Implementation of Systematic Childbirth Education Through a Birth Planning Visit at a Tertiary Care Hospital in India: A Quality Improvement Project.

Background and aim Antenatal education and birth planning are essential components of respectful maternity care, improving childbirth experiences by preparing families for labor. Knowledge about prenatal exercises, birth companions, pain relief, delivery methods, and postpartum contraception empowers couples during childbirth and enhances the quality of care. Despite evidence supporting routine birth plans, our antenatal clinics lacked a formal policy for prenatal education. This study aimed to establish the practice of birth plan counseling from an existing rate of 0% and increase it to 50% within 10 months using the Point of Care Quality Improvement methodology. Methods Following baseline data collection and a fishbone analysis of existing deficits, five sequential Plan-Do-Study-Act cycles were implemented: (1) physician-led counseling and stakeholder training; (2) integration of paramedics and physiotherapists via video consultations; (3) transition of services to ultrasound rooms during COVID-19 outpatient closures; (4) implementation of trimester-wise room redistribution for group counseling; and (5) transfer of responsibilities to permanent family planning staff to ensure sustainability after resident graduation. Results Over the 10-month period, birth plan clinic attendance increased from a median of 0% to 50% and was sustained for an additional six months. Secondary outcomes also improved, including postpartum contraception adoption (from 28% to 54.25%), prenatal exercise participation (from 10% to 57%), and labor analgesia use (from 0% to 50%), although birth companion presence decreased from 40% to 29% because of pandemic-related social distancing mandates. Conclusions Systematic healthcare worker training and methodical staff utilization successfully established antenatal counseling practices. Implementing new healthcare practices requires a multistep approach with system-level changes, while routine monitoring ensures sustainability.