Childbirth Education Class and Birth Plans Are Associated with a Vaginal Delivery

被引:47
作者
Afshar, Yalda [1 ]
Wang, Erica T. [2 ]
Mei, Jenny [3 ]
Esakoff, Tania F. [4 ]
Pisarska, Margareta D. [2 ,5 ,6 ]
Gregory, Kimberly D. [6 ,7 ]
机构
[1] Univ Calif Los Angeles, Dept Obstet & Gynecol, 10833 Le Conte Ave,Room 27-139 CHS, Los Angeles, CA 90095 USA
[2] Cedars Sinai Med Ctr, Dept Obstet & Gynecol, Div Reprod Endocrinol & Infertil, Los Angeles, CA 90048 USA
[3] Univ Calif Los Angeles, Los Angeles, CA 90095 USA
[4] Cedars Sinai Med Ctr, Dept Obstet & Gynecol, Div Maternal Fetal Med, Los Angeles, CA 90048 USA
[5] Cedars Sinai Med Ctr, Div Reprod Endocrinol & Infertil, Los Angeles, CA 90048 USA
[6] Cedars Sinai Med Ctr, Dept Obstet & Gynecol, Los Angeles, CA 90048 USA
[7] Cedars Sinai Med Ctr, Div Maternal Fetal Med, Los Angeles, CA 90048 USA
来源
BIRTH-ISSUES IN PERINATAL CARE | 2017年 / 44卷 / 01期
关键词
birth plan; birth preference; childbirth education; choice behavior; mode of delivery; CESAREAN DELIVERY; WOMEN;
D O I
10.1111/birt.12263
中图分类号
R47 [护理学];
学科分类号
1011 ;
摘要
Background: To determine whether the mode of delivery was different between women who attended childbirth education (CBE) class, had a birth plan, or both compared with those who did not attend CBE class or have a birth planp Methods: This is a retrospective cross-sectional study of women who delivered singleton gestations > 24weeks at our institution between August 2011 and June 2014. Based on a self-report at the time of admission for labor, women were stratified into four categories: those who attended a CBE class, those with a birth plan, both, and those with neither CBE or birth plan. The primary outcome was the mode of delivery. Multivariate logistic regression analyses adjusting for clinical covariates were performed. Results: In this study, 14,630 deliveries met the inclusion criteria: 31.9 percent of the women attended CBE class, 12.0 percent had a birth plan, and 8.8 percent had both. Women who attended CBE or had a birth plan were older (p < 0.001), more likely to be nulliparous (p < 0.001), had a lower body mass index (p < 0.001), and were less likely to be African-American (p < 0.001). After adjusting for significant covariates, women who participated in either option or both had higher odds of a vaginal delivery (CBE: OR 1.26 [95% CI 1.15-1.39]; birth plan: OR 1.98 [95% CI 1.56-2.51]; and both: OR 1.69 [95% CI 1.46-1.95]) compared with controls. Conclusion: Attending CBE class and/or having a birth plan were associated with a vaginal delivery. These findings suggest that patient education and birth preparation may influence the mode of delivery. CBE and birth plans could be used as quality improvement tools to potentially decrease cesarean rates.
引用
收藏
页码:29 / 34
页数:6
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