At The Real Birth Company, one of our fundamental principles is learning from any initiative we work on. During the development of the Real Birth Online Workshop we included the following steps:

• Research – we spoke to pregnant women, midwives and health professionals, conducted written and spoken surveys to gain as much information as possible about experiences of antenatal education from within the maternity services. We piloted our own antenatal sessions, gathered feedback and followed up with women post birth to see if the methods we used to teach antenatal education were effective and helped in their births.We evaluated the pilot sessions using qualitative research and developed ideas based on feedback and findings on how we could develop antenatal sessions and reach more pregnant women and their birth partners than are currently being reached. Gathered quantative evidence of our antenatal education to help evaluate the effectiveness of the antenatal information we imparted in the intrapartum and postpartum periods.

• Formed an idea – We wanted to reach as many pregnant women as possible across multiple ethnicities, geographical and economic backgrounds and started thinking of ways in which we could develop an online multilingual tool that would encompass the ethos of the Real Birth Company.

• Prioritise – Using our Real Birth Training Programme as a basis for the online workshop we looked at a variety of methods of prioritising the needs of pregnant women when planning for their births.

• Design – We started to map, sketch and debate our ideas until we had a functioning prototype. We tested these ideas on volunteer users from a variety of spoken languages, geographical and social backgrounds and monitored how they used the prototype, we recorded their feedback.

• Build – The online programme was built using PHP,HTML and CSS code. Once the original framework was developed, specific antenatal education content, video tutorials and the ‘ask the midwife’ feature which enables user interaction, was added.

• Test and learn – The testing of the Real Birth Programme was manually completed by the developers involved in the project. It was peer reviewed to ensure that functionality met the specified requirements of the project and end user. We asked for volunteer pregnant testers from the local community to review the content and functionality of the online programme, their comments and suggestions if appropriate were integrated into the final version of the programme. We constantly monitor feedback from users implementing changes where appropriate, review the programme across all languages every six months and make updates to the workshop annually.

Jill Palmer – Registered Midwife Calderdale & Huddersfield Trust Great to see such a positive approach to birth and an obvious commitment to empowering through informing. Good work! Thank you

Gill Houghton – Consultant Midwife Liverpool Womens The Liverpool Women’s Hospital has on average 8,000 births per annum and covers a wide area of differing communities, each with their own needs and priorities. For a variety of reasons reaching pregnant women from these communities has always been a challenge. Whilst aware of these challenges, we have never had the capacity to address them in a way that was cohesive and conformed with our existing antennal education programme. When Zoe Wright from the Real Birth Company approached me with details of their innovative multilingual on- line training workshop I could immediately see the benefits such a programme could bring to the Liverpool Women’s current maternity service. I found the programme to be well researched, evidence based and written in a style that would be easy for anyone to follow and most importantly these days, accessible by computer, tablet and phone. The graphics and video clips are informative and definitely add to the enjoyment of the programme and where appropriate they are culturally respectful providing all women with an understanding of the physiology of birth. The programme has the ability to reach many more women than we can using our existing antenatal education model and the fact it has already been written in four languages with more to come means we now have the ability to provide the majority of women with an understanding of birth and the positive choices that can be made prior to starting labour. Taking part in the pilot project has given the LINK and Midwiferyå teams opportunity to assess the feasibility of providing this resource to women in our local population within the context of their usual practice and so far, results have been encouraging. Participants in the trial have been asked to complete the anonymous online survey built in at the end of the course so we can monitor latent phase admissions, use of analgesia in labour and whether the programme has contributed to a positive birth experience. This information will then be evaluated to see what impact the programme has had on patient care, patient safety, quality of service, decision making and cost savings.