Antenatal relaxation classes in preparation for childbirth may not be as effective as hoped, researchers warned today.
A team of researchers led by clinical psychologist Dr Malin Bergstrom at the Karolinska Institute in Sweden looked at the effects of natural childbirth preparation on epidural use, childbirth experience and parental stress among 1,087 first-time mothers and 1,064 first-time fathers.
The parents received four two-hour sessions of either "psychoprophylactic" training (relaxation, breathing and psychological coping techniques) or standard antenatal education during the third trimester of pregnancy, and one follow-up session after delivery.
The epidural rate was the same (52 per cent) in both groups, as was the spontaneous vaginal birth rate (66 per cent), report the team in BJOG: An International Journal of Obstetrics and Gynaecology.
They add: "There were no statistically significant differences in the experience of childbirth or parental stress between the randomised groups, either in women or men."
"Natural childbirth preparation including training in breathing and relaxation did not decrease the use of epidural analgesia during labour, nor did it improve the birth experience or affect parental stress in early parenthood," they conclude.
Journal editor, Professor Philip Steer, commented: "The findings of this study are contrary to what many of us would expect. The lack of benefit from psychoprophylactic techniques is disappointing, and suggests that parents’ experience of childbirth is affected more by their personality and previous psychological orientation than by the relatively limited training that is possible during pregnancy.
"An alternative view is that standard antenatal classes are ‘good enough’ and therefore represent an effective use of limited resources."
Bergstrom, M., Kieler, H. and Waldenstrom, U. Effects of natural childbirth preparation versus standard antenatal education on epidural rates, experience of childbirth and parental stress in mothers and fathers: a randomised controlled multicentre trial. BJOG 2009; DOI: 10.1111/j.1471-0528.2009.02144.x.
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