Powys Teaching Local Health Board
Directorate: Women’s and Children’s
Author: Lewis, Owen, Davies, Revell / Title: Guideline for antenatal education
Code: to be completed by Q&S Unit if new policy

GUIDELINE FOR ANTENATAL PARENT EDUCATION

Policy Code / Date / Version Number / Planned Review Date
Jan 2012 / 1st Issue / Jan 2015
Document Owner / Approved By / Date
Women’s and Children’s Directorate / Women’s and Children’s Directorate
Clinical Effectiveness / 29/03/2012
16/04/2012
Document Type / Guidelines

Bwrdd Iechyd Addysgu Powys yw enw gweithredol Bwrdd Iechyd Lleol Addysgu Powys

Powys Teaching Health Board id the operational name of Powys Teaching Local Health Board

GUIDELINE FOR ANTENATAL PARENT EDUCATION

Contents / Page
Validation Form / 3
Equality Assessment / 4
Relevant to / 5
Purpose / 5
Definitions / 5
Responsibilities / 5
Process / 5
References / 5
Appendices

For Reviewed / Updated Policies Only:

Relevant Changes – / Date

VALIDATION & RATIFICATION

Title: Antenatal Parent Education Guideline
Authors: Marie Lewis Practice Development Midwife, Donna Owen – Lead Midwife North Powys, Dawn Davies Lead Midwife South Powys, Denise Revell Integrated Midwife
Directorate: Women and Children’s
Approved for submission by: Cate Langley Date: 14/02/12
Evidence Base
Are there national guidelines, policies, legislation or standards relating to this subject area?
If yes, please include below:
DOH (2007) b: The Pregnancy Book. Department of Health. London
Welsh Government (2010): Delivering Expectations. Midwifery 2020available at
National Institute of Clinical Excellence (2008): Antenatal Care-routine care for the healthy pregnant woman 3.3 p58. NICE, London
If No, please provide information on the evidence/expert opinion upon which the policy has been based.
CONSULTATION
Please list the groups, specialists or individuals involved in the development & consultation process:
Name / Date
Powys Midwives / 26.2.2012
Supervisor of Midwives / 26.2.2012
Practice Development Midwife / 26.2.2012
Agreed by Women’s and Children’s Directorate / 26.2.2012
Agreed by Head of Midwifery / 26.2.2012
Please insert the name of the Directorate/ Departmental/Discipline Committee or Group that has approved this policy/procedure/guidelines/protocol
Name / Date
Women’s and Children’s Directorate / 29/03/12
Clinical Effectiveness / 16/04/12
Implications
Please state any training implications as a result of implementing the policy / procedure: . None
Please state any resource implications associated with the implementation.
No Additional Resources required
Please state any other implications which may arise from the implementation of this policy/procedure: none
For Completion by Quality & Safety Unit
Checked by: / Date:
Submitted to CEC: / Date:

Equality Assessment Statement

Equality statement
No impact / Adverse / Differential / Positive / Comments
Age / X
Disability / X
Gender / X / Woman focused midwifery policy
Race / X
Religion/ Belief / x
Sexual Orientation / X
Welsh Language / X
Human Rights / X

Please complete the following table to state whether the following groups will be adversely, positively, differentially affected by the policy or that the policy will have no affect at all.

Risk Assessment

Are there any new or additional risks arising from the implementation of this policy?
None
Do you believe that they are adequately controlled?N/A.

Relevant to:

Local guideline for all midwives working in Powys.

Purpose:

The overall aim is to provide appropriate and up to date information to assist women and their families to make informed decisions about the transition from pregnancy to parenthood.

Responsibilities

All midwives working within Powys tHB hold a recognised midwifery qualification. No additional qualifications are required to carry out this guideline. Professional development in relation to this guideline will be on an individualised basis as required.

Monitoring

This policy will be monitored through clinical midwifery supervision, issues raised through training days and the Datix reporting system.

Process: GUIDELINE FOR ANTENATAL PARENT EDUCATION

Introduction

Antenatal classes have traditionally been one of the main sources of preparation for parenthood, and are intended to ‘influence health behaviour; build women's confidence in their ability to give birth; prepare women and their partners for childbirth; prepare for parenthood; develop social support networks; promote confident parents; and contribute to reducing perinatal morbidity and mortality’ (Gagnon and Sandall, 2009). There is increasing consensus that the role of antenatal education should encompass the transition to parenthood, and that current antenatal provision is not adequately addressing the needs of women and their partners in terms of access, contact time, timing, and content (Scrader McMillen et al 2009). A recent review carried out by the University of Warwick for the Department of Health (Schrader McMillen et al 2009) found that antenatal education provision to be variable and patchy, with the uptake from disadvantaged families being low. Many of the factors associated with inequalities are present in pregnancy and infancy, so tailored and targeted parenting programmes can contribute to reducing inequalities (Billingham 2011). Pregnant women should be offered opportunities to attend participant-led antenatal education, including breastfeeding workshops, and the information given should be easily understood by all women, including women with additional needs, learning difficulties and women who do not speak English (NICE 2008). Although there is little evidence that attending antenatal classes affects any birth outcome such as mode of birth or analgesia used, there is evidence that the woman’s experience of birth and parenting may be improved by attending client-led classes (NICE 2008)

Powys Maternity Services have adopted a four pronged approach to Parentcraft Education:

One to one Individualised education for all women:

  • Named midwife will as part of routine antenatal care provide all the essential information that a woman requires in order to prepare herself for birth and parenthood
  • Aimed at ensuring education given to women is specific to their needs and delivered in an appropriate way for them as an individual
  • Provided to all women who are accessing midwifery care without exception

Community based groups [e.g.Bumps to Babies]:

  • Midwife to attend and provide flexible education sessions within locally run established groups such as ‘Bumps to Babies’ often supported by Action for Children
  • Aimed at pregnant women and new parents (often until child reaches approx 1 yr old)
  • Multi-agency approach (often including midwives and health visitors)
  • Encourages healthy pregnancy, preparation for parenthood, child development and parenting skills
  • Encourages ongoing social networking and support beyond the timeframe of pregnancy
  • Participation in specific community groups may allow parent education to reach some of the more vulnerable groups – teenage parents groups etc.

Roadshows:

  • Rotate throughout Powys during the year
  • Multi-agency Partnership events
  • Active involvement from midwives
  • Local information available to families about local pregnancy and parenthood provision and support available within the area.
  • Aim to give ‘taster sessions’ for antenatal and postnatal parents
  • Involve community groups and third sector organisationse.g. Credit Unions, TWF, BIBS

Active Birth Workshops:

  • Facilitated by midwives within Powys Birth Centres
  • Should be client led
  • Aim to facilitate a woman’s preparation for labour and birth
  • Promote normality
  • Promote Powys Birth centre’s as an appropriate environment for low risk women to birth

Midwives should use their advocacy role for improving the health and wellbeing of women, and are ideally placed to deliver public health messages and facilitate access to parenting programmes (Midwifery 2020). Women should be allowed sufficient time at antenatal appointments to discuss any concerns regarding pregnancy, preparation for labour and birth, and the transition to parenthood (NICE 2008). Midwives should also be actively involved in promoting parent education to all women, whether in a group or on a one to one basis.

Actions:

Specific guidance for one to one parent education incorporated within routine midwifery care

Booking:

  • Offer general advice about healthy lifestyle during pregnancy
  • Ensure women are given The Pregnancy Book (DOH 2007) which can be used at future appointments to discuss fetal development, employment rights, benefits, preparation for labour etc.
  • Discuss Powys’ four pronged approach for parent education and ensure women are aware of when it is likely they will be invited to Road shows,community groups and active birth workshops.
  • Discuss availability of local multiagency groups and ensure women are aware of times and place of meetings.
  • Identify women’s information requirements and priorities for future antenatal education and how these will be met
  • Identify women with additional needs and offer further multiagency support as required e.g. Action for Children, Barnardos

25/28 Weeks:

  • Ensure women are given Breastfeeding DVD (discuss at next appointment)
  • Give invite/dates for next available Parent education road show/ workshops
  • Continue to offer one to one support and healthy lifestyle advice for individual requirements

36 Weeks:

  • Undertake birth plan visit at home
  • Discuss preparations for labour and birth, including pain relief, active birth, and document woman and partner’s wishes in hand held records
  • Ensure that the woman has had opportunity to receive antenatal education including attendance at active birth workshop, community groups and road shows as individually preferred
  • Discuss availability of Postnatal support groups e.g. BIBS, Bumps to Babies
  • Continue to offer one to one support and healthy lifestyle advice as required

Postnatally

  • Continue one to one support especially around breastfeeding and infant care
  • Discuss and support transition to parenthood
  • Provide information on issues that may impact on a future pregnancy, healthy lifestyles, follow up care, preparation for pregnancy
  • Advise women of times/venues of Peer Support Groups e.g. BIBS, Bumps to Babies

References:

Billingham K (2011): New Approaches for Preparing for Parenthood. MIDIRS Essence full article available at:

DOH (2007) b:The Pregnancy Book. Department of Health. London

Gagnon AJ, Sandall S (2009): Individual or group antenatal education for childbirth or parenthood, or both. Cochrane Collaboration, Issue 1. p4

Welsh Government (2010): Delivering Expectations. Midwifery 2020available at

National Institute of Clinical Excellence (2008): Antenatal Care-routine care for the healthy pregnant woman 3.3 p58. NICE, London

Schrader McMillen et al (2009): Birth and Beyond-A review of the evidence about antenatal education. University of Warwick

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Issue Date: 2012
Status: Final / Page 1 of 9 / Review Date: 2015
Approved by: Clinical Effectiveness 16/04/12