E-Module Based Antenatal Education and Its Effects On Breastfeeding Related Anxiety, Readiness and Attitudes Among Primiparous Women: A Quasi-Experimental Study

Breastfeeding-related anxiety, inadequate readiness, and unfavorable attitudes during pregnancy may hinder optimal breastfeeding practices, particularly among primiparous women. This study evaluated the effectiveness of e-module–based antenatal education on breastfeeding-related anxiety, readiness, and attitudes. A quasi-experimental pretest–posttest control group design was conducted among 104 healthy primiparous pregnant women at a primary healthcare center in Kediri Regency, Indonesia. Participants were allocated to an intervention group receiving e-module–based antenatal breastfeeding education in addition to standard care (n = 52) and a control group receiving standard antenatal care (n = 52). Data were collected at 20 (baseline) and 36 weeks of gestation (post-test). At baseline, no significant differences were observed between groups (p > 0.05). At 36 weeks, anxiety scores were lower (23.5 vs 28.2, p < 0.001), while breastfeeding readiness (14.2 vs 10.8, p < 0.001) and attitudes (73.5 vs 61.0, p < 0.001). Improvements from baseline were significantly greater in the intervention group across all outcomes. Multivariate analysis controlling for baseline scores confirmed a significant overall effect of the e-module–based antenatal education on anxiety, breastfeeding readiness, and attitudes (Wilks’ ? = 0.38, p < 0.001). These findings indicate that e-module–based antenatal education effectively reduces anxiety while enhancing maternal breastfeeding attitudes and readiness. Integrating e-modules into routine antenatal education may strengthen maternal preparedness and support improved breastfeeding outcomes.