The Institut national de santé publique du Québec (INSPQ) [Québec’s public health institute] was mandated by Québec’s Ministère de la Santé et des Services sociaux (MSSS) [ministry of health and social services] to produce a report on the effects of group prenatal classes. In Québec, prenatal classes are meant to provide pregnant women and their partners with information and to prepare them for childbirth and their new role as parents.
The purpose of this report is to identify the effects of group prenatal classes based on the recent scientific literature in order to better position their contribution to the service offering in Québec.
Bibliographic research was conducted with a focus on publications dated between 2004 and 2015 in the Ovid SP, Medline and EBSCOhost databases using keywords related to health promotion, obstetrical procedures, pregnancy outcomes, breastfeeding, health and adaptation. The model of health status and its determinants developed by Québec’s Ministère de la Santé et des Services sociaux (2012) is used to organize the presentation of the results.
The analysis has yielded four findings for the universal clientele. The current state of knowledge does not allow for confident assertions regarding effects on a vulnerable clientele:
- Group prenatal classes can inform, increase confidence and provide a greater sense of emotional support during pregnancy;
- Group prenatal classes can influence the determinants of health if the mother has control over them;
- Group prenatal classes cannot alone influence health;
- Group prenatal classes that meet these conditions have a greater chance of leading to positive effects:
- Adapt content based on the needs of different clienteles;
- Offer multiple classes;
- Lower barriers to participation;
- Add specific topics and approaches;
- Include adult learning principles.
The key findings resulted in four recommendations for the provision of prenatal classes as a service in Québec:
- Continue to offer group prenatal classes as a service to all future parents in Québec, as indicated in the province's perinatal policy, Politique de périnatalité 2008-2018;
- Place a focus during group prenatal classes on behaviours and choices over which parents have control, rather than on situations that involve other individuals or unforeseeable events;
- Review the objectives of prenatal classes to target the determinants of health, that is, knowledge, confidence in their abilities and social support;
- Draw on the five conditions that have a greater chance of leading to positive effects to establish implementation rules for group prenatal classes in Québec.
The analysis of the effects of group prenatal classes highlights their potential for health promotion and reaffirms their usefulness as part of the service offering in Québec, as specified in the province's Politique de périnatalité 2008-2018.
Further studies are required for a better characterization of the effects of group classes on health status, women in vulnerable situations and fathers. There is also a need for better understanding of how the effects, if present, can be explained by the presence of certain conditions.