Regarding healthy lifestyle information in prenatal classes and Jean-Marc Dupont's comment that there was very little smoking cessation information provided in prenatal classes. I have taught prenatal classes on and off for at least 16 years, in many different locations across Canada and on military bases.  We have included lifestyle information in all series of classes - sometimes even making it the main focus of the program rather than information on birth and baby care.  From my experience, most people attending prenatal classes are 1) not smokers and 2) pretty aware of lifestyle issues 3) very tired and focused solely on the big life change they are going through.  I think we need to figure out how to reach people in need of lifestyle information and prenatal eduction and make the classes more accessible to those who have some risk factors.  The most effective way to do this that I've seen is through the CPNP programs that provide food, transportation and child care to p!
 regnant women as well as education.  These groups allowed for the development of good support groups, small group teaching, and enhanced food security for mums at risk from smoking and other factors (like poverty and isolation).  Outcome evaluation from these groups is positive in terms of reduced numbers of SGA babies and preterm births. Unfortunately these are very expensive programs to run and the financial support for them is difficult to maintain.  I'd rather see a focus on how to reach the difficult-to-reach with food security support and lifestyle information than trying to enhance information to the already convinced.

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