ACE ID
Research type
Research Study
Full title
The ACE antenatal education intervention development study (ACE ID)
IRAS ID
294035
Contact name
Abi Merriel
Contact email
Sponsor organisation
North Bristol NHS Trust
Clinicaltrials.gov Identifier
18018389 (https://doi.org/10.1186/ISRCTN180183890), ISRCTN
Duration of Study in the UK
0 years, 8 months, 31 days
Research summary
Summary of Research
There is variation in the quantity and quality of the antenatal education (ANE) that is provided across England and Wales. At North Bristol Trust (NBT), all first-time parents are offered 4-6 hours of group education, a reduction in hours provided over the 10 years.
While many women report positive birth experiences, national surveys report that a significant number of women do not. Risk factors for PTSD include subjective birth experience relating to negative emotions and lack of agency, operative birth (caesarean or instrumental delivery), lack of support from staff, and dissociation. Many first-time mothers expect to give birth without intervention, which may be unrealistic, since only 21% do so. This discrepancy may contribute to negative experiences and poorer psychosocial outcomes, impacting the woman and her family, as well as NHS resources. Antenatal education (ANE) can support women to view their experiences positively.
In the previous ACE antenatal education study, focus groups with 48 parents and 21 staff identified strengths and weaknesses of current ANE. Following this, 33 parents and 3 staff co-designed a new ANE programme. Before a feasibility study can be carried out to determine whether a trial can take place, further development work is needed to determine whether the ACE programme is acceptable to women, birth partners and the staff delivering it. In the absence of measures to assess women's expectations, a tool to assess this needs to be developed.
In ACE ID we will train midwives to deliver the ACE intervention to a group of pregnant women and their partners. We will conduct focus groups with midwives delivering it, and interviews and surveys with class participants to understand if it is acceptable, and compare their experiences of usual care and ACE. We will validate a tool to assess women's expectations, and establish feasibility study methods with staff and parents.Summary of Results
We wanted to improve the quality of antenatal education for parents. We listened to 46 postnatal women and 21 maternity staff and over 1000 a women and antenatal educators completed surveys. We used this information to work alongside 29 women, 4 partners and 3 maternity staff to develop the 'ACE' session which is a 2 hour session to prepare parents for labour and birth. In this part of the study 19 ACE classes were run by 4 midwives, 142 women and 94 partners attended. We asked them using surveys and interviews for feedback from the sessions. Generally women enjoyed the classes and found them useful, partners found the information useful but did not find the classes engaging. Parents, midwifes and the research team suggested 38 changes to make to the classes. We used this feedback to update a training manual for midwifes and have made a training film. This means that any antenatal educator can use the training package to support their antenatal sessions.
REC name
Wales REC 6
REC reference
21/WA/0091
Date of REC Opinion
19 Mar 2021
REC opinion
Favourable Opinion