title: Developing strategies to be added to the protocol for antenatal care: an exercise and birth preparation program.
abstract: OBJECTIVE
  To describe the implementation process of a birth preparation program, the activities in the protocol for physical and birth preparation exercises, and the educational activities that have been evaluated regarding effectiveness and women's satisfaction. The birth preparation program described was developed with the following objectives: to prevent lumbopelvic pain, urinary incontinence and anxiety; to encourage the practice of physical activity during pregnancy and of positions and exercises for non-pharmacological pain relief during labor; and to discuss information that would help women to have autonomy during labor.
  
  
  METHODS
  The program comprised the following activities: supervised physical exercise, relaxation exercises, and educational activities (explanations of lumbopelvic pain prevention, pelvic floor function, labor and delivery, and which non-pharmacological pain relief to use during labor) provided regularly after prenatal consultations. These activities were held monthly, starting when the women joined the program at 18-24 weeks of pregnancy and continuing until 30 weeks of pregnancy, fortnightly thereafter from 31 to 36 weeks of pregnancy, and then weekly from the 37th week until delivery. Information and printed materials regarding the physical exercises to be performed at home were provided. Clinicaltrials.gov: NCT01155804.
  
  
  RESULTS
  The program was an innovative type of intervention that systematized birth preparation activities that were organized to encompass aspects related both to pregnancy and to labor and that included physical, educational and home-based activities.
  
  
  CONCLUSIONS
  The detailed description of the protocol used may serve as a basis for further studies and also for the implementation of birth preparation programs within the healthcare system in different settings.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade de Campinas, Campinas, SP, Brazil.
authors.forename: Maria Amélia
authors.initials: MA
authors.lastname: Miquelutti
authors.affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade de Campinas, Campinas, SP, Brazil.
authors.forename: José Guilherme
authors.initials: JG
authors.lastname: Cecatti
authors.affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade de Campinas, Campinas, SP, Brazil.
authors.forename: Maria Yolanda
authors.initials: MY
authors.lastname: Makuch
mesh_terms: D001007:Anxiety / Q000517:prevention & control; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D048949:Labor Pain / Q000503:physiopathology; D059408:Pain Management; D036801:Parturition / Q000502:physiology; D017773:Pelvic Floor / Q000502:physiology; D011187:Posture / Q000502:physiology; D016742:Preconception Care / Q000379:methods* / Q000592:standards; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods* / Q000592:standards; D064186:Prenatal Education / Q000379:methods* / Q000592:standards; D015203:Reproducibility of Results; D013997:Time Factors; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000517:prevention & control