Influence of Integrating Childbirth Preparation Program on Birth Outcomes among Pregnant Women in Western Kenya

Abstract

Childbirth education and preparation has been fronted as key element in enhancing maternal and neonatal health and preventing some adverse outcomes. There is paucity of literature in Kenyan setting linking maternal childbirth education and maternal and neonatal outcomes. The study aimed to assess the effect of an educational intervention in childbirth and its influence on maternal and neonatal outcomes among expectant women in western Kenya. A Quasi-experimental design was utilised. The health facilities were selected by simple random sampling. Expectant women were enrolled at antenatal care services and allocated to either the control group or the intervention group. Those in the intervention group went through 2 hourly sessions of childbirth preparation teaching twice in the course of the 32nd–35th weeks of gestation.  Investigation and assessment on specific maternal and neonatal outcomes was done within 48 hours following delivery. Chi-square and independent t tests were used to determine the statistical difference. More mothers in the control experienced prolonged labour 12% compared to 2.2% in the intervention (P<0.001). Progression failure was high in the control 8.9% compared to 1.1% in the intervention (P=0.001). The control had more cases of augmentation   11% compared to 2.7% in the intervention (P=0.004).  Higher APGAR scores were recorded in the intervention group at 1 and 5 minutes compared to the control (P<0.001).  Few cases of birth asphyxia were in the intervention 1.6% compared to 5.8% in the control (P<0.001). The intervention program aimed at enhancing childbirth knowledge and improving   self- efficacy offered prior to birth was successful in reducing adverse birth outcomes in mothers and their neonates in the intervention group. A  program aimed at  enhancing women’s’ self- efficacy and improving their knowledge on childbirth  should be  structured and incorporated in the routine antenatal care to reduce some  adverse maternal and neonatal health outcomes associated with fear anxiety and uncertainty related to inadequate childbirth knowledge.