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Cited for “Significant Contributions to Generalist Research”
Childbirth education courses are a key component of prenatal care; they help to reduce pregnant individuals’ anxiety and fear, aim to increase understanding of pain management, may improve feelings of control and self-efficacy, and assist with the the transition into parenthood.
Barriers, such as time constraints or transportation, can prevent patients from participating in traditional childbirth education classes. To address this, many specialties, including obstetrics, have turned to using digital technologies, which have had positive impacts. Podcasts in particular have the potential to broaden the reach of educational materials.
A recent study published in the American Journal of Obstetrics and Gynecology and conducted by LDI Senior Fellow Sindhu Srinivas and colleagues, found that patients randomized to receive podcast education had higher median birth satisfaction scores compared with the control group, without a significant difference in feelings of control. For patients who underwent induction, feelings of control were significantly higher in the podcast group. Additionally, more than 95% of participants would recommend the podcasts to family and friends.
We spoke to Dr. Srinivas and her colleague and first author of the study, Dr. Fei Cai, a third-year maternal fetal medicine fellow at the Hospital of the University of Pennsylvania, to dive deeper into these findings and learn more about the use of educational podcasts in improving the childbirth experience.
In the episodes, we talk about labor and birth in an objective, evidence-based way to provide the best information possible so that patients can have an informed and empowered birth. Before we created the podcasts, we held focus groups for recently postpartum individuals 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 on questions and concerns that recently postpartum, first-time mothers had.
The episodes are 15-20 minutes of conversations between Dr. Cai and an expert in the specific episode topic. For example, one concern of many pregnant people is pain relief during labor, so we invited an anesthesiologist to review different types of labor pain management. In another episode, we talk about induction of labor, because this is something that is sometimes recommended to patients, but there are many misconceptions, such as that it can increase the risk of cesarean delivery. We also discuss other topics including normal labor, complications of labor and birth, reasons why a cesarean delivery 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.
We hypothesized that patients randomized to getting the podcasts would have a higher sense of control and satisfaction, but we found that while these patients had higher satisfaction, there was no difference in sense of control.
Interestingly, when we just looked at patients who underwent an induction of labor, we found that those who were randomized to podcast education did express a higher sense of control during labor and birth. And the induction of labor podcast was the most frequently watched podcast in our study.
Due to the limitation of our resources, we were only able to create the podcast in its current form in English. In the future, we hope that the podcast can be expanded to other languages so that more people can access its information.
Also, this study was done at two academic institutions in Philadelphia, so our research population is reflective of the Philadelphia population. This may be different from the population in other locations. While the podcast can be accessed widely, further research should be done to evaluate the utility of these podcasts in different populations.
The topics of the Penn Medicine Labor Podcast were identified by people experiencing their first pregnancy, labor, and birth. However, it opens the possibility for the creation of more episodes based on additional questions from diverse populations. I think our findings show that our patients are interested in this type of education, and there is certainly room to expand with other diverse, patient-identified topics.
This study did not compare podcast education to in-person childbirth education classes. In fact, more than 60% of our overall study population also attended some form of childbirth class. Because the podcasts are short (about 15-20 minutes) and speak more generally about the topics included, it cannot compare to the breadth and depth that an hour-long, multiple-session, in-person childbirth class can have, where an instructor can potentially answer more personalized questions. However, if someone is not able to attend in-person or virtual childbirth classes, podcasts may be an acceptable alternative.
This is definitely something that we are interested in studying. As we said previously, we did not find any difference in postpartum depression scores between our two study groups. However, it is possible that we were not powered to find these differences given that our study population was small. I think that podcasts have the potential to address these concerns, and future studies should look at how podcasts can address these issues.
This study shows that our patients are interested in using technology to learn about their health and that podcasts are also a great way to increase patient satisfaction and sense of control. Recent studies reveal that 85% of all people in the U.S. own a smartphone, and 93% have access to the internet. Therefore, it is very likely that pregnant women are already using technology to learn more about pregnancy, labor, and birth.
Given the near ubiquity of the internet and smart devices, podcasts and other innovative forms of education and information delivery could be used to promote equity in maternal and child health outcomes, as it allows for near universal access of information. Technologic approaches, like podcasts are a promising way to ensure that evidence based, accurate information is accessible to all patients.
Our future research prospects are twofold:
We would like to examine how our patients are already using technology and social media to learn about pregnancy, labor, and birth. Knowledge about what patients are exposed to regarding pregnancy and birth on social media can help physicians address certain concerns and alleviate patient fears. It would also allow for the development of additional content that is based on what patients are searching for.
Additionally, we would like to study how technological innovations and social media can be used to teach our next generation of ob-gyn physicians.
The study, “A Randomized Trial Assessing the Impact of Educational Podcasts on Personal Control and Satisfaction During Childbirth,” was published on February 13, 2023 in the American Journal of Obstetrics and Gynecology. Authors include Fei Cai, Meaghan McCabe, and Sindhu Srinivas.
Cited for “Significant Contributions to Generalist Research”
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