Strategies for coping with labour: does antenatal education translate intopractice?

There is little evidence to associate attendance at antenatal classes with a reduction in psychological distress or increased satisfaction with the ex perience of labour. There may be several reasons for this, including failur e to implement coping strategies. A within-subjects research design explore d the use in labour of coping strategies taught in antenatal classes and th e role of practice. Women's views about using these strategies and their ex pectations of their midwives and birth companions were also identified. Fol lowing Ethics Committee approval and providing informed consent, 121 nullip arous women completed a questionnaire at their final antenatal class. This included questions on confidence and the amount of effort required to use c oping strategies, the involvement hoped for from birth companions and midwi ves in using coping strategies in labour and satisfaction with the amount o f practice of coping strategies. Within 72 hours of delivery, women were in terviewed to obtain a narrative of the events of labour and their use of th e coping strategies (sighing-out-slowly breathing, Laura Mitchell relaxatio n and postural change). A questionnaire obtained information on the involve ment of the midwife and birth companion. Women used the three coping strate gies to different extents. Midwives were not involved to the extent that wo men had hoped for antenatally. Birth companions achieved a level of involve ment closer to women's hopes than that achieved by midwives. A significant proportion of women expressed dissatisfaction with the amount of practice o f coping strategies during antenatal classes. The findings of this study of a group of well-prepared women raise questions about the correct component s of antenatal classes and how midwives and birth companions can be involve d optimally in this aspect of a woman's labour. Further research is require d to determine how women can best be helped to cope with the experience of labour.