• Antenatal education programmes should be women centred, focusing on health and wellbeing and normalisation of birth, even for women experiencing complex pregnancies.
• A facilitative approach to learning is advocated to ensure couples’ needs are central to any antenatal education session.
• Antenatal education should not just focus on labour and birth and health promoting activities but also transition to parenting and changing relationships.
• Couples value learning strategies to prepare for and cope with labour and birth.
• While there is no evidence on optimal class size, smaller groups enable greater opportunities for participative learning.