Does Place Of Birth Influence A Healthy Start To Life?
Funder
National Health and Medical Research Council
Funding Amount
$343,050.00
Summary
There are over 255,000 births in Australia each year and a major challenge in terms of planning and provision is to ensure that these babies are born in hospitals with the appropriate facilities to care for them. International studies suggest that transferring the mother before birth results in better infant outcomes than transferring the baby after birth. In Australia births occur in a range of hospitals, from small rural hospitals to tertiary obstetric and neonatal centres. However, few Austra ....There are over 255,000 births in Australia each year and a major challenge in terms of planning and provision is to ensure that these babies are born in hospitals with the appropriate facilities to care for them. International studies suggest that transferring the mother before birth results in better infant outcomes than transferring the baby after birth. In Australia births occur in a range of hospitals, from small rural hospitals to tertiary obstetric and neonatal centres. However, few Australian studies have looked at infant outcomes based on place of birth. This study will use existing population health data sets to evaluate the provision of care prior to and at birth and the impact it has on infant outcomes up to one year of age. It will also describe for the first time the hospital care utilisation associated with birth and infant health. Information will be obtained from routinely-collected birth, death and birth defect registers, and hospital, midwives and perinatal death review data. Variations in health outcomes for babies may be due to factors that occur before or during pregnancy, or may be due to differences in the care provided at birth. We need to take account of maternal factors to comprehensively assess the role of level of care at birth. We will use statistical techniques to 'predict' infant health outcomes and see if differences between places of birth are real or not. If variations are explained by different levels of care then there is enormous potential for improvement in the provision of pregnancy and newborn services. We will also compare the benefits and consequences of maternal versus neonatal transfer, and assess hospital costs. The results of this study could be applied to direct health services policy and organisational changes to improve pregnancy care and optimise infant outcomes for a healthy start to life.Read moreRead less
Planned Vaginal Birth Or Planned Elective Repeat Caesarean For Women At Term With A Single Previous Caesarean Section
Funder
National Health and Medical Research Council
Funding Amount
$741,750.00
Summary
In Australia over 1 in 5 women give birth by caesarean section. The largest contribution to the total number of caesareans is from women having a repeat caesarean; who have previously had a caesarean. Two care policies are standard for women who have had a previous caesarean; either a planned trial of vaginal birth or a planned elective repeat caesarean. This prospective cohort study will compare the risks and benefits of these two forms of care. The results will help provide better evidence fro ....In Australia over 1 in 5 women give birth by caesarean section. The largest contribution to the total number of caesareans is from women having a repeat caesarean; who have previously had a caesarean. Two care policies are standard for women who have had a previous caesarean; either a planned trial of vaginal birth or a planned elective repeat caesarean. This prospective cohort study will compare the risks and benefits of these two forms of care. The results will help provide better evidence from which to develop health advice that will guide clinical practice, for the optimal care of women who have had a previous caesarean and their infants.Read moreRead less
Healthy and working life expectancies in an ageing Australia. This project aims to identify social circumstances that optimise healthy and working life years in Australia. The project draws on international multidisciplinary expertise to critically evaluate social variation and inequalities in the years older adults live in good health and are engaged in work. Expected outcomes include the generation of new policy-relevant knowledge on older workers, active retirement, and healthy ageing which w ....Healthy and working life expectancies in an ageing Australia. This project aims to identify social circumstances that optimise healthy and working life years in Australia. The project draws on international multidisciplinary expertise to critically evaluate social variation and inequalities in the years older adults live in good health and are engaged in work. Expected outcomes include the generation of new policy-relevant knowledge on older workers, active retirement, and healthy ageing which will advance the field of life course epidemiology and inform the debate about Australia’s future ageing. This project should provide benefits for individual wellbeing, and provide evidence that can inform long-term public policy on health, work, welfare, and retirement.Read moreRead less
Beyond successful ageing: Longevity & healthy ageing among Australian women. This project has three key aims. First, to test and contrast two empirical models of successful ageing. Secondly, to compare these empirical models with women’s own perspectives of their ageing gained from prospective qualitative data. Thirdly, provide insights into women’s experience of very old age through interviews with women in their 90s. In addition to interview data, the project will analyse data from the 1921-2 ....Beyond successful ageing: Longevity & healthy ageing among Australian women. This project has three key aims. First, to test and contrast two empirical models of successful ageing. Secondly, to compare these empirical models with women’s own perspectives of their ageing gained from prospective qualitative data. Thirdly, provide insights into women’s experience of very old age through interviews with women in their 90s. In addition to interview data, the project will analyse data from the 1921-26 and 1946-51 cohorts of the Australian longitudinal study on women’s health. The expected outcomes will provide significant benefits, such as projecting potential health trajectories as women enter their later years.Read moreRead less
Regionalised Maternity Care - Is There Room For Improvement?
Funder
National Health and Medical Research Council
Funding Amount
$467,752.00
Summary
A central dilemma in the provision of maternity care is that some mothers and babies need access to expertise and sophisticated technologies, but most do not. In Australia regionalised maternity care aims to ensure the provision of the appropriate level of care to all women, via antenatal identification of at-risk pregnancies and subsequent transfer to risk-appropriate settings, should the need arise. Furthermore, delayed childbearing and increasing rates of caesarean section are increasing the ....A central dilemma in the provision of maternity care is that some mothers and babies need access to expertise and sophisticated technologies, but most do not. In Australia regionalised maternity care aims to ensure the provision of the appropriate level of care to all women, via antenatal identification of at-risk pregnancies and subsequent transfer to risk-appropriate settings, should the need arise. Furthermore, delayed childbearing and increasing rates of caesarean section are increasing the pool of women with existing medical conditions and risk factors for adverse pregnancy outcomes. There is an urgent need to identify risk-appropriate levels of maternity care based on women's antenatal conditions and risk factors that can be identified early or during pregnancy. The project will use existing population health data sets to determine to what extent regionalised maternity care is delivering women and their babies in risk-appropriate settings or whether there is room for improvement through increased transfer of at-risk pregnancies to higher levels of care. Variations in outcomes for mothers and babies may be due to factors that occur before or during pregnancy, or may be due to differences in the level of maternity care provided. We need to take account of maternal factors to fairly assess the role of the level of maternity care. To do this our project will develop and utilise innovative statistical techniques to look at the risk factors associated with poor outcomes (severe illness or death) for mothers and their babies. We will then be able to 'predict' outcomes and see if differences between levels of maternity care are real or not. If variations are explained by different levels of care then there is enormous potential for improvement in the provision of maternity services. Results could be applied to direct health services policy and organisational changes to improve maternity care and optimise pregnancy outcomes for a healthy start to life.Read moreRead less