Antenatal education incorporating complementary medicine techniques to reduce birth interventions: A randomised control trial

Background
A previous randomised controlled trial at two Sydney, Australian hospitals found that a novel antenatal education program of integrative complementary therapies significantly reduced rates of interventions for low risk primiparous women.

Aim
This study aimed to: (i) replicate the program in a different state and recruit from a more diverse group of women, and (ii) provide further evidence of generalisability of the program as part of a meta-analysis.

Methods
Low to moderate risk women were randomised to either standard hospital antenatal classes at 24-36 weeks’ gestation or to the intervention group of complementary therapy education workshops in conjunction with standard care. Outcomes included psychological measures as assessed by validated scales, and birth interventions including epidural and caesarean. Outcomes were analysed by intention-to-treat.

Results
In total, 178 primiparous women were randomised (n=88 intervention group, n=90 Standard care), Pre-existing medical conditions and demographic characteristics were similar in both groups. No statistical differences were found between groups for birth interventions, though women in the intervention group were less likely to use an epidural (47.7% vs 56.7%) and more likely to experience a vaginal birth (52.3% vs 42.2%) than women who received standard care alone. Attitude to childbirth scores were statistically significantly higher for women who attended the intervention as compared to standard care (59.1 vs 54.3 p0.001). This was also reflected in higher Labour Agentry scores demonstrating women in the intervention group felt an increased sense of coping and control during labour and birth.

Conclusions
Findings from this study contribute to a larger prospective meta-analysis design to determine if the educational intervention reaches statistical significance for reduced operative birth.