Association of Delivery Outcomes With the Number of Childbirth Education Sessions.
Jennifer Vanderlaan, Christen Sadler, Kristen Kjerulff
PMID 34330134WHAT IT FOUND
Overall cesarean delivery was not associated with childbirth education sessions.
Three or more sessions were linked to higher shared decision-making and lower planned cesarean birth, a secondary outcome.
Key findings
01Attending any childbirth education was not associated with overall cesarean delivery, but it was associated with reduced planned cesarean delivery, a secondary outcome.
02Attending three or more childbirth education sessions was associated with reduced planned cesarean delivery (approximated risk ratio 0.74) and increased shared decision-making (approximated risk ratio 1.20).
03Any childbirth education was associated with reduced pain medication during labor and reduced epidural use (both approximated risk ratio 0.94), but increased opioid use (approximated risk ratio 1.22).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was an observational analysis of associations, not a randomized trial. The study compared number of sessions but did not measure course content, educator training, or session length. The data came from Pennsylvania between 2009 and 2011, and the paper says participation rates should not be generalized to current participation. The sample was mostly non-Hispanic white, a group with the highest rate of non-medically indicated induction. Participants were restricted to those who answered the childbirth education question and delivered at or after 37 weeks. Shared decision-making scores were highly skewed and dichotomized. The study did not control for intention to use medication during labor.
The easy way to misread this
Do not conclude that adding childbirth education sessions causes fewer cesarean births or better decision-making. The study is an observational analysis of associations, did not measure course content, and overall cesarean delivery was not associated with childbirth education.