The AEDUCATE Collaboration. Comprehensive antenatal education birth preparation programmes to reduce the rates of caesarean section in nulliparous women. Protocol for an individual participant data prospective meta-analysis

doi:10.1136/bmjopen-2020-037175

. 2020 Sep 23;10(9):e037175.

doi: 10.1136/bmjopen-2020-037175.

The AEDUCATE Collaboration. Comprehensive antenatal education birth preparation programmes to reduce the rates of caesarean section in nulliparous women. Protocol for an individual participant data prospective meta-analysis

Kate M Levett^{1

2}, Sarah J Lord^{3

4}, Hannah G Dahlen⁵, Caroline A Smith^{2

6}, Federico Girosi^{7

8}, Soo Downe⁹, Kenneth William Finlayson⁹, Julie Fleet¹⁰, Mary Steen¹⁰, Mary-Ann Davey¹¹, Elizabeth Newnham¹², Anette Werner¹³, Leslie Arnott¹⁴, Kerry Sutcliffe³, Anna Lene Seidler¹⁵, Kylie Elizabeth Hunter¹⁵, Lisa Askie¹⁵

Affiliations

¹ School of Medicine Sydney, University of Notre Dame Australia, Darlinghurst, New South Wales, Australia kate.levett@nd.edu.au.
² NICM Health Research Institute, University of Western Sydney, Penrith South, New South Wales, Australia.
³ School of Medicine Sydney, University of Notre Dame Australia, Darlinghurst, New South Wales, Australia.
⁴ NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia.
⁵ School of Nursing and Midwifery, University of Western Sydney, Parramatta, New South Wales, Australia.
⁶ Graduate Research School, University of Western Sydney, Kingswood, New South Wales, Australia.
⁷ Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia.
⁸ Capital Markets CRC, New South Wales, Australia, Sydney, New South Wales, Australia.
⁹ School of Midwifery and Community Health, University of Central Lancashire, Preston, Lancashire, UK.
¹⁰ School of Nursing and Midwifery, University of South Australia, Adelaide, South Australia, Australia.
¹¹ Obstetrics & Gynaecology, Monash Health, Monash University Central Clinical School, Melbourne, Victoria, Australia.
¹² School of Nursing & Midwifery, Griffith University, Medowbrook, Queensland, Australia.
¹³ Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
¹⁴ The B.E.A.R. Program, Lamaze Australia, Melbourne, Victoria, Australia.
¹⁵ NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, New South Wales, Australia.

PMID: 32967876
PMCID: PMC7513601
DOI: 10.1136/bmjopen-2020-037175

The AEDUCATE Collaboration. Comprehensive antenatal education birth preparation programmes to reduce the rates of caesarean section in nulliparous women. Protocol for an individual participant data prospective meta-analysis

Kate M Levett et al. BMJ Open. 2020.

. 2020 Sep 23;10(9):e037175.

doi: 10.1136/bmjopen-2020-037175.

Authors

Affiliations

¹ School of Medicine Sydney, University of Notre Dame Australia, Darlinghurst, New South Wales, Australia kate.levett@nd.edu.au.
² NICM Health Research Institute, University of Western Sydney, Penrith South, New South Wales, Australia.
³ School of Medicine Sydney, University of Notre Dame Australia, Darlinghurst, New South Wales, Australia.
⁴ NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia.
⁵ School of Nursing and Midwifery, University of Western Sydney, Parramatta, New South Wales, Australia.
⁶ Graduate Research School, University of Western Sydney, Kingswood, New South Wales, Australia.
⁷ Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia.
⁸ Capital Markets CRC, New South Wales, Australia, Sydney, New South Wales, Australia.
⁹ School of Midwifery and Community Health, University of Central Lancashire, Preston, Lancashire, UK.
¹⁰ School of Nursing and Midwifery, University of South Australia, Adelaide, South Australia, Australia.
¹¹ Obstetrics & Gynaecology, Monash Health, Monash University Central Clinical School, Melbourne, Victoria, Australia.
¹² School of Nursing & Midwifery, Griffith University, Medowbrook, Queensland, Australia.
¹³ Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
¹⁴ The B.E.A.R. Program, Lamaze Australia, Melbourne, Victoria, Australia.
¹⁵ NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, New South Wales, Australia.

PMID: 32967876
PMCID: PMC7513601
DOI: 10.1136/bmjopen-2020-037175

Abstract

Introduction: Rates of medical interventions in normal labour and birth are increasing. This prospective meta-analysis (PMA) proposes to assess whether the addition of a comprehensive multicomponent birth preparation programme reduces caesarean section (CS) in nulliparous women compared with standard hospital care. Additionally, do participant characteristics, intervention components or hospital characteristics modify the effectiveness of the programme? METHODS AND ANALYSIS: Population: women with singleton vertex pregnancies, no planned caesarean section (CS) or epidural.Intervention: in addition to hospital-based standard care, a comprehensive antenatal education programme that includes multiple components for birth preparation, addressing the three objectives: preparing women and their birth partner/support person for childbirth through education on physiological/hormonal birth (knowledge and understanding); building women's confidence through psychological preparation (positive mindset) and support their ability to birth without pain relief using evidence-based tools (tools and techniques). The intervention could occur in a hospital-based or community setting.Comparator: standard care alone in hospital-based maternity units.

Outcomes: Primary: CS.Secondary: epidural analgesia, mode of birth, perineal trauma, postpartum haemorrhage, newborn resuscitation, psychosocial well-being.Subgroup analysis: parity, model of care, maternal risk status, maternal education, maternal socio-economic status, intervention components.

Study design: An individual participant data (IPD) prospective meta-analysis (PMA) of randomised controlled trials, including cluster design. Each trial is conducted independently but share core protocol elements to contribute data to the PMA. Participating trials are deemed eligible for the PMA if their results are not yet known outside their Data Monitoring Committees.

Ethics and dissemination: Participants in the individual trials will consent to participation, with respective trials receiving ethical approval by their local Human Research Ethics Committees. Individual datasets remain the property of trialists, and can be published prior to the publication of final PMA results. The overall data for meta-analysis will be held, analysed and published by the collaborative group, led by the Cochrane PMA group.

Trial registration number: CRD42020103857.

Keywords: antenatal education; complementary medicine; maternal medicine; obstetrics; pain management.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Cited by

Birth outcomes by type of attendance at antenatal education: An observational study.
Shand AW, Lewis-Jones B, Nielsen T, Svensson J, Lainchbury A, Henry A, Nassar N. Shand AW, et al. Aust N Z J Obstet Gynaecol. 2022 Dec;62(6):859-867. doi: 10.1111/ajo.13541. Epub 2022 May 17. Aust N Z J Obstet Gynaecol. 2022. PMID: 35581951 Free PMC article.
Antenatal Education Services in Oman: A Descriptive Qualitative Inquiry of Healthcare Provider's Perspective.
AlDughaishi MYK, Seshan V, Matua GA. AlDughaishi MYK, et al. SAGE Open Nurs. 2023 Apr 3;9:23779608231167820. doi: 10.1177/23779608231167820. eCollection 2023 Jan-Dec. SAGE Open Nurs. 2023. PMID: 37032959 Free PMC article.
The "Ideal Birth": The Occurrence of Severe Perineal Lacerations, Related Factors and the Possibility of Identifying Patients at Higher Risk.
Aquino CI, Tivano A, Sala FD, Colagiorgio S, Scalisi L, Alemu TE, Scotti L, Tarrano E, Remorgida V, Surico D. Aquino CI, et al. Healthcare (Basel). 2024 Dec 22;12(24):2584. doi: 10.3390/healthcare12242584. Healthcare (Basel). 2024. PMID: 39766010 Free PMC article.

References

1. Gibbons L, Belizán JM, Lauer JA, et al. . The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage. World health report 2010;30:1–31.
1. World Health Organization WHO statement on caesarean section rates. Geneva: WHO; 2015.
1. Betran AP, Torloni MR, Zhang JJ, et al. . WHO statement on caesarean section rates. BJOG 2016;123:667–70. 10.1111/1471-0528.13526 - DOI - PMC - PubMed
1. Visser GHA, Ayres-de-Campos D, Barnea ER, et al. . FIGO position paper: how to stop the caesarean section epidemic. Lancet 2018;392:1286–7. 10.1016/S0140-6736(18)32113-5 - DOI - PubMed
1. WHO WHO recommendations: intrapartum care for a positive childbirth experience. Geneva: World Health Organization; 2018. - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information

[1] Gibbons L, Belizán JM, Lauer JA, et al. . The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage. World health report 2010;30:1–31.

[2] Gibbons L, Belizán JM, Lauer JA, et al. . The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage. World health report 2010;30:1–31.

[3] World Health Organization WHO statement on caesarean section rates. Geneva: WHO; 2015.

[4] World Health Organization WHO statement on caesarean section rates. Geneva: WHO; 2015.

[5] Betran AP, Torloni MR, Zhang JJ, et al. . WHO statement on caesarean section rates. BJOG 2016;123:667–70. 10.1111/1471-0528.13526 - DOI - PMC - PubMed

[6] Betran AP, Torloni MR, Zhang JJ, et al. . WHO statement on caesarean section rates. BJOG 2016;123:667–70. 10.1111/1471-0528.13526 - DOI - PMC - PubMed

[7] Visser GHA, Ayres-de-Campos D, Barnea ER, et al. . FIGO position paper: how to stop the caesarean section epidemic. Lancet 2018;392:1286–7. 10.1016/S0140-6736(18)32113-5 - DOI - PubMed

[8] Visser GHA, Ayres-de-Campos D, Barnea ER, et al. . FIGO position paper: how to stop the caesarean section epidemic. Lancet 2018;392:1286–7. 10.1016/S0140-6736(18)32113-5 - DOI - PubMed

[9] WHO WHO recommendations: intrapartum care for a positive childbirth experience. Geneva: World Health Organization; 2018. - PubMed

[10] WHO WHO recommendations: intrapartum care for a positive childbirth experience. Geneva: World Health Organization; 2018. - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

The AEDUCATE Collaboration. Comprehensive antenatal education birth preparation programmes to reduce the rates of caesarean section in nulliparous women. Protocol for an individual participant data prospective meta-analysis

Affiliations

The AEDUCATE Collaboration. Comprehensive antenatal education birth preparation programmes to reduce the rates of caesarean section in nulliparous women. Protocol for an individual participant data prospective meta-analysis

Authors

Affiliations

Abstract

Conflict of interest statement

Similar articles

Cited by

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Abstract

Conflict of interest statement

Similar articles

Cited by

References

Publication types

MeSH terms

Related information

LinkOut - more resources

Full Text Sources

Medical