Online tutorials risk increasing postnatal depression

A BRITISH hospital has scrapped traditional antenatal classes in favour of online tutorials, a format New Zealand childbirth educators say would increase postnatal depression.

York Hospital, in the north of England, said it would phase out the traditional classes for expectant parents because less than 25 per cent of mothers-to-be were attending.

Instead, the same information would be filmed and made available online, the Daily Mail reported.

Counties Manukau childbirth educator Charlie Saunders said she believed online antenatal classes would isolate mothers and increase the risk of postnatal depression.

She said that as well as allaying labour and birth fears and teaching parents basic skills, antenatal classes brought couples together and built support networks.

"If you don't turn up to a coffee group where three other women's eyes are hanging out of their head and they've not done their hair and there's some sort of vomit or poo on their clothing somewhere, you can't look at them and go 'Oh thank God I'm normal'."

Antenatal classes gave an opportunity for first-time parents to meet other couples about to embark on the same life-changing experience, Mrs Saunders said.

"I think you are going to eliminate some of that mother-to-mother and father-to-father support if you go online."

Mrs Saunders, who coached 1050 couples during eight years as an educator for Parents Centre and Childbirth Educators New Zealand, said there were other components of traditional antenatal classes that could not be delivered online.

That included a visit to a delivery suite or birthing unit, dressing a baby (doll), hearing first-hand from new parents and, most importantly, being able to ask questions and hear questions from others.

Wellington BirthEd manager and midwife Nicky Jackson said online tutorials could never replace the networking of an antenatal class or the emphasis on postnatal support.

"It's women going through the same thing at the same time together and hopefully our best outcome for a class is there is some networking between people that can meet postnatally."

Kuaotunu childbirth educator and midwife Sandy Cotman said online tutorials could result in husbands or partners not being involved, and not all households had internet access.

She said that in her experience women liked the personal contact of an antenatal class.

"They still like to have a personal discussion, to have it explained to them and to ask questions they need answered."

An educator also often became an advocate or birth-support person for mothers-to-be which would be lost through online content delivery.

None of the educators was aware of plans to stop traditional antenatal classes in New Zealand, but a Ministry of Health consultation document being prepared to update pregnancy and parenting education services.

Capital and Coast District Health Board's Linda Ryan said the DHB had no plans to use online tutorials in place of antenatal classes. Ms Ryan said classes in the region were well attended and there was no need to look at other options.

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Antenatal class friends got me through, says mum

Toni Paget says she would not have survived the challenge of becoming a first-time mother without the friends she made in her antenatal class.

"I didn't cope very well with Ryan, and it was nice to go to somebody's house and see they were having just as bad a time as I was ... and they're looking as ragged as I am. I wouldn't have coped without them."

Now a mother of two, Mrs Paget chose a Hamilton Parents Centre antenatal class after hearing it helped set up lasting coffee groups.

"The classes are important because they help you prepare mentally for what you are going to do, and to make connections with people you would never have known in a like-minded situation."

Mrs Paget said that through the class she bonded with seven other mothers and became so reliant on them for support that she still keeps in touch, despite moving to Auckland.
"We still get together as many times as we can and three years later we get together for birthdays and Christmas every year."

The 36-year-old said it didn't matter where she was because she could connect with her antenatal class mates, a benefit that could be lost if the classes were disestablished.
"That hospital in England will be hoping there's different childcare providers that can maybe see and assess a mum and steer her in the direction of a coffee group if she doesn't have one."


Preparing for baby

Topics covered at antenatal classes:

  • Labour, including birthing videos
  • Types of birth
  • Pain relief
  • Maternity unit tour
  • Breastfeeding
  • Safe sleeping
  • What to buy for a baby
  • Cloth nappy demonstration
  • Immunisations, Vitamin K and newborn blood tests
  • Bathing, dressing and settling a baby
  • A "typical" day with a baby

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