ABSTRACT: A study was made of 97 clinic women who attended a series of preparation for childbirth classes and 24 primigravida clinic women who elected not to attend such classes. Both groups completed a standardized knowledge and understanding (KU) questionnaire related to pregnancy, labor and delivery. In addition, a post-delivery structured interview was undertaken to determine the relative importance of certain subjective variables relating to the labor and delivery experience. KU scores were significantly higher in clinic women who elected to attend such classes. Class attendance was associated with a significant increase in KU scores following 4 class sessions. An inverse correlation was observed between KU scores and the number of anesthesia encounters for prepared clinic women during first and second stage of labor. Prepared multigravidas had significantly fewer medication encounters than did prepared primigravidas (P <.001) and, as a group, prepared women had significantly fewer medication encounters than unprepared primigravid women (P <.001). Both groups of clinic women rated medication during labor of less importance than the presence of a labor companion.