Chapter 10 – Preparation that makes the difference

“Health promotion must produce skills and awareness.” This sentence, taken from a report by the Istituto Superiore di Sanità on the birth pathway, clearly conveys the usefulness of childbirth preparation courses: they serve to inform the expectant mother, actively involve her in decision-making processes about pregnancy and childbirth, strengthen her confidence in her own abilities, and allow her to share experiences, doubts, and emotions with other women going through the same journey. It is a useful and valuable moment also for the couple, to face changes together and prepare for their new roles.

Since 2017, childbirth preparation courses have been included among the health services that must be provided free of charge throughout Italy under the Essential Levels of Care (LEA), but at present not all Regions are equipped to offer them in a systematic way. Many family counseling centers and maternity units organize free series of meetings throughout the year for expectant mothers approaching the end of pregnancy.

Topics covered in the courses include lifestyle during pregnancy, childbirth methods, assistance protocols adopted in the specific facility organizing the course, breastfeeding, and newborn care. Rarely addressed topics, which instead would require greater in-depth discussion, include vaccinations in early childhood and the choice of the most effective contraceptive method compatible with breastfeeding for the resumption of sexual activity, with the aim of spacing out or avoiding a subsequent pregnancy if the couple has reached the desired size of their family.

There are also associations of freelance midwives, private medical practices, and other organizations that offer paid meetings, sometimes dedicated to specific topics, such as natural methods to ease labor and childbirth pain, or changes in family dynamics after the birth of a baby.

According to the results of two surveys recently conducted by the ISS, 53.6% of Italian expectant mothers have attended a childbirth preparation course during at least one of their pregnancies, usually the first. In 70% of cases, women attended the course from the seventh month onward, although experts recommend starting earlier, as the information acquired during the meetings does not only concern childbirth but is also useful in the early months of pregnancy.

Attending a childbirth preparation course reduces the likelihood of resorting to cesarean delivery and increases the likelihood of initiating breastfeeding early and continuing it beyond the first 5 months of the baby’s life (27).