Opportunities to improve maternal health literacy through antenatal education: an exploratory study

This paper examines the concept of maternal health literacy, defined as the cognitive and social skills that determine the motivation and ability of women to gain access to, understand, and use information in ways that promote and maintain their health and that of their children. Specifically, it investigates the feasibility of using the concept of health literacy to guide the content and process of antenatal classes. The paper reports on the results of focus groups and interviews conducted with a range of health care providers, pregnant women and new mothers to obtain different perspectives on the issues surrounding antenatal education and parenting. The results give us a realistic look at what women are learning from existing antenatal education and how it can be improved. Comparing the results from the educators and the women, the same basic issues surface. Both recognize that there are serious time limitations in antenatal classes. These limitations, combined with natural anxiety and curiousity about childbirth, generally ensure that the content of classes is confined to pregnancy and childbirth. The limitations of time are also cited as a reason for the teaching methods being heavily weighted towards the transfer of factual information, as distinct from the development of decision-making skills, and practical skills for childbirth and parenting The results indicate clearly that antenatal classes cannot possibly cover all there is to know about pregnancy, childbirth and parenting. If the purpose of antenatal classes is to improve maternal health literacy, then women need to leave a class with the skills and confidence to take a range of actions that contribute to a successful pregnancy, childbirth and early parenting. This includes knowing where to go for further information, and the ability to analyse information critically. The authors conclude that this would represent a very challenging change in orientation for both the educators and pregnant women included in this study. Work continues on the development of the tools that will be needed to support this change.