Enhancing Maternal Preparedness: A Quasi-Experimental Study On The Effectiveness Of Nurse-Led Childbirth Education In Primigravida Women

Abstract

Background
Childbirth is a significant life event, particularly for primigravida mothers who often face it with anxiety and limited awareness. Lack of adequate antenatal education is linked to increased obstetric interventions, poor birth preparedness, and negative maternal and neonatal experiences. Structured childbirth education, especially when nurse-led, can equip mothers with essential knowledge, reduce childbirth-related fear, and promote positive health outcomes. This study aimed to evaluate the effectiveness of a structured, nurse-led childbirth education program in improving knowledge, childbirth experience, and maternal-fetal outcomes among primigravida mothers.

Methodology
A quasi-experimental, two-group pre- and post-test design was conducted at a tertiary care hospital in Gandhinagar, Gujarat. A total of 200 eligible primigravida mothers (≥28 weeks of gestation, medically stable, with no prior childbirth experience) were selected using purposive sampling. Participants were divided equally into experimental and control groups. The experimental group received two structured childbirth education sessions featuring interactive discussions, video demonstrations, and printed educational materials, while the control group received standard antenatal care. A validated tool developed with expert input (Cronbach’s α = 0.84) was used for data collection. Data were analyzed using descriptive and inferential statistics, including paired and unpaired t-tests and Chi-square tests. Ethical clearance was obtained from the Pagarav Ethics Committee (Approval No. P.NO/EC/001/2024).

Results
Post-intervention, the experimental group demonstrated a significant improvement in knowledge scores (from 13.28 ± 2.14 to 20.68 ± 2.31; p < 0.0001), compared to only a marginal change in the control group. Forty-four percent of participants in the experimental group achieved excellent knowledge levels post-intervention. The experimental group also reported significantly better childbirth experience scores (47.84 ± 4.86) than the control group (29.87 ± 2.84; p < 0.00001). Furthermore, favorable maternal outcomes (higher rates of spontaneous labor and vaginal deliveries) and improved fetal outcomes (increased live births and higher APGAR scores) were more common in the experimental group. Knowledge levels were significantly associated with occupation, income, religion, and sources of information.

Conclusion
The structured nurse-led childbirth education program significantly enhanced maternal knowledge, improved childbirth experiences, and led to better maternal and fetal health outcomes. These findings advocate for the integration of structured educational interventions into routine antenatal care to support safe and informed childbirth, especially among first-time mothers.