Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov 19;22(1):856.
doi: 10.1186/s12884-022-05178-w.

The effectiveness of skilled breathing and relaxation techniques during antenatal education on maternal and neonatal outcomes: a systematic review

Vanessa Leutenegger  1   2 , Susanne Grylka-Baeschlin  3 , Frank Wieber  4   5 , Deirdre Daly  6 , Jessica Pehlke-Milde  3
Affiliations

The effectiveness of skilled breathing and relaxation techniques during antenatal education on maternal and neonatal outcomes: a systematic review

Vanessa Leutenegger et al. BMC Pregnancy Childbirth. .

Abstract

Background: Several studies have investigated the relationship between antenatal education classes and pregnancy outcomes. These studies have shown positive effects on mothers, such as a lower epidural rate in the intervention groups. However, until now, the impact on outcomes for mothers and newborns of antenatal education classes that focus on breathing and relaxation techniques has not been examined.

Aim: Investigate the effects of skilled breathing and relaxation techniques provided in antenatal education classes on maternal and neonatal birth outcomes.

Methods: The protocol for this study was registered with PROSPERO (ID: CRD42020192289). A systematic literature search was undertaken and completed in January 2022, using the databases MEDLINE, CINAHL, clinicalTrials.gov, Cochrane Library, Embase and MIDIRS according to a priori formulated PICO criteria: population (pregnant women), intervention (antenatal education classes with integrated breathing and relaxation techniques), comparison (antenatal education classes that do not include skilled breathing and relaxation techniques), and outcome (maternal and neonatal outcomes). The quality of the studies was assessed by two reviewers using the standardised instruments RoB 2 and ROBINS-I.

Results: Ten studies were included in this review, nine randomised controlled trials and one quasi-experimental study. The results indicate that skilled breathing and relaxation techniques may positively influence self-efficacy, the need for pharmacological support, specifically the use of epidural anaesthesia, and the memory of labour pain. No effects were found in relation to predefined neonatal outcomes. The quality of evidence on maternal and neonatal outcomes is inconsistent across studies, as different antenatal education classes with varying interventions, including breathing and relaxation techniques, were offered in the studies.

Conclusions: Women who attended an antenatal education class with breathing and relaxation techniques appear to benefit from the intervention. This applies to the practical implementation and use of breathing and relaxation techniques during labour, increased self-confidence and self-efficacy, and a increased feeling of being in control during labour. This demonstrates the importance of information provision and a focus on breathing and relaxation techniques in antenatal education.

Keywords: Antenatal classes; Breathing exercise; Childbirth preparation; Maternal; Neonatal and birth outcomes.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow-Chart of literature search (PRISMA)
Fig. 2
Fig. 2
Summary of risk of bias assessment for randomised controlled trials according to RoB 2.0
Fig. 3
Fig. 3
Summary of risk of bias assessment for non-randomised studies according to ROBINS-I
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Hong K, Hwang H, Han H, Chae J, Choi J, Jeong Y, et al. Perspectives on antenatal education associated with pregnancy outcomes: systematic review and meta-analysis. Women Birth. 2020 doi: 10.1016/j.wombi.2020.04.002. - DOI - PubMed
    1. Barimani M, Forslund Frykedal K, Rosander M, Berlin A. Childbirth and parenting preparation in antenatal classes. Midwifery. 2018;57:1–7. doi: 10.1016/j.midw.2017.10.021. - DOI - PubMed
    1. Shorey S, Ang L, Tam WWS. Informational interventions on paternal outcomes during the perinatal period: A systematic review. Women Birth. 2019;32:e145–e158. doi: 10.1016/j.wombi.2018.06.008. - DOI - PubMed
    1. Hassanzadeh R, Abbas-Alizadeh F, Meedya S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M. Primiparous women’s knowledge and satisfaction based on their attendance at childbirth preparation classes. Nurs Open. 2021;8:2558–66. doi: 10.1002/nop2.787. - DOI - PMC - PubMed
    1. Hassanzadeh R, Abbas-Alizadeh F, Meedya S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand Perceptions of primiparous women about the effect of childbirth preparation classes on their childbirth experience: a qualitative study. Midwifery. 2021;103:103154. doi: 10.1016/j.midw.2021.103154. - DOI - PubMed

Publication types