Are we still woman-centred? Changing ideologies, a history of antenatal education in Australia

Background: The medicalisation of childbirth that began in the early 20th century continues to this day. As birth moved from home to the medical environment, antenatal education that prepared families for childbirth and parenting has also changed with little evidence of its effectiveness.Aim: To document historical influences underpinning contemporary antenatal education practice to inform future directions.Findings: Persistent medicalisation and commercialisation of antenatal education raises professional and quality related issues with regards to educational content and delivery. In Australia, as in other countries, there are no requirements for antenatal educators to have any formal training or qualifications; this poses questions about the need for professional regulation.Discussion: Antenatal education remains a significant component of antenatal care, despite evaluations of antenatal education demonstrating variable efficacy to date. Changing ideologies have led to the need for professional specialisation for antenatal educators. It is recommended that the Competency Standards for Childbirth and Early Parenting should be implemented to enable evaluation of and compliance with antenatal education programs. Antenatal educators have changed their strategies in providing education within some of the newer models of care; however, without recognition, regulation or a research agenda that could confirm or change these models, evidence-based practices remain elusive.Conclusion: The history of antenatal education is important to the care of women and their families. Knowing what has preceded the current situation can help health practitioners develop appropriate classes in the future, ensuring that antenatal education continues to be woman centred. (C) 2020 Australian College of Nursing Ltd. Published by Elsevier Ltd.