Learning design for couple prenatal education program; birthing class

Background : The involvement of birth attendants has been shown to have a positive impact on pregnancy outcomes. Unprepared fathers tend to have negative experiences during childbirth. Mothers and partners need to be prepared since pregnancy to face childbirth and have a satisfying birth experience. It is necessary to arrange a learning program for childbirth classes not


INTRODUCTION
Methods: This research design is research and development (R&D) level 1. The product to be developed is a birthing class learning design for prenatal couple education program. The stages of the research are 1) analysis of gaps and needs of the developed program; 2) Drafting; 3

) internal validation of the design
Results: This study found that the needs of mother and their partners for birthing classes are high. The material most needed in birthing class is husband's role in delivery process. In the management of birthing class, mother and partner want a balance practicum and theory method, the duration of the class is 90 minutes, with the number of participants less than 5 couples and the use of learning modules. The birthing class learning design for prenatal couple education program is structured in form of training program curriculum that consist 1) competencies; 2) learning outcome; 3)study materials; 4) training subjects; 5) training course loads; 6) learning methods and 7) assessments. Conclusions: The birthing class learning design for prenatal couple education program is needed by pregnant women and their partners. The design can be used for preparing the birthing class model. Being involved during labor for father is a uniquely transformative experience.
Enthusiasm mixed with feelings of insecurity in unfamiliar delivery room environment as well as the uncertain development of the labor (5). There are also reports of father's posttraumatic stress disorder symptoms and anxiety after accompanying childbirth (6). The material that is expected to be receive in prenatal class are newborn care, birth plan and supporting mother during childbirth '''(10)- (11). Material that related to childbirth in Kelas Ibu hamil program is sign and delivery process, also birth plan (8).
Education related to the need of mother, pain management and the role of companion in delivery process is not specifically discussed.
This study aims to develop a learning design for a prenatal couple education program that is focused on increasing the confidence of pregnant women and their partners in facing childbirth. This program is not intent to replace the existing education program for pregnant women, but as an alternative choice for health practitioners who wish to organize classes for couple s focused on preparation for childbirth and support for mother during birthing process. At this stage the research is focused on developing learning designs, while design testing will be carried out in further research.

MATERIALS AND METHODS
The design of this research is research and development level 1 (12).

Gap analysis and user needs
The respondents' characteristics in this study are described in the following table.
The majorities of respondent were 25-30 years old, completed middle education, had their first pregnancy and were in the second trimester of pregnancy. The majority of respondents in the wife group have no occupation, while in the husband/spouse group most worked as private employees.       The surveys show that the use of the module in childbirth classes is most desired by the wife and husband/spouse groups.

Learning design drafting
The learning design is arranged in the form of a birthing class training curriculum.

Table 4. Learning outcomes of birthing class in the couple prenatal education program
Learning outcomes Attitudes 1) Believing that childbirth is a couple's experience 2) Believing that the natural birth process can be passed by the couple 3) Believing that the efforts may positively help couples go through the delivery process safely and satisfactorily Skills 1) Able to recognize the signs of natural labor 2) Able to take actions and efforts to get a safe and satisfying natural childbirth experience 3) Able to facilitate the initiation of parent-newborn relationships 4) Be able to make a birth plan   Wife and husband/spouse groups agreed that the important material discussed in childbirth classes was the husband's role.
The presence of a companion who is able to play an active role in the birth process will have a direct impact on the mother in the delivery process. Research shows that the active involvement of birth attendants will improve control of labor pain (15) and smooth delivery (16). Practicing to carry out the role during childbirth is needed in order to be able to carry The assessments by the two experts are very valid which shows that the learning design that has been prepared can be continued in the next development process.
Nevertheless the lowest rating is given for 2 aspects; Learning method and Learning subject load. Improvement is needed in these two aspects.
The design testing stage needs to be continued to get the birthing class learning model in the prenatal Couple education program. Further testing is carried out by testing external validity to test the product in a limited group and in a larger group before finally the product can be disseminated (21).

CONCLUSION AND RECOMENDATION
The birthing class learning design for prenatal couple education program is needed by pregnant women and their partners. The design can be used for preparing the birthing class model.