A trial childbirth program run by Western Sydney University found women who took part had fewer interventions and fewer c-section births compared with women who took a standard birth course.
The Australian research shows evidence-based antenatal education reduces unnecessary interventions and saves the Australian healthcare system almost $100 million every year.
Birth Education Reduces Interventions And Saves Money
Antenatal education, or birth classes, are fairly standard for most parents-to-be, particularly those having their first baby. They are often a pregnant couple’s first real look at birth and the possibilities ahead.
Birth classes have an important role to play in preparing parents for birth. Who offers these classes, and where they are delivered, however, can have a major impact on the kind of information delivered.
How Can A Birth Program Prevent Interventions?
There are many opinions and voices clamouring to be heard about the best way to improve the current maternity system.
More medical interventions, or fewer medical interventions? More midwives, more obstetric care, fewer home births, more tests and procedures… the list is endless. Some solutions have merit, others not so much.
Improving maternity care is vital to making sure women have the births they want, and achieve positive outcomes. But there’s something it doesn’t resolve: there is a great deal of fear about birth, and it starts long before a woman turns up in the birth room.
Women are exposed to the fear of birth in ways they’re not even aware of. It’s in the TV shows they watch, the stories they hear, and in the way birth is viewed by those we trust in the health professions.
Most women never see a birth before they give birth themselves. There’s a large gap in their knowledge of their own body’s capability. Women are taught to filter what they know and feel through ‘experts’ who have the training and experience they don’t.
But birth happens to a woman’s body. It is a physical AND emotional experience unique to her.
From the outside, birth should be a reasonably straightforward process. In an undisturbed labour, when the birthing woman feels supported and free of fear, it’s rarely otherwise.
Yet birth most commonly takes place in an environment that doesn’t support an undisturbed labour. In obstetric settings such as hospitals, a normal birth is hard to achieve – especially one which doesn’t leave a woman traumatised at the end.
Fear of the unknown is normal and healthy. But fear based on what we’re told to fear isn’t useful, and perpetuates the problem. It creates the foundation on which women are expected to give birth.
Women who are born into a culture of birth fear need support to overcome it before they give birth themselves. In the right antenatal classes, this is achievable.
Hospital-connected birth classes are far more likely to promote a fear-based birth culture than independent birth classes are. How is this possible, considering they both teach the same thing?
Hospital-based classes tend to focus on preparing women for what might go wrong during labour and birth. Independent birth classes usually focus on the innate ability of birth to unfold naturally, and how best to promote this.
The trial childbirth program study run by Western Sydney University was designed to compare the outcomes of hospital antenatal classes with the results of a 2-day antenatal program, Complementary Therapies for Labour and Birth (CTLB).
The outcomes were startling.
You can read more about it in Hospital Birth Classes Are Sabotaging Women’s Birth Plans, Say Midwives.
What becomes apparent is women and their partners who are informed about normal birth, and well prepared for it, won’t choose medical assistance as their first option for support.
How Can A Birth Program Save Money?
Saving money in a health system isn’t necessarily the first thing we think about when improving maternity care. But it’s a very tangible way to see what is working when it comes to making improvements. Normal births costs the system less.
The study’s lead author, Dr Kate Levett, conducted a cost analysis follow up study, which has been published in the BMJ Open. The team multiplied the average saving of $808 per woman by 120,000, which is the total number of women who give birth for the first time, each year.
Taking into consideration the cost of providing the childbirth education program – a mere $150 – this results in a minimum saving of $659 per woman.
The biggest cost saving was the reduction in c-sections. In the standard hospital classes, there was a c-section rate of 32.5%. compared with 18.2% in the CLBT course. The cost of a c-section is about twice that of a normal birth (with no interventions).
This is a substantial difference and could be better invested in more evidence-based childbirth programs and midwifery led models of care.
In 2015 a world-first study from the University of Sydney found caseload midwifery reduced interventions in birth and reduced costs.
These financial savings could be reinvested into the maternity system to create further positive outcomes and long term benefits for women and future childbearing generations.
Why Does This Matter?
Hospitals can continue to attract women with birth pools and home-like décor, but these cosmetic options don’t do anything about the underlying attitudes to birth, which have the greatest impact on women.
Women who give birth in fear are at the mercy of a risk avoidance model of care, which interferes with normal birth and leads to the cascade of interventions. The more this happens, the more it’s normalised and becomes what we expect from birth.
Normal physiological birth starts long before the first contraction. Good quality, evidence-based childbirth programs are key to ensuring women have access to the best knowledge available, and can approach birth in a positive and informed way.