How prepared for the realities of labour and childbirth are your patients?

[reprise]

I had my first child in a maternity hospital some 24 years ago, and one thing I've noticed as the birth of my grandson approaches is how much better educated and prepared for the realities of labour and childbirth "average" (ie, those who are not paying kazillions of dollars to attend specialised birthing classes) first time mothers are today.

Have those of you who work in labour and delivery found women better prepared now than ever before, or is it very dependent on the system within which you work? The vast majority of antenatal care and education here is now provided by midwives and it's extremely "holistic" in that addressing non-obstetric issues is seen as part of the package of producing better outcomes for mothers and babies (within the public health system, at least). The reasons why pregnancy changed from doctor managed to midwife managed here are largely economic (for public hospitals, it's cheaper staff-wise and for private practitioners it's more expensive to practise obstetrics and gyneocology than to practise alone), but I can't help thinking that the change has - overall - been for the better.

How have things changed where you work?