Evaluation of Pregnancy, Delivery, and Postpartum Effectiveness of Maternity School Trainings Organized Based on the Guideline of Ministry of Health in Turkey: A Comparative Study

Sibel Mutlu, Enis Ozkaya

Abstract


Background: There are uncertainties and contradictions in the literature about the effectiveness of maternity schools. The purpose of this study is to determine the effectiveness of prenatal trainings performed in an institutional and disciplined manner. Methods: This study was prospectively conducted between 2018 and 2019, and 245 primiparous pregnant women who gave birth in our hospital were examined. On a volunteer basis, a study group (n = 108) was created including patients who attended the maternity school trainings and a control group was created including patients who did not attend these trainings (n = 137). Both groups were compared in terms of caesarean section rates, active phase periods of birth, visual analogue scale (VAS) during active labor, Edinburgh Postnatal Depression Scale (EPDS) score, time from birth to first skin contact, newborn Apgar scores, and admission rates to the neonatal intensive care unit. Results: Cesarean section rates were significantly lower in the maternity school group (21.1% versus 29.19%). In the maternity school group, the active phase period of delivery was shorter (p < 0.001), VAS was lower during active labor (p < 0.001), and EDPS score was lower (p < 0.001). Education level was higher in the maternity school group than in the control group (p < 0.001). Conclusions: Institutional and disciplined antenatal pregnancy trainings provide significant benefits during pregnancy, delivery, and postpartum period depression by especially reducing the rates of cesarean section and postpartum depression.

Keywords


Apgar score; cesarean section; Edinburgh postnatal depression scale; pregnancy; prenatal education

Full Text:

PDF

References


Yılmaz E, Gülümser C. The risk factors, consequences,

treatment, and importance of gestational depression. Turk J

Obstet Gynecol 2015;12:102‑13.

Ancel J, Rault E, Fernandez MP, Huissoud C, Savidan A,

Gaire C. When can obstetric risk be predicted? J Gynecol Obstet

Hum Reprod 2018;18:30226‑5.

Ministry of Health of Turkey Public Health Institution

Women and Reproductive Health Department. Pregnant

Information Class Educator Book 2013. Ankara: Department

of Women and Reproductive Health of Turkey Public Health

Institution; 2013. p. 2‑17

Taheri Z, Mazaheri MA, Khorsandi M, Hassanzadeh A, Amiri M.

Effect of educational intervention on self‑efficacy for choosing

delivery method among pregnant women in 2013. Int J Prev

Med 2014;5:1247–54.

Maimburg RD, Vaeth M, Durr J, Hvidman L, Olsen J.

Randomised trial of structured antenatal training sessions to

improve the birth process. BJOG 2010;8:921‑8.

Ministry of Health Prenatal Care Management Guide Circular

Available from: https://sbu.saglik.gov.tr/Ekutuphane/

kitaplar/dogumonubakim.pdf. [Last accessed on 2020 Jul 02].

Brixval CS, Axelsen SF, Lauemoller SG, Andersen SK, Due P,

Koushede V. The effect of antenatal education in small classes

on obstetric and psycho‑social outcomes‑A systematic review.

Syst Rev 2015;4:1–9.

Ministry of Health Pregnant School Circular 2019. Available

from: https://shgmsmdb.saglik.gov.tr/TR-77063/genelgeler.html.

[Last accessed on 2020 Feb 02].

Aydin N, Inandi T, Yigit A, Hodoglugil NNS. Validation of the

Turkish version of the Edinburgh Postnatal Depression Scale

among women within their first postpartum year. Soc Psychiatry

Psychiatr Epidemiol 2004;6:483‑6.

T.R. Ministry of Development and TUBITAK. Turkey

Demographic and Health Survey 2013. Available from: http://

www.hips.hacettepe.edu.tr/tnsa2013/rapor/tnsa_2013_ana_rapor.

pdf. It was published in 2014. [Last accessed on 2019 Mar].

Dursun P, Yanik FB, Zeyneloglu HB, Baser E, Kuscu E,

Ayhan A. Why women request cesarean section without medical

indication? J Matern Fetal Neonatal Med 2011;9:1133‑7.

Eskicioğlu F, Hasdemir SF, Çelik H, Koyuncu FM. The effect of

health policies on physicians taking caesarean section: Evaluation

of secondary health care institutions. Pamukkale Medical Journal

;119‑23.

Merzougui L, Marwen N, Hannachi H, Asma M, Elhaj OB,

Waddah M. Incidence and risk factors of surgical site infection

following caesarean section in a Tunisian maternity unit. Sante

Publique 2018;3:339‑47.

Pinar G, Avsar F, Aslantekin F. Evaluation of the impact

of childbirth education classes in Turkey on adaptation to

pregnancy process, concerns about birth, rate of vaginal birth,

and adaptation to maternity: A case‑control study. Clin Nurs Res

;27:315‑42.

Karabulut Ö, Coşkuner Potur D, Doğan Merih Y, Cebeci

Mutlu S, Demirci N. Does antenatal education reduce fear of

childbirth? Int Nurs Rev 2016;63:60‑7.

Soriano‑Vidal FJ, Vila‑Candel R, Soriano‑Martín PJ,

Tejedor‑Tornero A, Castro‑Sánchez E. The effect of prenatal

education classes on the birth expectations of Spanish women.

Midwifery 2018;60:41‑7.

Bergh I, Söderlund T, Vinterskog L, Martensson LB. Reliability

and validity of the Acceptance Symptom Assessment Scale in

assessing labour pain. Midwifery 2012;5:684‑8.

Ip W‑Y, Tang CS, Goggins WB. An educational intervention to

improve women’s ability to cope with childbirth. J Clin Nurs

;15:2125‑35.

Mergen H, Ongel K. Factors associated with depression among

Turkish faculty of education freshmen by beck depression

inventory‑II‑Turkish. Zdravniski Vestnik 2009;10:548‑54.

Altuntuğ K, Ege E. The effect of health education on the readiness of mothers for discharge, postpartum difficulties, life

and quality of life. Nursing Research and Development Journal

;2:45‑56.

Barlow J, Smailagic N, Huband N, Roloff V, Bennett C.

Group‑based parent training programmes for improving

parental psychosocial health. Cochrane Database Syst Rev

;17:CD002020. doi: 10.1002/14651858.CD002020.pub3.

Ortiz Collado MA, Saez M, Favrod J, Hatem M. Antenatal

psychosomatic programming to reduce postpartum depression

risk and improve childbirth outcomes: A randomized controlled

trial in Spain and France. BMC Pregnancy Childbirth

;14:22.

Lederman SA. The effect of pregnancy weight gain on later

obesity. Obstet Gynecol 1993;82:148–55.

Goldstein RF, Abell SK, Ranasinha S, Misso M, Boyle JA,

Black MH. Association of gestational weight gain with maternal

and infant outcomes: A systematic review and meta‑analysis.

JAMA 2017;21:2207‑25.