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The Birth Project - Based on Research and Experience

Support and Preparation Makes a Difference

Research show us that, if a woman giving birth feels supported - it is easier for her to relax and she will have a better experience.

If her partner or birth coach have prepared together before birth, it is easier to become a team during birth. Of course. It is logical.

The Birth Project is based on extended research, books and Anna Wilsby Frisk´s own experience from more than 350 births as well as more than 67 000 participants since the first course in February in the year 2001.

Evidence Based Tools and Strategies
The Birth Project (AnnasProfylax in Sweden) has been evaluated in several major studies. Several regions in Sweden have for more than ten years certified their doctors and midwives with The Birth Project-tools.

Studies have shown that parents feel more confident and expectant after doing The Birth Project. Women using the conscious adaptive breathing, mental focus and relaxation during birth need less interventions and anesthesia.

There are no guarantees, but if we can help the woman to breathe, relax, change positions and keep her mental focus during birth, we will reduce the risk of complications and need less intervention. 

Studies and Links

In February 2001, Anna Wilsby Frisk, conducted her first Birth Project course (formely called AnnasProfylax).

The educational company "Profylaxgruppen i Sverige AB" was consequently established  in April 2003. The word "prophylaxis" means preventing and proactive measures. The training provided is a combination of old and new techniques and approaches, focusing on the couple's own strategies and collaboration. These are summarized in four themes in the course:

* Breathing and Pushing
* Massage and Relaxation
* Mental Tools and Strategies
* The Role of the Partner and Collaboration.

One reason psycho-prophylaxis lost ground in the late 1980s was the risk of hyperventilation. For Anna Wilsby Frisk, it has been crucial to continually study and learn for the best possible results. Her courses and deliveries have been followed up with surveys to assess effectiveness. Anna Wilsby Frisk has participated in over 350 deliveries, and these experiences, combined with numerous courses, contribute to the constant development and improvement of the concept. Since its inception, Anna Wilsby Frisk and Profylaxgruppen has chosen to be transparent with course content, allowing itself to be studied in various research papers and master's theses. The goal is to contribute to as many positive childbirth experiences as possible and create an evidence-based toolkit for both parents and healthcare professionals.

Many attribute the success to the pedagogical approach, straightforward information, and individual, hands-on coaching. The aim of interactive pedagogy is to reach and inspire all types of expectant parents, regardless of their knowledge level, level of tension, fear, or calmness.

In a study from Karolinska Institute (Stockholm, 2018), comparing The Birth Project/AnnasProfylax with mindfulness, a reduction in the need for medical pain relief, such as epidural anesthesia, and a lower rate of cesarean sections were observed. 

A Study on Prophylaxis by Susanne Wennerström (Skåne, Åhus) 2018
After becoming a Birth Project instructor, nurse/midwife Susanne Wennerström became interested in the partner's role. Observing newfound confidence in partners after AnnasProfylax courses led to a study with in-depth interviews of 12 couples, giving voice to both partners. The results will soon be published in a scientific journal.

First-Time Fathers' Experiences of Parental Education, Childbirth, and the First Year as a Father - Master's Thesis by Midwife Åsa Premberg (University of Gothenburg)
Åsa Premberg studied fathers' participation in parental courses and its effects on childbirth and the early days of fatherhood. The summary states: Joint preparation strengthens the parental couple! It is increasingly common for both parents to prepare by taking a course before the child's birth. However, many fathers claim to be there solely for the mother. Åsa Premberg researched how fathers experience maternity care parental courses and found that their involvement in preparations increases their participation in childbirth and afterward.

Experiences of Using AnnasProfylax during Labor - Master's Thesis, University of Borås, by Anna Nyberg and Charlotta Thomasson Prophylaxis works.
Ten couples participating in a recently published study conducted by two aspiring midwives attest to more control, presence, pain relief through focus, enhanced self-esteem, and partner support. Read the full study here.

"This is Probably the Best Thing I've Done in My Life" - Qualitative Interview Study with Women on Their Experience of Psycho-Prophylaxis in Connection with Childbirth, by Maria Riström and Johanna Öhrman (Mälardalen University Eskilstuna Västerås) 2015 
Trends in childbirth have shifted between so-called natural and medicalized childbirth over the last century. Psycho-prophylaxis emerged in Sweden in the 1970s but disappeared from parent groups. In recent years, psycho-prophylaxis has resurfaced. Women's childbirth experiences are influenced by various factors, and different coping strategies can be used during labor. Purpose: To explore and describe women's experiences of preparing for childbirth and giving birth after attending a psycho-prophylaxis course. Also, to explore and describe women's experiences of support from midwives practicing psycho-prophylaxis techniques.

Method: The study had a qualitative, inductive approach, involving seven interviews with mainly open-ended questions. The material was analyzed using qualitative content analysis.

Results: The analysis revealed four categories: The Midwife as a Significant Person, Acquiring Tools for Labor Preparation, The Course Contributes to Coping Strategies, and Acquiring Indispensable Knowledge.

Conclusion: Most women felt that the midwives they encountered lacked support regarding psycho-prophylaxis. Women believed that the psycho-prophylaxis course provided positive tools for labor preparation and coping strategies during pregnancy and childbirth. Women's expectations of the course were met, and it was of significant value to them.

TUFF Project (Training and Education for Parents): Malin Bergström PhD and Professor Ulla Waldenström, 2011
The TUFF project aims to evaluate a new model of parental education focusing on labor preparation and psycho-prophylaxis training. It is a randomized controlled study comparing a control group with standard parental education to a group with psycho-prophylaxis training.
The study showed, among other things, a lower rate of emergency cesarean sections in the group of highly educated women and that anxious and labor-fearful fathers became calmer after attending a parental education incorporating psycho-prophylaxis training.

Quick Search Study Shows 94% Satisfaction with Prophylaxis in Halland In northern and central Halland, efforts have been made to introduce prophylaxis throughout the care chain since 2011.
The concept used as a basis for training is AnnasProfylax. A survey conducted in the region showed that 94% are very satisfied or satisfied with prophylaxis as a pain relief


In summary, ongoing research in obstetrics continues to provide valuable insights into various aspects of childbirth, aiming to improve outcomes and experiences for women during labor and delivery.

Avoiding Complications During Birth
Research has shown that certain interventions, such as continuous support during labor, can help reduce the risk of complications during birth. Studies have indicated that continuous support from a doula or a trained professional can lead to a decrease in the likelihood of cesarean birth, the use of pain medications, and the need for forceps or vacuum extraction.

Importance of Preparing and Practicing Before Birth for a Better Outcome
Preparation and practice before birth, including childbirth education classes and prenatal exercises, have been associated with improved maternal confidence, better coping strategies during labor, and a more positive childbirth experience overall.

Pros and Cons of the Epidural
Epidural anesthesia is a commonly used method for pain relief during labor. Research suggests that while epidurals provide effective pain relief, they may be associated with longer labor, an increased risk of instrumental vaginal delivery, and a higher likelihood of fever during labor However, it's important to note that individual experiences with epidurals can vary, and the decision to use epidural anesthesia should be based on a thorough discussion between the woman and her healthcare provider.

Importance of Support During Birth for the Woman
Studies have highlighted the significant benefits of continuous support for women during childbirth. This support can come from a partner, family member, friend, or a doula. Research indicates that continuous support can lead to shorter labors, reduced use of pain medications, and an overall more positive childbirth experience for the woman.

Best Positions During the Pushing Phase to Avoid Tearing
Research has explored the impact of different birthing positions on perineal outcomes. Studies have suggested that upright positions, such as squatting, lying on the side or being on hands and knees, may reduce the risk of severe perineal trauma compared to the lithotomy position (lying on the back with legs raised)

To be continued!

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