to be omitted from analysis of birth outcomes. The intervention is only provided once during the course of the pregnancy Participants can use the knowledge they obtain at their discretion and are not required to utilise any techniques taught in the course if not so desired Birth outcome data will be accessed through a public database which stores maternity data from the mid-north coast and collection of this data does not require action by the participant The 4 Core Modules of the course are described below and are delivered in a series of short videos running roughly 10 hours total. There is also additional content in the form of handbooks, visualisations, videos and downloads. Module 1: Learning to trust the body Nutrition; hormones; mind-body connection; transforming fear; nervous system; relaxation; the culture of birth; uterine layers; active birth and optimal positioning, and yoga demonstration Module 2: Discovering practical tools Breathing techniques ; mind and birth as meditation; altering pain perception; massage techniques and acupressure Module 3: Labour Stages and Strategies How Labour Begins; pre-labour and active labour; breathing techniques for transition and second stage of labour; third stage of labour; birth preferences; B.R.A.N.D: Conscious Decision Making; birth documentary; 3 ways to labour; setting up for birth at home and hospital; spiralling; perineal massage; rebozo demonstration; full birth rehearsal Module 4: Breastfeeding & Early Parenting Lotus flower breath; baby-led attachment; breastfeeding tips; breastfeeding positions, tiredness & safe sleeping; baby communication and language and conscious parenting Visualisations, videos and downloads 1 x Prenatal Yoga Class Download, 6 x Visualisations, 20 x Birth Story Videos, 2 x Actual Births at Home & Hospital; Breastfeeding Resources; Q&A forums; Podcast interviews
Sponsors
UNSW, Sydney - Rural Clinical Campus
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
18 years or older Availability to participate in 10hrs of an online course at between 24 to 30 weeks’ gestation A singleton pregnancy A low-risk pregnancy (no pre-existing medical or obstetric complications - se exclusion criteria) Fluency in English sufficient to participate in an online course Access to a computer and the internet
Exclusion criteria
A risk associated with pregnancy such as • pre-pregnancy diabetes or high blood pressure • diabetes or high blood pressure diagnosed during my pregnancy • major health conditions requiring regular prescription medication • a condition with higher risk of premature birth such as a short cervix or recurrent episodes of vaginal bleeding Enrolment or intention to enrol in another private midwifery programme or birth preparation course Previously randomisation to this trial No access to a computer or the internet non-fluent in English Absence of a “support person” Planned caesarean section
Outcome results
None listed