Background
Antenatal preparation programmes involve several techniques and activities performed by different healthcare professionals. The main aims of antenatal preparation programmes are to promote healthy practices, minimize excessive anxiety and prevent or minimize the discomforts of pregnancy and labor. Such programmes may include educational activities, physical exercise and psychoprophylactic techniques, among others. Despite the fact that such programmes are recommended in different parts of the world, Gagnon and Sandall in a systematic review found no evidence regarding the benefits of general antenatal education for childbirth.
The practice of regular physical exercise during pregnancy with the objective of keeping women healthy during pregnancy is recommended by the American College of Obstetricians and Gynecologists (ACOG), and can be included in antenatal programs. Moreover, daily exercises can prevent gestational diabetes and excessive gestational weight gain. There is evidence that physical exercise during pregnancy does not increase the risk of muscle injuries or changes in arterial blood pressure, and does not increase the risk of preterm labor or low fetal weight.
Investigations have been conducted to evaluate whether exercise during pregnancy is able to reduce discomfort resulting from lumbopelvic pain and decrease the occurrence of urinary incontinence. Pennick and Young in a systematic review showed evidence that the practice of specific exercises was able to alleviate lumbopelvic pain during pregnancy. However, it is still under debate whether pelvic floor muscle exercises during pregnancy could protect against urinary incontinence both during pregnancy and in the postpartum period.
Anxiety during pregnancy has been related to adverse outcomes, such as fetal distress, premature labor, low birth weight, and problems in child development. Khianman et al., in a systematic review discussed how the use of relaxation techniques (breathing exercises, massage, yoga, reflexology, visualization) during pregnancy may reduce stress and anxiety.
Information related to the effect of antenatal preparation programmes on perinatal outcomes is scarce. Some studies have suggested that a shorter duration of labor and a reduction in Cesarean section (C-section) rates is important to improve perinatal outcomes. The existing evidence is mainly based on small studies that analysed outcomes in women from middle or low income countries with high C-section rates.
The objective of this study was to evaluate the effectiveness and safety of a birth preparation programme (BPP) to minimize lumbopelvic pain, urinary incontinence, anxiety, and increase physical activity during pregnancy, as well as, to compare its effects on perinatal outcomes comparing two groups of nulliparous women.