A generous midwife and group of expectant parents recently allowed me to teach their antenatal class as part of a university assignment. It was an eye-opening privilege.
I was determined not to lecture, and challenged myself to fit an interactive learning session into the allotted time. The process stimulated valuable reflection surrounding both personal and wider improvement of antenatal education (ANE).
Midwifery 2020 (2010) states that the midwife should be the lead professional for all women with straightforward pregnancies, and the coordinator of care for women with complex pregnancies. Good antenatal care is foundational for good pregnancy and birth experiences (Healthcare Commission, 2008). ANE as a component of antenatal care is an important source of information and support for expectant parents (National Perinatal Epidemiology Unit, 2010). The NMC (2009) therefore specifies that prior to registration, midwives must be able to share clear, meaningful and accurate information, in a balanced and easily understood manner, while reducing barriers to effective communication and understanding. As I am inexperienced in delivering ANE, meeting these NMC expectations while skilfully teaching felt like an elusive ideal.
A recent review, undertaken to ascertain expectant parents’ views on ANE, concluded midwives are viewed as inadequately prepared ‘reluctant providers’ of ANE (Barlow et al, 2009). It recognised that confidence, skills in delivery, methods and materials required some improvement.
Supporting midwives to achieve these improvements is essential for the delivery of effective ANE (Barlow et al, 2009). Wiener and Rogers (2008) suggested that group facilitation training should form an integral part of midwifery education. I concur with this suggestion and feel that group facilitation training would have increased my preparedness for delivering this session.
While it is perhaps unrealistic to expect all midwives to be trained in group facilitation, an expert group is developing resources that look promising in terms of enabling midwives to provide a facilitative approach towards ANE. Entitled
Preparation for birth and beyond: a resource pack for leaders of community groups and activities (PBB), the group has produced a handbook for practitioners running community antenatal groups (Gore et al, 2011).
This new framework suggests content for ANE divided into six overarching themes, with a focus on the transition to and preparation for parenthood. The framework acknowledges expectant parents bring with them existing knowledge and encourages them to choose the topics that would be useful to them.
Personal experience led me to consider the possibility that midwives’ reluctance to engage with ANE may stem from the suspicion that the type of service expectant parents want isn’t easily achieved within the current ANE framework. As a student midwife considering how to develop my confidence and lessen the hesitation that often accompanies learning a new skill, embracing the exciting PBB framework might help achieve this goal.
References
Barlow J, Coe C, Redshaw M, Underdown A. (2009)
Birth and beyond: stakeholder perceptions of current antenatal education provision in England. HMSO: London. See:
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_109833 (accessed 14 November 2011).
Healthcare Commission. (2008)
Towards better births – a review of maternity services in England. Healthcare Commission: London.
Gore S, Newburn M, Garrod D et al (2011) A new approach for antenatal education: preparing for pregnancy, birth and beyond.
New Digest 53: 10-1. See:
http://www.nct.org.uk/sites/default/files/related_documents/Gore%20A%20new%20approach%20for%20antenatal%20education%20(10-11).pdf (accessed 14 November 2011).
Midwifery 2020. (2010)
Midwifery 2020: delivering expectations. HMSO: London. See:
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_119261 (accessed 14 November 2011).
Redshaw M, Heikkila K. (2010)
Delivered with care: a national survey of women’s experiences of maternity care 2010. National Perinatal Epidemiology Unit: Oxford. See:
https://www.npeu.ox.ac.uk/files/downloads/reports/Maternity-Survey-Report-2010.pdf (accessed 14 November 2011).
NMC. (2009)
Standards for pre-registration midwifery education. NMC: London.
Wiener A, Rogers C. (2008) Antenatal classes: women can’t think beyond labour.
British Journal of Midwifery 16(2): 121-4.
