The Role of Childbirth Education in Increasing a Woman’s Confidence to cope with labor and birth

conducted by Dr. Ruth Haikin

Background and Significance of the Study

A woman’s confidence to cope with labor and birth has a significant impact on her satisfaction with childbirth experience and her subsequent well-being. Studies have found that the greater the woman’s confidence in her abilities to cope with the labor process, the lower her fears and anxiety of childbirth. Therefore, the purpose of this study was to examine what role childbirth education plays in strengthening a woman’s confidence to cope with labor and in decreasing childbirth anxiety.   


An observational study was conducted on 70 nulliparous women who participated in childbirth preparation classes between 30 and 37 weeks of their pregnancies. The levels of a woman’s confidence and anxiety were measured before and after attending childbirth preparation classes using Lowe’s Childbirth Self-Efficacy Inventory and Spilberger’s State-Trait Anxiety Inventory. The study also included a control group of 32 women who did not attend any childbirth preparation classes. These women completed the same questionnaires while waiting for routine physician examinations at the end of their pregnancies.     


After attending childbirth preparation classes, the level of women’s confidence to cope with labor increased but non-significantly (p>.05). However, childbirth preparation classes resulted in a significant decrease in anxiety (p<.05). Furthermore, there was a strong negative relationship between the levels of women’s confidence and anxiety (p <.05).  Surprisingly, the levels of anxiety and confidence of women who did not attend any childbirth preparation classes were similar to those who did (p>.05).         


The study results indicate that childbirth education does not impact on women’s confidence but seems to decrease their anxiety. This finding supports the view that childbirth education continues to focus mainly on providing women with knowledge and information about childbirth, and not with the skills to give birth in the current highly medicalized maternity care system. The study results suggest examining the content delivered and the methods employed in childbirth education and adjust as needed. Further research should be conducted to identify strategies used by women who do not attend childbirth preparation classes to cope with the labor process and to apply these strategies to other populations