Q&A: Childbirth education podcast increases patient satisfaction

Podcasts may be an effective form of childbirth education, according to a study published in the American Journal of Obstetrics and Gynecology.

In a randomized controlled trial of 153 women with first-time, low-risk pregnancies at two academic hospitals in Philadelphia, participants were asked to review either typical childbirth education materials or a seven-episode educational podcast with topics about labor suggested by patients during their pregnancy. The researchers found that participants in the podcast group had higher median birth satisfaction scores, similar labor agentry scores for experiences of personal control during delivery, and for those who underwent induction, increased perception of control when compared to the control group.

Healio spoke with Fei Cai, MD, a board-certified obstetrician and gynecologist and third year fellow in maternal and fetal medicine at the Perelman School of Medicine at the University of Pennsylvania, about this study and its implications for clinicians.
Healio: What are some examples of the usual education that pregnant women generally receive?

Cai: Usual education varies depending on the different practices or providers that pregnant people go to. In general, this may consist of verbal education regarding labor and birth expectations from their provider, written handouts that are given at the end of their prenatal visits, and virtual childbirth classes that are available for all Penn patients.

“Usual care" may be different for every pregnant person, even in the same hospital system, as some people may not access these classes, may not read the material they are given, or may not ask certain questions that can give them more information. This was the reason behind the study. As podcasts have become a growing modality of education, we wanted to create a standardized childbirth podcast education that is informative, accurate and available for anyone who desires it.

Healio: What are some currently available educational podcasts for pregnant women?

Cai: There are not many current education podcasts on Apple or Spotify that provide standardized, medically accurate childbirth education. There are many pregnancy podcasts overall, but they tend to be made by lay people and contain birth stories and review birth or pregnancy journeys. These are, of course, informative and great for pregnant people to listen to, but largely do not provide education on labor and birth with objective evidence.

Healio: What specific information can pregnant women gain from the podcasts used in your study?

Cai: We talk about labor and birth in an objective, evidence-based way to give those who desire a hospital birth the best information possible so that they can have an informed and empowered birth. Before we created the podcasts, we held focus groups for recently postpartum women who delivered at Penn and asked them what questions they had going into their labor and birth, or what they wished they had known. All of our podcasts are based off questions and concerns that recently postpartum, first-time mothers had.

For example, one concern of many pregnant people is pain relief during labor. We invited an anesthesiologist to come on the podcast to review all different types of labor pain management. We review the method and safety of each of these forms of pain management and tried to answer the questions that some of our patients have regarding things like IV pain medication and epidurals. There is a lot of misconception on different types of pain management in labor, and we want pregnant people to feel safe and comfortable when they choose to come to the hospital to deliver.

In another episode, we talk about induction of labor, because this is something that is recommended to some people to achieve a healthy birth and healthy baby. There are also a lot of misconceptions out there about induction of labor, such as that it can increase the risk of C-section, which is not true. We review each step of the induction process to try to give people as much information as possible.

Finally, we discuss things like complications of labor and birth, reasons why a C-section would be needed, and postpartum healing and recovery. We want to be open and honest about the labor and birth process. Anyone who has questions about the labor and birth process should listen to our episodes to gain some information.

Healio: In your study, were there any negative outcomes observed among pregnant women who listened to such podcasts (i.e. stress, concern, worry, fear, etc.)?

Cai: We did not find any negative outcomes overall. What we did find was that pregnant women who listened to the podcasts were more satisfied with their labor and birth compared to those in the usual education group. We also studied labor agentry, or patients’ sense of control during their labor and birth course. Interestingly, only those who were induced felt that they had more control of their labor and birth among those randomized to the podcast compared to those that did not.

Healio: How can physicians caring for pregnant women utilize educational podcasts more in practice?

Cai: We are using more and more technology and innovation in our everyday lives, and pregnant women also have more access to this technology. Links or QR codes to podcasts can be sent to pregnant people via their patient portal, which every patient can access at Penn and many other hospital systems, or can even be printed out for pregnant women to search.

Physicians and providers can also encourage patients to listen to these podcasts in advance and come to their visits with questions after listening.

Healio: Anything else?

Cai: I hope that this study will increase medical provider interest in using technology and innovation to teach our patients about their health and health care.

Recent studies show that 85% of all people in the U.S. own a smartphone, and 93% have access to the internet. This number is potentially higher in the population that we see who become pregnant. Therefore, it is very likely that pregnant women are already using the internet and their technology to learn more about pregnancy, labor and birth. There are currently studies published that show that women are already using social media to talk about their health care experiences. Similarly, OB/GYNs are also already using social media to educate their patients. We, as physicians and pregnancy care providers, should try as best we can to make sure the information out there is accurate and complete.

For more information:

Find The Penn Medicine Labor Podcast on Apple Podcasts, Google Podcasts, Podbean and Spotify.

Fei Cai, MD, can be reached at fei.cai@pennmedicine.upenn.edu.

Reference:

• Cai F, et al. Am J Obstet Gynecol. 2023;doi:10.1016/j.ajog.2023.01.021.