Characteristics of Swedish women who do not attend childbirth and parenthood education classes during pregnancy

Objective: to investigate the attendance rate at childbirth and parenthood education classes during pregnancy in a national Swedish sample and describe the characteristics of women who did not attend. Design: a cohort study utilising a postal questionnaire in early pregnancy and at 2 months after birth. Setting: women were recruited from 97% of all antenatal clinics in Sweden at their first 'booking' visit during three different weeks spread over 1 year in 1999-2000. Participants: 2546 women, who were 77% of those who consented to participate in the study and 55% of all women eligible for the study. Measurement and findings: most primiparous women (93%) attended classes and the majority of the multiparae (81%) did not. Having a native language other than Swedish was associated with non-attendance in both primiparae and multiparae (OR 2.7, 95% Cl 1.3-5.4; OR 2.1, 95% Cl 1.4-3.1). In addition, the following factors were associated with non-attendance in the primiparae: unemployment (OR 2.0, 95% Cl 1.1-3.8), smoking during pregnancy (OR 2.7, 95% Cl 1.2-5.8), having considered abortion (OR 4.3, 95% Cl 1.2-16.1), and having had few antenatal check-ups (OR 2.0, 95% Cl 1.1-3.7). The following factors were associated with non-attendance in the multiparae: age older than 35 years (OR 1.6, 95% Cl 1.1-2.3), low level of education (OR 3.6, 95% Cl 2.3-5.7), and pregnancy unplanned but welcome (OR 1.5, 95% Cl 1.1-2.0), having had counselling because of fear of childbirth (OR 1.6, 95% Cl 1.1-2.4), and expressing a need of such counselling (OR 1.9, 95% Cl 1.1-3.1). Key conclusions: the childbirth and parenthood education programme reached the majority of pregnant women, and that non-attendees were more disadvantaged in terms of socio-demographic background and feelings about the approaching birth. These women should be given special attention during the antenatal check-ups so that childbirth and parenthood education could be adapted to their specific needs. (C) 2004 Elsevier Ltd. All rights reserved.