Table 1.

The couple-centered antenatal education program

Goal based on the ecological interaction model	Methods	Content
Session 1: Becoming happy parents (1 hour by a midwife)
Social-role preparation	Education, information, practice, Q&A	Happy environment, relieving stress, and participation of the husband
Attachment promotion: parental-fetal attachment		Talking and singing with finger movement for the fetus
Self-care promotion: preparation for a normal delivery	Education, information, practice, Q&A	Normal delivery process and husband roles
		Method of how to breathe, relax, and massage to relieve the pain
Session 2: Becoming competent parents (1 hour by a midwife)
Social-role preparation	Education, information, Q&A	Newborn care in growth and development, normal reflex reactions, and getting used to baby signals, father–child care
Infant-caregiving instruction	Education, information, Q&A	Advantages of breastfeeding (for mother and baby), and breastfeeding method, baby’s signals, and deep breastfeeding (latch and positioning)
	Practice, Q&A	Breast massage and breastfeeding, holding a baby, feeding and burping, soothing a crying baby, changing diapers, bathing, and managing the umbilical cord
Session 3: Becoming a happy couple and family (1 hour by a women’s health nurse)
Well-being promotion	Education, information, conversation, Q&A	1. Physical and mental changes in the pregnant woman and her husband
		2. Check the mother’s and father’s situations during the perinatal period and talk about each other’s difficulties and how to help, and how to maintain the marital relationship
	Experience	1. Husbands wear pregnancy simulator vest
	Conversation practice	1. Identify usual communication patterns, and practice positive self-assertive communication
Self-care promotion	Education, information, Conversation, Q&A	1. Physical changes, and discomfort of pregnant women, and caution and self-care methods, importance of spousal support during the third trimester
		2. Prenatal and postpartum depression, stress related to the parental transition in couples, the importance of mutual support for couples, and self-care for couples, express their feelings with each other on parental transition
Session 4: Becoming a happier couple (1 hour by a women’s health nurse)
Well-being promotion	Education, information, conversation practice, Q&A	1. Understanding and empathy between spouses, and the effects of the virtuous cycle of expressing gratitude and empathy
		2. Identifying common marital problems in parents and discuss current marital problems or difficulties
		3. Characteristics of well-adapting parents, the positive effects of hugging, and consideration for each other
	Conversation practice	1.Thank-you messages (conversations and letter-writing)
		2.Talk about what they want from others
Social-role preparation	Education, information, conversation Q&A	1. Importance of accepting and adapting to parenthood in a positive manner
		2. Talking about the difficulties, burdens, and fears of childbirth