Codesign and refinement of an optimised antenatal education session to better inform women and prepare them for labour and birth

Abi Merriel; Miriam Toolan; Mary Lynch; Gemma Clayton; Andrew Demetri; Lucy Willis; Narendra Mampitiya; Alice Clarke; Katherine Birchenall; Chloe de Souza; Emma Harvey; Tamarind Russell-Webster; Eva Larkai; Mariusz Grzeda; Kate Rawling; Sonia Barnfield; Margaret Smith; Rachel Plachcinski; Christy Burden; Abigail Fraser; Michael Larkin; Anna Davies

doi:10.1136/bmjoq-2023-002731

Codesign and refinement of an optimised antenatal education session to better inform women and prepare them for labour and birth

Abi Merriel^*, Miriam Toolan, Mary Lynch, Gemma Clayton, Andrew Demetri, Lucy Willis, Narendra Mampitiya, Alice Clarke, Katherine Birchenall, Chloe de Souza, Emma Harvey, Tamarind Russell-Webster, Eva Larkai, Mariusz Grzeda, Kate Rawling, Sonia Barnfield, Margaret Smith, Rachel Plachcinski, Christy Burden, Abigail FraserMichael Larkin, Anna Davies

^*Corresponding author for this work

School of Psychology

Research output: Contribution to journal › Article › peer-review

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Abstract

Objective: Our objective was to codesign, implement, evaluate acceptability and refine an optimised antenatal education session to improve birth preparedness. Design: There were four distinct phases: codesign (focus groups and codesign workshops with parents and staff); implementation of intervention; evaluation (interviews, questionnaires, structured feedback forms) and systematic refinement. Setting: The study was set in a single maternity unit with approximately 5500 births annually. Participants: Postnatal and antenatal women/birthing people and birth partners were invited to participate in the intervention, and midwives were invited to deliver it. Both groups participated in feedback. Outcome measures: We report on whether the optimised session is deliverable, acceptable, meets the needs of women/birthing people and partners, and explain how the intervention was refined with input from parents, clinicians and researchers. Results: The codesign was undertaken by 35 women, partners and clinicians. Five midwives were trained and delivered 19 antenatal education (ACE) sessions to 142 women and 94 partners. 121 women and 33 birth partners completed the feedback questionnaire. Women/birthing people (79%) and birth partners (82%) felt more prepared after the class with most participants finding the content very helpful or helpful. Women/birthing people perceived classes were more useful and engaging than their partners. Interviews with 21 parents, a midwife focus group and a structured feedback form resulted in 38 recommended changes: 22 by parents, 5 by midwives and 11 by both. Suggested changes have been incorporated in the training resources to achieve an optimised intervention. Conclusions: Engaging stakeholders (women and staff) in codesigning an evidence-informed curriculum resulted in an antenatal class designed to improve preparedness for birth, including assisted birth, that is acceptable to women and their birthing partners, and has been refined to address feedback and is deliverable within National Health Service resource constraints. A nationally mandated antenatal education curriculum is needed to ensure parents receive high-quality antenatal education that targets birth preparedness.

Original language	English
Article number	e002731
Number of pages	12
Journal	BMJ Open Quality
Volume	13
Issue number	2
Early online date	10 Jun 2024
DOIs	https://doi.org/10.1136/bmjoq-2023-002731
Publication status	Published - 10 Jun 2024

Bibliographical note

Data Access Statement

Data are available upon reasonable request. Most data are presented in the text and supplemental material. The qualitative data are presented as quotes. Data will be available upon reasonable request and with appropriate ethical permissions.

Funding

This work was supported by a Health Foundation Innovating for Improvement award, a David Telling Award and the Elizabeth Blackwell Institute, University of Bristol, and funded in whole, or in part, by the Wellcome Trust Institutional Strategic Support Fund (grant number: 204813/Z/16/Z). For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. AM/MT/ADe were funded by the NIHR for this research project.

Funders	Funder number
National Institute for Health and Care Research
Elizabeth Blackwell Institute for Health Research, University of Bristol
Health Foundation
University of Bristol
Wellcome Trust	204813/Z/16/Z

Keywords

Healthcare quality improvement
Maternal Health Services
Obstetrics and gynecology
Patient education

Access to Document

10.1136/bmjoq-2023-002731Licence: CC BY 4.0

A Merriel et al_Codesign of optimised antenatal education session
Copyright © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/
Final published version, 1.49 MBLicence: CC BY 4.0

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Merriel, A., Toolan, M., Lynch, M., Clayton, G., Demetri, A., Willis, L., Mampitiya, N., Clarke, A., Birchenall, K., de Souza, C., Harvey, E., Russell-Webster, T., Larkai, E., Grzeda, M., Rawling, K., Barnfield, S., Smith, M., Plachcinski, R., Burden, C., ... Davies, A. (2024). Codesign and refinement of an optimised antenatal education session to better inform women and prepare them for labour and birth. BMJ Open Quality, 13(2), Article e002731. https://doi.org/10.1136/bmjoq-2023-002731

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abstract = "Objective: Our objective was to codesign, implement, evaluate acceptability and refine an optimised antenatal education session to improve birth preparedness. Design: There were four distinct phases: codesign (focus groups and codesign workshops with parents and staff); implementation of intervention; evaluation (interviews, questionnaires, structured feedback forms) and systematic refinement. Setting: The study was set in a single maternity unit with approximately 5500 births annually. Participants: Postnatal and antenatal women/birthing people and birth partners were invited to participate in the intervention, and midwives were invited to deliver it. Both groups participated in feedback. Outcome measures: We report on whether the optimised session is deliverable, acceptable, meets the needs of women/birthing people and partners, and explain how the intervention was refined with input from parents, clinicians and researchers. Results: The codesign was undertaken by 35 women, partners and clinicians. Five midwives were trained and delivered 19 antenatal education (ACE) sessions to 142 women and 94 partners. 121 women and 33 birth partners completed the feedback questionnaire. Women/birthing people (79%) and birth partners (82%) felt more prepared after the class with most participants finding the content very helpful or helpful. Women/birthing people perceived classes were more useful and engaging than their partners. Interviews with 21 parents, a midwife focus group and a structured feedback form resulted in 38 recommended changes: 22 by parents, 5 by midwives and 11 by both. Suggested changes have been incorporated in the training resources to achieve an optimised intervention. Conclusions: Engaging stakeholders (women and staff) in codesigning an evidence-informed curriculum resulted in an antenatal class designed to improve preparedness for birth, including assisted birth, that is acceptable to women and their birthing partners, and has been refined to address feedback and is deliverable within National Health Service resource constraints. A nationally mandated antenatal education curriculum is needed to ensure parents receive high-quality antenatal education that targets birth preparedness.",

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Merriel, A, Toolan, M, Lynch, M, Clayton, G, Demetri, A, Willis, L, Mampitiya, N, Clarke, A, Birchenall, K, de Souza, C, Harvey, E, Russell-Webster, T, Larkai, E, Grzeda, M, Rawling, K, Barnfield, S, Smith, M, Plachcinski, R, Burden, C, Fraser, A, Larkin, M & Davies, A 2024, 'Codesign and refinement of an optimised antenatal education session to better inform women and prepare them for labour and birth', BMJ Open Quality, vol. 13, no. 2, e002731. https://doi.org/10.1136/bmjoq-2023-002731

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T1 - Codesign and refinement of an optimised antenatal education session to better inform women and prepare them for labour and birth

AU - Merriel, Abi

AU - Toolan, Miriam

AU - Lynch, Mary

AU - Clayton, Gemma

AU - Demetri, Andrew

AU - Willis, Lucy

AU - Mampitiya, Narendra

AU - Clarke, Alice

AU - Birchenall, Katherine

AU - de Souza, Chloe

AU - Harvey, Emma

AU - Russell-Webster, Tamarind

AU - Larkai, Eva

AU - Grzeda, Mariusz

AU - Rawling, Kate

AU - Barnfield, Sonia

AU - Smith, Margaret

AU - Plachcinski, Rachel

AU - Burden, Christy

AU - Fraser, Abigail

AU - Larkin, Michael

AU - Davies, Anna

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AB - Objective: Our objective was to codesign, implement, evaluate acceptability and refine an optimised antenatal education session to improve birth preparedness. Design: There were four distinct phases: codesign (focus groups and codesign workshops with parents and staff); implementation of intervention; evaluation (interviews, questionnaires, structured feedback forms) and systematic refinement. Setting: The study was set in a single maternity unit with approximately 5500 births annually. Participants: Postnatal and antenatal women/birthing people and birth partners were invited to participate in the intervention, and midwives were invited to deliver it. Both groups participated in feedback. Outcome measures: We report on whether the optimised session is deliverable, acceptable, meets the needs of women/birthing people and partners, and explain how the intervention was refined with input from parents, clinicians and researchers. Results: The codesign was undertaken by 35 women, partners and clinicians. Five midwives were trained and delivered 19 antenatal education (ACE) sessions to 142 women and 94 partners. 121 women and 33 birth partners completed the feedback questionnaire. Women/birthing people (79%) and birth partners (82%) felt more prepared after the class with most participants finding the content very helpful or helpful. Women/birthing people perceived classes were more useful and engaging than their partners. Interviews with 21 parents, a midwife focus group and a structured feedback form resulted in 38 recommended changes: 22 by parents, 5 by midwives and 11 by both. Suggested changes have been incorporated in the training resources to achieve an optimised intervention. Conclusions: Engaging stakeholders (women and staff) in codesigning an evidence-informed curriculum resulted in an antenatal class designed to improve preparedness for birth, including assisted birth, that is acceptable to women and their birthing partners, and has been refined to address feedback and is deliverable within National Health Service resource constraints. A nationally mandated antenatal education curriculum is needed to ensure parents receive high-quality antenatal education that targets birth preparedness.

KW - Healthcare quality improvement

KW - Maternal Health Services

KW - Obstetrics and gynecology

KW - Patient education

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DO - 10.1136/bmjoq-2023-002731

M3 - Article

SN - 2399-6641

VL - 13

JO - BMJ Open Quality

JF - BMJ Open Quality

IS - 2

M1 - e002731

ER -

Codesign and refinement of an optimised antenatal education session to better inform women and prepare them for labour and birth

Abstract

Bibliographical note

Data Access Statement

Funding

Keywords

Access to Document

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