Prenatal Education Planning

• The prenatal period of pregnancy is one of the most opportune teaching points during the antepartum, intrapartum, and postpartum phases. 
• There are so many variables and factors to consider when considering the presentation and engagement of prenatal education to each patient. 
• Creating individual education game plans and goals is one of the best strategies to attempt conducting sufficient teaching. 

With the confirmation of pregnancy, there is an enormous number of changes presented to a patient and multiple dynamics to consider. These changes can be physical, mental, and social because each aspect of their overall health can be impacted in some way.

The prenatal period of pregnancy is one of the most opportune teaching points during the antepartum, intrapartum, and postpartum phases.  

Each patient is extremely individual in their learning needs. Some patients may be a first-time mom, while some patients may have had multiple previous pregnancies and children.  

Regardless of the number, each pregnancy may differ immensely. Some women have a huge support system, while others have no support system. There are so many variables and factors to consider when considering the presentation and engagement of prenatal education to each patient. 

Prenatal Education Considerations

In addition to the individual patient learning needs, style, and influential factors, there is also an enormous amount of educational material. With all of these potential avenues to consider, it is very easy to wonder how to provide basic to even in-depth education to each patient.  

Creating individual prenatal education game plans and goals is one of the best strategies to attempt conducting sufficient teaching.  These educational game plans are most effective when initiated with the very first entry to prenatal care. This early planning strategy can provide individualized educational plans to be developed to increase the opportunity for their personal learning success.  

The overall entry to care may differ between facilities and communities, creating the need for community wide on-boarding can help to ensure all patients are provided equivalent opportunities for thorough education.  

Typically, most patients present for a confirmation of pregnancy and at this time or closely to follow this confirmation, is the completion of an OB history intake. During either of these visits or even a short visit in between can be a prime time to establish a baseline education plan. Performing this baseline assessment can establish individual learning aspects to develop the overall education plan and allow for contingency planning as well.  

Some readers may already be wondering, how do we establish a baseline for prenatal education? How can this fit into prenatal visits? How can it be monitored? What about lack of prenatal care patients? Each of these questions are great questions and I will try to help answer each one throughout.  

Establish a Baseline for Prenatal Education

Again, each prenatal care area differs between how prenatal clinics are ran based on patient demographics in the area, number of staff, providers, clinics, and many additional factors which will require certain detail specifics to be tailored to each community.  

Many of the questions to complete an educational baseline survey are questions that are also part of the OB medical history information. While one-to-one discussion can be helpful to clarify any questions or answers, patients can also be provided a questionnaire upon check-in or checkout to fill out and hand over to a designated person.   

Encourage patients that this is completely personal to them, and any additional information is encouraged to help create individual needs. 

Sample Questions to Develop a Prenatal Education Plan

The following questions are sample questions to utilize in a baseline survey to build the prenatal education game plan. While there are many important educational topics to cover and review with all patients, this will help provide insight on where patients feel they need more in-depth education. 

1. What pregnancy is this for you? 
2. If this is not your first pregnancy, what were the outcomes of previous pregnancies? 
3. How many children are currently living at home with you and what are the ages? 
4. Have you ever taken any prenatal classes, newborn classes, or labor classes? When were those classes taken? 
5. What is your preferred learning style? 
   1. Reading 
   2. Videos
   3. Discussion
   4. Demonstration
6. What topics are most important to you?
   1. Body changes during pregnancy
   2. Newborn care
   3. Newborn safety
   4. Pregnancy Safety
      1. Medications
      2. Substance Use
      3. Physical Activity
      4. Sexual Activity
      5. Mental Health
      6. Oral Health
      7. Nutrition
   5. Family
      1. Family Planning
      2. Support Systems
      3. Siblings
      4. Family & Newborn
   6. Labor and Delivery
      1. Birth
      2. Pain Management
      3. Labor Course
      4. Signs of Labor
   7. Communication
      1. Questions to ask
      2. How to prepare
      3. Where to go
   8. Postpartum
      1. What to expect
      2. Returning to work
      3. Parenting
      4. Newborn visits
   9. Pregnancy Expectations
      1. Prenatal visits
      2. Prenatal testing
         1. Labs
         2. Ultrasounds
      3. Conditions/Complications
      4. Consults
   10. Miscellaneous
       1. Baby Showers
       2. Gender Reveals
       3. 3D Ultrasounds
       4. Photographers
       5. Nursery Preparations
       6. Packing hospital bags
       7. Other information

Fitting Broad Prenatal Education into Prenatal Visits

With most medical clinics, there are appointment time slots and fitting in education can become a complex issue. Having an established education plan from early in the prenatal period can allow for the disbursement of education throughout the course of pregnancy, making it more manageable.

If a clinic has a designated patient educator, it can really make an impact in ensuring compliance and meeting prenatal education needs.  

Monitoring Prenatal Education

The established education plan can become something integrated into the EMR allowing for print outs, assigned video education that can be done while waiting in the waiting room, or broken down throughout prenatal visits to much more attainable.  

Having the integration into the EMR is the most ideal because it will allow for across the board communication of where patients are within their individual education plan. The integration can also allow each provider to see where another provider left off. Less repetitious education or focal points for the patient during the intrapartum and immediate postpartum periods, can also serve multiple benefits. 

Lack of Prenatal Care

Both patients with lack of prenatal care and late entry to care are issues that are complex across the board for pregnant patients. To help with compliance with prenatal care and education, discussing the course of prenatal appointments, alongside discussing their importance can really serve as useful to patients to comply.   

There will be some patients this will just not be achievable for; investigating barriers can provide additional insight into compliance issues. Being transparent from the beginning, mentioning this is your intended education plan throughout your course of pregnancy. 

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