{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T07:54:33Z","timestamp":1788508473418,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,11,15]],"date-time":"2016-11-15T00:00:00Z","timestamp":1479168000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth"],"published-print":{"date-parts":[[2017,3]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>To determine whether the mode of delivery was different between women who attended childbirth education (CBE<\/jats:styled-content>) class, had a birth plan, or both compared with those who did not attend CBE<\/jats:styled-content> class or have a birth plan.<\/jats:p><\/jats:sec>Methods<\/jats:title>This is a retrospective cross\u2010sectional study of women who delivered singleton gestations >\u00a024\u00a0weeks at our institution between August 2011 and June 2014. Based on a self\u2010report at the time of admission for labor, women were stratified into four categories: those who attended a CBE<\/jats:styled-content> class, those with a birth plan, both, and those with neither CBE or birth plan. The primary outcome was the mode of delivery. Multivariate logistic regression analyses adjusting for clinical covariates were performed.<\/jats:p><\/jats:sec>Results<\/jats:title>In this study, 14,630 deliveries met the inclusion criteria: 31.9 percent of the women attended CBE<\/jats:styled-content> class, 12.0 percent had a birth plan, and 8.8 percent had both. Women who attended CBE<\/jats:styled-content> or had a birth plan were older (p<\/jats:italic>\u00a0<\u00a00.001), more likely to be nulliparous (p<\/jats:italic>\u00a0<\u00a00.001), had a lower body mass index (p\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.001), and were less likely to be African\u2010American (p\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.001). After adjusting for significant covariates, women who participated in either option or both had higher odds of a vaginal delivery (CBE<\/jats:styled-content>: OR<\/jats:styled-content> 1.26 [95% CI<\/jats:styled-content> 1.15\u20131.39]; birth plan: OR<\/jats:styled-content> 1.98 [95% CI<\/jats:styled-content> 1.56\u20132.51]; and both: OR<\/jats:styled-content> 1.69 [95% CI<\/jats:styled-content> 1.46\u20131.95]) compared with controls.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Attending CBE<\/jats:styled-content> class and\/or having a birth plan were associated with a vaginal delivery. These findings suggest that patient education and birth preparation may influence the mode of delivery. CBE<\/jats:styled-content> and birth plans could be used as quality improvement tools to potentially decrease cesarean rates.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12263","type":"journal-article","created":{"date-parts":[[2016,11,16]],"date-time":"2016-11-16T18:02:14Z","timestamp":1479319334000},"page":"29-34","source":"Crossref","is-referenced-by-count":65,"title":["Childbirth Education Class and Birth Plans Are Associated with a Vaginal Delivery"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3807-7022","authenticated-orcid":false,"given":"Yalda","family":"Afshar","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of California, Los Angeles Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica T.","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology and Infertility in the Department of Obstetrics and Gynecology Cedars\u2010Sinai Medical Center Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Mei","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania F.","family":"Esakoff","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine in the Department of Obstetrics and Gynecology Cedars\u2010Sinai Medical Center Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margareta D.","family":"Pisarska","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology and Infertility in the Department of Obstetrics and Gynecology Cedars\u2010Sinai Medical Center Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly D.","family":"Gregory","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine in the Department of Obstetrics and Gynecology Cedars\u2010Sinai Medical Center Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,11,15]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Guidelines for Perinatal Care","author":"AAP\/ACOG","year":"2007"},{"key":"e_1_2_6_3_1","volume-title":"Integrated Management of Pregnancy and Childbirth","author":"WHO","year":"2006"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1891\/1058-1243.21.3.158"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2008.04.005"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1624\/105812407X217985"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1369-6513.1998.00023.x"},{"key":"e_1_2_6_8_1","unstructured":"AmisD GreenJ.Prepared Childbirth. 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