DOES CONTINUITY OF MIDWIFERY CARE INCREASE VAGINAL BIRTH AFTER CAESAREAN (VBAC): A RANDOMISED CONTROLLED TRIAL
Funder
National Health and Medical Research Council
Funding Amount
$271,960.00
Summary
Pregnancy and birth directly affect almost 300,000 families in Australia each year. A key concern is that the caesarean section rate in Australia is higher than similar countries with a lack of support for women to have a vaginal birth after caesarean section. We plan to undertake a trial to determine whether midwifery continuity of care increases the rate of vaginal birth in women who have had a previous caesarean section. This trial could significantly alter the way maternity care is provided.
Building On Our Strengths (BOOSt): Developing And Evaluating Birthing On Country Primary Maternity Units
Funder
National Health and Medical Research Council
Funding Amount
$1,090,701.00
Summary
Optimal healthcare during the year before and after birth can provide benefits for a lifetime. Our project will deliver this optimal care by implementing and evaluating Birthing on Country Service Delivery Models in urban, regional and remote sites. Birthing on Country combines Indigenous knowledge and governance, culturally safe care, continuity of midwifery carer, birth in an Indigenous birth centre and development of the Indigenous maternal and infant workforce.
Improving Maternal And Infant Outcomes: A Multicentre Randomised Controlled Trial Of Midwifery And Dental Intervention
Funder
National Health and Medical Research Council
Funding Amount
$457,724.00
Summary
Poor oral health during pregnancy can impact the health of the mother and baby. Yet, many expectant mothers are unaware of the implications of poor oral health. In Australia there is a lack of importance being placed on maternal oral health. The aim of this study is to determine the effectiveness of a new service which will promote maternal oral health through collaboration between midwives and dentists. We expect the new service will improve women's oral health, uptake of dental services and po ....Poor oral health during pregnancy can impact the health of the mother and baby. Yet, many expectant mothers are unaware of the implications of poor oral health. In Australia there is a lack of importance being placed on maternal oral health. The aim of this study is to determine the effectiveness of a new service which will promote maternal oral health through collaboration between midwives and dentists. We expect the new service will improve women's oral health, uptake of dental services and potentially improve pregnancy outcomes.Read moreRead less
Therapeutic pluralism in pregnancy, labour and birthing: Decision-making, communication and inter-professional dynamics. Women are frequent users of practices outside 'mainstream' medicine. Pregnancy, labour and birthing (PLB) is a key area of integration, but no research has examined how women perceive obstetrics, midwifery and complementary medicine, or the impact on their health and wellbeing. This study systematically document Australian women's experiences of PLB with a nationally-represe ....Therapeutic pluralism in pregnancy, labour and birthing: Decision-making, communication and inter-professional dynamics. Women are frequent users of practices outside 'mainstream' medicine. Pregnancy, labour and birthing (PLB) is a key area of integration, but no research has examined how women perceive obstetrics, midwifery and complementary medicine, or the impact on their health and wellbeing. This study systematically document Australian women's experiences of PLB with a nationally-representative sample of women of child-bearing age to document decision making, lay-professional communication, and inter-professional dynamics.Read moreRead less
Caseload Midwifery For Women At Low Risk Of Medical Complications: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$604,527.00
Summary
In June 2004, the Victorian Department of Human Services released a policy document Future directions for Victoria's maternity services. The document endorsed the expansion of public models of maternity care that offer 'one on one' midwifery care (caseload). This model has had limited evaluation with safety and efficacy largely unknown. Research conducted in the UK and in Australia has largely measured the effect of teams of care providers (commonly 6-12 midwives) with only two in the UK testing ....In June 2004, the Victorian Department of Human Services released a policy document Future directions for Victoria's maternity services. The document endorsed the expansion of public models of maternity care that offer 'one on one' midwifery care (caseload). This model has had limited evaluation with safety and efficacy largely unknown. Research conducted in the UK and in Australia has largely measured the effect of teams of care providers (commonly 6-12 midwives) with only two in the UK testing caseload care. Studies of continuity of midwifery teams have reported reduced caesareans and other interventions in labour. They have also found increased satisfaction, with no statistically significant differences in health outcomes for babies. Women who are identified at low medical risk will be recruited from the antenatal clinic of a large, tertiary, public maternity hospital. Women will be randomly allocated to caseload midwifery or standard low risk care. Those allocated to caseload will receive pregnancy, birth and postnatal care from a primary midwife with one or two pregnancy visits to be conducted by a 'back-up' midwife. The midwife will collaborate with obstetricians and other health professionals as necessary. This will be the first RCT of caseload midwifery care in Australia and only the third one conducted anywhere. It is a unique opportunity to provide a rigorous evaluation of a model that is beginning to be implemented widely in Australia. The trial will provide much needed information regarding the outcomes of caseload midwifery including interventions in childbirth, safety, costs, women's satisfaction with care and impact on the midwifery workforce. The study will provide data that will inform clinical practice and guide service providers involved in the organisation of maternity services.Read moreRead less
The perinatal journey: the process and impact of psychosocial assessment. This study of the process and impact of psychosocial assessment and depression screening during pregnancy and after birth will have immediate national application and benefit as Australian governments prepare policy to implement universal psychosocial assessment. Findings will provide evidence-based approaches to assessment and service delivery impacting positively on large numbers of Australian women who use maternity and ....The perinatal journey: the process and impact of psychosocial assessment. This study of the process and impact of psychosocial assessment and depression screening during pregnancy and after birth will have immediate national application and benefit as Australian governments prepare policy to implement universal psychosocial assessment. Findings will provide evidence-based approaches to assessment and service delivery impacting positively on large numbers of Australian women who use maternity and early childhood nursing services. Most importantly, skillful early identification of women in distress or 'at risk' is the first step in providing appropriate services and support to ensure better child outcomes. The research will be at the cutting edge internationally and directly addresses National Research Priorities.Read moreRead less
Establishing Breastfeeding: an analysis of the language and practices used by midwives and lactation consultants when interacting with new mothers. Breastfeeding confers extensive health benefits for infants and women, and social and economic benefits for Australian society. Studies indicate that although 80 to 90 percent of women initiate breastfeeding, approximately 25% cease within the first six weeks. It is estimated that if the prevalence of breastfeeding at three months post-birth increase ....Establishing Breastfeeding: an analysis of the language and practices used by midwives and lactation consultants when interacting with new mothers. Breastfeeding confers extensive health benefits for infants and women, and social and economic benefits for Australian society. Studies indicate that although 80 to 90 percent of women initiate breastfeeding, approximately 25% cease within the first six weeks. It is estimated that if the prevalence of breastfeeding at three months post-birth increased from 60% to 80%, a saving of at least $11.5 million would be made to the Australian health system. This study will provide knowledge about the impact of health professionals' practices on women's infant-feeding decisions, identifying effective components of professional support to inform interventions that increase breastfeeding durationRead moreRead less
Is Lactic Acid Concentration In Amniotic Fluid A New Predictor Of Labour Dystocia?
Funder
National Health and Medical Research Council
Funding Amount
$682,538.00
Summary
This study will establish whether higher concentrations of lactate in the amniotic fluid of labouring women can be used as a surrogate marker to improve diagnoses of presence or absence of dystocia. Labour dystocia is a serious problem experienced during childbirth, and is one of the main indications for emergency caesarean section or forceps or vacuum delivery. Although dystocia is a common clinical problem, the current lack of a precise definition leads to considerable variation in practice.
A study of contemporary family, social and cultural influences on first-time mothers' decisions about infant feeding and early parenting practices. Children who are never breastfed are more likely to experience respiratory infections, gastroenteritis, diabetes and as adults, high blood pressure, obesity and type-2 diabetes. This study of infant feeding decision-making in first-time mothers will inform strategies, grounded in the daily lives of women and families to assist mothers to breastfeed f ....A study of contemporary family, social and cultural influences on first-time mothers' decisions about infant feeding and early parenting practices. Children who are never breastfed are more likely to experience respiratory infections, gastroenteritis, diabetes and as adults, high blood pressure, obesity and type-2 diabetes. This study of infant feeding decision-making in first-time mothers will inform strategies, grounded in the daily lives of women and families to assist mothers to breastfeed for longer particularly in communities where breastfeeding is not the norm. Increased support for breastfeeding women from family, community and health professionals is likely to reduce the distress reported by many new mothers. Strategic application of findings will lead to health gains from increased breastfeeding and translate into significant cost savings for the Australian health system. Read moreRead less
Improving Birth Outcomes in China: consequences and potentials of policy, state and professional interactions. The aim of the project is to reduce morbidity and mortality associated with birth by informing health systems improvement in China. We will develop an innovative methodology to study consequences of policy, state and professional interactions on birth outcomes. This work is also relevant in other settings. Macro economic reforms in China have produced paradoxical disparities between ri ....Improving Birth Outcomes in China: consequences and potentials of policy, state and professional interactions. The aim of the project is to reduce morbidity and mortality associated with birth by informing health systems improvement in China. We will develop an innovative methodology to study consequences of policy, state and professional interactions on birth outcomes. This work is also relevant in other settings. Macro economic reforms in China have produced paradoxical disparities between rich and poor and urban and rural populations evident in maternal morbidity and mortality. Results will inform facilitative policies and models of service to optimise safety and increase effectiveness in deployment of human and monetary resources.Read moreRead less