Holistic antenatal education class interventions: a systematic review of the prioritisation and involvement of Indigenous Peoples’ of Aotearoa New Zealand, Australia, Canada and the United States over a 10-year period 2008 to 2018

Abstract

Background Research into the effectiveness of antenatal education classes is crucial for Indigenous Peoples from Aotearoa New Zealand, Australia, Canada and the United States who experience poorer maternal and infant health outcomes compared to non-Indigenous populations. Our systematic review questions were intended to determine the extent of Indigenous Peoples prioritisation and involvement in antenatal education classes, and to understand the experience of Indigenous Peoples from these countries in antenatal education classes. Methods Using a standardised protocol, we systematically searched five electronic databases for primary research papers on antenatal education classes within the four countries noted and identified 17 papers that met the criteria. We undertook a qualitative meta-synthesis using a socio-critical lens. Results Systematic review of the academic literature demonstrates that Indigenous Peoples of Aotearoa New Zealand, Australia, Canada and the United States are not prioritised in antenatal education classes with only two of 17 studies identifying Indigenous participants. Within these two studies, Indigenous Peoples were underrepresented. As a result of poor engagement and low participation numbers of Indigenous Peoples in these antenatal education classes, it was not possible to understand the experiences of Indigenous Peoples. Conclusion Given that Indigenous Peoples were absent from the majority of studies examined in this review, it is clear little consideration is afforded to the antenatal health needs and aspirations of Indigenous Peoples of Aotearoa New Zealand, Australia, Canada and the United States. To address the stark antenatal health inequities of Indigenous Peoples, targeted Indigenous interventions that consider culture, language, and wider aspects of holistic health must be privileged. Trial registration PROSPERO Registration ID: CRD4202017658

Determinants of Antenatal Education and Breastfeeding Uptake in Refugee-Background and Australian-Born Women

“…Antenatal services are predominantly attended by women with higher levels of education and from the middle-to-upper socioeconomic strata across various developed nations, namely Canada and the United States [62,63], South Korea [64], and Belgium [65]. Regardless of immigration background, women attaining higher levels of education typically exhibit greater health literacy and autonomy in navigating their pregnancy [66,67]. As such, our study confirms that maternal educational level is the universal and most predictive determinant of ANE utilization, encompassing both women from refugee backgrounds and native Australians.…”

Using Social Media Platforms to Enhance the Delivery of a Childbirth Education Program

“…Health care personnel must consider cultural and language differences when providing holistic antenatal educational sessions 14. A recent systematic review conducted by Barrett et al found that the Indigenous Peoples of New Zealand, Australia, Canada, and the United States (U.S.) have poor engagement and low participation in antenatal education classes 14. They recommended targeted interventions that consider culture, language, and wider aspects of holistic health 14.…”

“…14 They rec-ommended targeted interventions that consider culture, language, and wider aspects of holistic health. 14 Engagement in CBE classes can empower these women and enhance coping behavior during the birthing process.…”

“…Pregnancy and birthing information and practices vary with cultures. Health care personnel must consider cultural and language differences when providing holistic antenatal educational sessions 14. A recent systematic review conducted by Barrett et al found that the Indigenous Peoples of New Zealand, Australia, Canada, and the United States (U.S.) have poor engagement and low participation in antenatal education classes 14.…”

“…14 A recent systematic review conducted by Barrett et al found that the Indigenous Peoples of New Zealand, Australia, Canada, and the United States (U.S.) have poor engagement and low participation in antenatal education classes. 14 They rec-ommended targeted interventions that consider culture, language, and wider aspects of holistic health. 14 Engagement in CBE classes can empower these women and enhance coping behavior during the birthing process.…”