By Vishwadha Chander

(Reuters Health) – First-time mothers who take childbirth classes are more likely to have normal deliveries without interventions, a small study suggests.

The study compared more than 300 women who gave birth to a first child at an Israeli medical center. Researchers found that those who took a series of classes on the experience of childbirth, pain management and postpartum issues were more likely to have normal vaginal deliveries and less likely to have vacuum extraction used during their delivery.

“We didn’t know the impact childbirth classes (have) on delivery outcomes in low-risk, first-time pregnant women,” lead study author Dr. Ohad Gluck, of the Edith Wolfson Medical Center in Holon, Israel, told Reuters Health in an email.

Past research has found that among women with severe fear or anxiety about childbirth, classes designed to prepare mothers for delivery and motherhood are associated with lower rates of cesarean delivery, better chances of breastfeeding and lower risk of postpartum depression, the study team notes in the International Journal of Gynecology and Obstetrics.

To see if childbirth classes also help women with healthy pregnancies and no excessive anxiety, Gluck and colleagues reviewed the medical records of 318 first-time mothers who had full-term deliveries from 2014 through 2017, including 159 who participated in the childbirth course.

The course, consisting of two 3-hour sessions conducted after the 30th week of gestation, is aimed at the mother and her partner. It’s taught by a certified hospital midwife and held in small groups of seven or fewer couples, the study authors write. The classes include lectures, video instruction and demonstration, practice sessions and tours of the labor and maternity wards.

The authors compared the women who took the classes with 159 other first-time mothers, matched to the study group by the babies’ gestational age and weight, who delivered at the same medical center but had not attended any childbirth class.

In their analysis, the authors took into account factors that could influence the women’s childbirth experiences, including their age, weight, pregnancy complications, education level and socioeconomic status.

Nearly 81% of the women who attended classes had normal vaginal deliveries, versus 59% of women in the comparison group. In addition, only 12 women who took the classes needed an intervention during delivery, such as a vacuum extraction, compared with 36 women who didn’t take the classes.

Rates of cesarean delivery were similar in the two groups.

Women who took the classes tended to have higher education levels and income, the authors note. This could indicate that women who are more well-off are more aware of the availability of childbirth classes, they write, and the findings should encourage healthcare providers to improve the availability of childbirth courses for a wider range of mothers.

Dr. Brenna Hughes, division chief of maternal-fetal medicine at Duke University in Durham, North Carolina, also noted the higher socioeconomic status of women who took the classes and said it could mean those women may have had less stress, “like not having to work two jobs to make ends meet.”

There may not be enough information in the current study to generalize the findings to other parts of the world, including the United States, added Hughes, who wasn’t involved in the research.

Still, the benefits of childbirth classes can extend after delivery, said Ruth Zielinski, a clinical associate professor and midwifery graduate program lead at the University of Michigan School of Nursing, in Ann Arbor.

“Education can be divided into prenatal, which covers nutrition, exercise and warning signs; childbirth, which deals with labor management; and postpartum, which includes breastfeeding, post-delivery mood and so on,” Zielinski, who was not involved in the current study, told Reuters Health in an email.

“These classes often educate women on breast-feeding, postpartum blues and risks of depression, so they know what to watch out for and whom to contact for help,” Hughes said.

SOURCE: International Journal of Gynecology and Obstetrics, online January 7, 2020.