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

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):

• Cesarean/vaginal birth

  • Afshar et al. 2016: vaginal birth in first‑time moms
    • No class: 64.1%
    • Took childbirth education or had a birth plan: 72.6% (about 8% absolute increase)
  • Stoll & Hall 2012: childbirth education associated with a lower cesarean rate, even after adjusting for age, number of babies, and income
  • Gluck et al. 2018: “failed induction”
    • Took a class: 3.3%
    • No class: 24.5%

• Operative/assisted birth

  • Gluck et al. 2020: vacuum extraction
    • Took a class: 7.5%
    • No class: 22%

• Induction

  • Mueller, Webb, Morgan 2020: induction of labor
    • Took prenatal education: 17%
    • No class: 29%

• Epidural and pain management

  • Stoll & Hall 2012: highest epidural use in first‑time moms who did not attend classes
  • Ricchi et al. 2020: class participants had lower epidural use and more use of breathing/natural coping
  • Bennett et al. 1985: more class attendance → less epidural use and higher breastfeeding rates

• Pain in early labor

  • Al‑Kerdy et al. 2017: class participants reported less pain in early labor, likely due to better self‑efficacy and knowing what to do

• Anxiety, fear, and adjustment

  • Pinar et al. 2016: class participants had less anxiety, more knowledge, and better adaptation to pregnancy and postpartum
  • 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
  • Hassanzadeh et al. 2020 (Iran): significantly lower fear of childbirth, anxiety, and depression in those who took prenatal education, even with sporadic attendance
  • Dai et al. 2021 (China): prenatal education reduced fear of childbirth
  • Sanaati et al. 2017: education for both partners about birth and postpartum reduced anxiety around the adjustment

• Combined “good outcome” classes

  • Levett et al. 2016: a class including both birth information and natural pain‑management skills (acupressure, visualization, breathing, etc.) showed:
    • Reduced augmentation
    • Lower cesarean rate
    • Shorter second stage of labor
    • Less perineal trauma
    • 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?