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Overview of “Prenatal Education in Ontario – Better Practices” Manual from the Best Start Resource Centre

I Description of project

In 2007, the Best Start Resource Centre released a manual entitled, "Prenatal Education in Ontario--Better Practices." This manual is intended to disseminate current research and promising effective practices used by prenatal educators. It is not a prenatal education curriculum but can provide guidance to organizations wishing to review, assess or update their curricula or create a new curriculum for a specific population. The manual will also be useful to prenatal educators who wish to stay current in their practice.

The manual is available for download or purchase at

In developing this manual, Best Start Resource Centre

  • established an advisory committee representing the prenatal educators of Ontario,
  • performed a literature review on prenatal education,
  • reviewed 11 curriculum of various types of prenatal education, and
  • interviewed 10 key informants and consult with 9 topic experts.

Although this manual is not a comprehensive review of literature, curricula, programs or resources, it does offer a good snapshot of the status of prenatal education in Ontario.

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II Key findings

Over 100 journal articles and reports were consulted and summarized for the literature review. Prenatal education has shown some effectiveness in increasing the initiation of breastfeeding and in improving some very specific health behaviours (i.e., hygiene practices to reduce toxoplasmosis and follow-up sickle cell screening).

Studies concluded that parents find the following prenatal education strategies beneficial:

  • Programs that help to set realistic expectations of the birth and offer ways to increase personal control during the birth event
  • Programs that prepare parents for unexpected outcomes
  • Programs that offer information at the relevant stage of the pregnancy
  • Program that aim to increase the parents' confidence in decision-making
  • Programs that involve fathers

The key informant interviews and the literature search helped identify some "best and promising practices" to meet parents' needs. One chapter of the manual covers suggested topics and key messages for course content and one chapter offers ideas and tips to make programs more effective.

The findings from this summary are limited, partly due to the small amount of research available and to the difficulty of isolating the impact of prenatal education from the other sources of prenatal information and care. Although most parents who take prenatal education programs indicate a high level of satisfaction, it is difficult to prove the effectiveness of the program regarding health outcomes. Some benefits may be difficult to measure, such as increased confidence and increased partner involvement.

In addition to this, there is also often a selection bias as women are more likely to attend prenatal education classes if they are older, have a higher level of education, are married or have a steady partner, and visit a health care provider. Unfortunately, most prenatal education studies do not control for the socio-demographic differences between attendees and non-attendees, making it difficult to draw conclusions.

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III Additional resources

A chapter of the "Prenatal Education in Ontario--Better Practices" manual lists some of the most popular resources used in Ontario for prenatal education. A partial list is included in this week's Related Resources.