Integrating Obstetricians into Childbirth Education and Its Association with Reduced Intrapartum Interventions

Global concern about unwarranted childbirth interventions has intensified, with calls for respectful, evidence-based intrapartum care that supports physiologic birth. While antenatal education for expectant parents is common, the impact of multidisciplinary childbirth education for obstetricians has been underexplored.

In a study of obstetricians (N = 112, M_age = 44.1 years, SD = 6.8, 57% female), those completing the Istanbul Birth Academy's Childbirth Educator and Doula Training (CEDT) program (n = 67) were compared with obstetricians without such training (n = 45) via a survey. Group differences were tested with independent-samples t test (Bonferroni-adjusted) and ANCOVA controlling for age, academic title, experience, low-risk caseload, and employer.

Of 31 practices, 26 differed by t test; 19 remained significant after correction. In adjusted models, 21 practices differed. CEDT-trained clinicians reported lower routine enemas, frequent digital exams, continuous CTG, routine IV lines, and IV fluids to shorten labor, with greater oral intake and nonpharmacologic pain relief; they more often supported instinctive pushing, upright positions, and delayed cord clamping, and less often used lithotomy and routine neonatal suctioning. Primary cesarean in nulliparas was lower.

This study's significance is that multidisciplinary childbirth educator-doula training for obstetricians is associated with fewer routine interventions and lower nulliparous primary cesarean rates. Prospective studies are warranted.