Antenatal education: why is it important?

The pregnancy and perinatal period is one of immense change for a woman as she gets to grips with becoming a mother, both physically and emotionally. In many regards, particularly for first-time mothers, pregnancy is a threshold which separates the known world from one that will be radically different. In this context, emotional balance is likely to be disturbed readily and substantially. Antenatal classes provide a safe space for women to explore this change and empower themselves with knowledge and confidence, while reflecting in an informed manner on the change that awaits them. As will be elucidated here, this provision of balance is achieved through the careful consideration of and respect for the relevant social, hormonal and bonding factors, as well as each mother’s own belief structures and anxieties.

A big consideration when thinking about a woman’s changing emotional state while pregnant is that of her adaptation to her new role, either as a first-time mother or when changing the family dynamic to include more children. Both parents are understandably nervous about that which they don’t yet know and this can cause extreme challenges within the family unit and for the parent’s mental health. Cowan and Cowan argue that there is a “conspiracy of silence[1]” around the pregnancy and newborn period that can make parents feel that they’re the only ones that are struggling. One only needs to take a quick glance at the multitude of mother forums online to see a glut of ‘am I the only one…’ and ‘is this normal…’ postings by mothers who suffer from a lack of support around them. One of the big reasons that women seek out antenatal classes is to make friends with other like-minded people in a similar situation to them, and a key role for the antenatal teacher is to help facilitate friendships within the groups they teach. Having a support network of people going through similar experiences will help de-mystify their journey and ease many worries of each woman.

Classes where a woman can take some time to focus and centre herself will be beneficial to those who are dealing with pregnancy difficulties bigger than those ‘normal’ feelings and worries. Helping mothers to use techniques to have control of their own labour can help to counteract the negative impacts of health concerns that the mother may have about her own body or that of the baby. Antenatal classes help to empower women to make genuine change over their pregnancy and to benefit from the confidence this gives them. Antenatal teachers help a woman take charge of her body, filling her with self-belief by empowering her with knowledge and therefore control of her pregnancy and birth, the definition of antenatal classes according to Dick-Read who champion antenatal education to remove anxiety and dread, inhibiting fear and replacing it with confidence and increase normal labours and pregnancies[2].

There have been studies which link the level of a mother’s bonding with her child after birth to the amount of engagement with her pregnancy and the thoughts she has around it and what the baby will be like once born[3]. Benoit, Parker and Zeanah[4] linked this to the security of attachment the baby has to its parents in the first year of life. Antenatal classes encourage the mother to focus on her baby, creating a peaceful bond between them and soothing anxieties that they may not develop a strong bond. Antenatal teachers aim to anchor these bonding moments through techniques used in pregnancy which baby will recognise and be soothed by once born. Classes are spaces within which mothers can reflect on their pregnancy and learn to prepare for the future; this has substantial benefits for her emotional balance.

It is not unusual for a pregnant woman to experience feelings of stress, anxiety or depression; often this is from the usual worries and concerns a woman has when embarking on a pregnancy as seen previously, and it is important that we encourage women to let these worries go. Creating balance and harmony in her mind has a knock-on effect on her body; there are a number of studies which show various physical responses to anxiety and stress hormones in the pregnant body including reducing oxygen and calorie intake to the baby, maternal cortisol crossing the placenta and restricting foetal brain growth, growth delays, reduced levels of serotonin, reduced ‘quiet and active alert states’ when born and increased risk of hyperactivity in the long-term[7]. As Gaskin alludes to, when the mind is steadied the body can open for birth[8] and it is our aim to equip each mother with the tools to help balance her mind as well as her body.

[1] Cowan, C.P.P. and Cowan, P.A. (1993) When partners become parents: The big life change for couples. New York: Basic Books.

[2] Grantly, D.-R. (2006) Childbirth without fear the principles and practice of natural childbirth. London: Pollinger in Print, United Kingdom.

[3] http://www.refuge.org.uk/get-help-now/what-is-domestic-violence/domestic-violence-and-pregnancy/

[4] Dex, S and Joshi, H (2005) Children of the 21st Century: From Birth to Nine Months. Bristol: Policy Press

[5] Stern D (1985) The Interpersonal World of the Infant. London: Karnac Books

[6] Benoit D, Parker K and Zeanah C (1997) Mother’s representations of their infants assessed pre-natally: Stability and association with infants’ attachment classifications. Journal of Child Psychology, Psychiatry, and Allied Disciplines

[7] https://www.rc.org.uk/sites/default/files/Emotional%Wellbeng_Guide_WEB.pdf

[8] Gaskin, I.M. (2003) Ina May’s guide to childbirth. New York: Random House Publishing Group.

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