Effectiveness of Participation in Pregnancy Classes to Reduce the Incidence of Obstetric Labor Complications and Cesarean Section

Objective: To assess the effectiveness of participation in pregnancy classes to inform such a prenatal program for physicians and midwives, focusing to reduce the incidence of obstetric labor complications and cesarean section. Methods: This study was done using an analytic observational approach, using a cross-sectional study and consecutive sampling. One hundred and ninety-four participants of this study were women aged 20-35 years who gave birth between January and November 2019 in balarejo sub-district, East Java, Indonesia. The subjects were divided into two groups: participation (four times) and nonparticipation (less than four times) in the pregnancy classes. The analyzed outcomes are labor complications (prolonged labor, postpartum hemorrhage, postpartum fever, premature rupture of membrane), and cesarean section birth. Results: The results of this study indicate that participants of pregnancy classes have a significantly lower probability of suffering prolonged labor (OR=0.05, 95% CI=0.01-0.23, p<0.05), postpartum hemorrhage (OR=0.20, 95% CI=0.04-0.95, p<0.05), and postpartum fever (OR=0.13, 95% CI=0.16-1.08, p<0.05) compared with non-participants. Also, participating women have a lower chance of undergoing cesarean section (OR=0.08, 95% CI=0.03-0.21, p<0.05). Conclusion: The incidence of obstetric labor complications and cesarean section can be effectively reduced by the participation of pregnant woman class.