Antenatal classes and preparation for birth
Antenatal classes help many women prepare for birth and parenthood, especially in their first pregnancy. Midwives have details of free NHS classes in each area....
Women’s need for information, advice and support in pregnancy features in most of the other sections. This section summarises:
Especially in a first pregnancy, women wanted to know about various aspects of pregnancy’ detailed information about the changes happening inside their body; how to take care of their health and the health of the unborn baby; understanding results of tests; what symptoms and emotions to expect; what birth would be like, including breathing, pain relief and possible interventions; how to feed and care for their new baby. Several people had felt less need for information in later pregnancies, but still valued reassurance that everything was progressing well and reminders of what they needed to do.
Most women had access to several sources of information. The pregnancy books and leaflets from their GP or midwife were generally well used and liked (such as ‘The Pregnancy Book’ and ‘Birth to Five’). Many also bought their own books or were given them by friends and family. Some used Internet sites and message boards.
One of the few criticisms of pregnancy books was that they said little about things that could go wrong, such as genetic problems with the baby, terminations and rare complications. One woman would have liked more about miscarriage in her pregnancy book. But people recognised that these topics can scare people unnecessarily (see Interview 25 above), and some women had read too much and frightened themselves.
Women affected by more unusual complications frequently found the Internet a good way to supplement the information given to them by doctors and midwives. Again, a few people were frightened by what they read and some were advised by staff not to use it. Some commented that information from the Internet can be of variable quality and reliability, and it is hard to know what to believe. The sheer quantity can also be overwhelming.
Specialist charitable support groups, many of which have their own websites, were also a highly valued source for people with specific conditions or complications, although a few found it difficult to approach support organisations (see Interview 31 below. See also Healthtalk website on Antenatal screening).
Apart from written sources such as books and websites, most information about normal pregnancy came through regular maternity appointments with GPs, midwives and obstetricians. Mostly people were very satisfied with this support, although a few felt they got conflicting or misleading information. Antenatal classes were another generally popular source of information for those people who went to them. At the classes, tips from other women were valued at least as much as the information from the class teacher. Informal conversation with other pregnant women or new mothers also helped (see Interview 02 and Interview 10 above. See also ‘Antenatal classes and preparation‘ and ‘Maternity care and antenatal visits’).
Some people turned to family members such as mothers or sisters for support and advice, whereas others preferred to talk to friends or professionals. A few said advice from family members sometimes conflicted with professional advice, and they had to decide which to follow. (See also ‘Advice on health and lifestyle’).
Several women had been especially helped by information from their local Sure Start project; other voluntary groups such as a specialist project for Asian women had also been used.
Timing of information was important. Most women wanted information very early, when they were feeling most unsure and anxious. Some felt they were given good advice and reassurance at their first visit to the GP, but others would have liked more. The gap between that first visit and their booking-in appointment with the midwife at 10-13 weeks seemed long, and some women did not want to trouble their midwife or doctor between appointments. (See ‘First contacts with services’ and ‘Maternity care and antenatal visits’).
In later pregnancy, women needed information early enough to think about birth choices. This was a problem for women who went into labour early and had not completed their antenatal classes (see ‘Looking back – Preterm birth and special care’).
Women’s satisfaction with their care was affected by how far they felt in control and understood what was happening. Some women with a relatively straightforward labour were unhappy because they had not been able to do things as they wanted or felt staff had not listened, whereas others felt well involved and informed, even if they were making choices they had not originally intended. If an emergency intervention is required during labour, there is often not enough time to discuss the implications in great detail; some women wished they had known more at an earlier stage. However, some were reassured when staff explained after the birth what had happened and why. (See ‘Thinking about where and how to give birth, ‘Looking back – vaginal birth’ and ‘Looking back – caesarean birth’).
Some women wanted more information during pregnancy about what to expect after birth, for example about feeding, washing and changing the baby and sleeping patterns, and recovery after a caesarean (see ‘Looking back – caesarean birth’ and ‘Feeding and caring for the baby’). One woman wanted to know more about postnatal depression. Other people felt they had enough information, or thought it would be difficult to make sense of it all until they had the baby.
Several people commented on the need for clear and understandable information. This might mean explaining technical jargon or long medical words (and see Interview 13 above), or having more available in another language. One woman suggested written birth plans (which her midwife considered unnecessary) could particularly help people whose first language was not English. Women also wanted advice that was sensitive to different religious and cultural needs.
Antenatal classes help many women prepare for birth and parenthood, especially in their first pregnancy. Midwives have details of free NHS classes in each area....
People experience strong emotions in pregnancy, both positive and negative. Especially in a first pregnancy, feeling a new life growing is exciting and awe-inspiring, totally...