Community-based antenatal education in Istanbul, Turkey: effects on health behaviours

In this article we describe the implementation and evaluation of a community-based antenatal education programme for first-time expectant mothers carried out in Istanbul, Turkey, as part of the Healthy Beginnings Project. We hypothesized that women participating in an antenatal education programme would be more likely to have a vaginal birth, practice recommended maternal and infant health-related behaviours, and adopt a contraceptive method after the birth than a control group, even after statistically controlling for differences in background characteristics. Methods used to evaluate the antenatal education programme included pre- and post-tests with programme participants and a household survey with participants and a control group. All antenatal education course participants, as well as a control group composed of women giving birth to their first child at the same hospitals, were interviewed in their homes by a trained interviewer 2.5-3 months after the baby's birth, starting in October 1998. Results of statistical analyses indicate that a community-based antenatal education programme, such as the one offered as part of The Healthy Beginnings Project in Istanbul, may increase the chance that women will adopt behaviours beneficial to health in the period following a birth. In particular, behaviours related to infant health (breastfeeding and infant check-up) and contraception appeared to be influenced by participation in the programme. In a developing country such as Turkey, with persistent maternal and child health problems, there is an urgent need to increase both demand for and quality of reproductive health services. Antenatal education is not the only answer, but it can be part of the answer. Reaching couples early in their reproductive lives may encourage them to adopt healthy behaviours and make use of available services during their reproductive years.