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What are the key statistics that support Hilary Erickson's childbirth education methods?

Updated May 20, 20262 min read

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key statisticsHilary Ericksonchildbirth educationmethods

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From Hilary Erickson

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Hi, I’m Hilary Erickson from The Pregnancy Nurse. Love this question.

From the research I’ve reviewed, these are the key stats that line up with what I focus on in my classes (realistic expectations, movement, and communication with your team, plus coping tools):

  1. Cesarean/vaginal birth
    1. Afshar et al. 2016: vaginal birth in first‑time moms
      1. No class: 64.1%
      2. Took childbirth education or had a birth plan: 72.6% (about 8% absolute increase)
    2. Stoll & Hall 2012: childbirth education associated with a lower cesarean rate, even after adjusting for age, number of babies, and income
    3. Gluck et al. 2018: “failed induction”
      1. Took a class: 3.3%
      2. No class: 24.5%
  2. Operative/assisted birth
    1. Gluck et al. 2020: vacuum extraction
      1. Took a class: 7.5%
      2. No class: 22%
  3. Induction
    1. Mueller, Webb, Morgan 2020: induction of labor
      1. Took prenatal education: 17%
      2. No class: 29%
  4. Epidural and pain management
    1. Stoll & Hall 2012: highest epidural use in first‑time moms who did not attend classes
    2. Ricchi et al. 2020: class participants had lower epidural use and more use of breathing/natural coping
    3. Bennett et al. 1985: more class attendance → less epidural use and higher breastfeeding rates
  5. Pain in early labor
    1. Al‑Kerdy et al. 2017: class participants reported less pain in early labor, likely due to better self‑efficacy and knowing what to do
  6. Anxiety, fear, and adjustment
    1. Pinar et al. 2016: class participants had less anxiety, more knowledge, and better adaptation to pregnancy and postpartum
    2. Ciochoń et al. 2022 (large Polish study): anxiety and depression were lowest in in‑person class participants, then online class, highest in those with no class
    3. Hassanzadeh et al. 2020 (Iran): significantly lower fear of childbirth, anxiety, and depression in those who took prenatal education, even with sporadic attendance
    4. Dai et al. 2021 (China): prenatal education reduced fear of childbirth
    5. Sanaati et al. 2017: education for both partners about birth and postpartum reduced anxiety around the adjustment
  7. Combined “good outcome” classes
    1. Levett et al. 2016: a class including both birth information and natural pain‑management skills (acupressure, visualization, breathing, etc.) showed:
      1. Reduced augmentation
      2. Lower cesarean rate
      3. Shorter second stage of labor
      4. Less perineal trauma
      5. Less newborn resuscitation

These are exactly the areas I build into my own prenatal classes: realistic expectations, movement and positioning, communication/advocacy, natural and medical pain‑management options, and postpartum adjustment.

Would you like me to translate these stats into “what this means for your birth plan” in a simple checklist?

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