1
|
Bowman A, Sullivan T, Makrides M, Flenady V, Shepherd E, Hawke K, Stuart-Butler D, Leane C, Middleton P. Lifestyle and sociodemographic risk factors for stillbirth by region of residence in South Australia: a retrospective cohort study. BMC Pregnancy Childbirth 2024; 24:368. [PMID: 38750442 PMCID: PMC11097586 DOI: 10.1186/s12884-024-06553-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 04/29/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Stillbirth rates remain a global priority and in Australia, progress has been slow. Risk factors of stillbirth are unique in Australia due to large areas of remoteness, and limited resource availability affecting the ability to identify areas of need and prevalence of factors associated with stillbirth. This retrospective cohort study describes lifestyle and sociodemographic factors associated with stillbirth in South Australia (SA), between 1998 and 2016. METHODS All restigered births in SA between 1998 ad 2016 are included. The primary outcome was stillbirth (birth with no signs of life ≥ 20 weeks gestation or ≥ 400 g if gestational age was not reported). Associations between stillbirth and lifestyle and sociodemographic factors were evaluated using multivariable logistic regression and described using adjusted odds ratios (aORs). RESULTS A total of 363,959 births (including 1767 stillbirths) were included. Inadequate antenatal care access (assessed against the Australian Pregnancy Care Guidelines) was associated with the highest odds of stillbirth (aOR 3.93, 95% confidence interval (CI) 3.41-4.52). Other factors with important associations with stillbirth were plant/machine operation (aOR, 1.99; 95% CI, 1.16-2.45), birthing person age ≥ 40 years (aOR, 1.92; 95% CI, 1.50-2.45), partner reported as a pensioner (aOR, 1.83; 95% CI, 1.12-2.99), Asian country of birth (aOR, 1.58; 95% CI, 1.19-2.10) and Aboriginal/Torres Strait Islander status (aOR, 1.50; 95% CI, 1.20-1.88). The odds of stillbirth were increased in regional/remote areas in association with inadequate antenatal care (aOR, 4.64; 95% CI, 2.98-7.23), birthing age 35-40 years (aOR, 1.92; 95% CI, 1.02-3.64), Aboriginal and/or Torres Strait Islander status (aOR, 1.90; 95% CI, 1.12-3.21), paternal occupations: tradesperson (aOR, 1.69; 95% CI, 1.17-6.16) and unemployment (aOR, 4.06; 95% CI, 1.41-11.73). CONCLUSION Factors identified as independently associated with stillbirth odds include factors that could be addressed through timely access to adequate antenatal care and are likely relevant throughout Australia. The identified factors should be the target of stillbirth prevention strategies/efforts. SThe stillbirth rate in Australia is a national concern. Reducing preventable stillbirths remains a global priority.
Collapse
Affiliation(s)
- Anneka Bowman
- Aboriginal Communities and Families Health Research Alliance (ACRA), Adelaide, Australia.
- South Australian Health and Medical Research Institute, North terrace, Adelaide, Australia.
- University of Adelaide, Adelaide, Australia.
- Centre for Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Australia.
| | - Thomas Sullivan
- South Australian Health and Medical Research Institute, North terrace, Adelaide, Australia
- University of Adelaide, Adelaide, Australia
| | - Maria Makrides
- South Australian Health and Medical Research Institute, North terrace, Adelaide, Australia
- University of Adelaide, Adelaide, Australia
| | - Vicki Flenady
- Centre for Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Australia
| | - Emily Shepherd
- South Australian Health and Medical Research Institute, North terrace, Adelaide, Australia
- University of Adelaide, Adelaide, Australia
| | - Karen Hawke
- Aboriginal Communities and Families Health Research Alliance (ACRA), Adelaide, Australia
- Flinders University, Adelaide, Australia
| | - Deanna Stuart-Butler
- Centre for Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Australia
| | - Cathy Leane
- Aboriginal Health Division of the Women's and Children's Health Network, Adelaide, Australia
| | - Philippa Middleton
- Aboriginal Communities and Families Health Research Alliance (ACRA), Adelaide, Australia
- South Australian Health and Medical Research Institute, North terrace, Adelaide, Australia
- University of Adelaide, Adelaide, Australia
- Centre for Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Australia
| |
Collapse
|
2
|
Yeshitila YG, Gold L, Riggs E, Abimanyi-Ochom J, Sweet L, Le HND. Trends and disparities in perinatal health outcomes among women from refugee backgrounds in Victoria, Australia: A population-based study. Midwifery 2024; 132:103980. [PMID: 38547597 DOI: 10.1016/j.midw.2024.103980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 03/03/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Women from refugee backgrounds generally experience poorer pregnancy-related outcomes compared to host populations. AIM To examine the trend and disparities in adverse perinatal outcomes among women of refugee background using population-based data from 2003 to 2017. METHODS A population-based cross-sectional study of 754,270 singleton births in Victoria compared mothers of refugee backgrounds with Australian-born mothers. Inferential statistics, including Pearson chi-square and binary logistic regression, were conducted. Multiple logistic regression was conducted to explore the relationship between adverse perinatal outcomes and the women's refugee status. FINDINGS Women of refugee background had higher odds of adverse neonatal and maternal outcomes, including stillbirth, neonatal death, low APGAR score, small for gestational age, postpartum haemorrhage, abnormal labour, perineal tear, and maternal admission to intensive care compared to Australian-born women. However, they had lower odds of neonatal admission to intensive care, pre-eclampsia, and maternal postnatal depression. The trend analysis showed limited signs of gaps closing over time in adverse perinatal outcomes. DISCUSSION AND CONCLUSION Refugee background was associated with unfavourable perinatal outcomes, highlighting the negative influence of refugee status on perinatal health. This evidences the need to address the unique healthcare requirements of this vulnerable population to enhance the well-being of mothers and newborns. Implementing targeted interventions and policies is crucial to meet the healthcare requirements of women of refugee backgrounds. Collaborative efforts between healthcare organisations, government agencies and non-governmental organisations are essential in establishing comprehensive support systems to assist refugee women throughout their perinatal journey.
Collapse
Affiliation(s)
- Yordanos Gizachew Yeshitila
- Institute for Health Transformation, Deakin Health Economics, School of Health and Social Development, Faculty of Health, Deakin University, 1Gheringhap Street, Geelong, Victoria 3220, Australia; School of Nursing, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia; Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
| | - Lisa Gold
- Institute for Health Transformation, Deakin Health Economics, School of Health and Social Development, Faculty of Health, Deakin University, 1Gheringhap Street, Geelong, Victoria 3220, Australia
| | - Elisha Riggs
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of General Practice, The University of Melbourne, Victoria, Melbourne, Australia
| | - Julie Abimanyi-Ochom
- Institute for Health Transformation, Deakin Health Economics, School of Health and Social Development, Faculty of Health, Deakin University, 1Gheringhap Street, Geelong, Victoria 3220, Australia
| | - Linda Sweet
- School of Nursing and Midwifery, Deakin University, Victoria, Australia; Centre for Quality and Patient Safety Research, Western Health Partnership, Institute for Health Transformation, Victoria, Australia
| | - Ha N D Le
- Institute for Health Transformation, Deakin Health Economics, School of Health and Social Development, Faculty of Health, Deakin University, 1Gheringhap Street, Geelong, Victoria 3220, Australia
| |
Collapse
|
3
|
Massi L, Lewis C, Stewart S, Jans D, Gautam R, Jalloub L, Bowman A, Middleton P, Vlack S, Boyle FM, Shepherd C, Flenady V, Stuart-Butler D, Rae KM. Looking after bubba for all our mob: Aboriginal and Torres Strait Islander community experiences and perceptions of stillbirth. Front Public Health 2024; 12:1385125. [PMID: 38689763 PMCID: PMC11059953 DOI: 10.3389/fpubh.2024.1385125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 03/18/2024] [Indexed: 05/02/2024] Open
Abstract
The stillbirth rate among Aboriginal and Torres Strait Islander women and communities in Australia is around double that of non-Indigenous women. While the development of effective prevention strategies during pregnancy and improving care following stillbirth for women and families in communities has become a national priority, there has been limited progress in stillbirth disparities. With community permission, this study aimed to gain a better understanding of community experiences, perceptions, and priorities around stillbirth. We undertook an Indigenous researcher-led, qualitative study, with community consultations guided by a cultural protection protocol and within an unstructured research framework. A total of 18 communities were consulted face-to-face through yarning interviews, focus groups and workshops. This included 54 community member and 159 health professional participants across remote, regional, and urban areas of Queensland, Western Australia, Victoria, South Australia, and Northern Territory. Thematic analysis of consultation data identified common themes across five focus/priority areas to address stillbirth: Stillbirth or Sorry Business Baby care needs to be family-centered; using Indigenous "ways of knowing, being, and doing" to ensure cultural safety; application of Birthing on Country principles to maternal and perinatal care; and yarning approaches to improve communication and learning or education. The results underscore the critical need to co-design evidence-based, culturally appropriate, and community-acceptable resources to help reduce existing disparities in stillbirth rates.
Collapse
Affiliation(s)
- Luciana Massi
- Stillbirth Centre of Research Excellence, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
- Indigenous Health Research Group, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Carolyn Lewis
- Curtin Medical School, Curtin University, Perth, WA, Australia
| | | | - Diana Jans
- Apunipima Cape York Health Council, Cairns, QLD, Australia
| | - Rupesh Gautam
- Stillbirth Centre of Research Excellence, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Lina Jalloub
- Stillbirth Centre of Research Excellence, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Anneka Bowman
- Department Aboriginal Communities and Families Research Alliance, South Australia Health and Medical Research Institute, Adelaide, SA, Australia
| | - Philippa Middleton
- Stillbirth Centre of Research Excellence, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
- Pregnancy and Perinatal Care, South Australia Health and Medical Research Institute, Adelaide, SA, Australia
| | - Sue Vlack
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Frances M. Boyle
- Stillbirth Centre of Research Excellence, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
- Institute for Social Science Research (ISSR), The University of Queensland, Brisbane, QLD, Australia
| | - Carrington Shepherd
- Curtin Medical School, Curtin University, Perth, WA, Australia
- Ngangk Yira Research Institute, Murdoch University, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
| | - Vicki Flenady
- Stillbirth Centre of Research Excellence, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Deanna Stuart-Butler
- Stillbirth Centre of Research Excellence, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Kym M. Rae
- Stillbirth Centre of Research Excellence, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
- Indigenous Health Research Group, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| |
Collapse
|
4
|
Medeiros PDB, Flenady V, Andrews C, Forbes M, Boyle F, Loughnan SA, Meredith N, Gordon A. Evaluation of an online education program for healthcare professionals on best practice management of perinatal deaths: IMPROVE eLearning. Aust N Z J Obstet Gynaecol 2024; 64:63-71. [PMID: 37551966 DOI: 10.1111/ajo.13743] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 07/23/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND The IMPROVE (IMproving Perinatal Mortality Review and Outcomes Via Education) eLearning, developed by the Stillbirth Centre of Research Excellence in partnership with the Perinatal Society of Australia and New Zealand was launched in December 2019. Based on the successful face-to-face program, the eLearning aims to increase availability and accessibility of high-quality online education to healthcare professionals providing care for families around the time of perinatal death, to improve the delivery of respectful and supportive clinical care and increase best practice investigation of perinatal deaths. AIMS To evaluate participants' reported learning outcomes (change in knowledge and confidence) and overall acceptability of the program. METHODS Pre- and post-eLearning in-built surveys were collected over two years (Dec. 2019-Nov. 2021), with a mix of Likert and polar questions. Pre- and post-eLearning differences in knowledge and confidence were assessed using McNemar's test. Subgroup analysis of overall acceptability by profession was assessed using Pearson's χ2 . RESULTS One thousand, three hundred and thirty-nine participants were included. The majority were midwives (80.2%, n = 1074). A significant improvement in knowledge and confidence was shown across all chapters (P < 0.01). The chapter showing the greatest improvement was perinatal mortality audit and classification (21.5% pre- and 89.2% post-education). Over 90% of respondents agreed the online education was relevant, helpful, acceptable, engaging. Importantly, 80.7% of participants considered they were likely to change some aspect of their clinical practice after the eLearning. There was no difference in responses to relevance and acceptability of the eLearning program by profession. CONCLUSIONS The IMPROVE eLearning is an acceptable and engaging method of delivery for clinical education, with the potential to improve care and management of perinatal deaths.
Collapse
Affiliation(s)
- Poliana de Barros Medeiros
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
- Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia
| | - Vicki Flenady
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Christine Andrews
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Madeline Forbes
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Fran Boyle
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Siobhan A Loughnan
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Natasha Meredith
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Adrienne Gordon
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
- The University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
5
|
de Graaff EC, Leisher SH, Blencowe H, Lawford H, Cassidy J, Cassidy PR, Draper ES, Heazell AEP, Kinney M, Quigley P, Ravaldi C, Storey C, Vannacci A, Flenady V. Ending preventable stillbirths and improving bereavement care: a scorecard for high- and upper-middle income countries. BMC Pregnancy Childbirth 2023; 23:480. [PMID: 37391688 PMCID: PMC10311809 DOI: 10.1186/s12884-023-05765-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/07/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Despite progress, stillbirth rates in many high- and upper-middle income countries remain high, and the majority of these deaths are preventable. We introduce the Ending Preventable Stillbirths (EPS) Scorecard for High- and Upper Middle-Income Countries, a tool to track progress against the Lancet's 2016 EPS Series Call to Action, fostering transparency, consistency and accountability. METHODS The Scorecard for EPS in High- and Upper-Middle Income Countries was adapted from the Scorecard for EPS in Low-Income Countries, which includes 20 indicators to track progress against the eight Call to Action targets. The Scorecard for High- and Upper-Middle Income Countries includes 23 indicators tracking progress against these same Call to Action targets. For this inaugural version of the Scorecard, 13 high- and upper-middle income countries supplied data. Data were collated and compared between and within countries. RESULTS Data were complete for 15 of 23 indicators (65%). Five key issues were identified: (1) there is wide variation in stillbirth rates and related perinatal outcomes, (2) definitions of stillbirth and related perinatal outcomes vary widely across countries, (3) data on key risk factors for stillbirth are often missing and equity is not consistently tracked, (4) most countries lack guidelines and targets for critical areas for stillbirth prevention and care after stillbirth and have not set a national stillbirth rate target, and (5) most countries do not have mechanisms in place for reduction of stigma or guidelines around bereavement care. CONCLUSIONS This inaugural version of the Scorecard for High- and Upper-Middle Income Countries highlights important gaps in performance indicators for stillbirth both between and within countries. The Scorecard provides a basis for future assessment of progress and can be used to help hold individual countries accountable, especially for reducing stillbirth inequities in disadvantaged groups.
Collapse
Affiliation(s)
- Esti Charlotte de Graaff
- Mater Research Institute, NHMRC Centre of Research Excellence in Stillbirth, University of Queensland, Brisbane, Australia
| | - Susannah Hopkins Leisher
- Mater Research Institute, NHMRC Centre of Research Excellence in Stillbirth, University of Queensland, Brisbane, Australia
- International Stillbirth Alliance, Millburn, USA
- University of Utah School of Medicine, Salt Lake City, USA
| | - Hannah Blencowe
- Centre for Maternal, Adolescent, Reproductive and Child Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Harriet Lawford
- Mater Research Institute, NHMRC Centre of Research Excellence in Stillbirth, University of Queensland, Brisbane, Australia
| | | | | | - Elizabeth S Draper
- MBRRACE-UK, Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Alexander E P Heazell
- Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Mary Kinney
- School of Public Health, University of the Western Cape, Belville, South Africa
| | | | - Claudia Ravaldi
- PeaRL Perinatal Research Laboratory, CiaoLapo Foundation for Perinatal Health, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | | | - Alfredo Vannacci
- PeaRL Perinatal Research Laboratory, CiaoLapo Foundation for Perinatal Health, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Vicki Flenady
- Mater Research Institute, NHMRC Centre of Research Excellence in Stillbirth, University of Queensland, Brisbane, Australia.
- International Stillbirth Alliance, Millburn, USA.
| |
Collapse
|
6
|
Hearn MF, Biggs DL, Brown PS, Krastev MA, Szwarc MJ, Riggs APE. Finding our own ways of working together: reflections on implementing and facilitating a multidisciplinary and equity-oriented model of Group Pregnancy Care for women of refugee background. Midwifery 2023; 123:103709. [PMID: 37209583 DOI: 10.1016/j.midw.2023.103709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/13/2023] [Accepted: 04/28/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVE This paper explores professional staff experiences of implementing and facilitating a multidisciplinary equity-oriented model of Group Pregnancy Care for women of refugee background. This model was the first of its kind in Australia and one of the first worldwide. DESIGN AND SETTING This exploratory descriptive qualitative study reports the process evaluation findings from the formative evaluation of Group Pregnancy Care for women of refugee background. Data were collected in Melbourne, Australia between January and March 2021 via semi-structured interviews, and analysed using reflexive thematic analysis. PARTICIPANTS Purposive sampling was used to recruit twenty-three professional staff involved in the implementation, facilitation, or oversight of Group Pregnancy Care. FINDINGS This paper reports five themes: knowledge sharing, bicultural family mentors - the critical link, finding our own ways of working together, power dynamics at the intersection of community and clinical knowledge, and system capacity for change. KEY CONCLUSIONS The bicultural family mentor role contributes to the cultural safety of the group, and increases the confidence and competence of professional staff through cultural bridging. Multidisciplinary cross-sector teams that collaborate well can provide cohesive care. It is possible for hospital and community-based services to establish cross-sector equity-oriented partnerships. However, there are challenges sustaining partnerships in the absence of explicit funding to support collaboration, and in context of organisational and professional inflexibility. IMPLICATIONS FOR PRACTICE Investing in change is necessary to achieve health equity. Creating explicit funding pathways for the bicultural family mentor workforce, multidisciplinary collaboration, and cross-sector partnerships would strengthen service capacity to provide equity-oriented care. Working towards health equity also requires a commitment to continuing professional development for professional staff and organisations to increase knowledge and capacity.
Collapse
Affiliation(s)
- Ms Fran Hearn
- Murdoch Children's Research Institute, Intergenerational Health, 50 Flemington Rd, Parkville, VIC, 3052, Australia.
| | - Dr Laura Biggs
- Murdoch Children's Research Institute, Intergenerational Health, 50 Flemington Rd, Parkville, VIC, 3052, Australia
| | - Professor Stephanie Brown
- Murdoch Children's Research Institute, Intergenerational Health, 50 Flemington Rd, Parkville, VIC, 3052, Australia; University of Melbourne, Department of General Practice, Swanston St, Parkville, VIC, 3052, Australia; University of Melbourne, Department of Paediatrics, Swanston St, Parkville, VIC, 3052, Australia; South Australian Health and Medical Research Institute, Adelaide, SA, 5001, Australia
| | - Ms Ann Krastev
- Murdoch Children's Research Institute, Intergenerational Health, 50 Flemington Rd, Parkville, VIC, 3052, Australia
| | - Mr Josef Szwarc
- The Victorian Foundation for Survivors of Torture Inc., Brunswick, VIC, 3056, Australia
| | - Associate Professor Elisha Riggs
- Murdoch Children's Research Institute, Intergenerational Health, 50 Flemington Rd, Parkville, VIC, 3052, Australia; University of Melbourne, Department of General Practice, Swanston St, Parkville, VIC, 3052, Australia
| |
Collapse
|
7
|
Schultz R. Investigating the health impacts of the Ranger uranium mine on Aboriginal people. Med J Aust 2021; 215:157-159.e1. [PMID: 34333775 DOI: 10.5694/mja2.51198] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 12/26/2022]
Affiliation(s)
- Rosalie Schultz
- Environment and Ecology Special Interest Group, Public Health Association of Australia, Canberra, ACT.,Centre for Remote Health, Flinders University, Alice Springs, NT
| |
Collapse
|
8
|
Stacey T, Haith-Cooper M, Almas N, Kenyon C. An exploration of migrant women's perceptions of public health messages to reduce stillbirth in the UK: a qualitative study. BMC Pregnancy Childbirth 2021; 21:394. [PMID: 34016084 PMCID: PMC8136107 DOI: 10.1186/s12884-021-03879-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stillbirth is a global public health priority. Within the United Kingdom, perinatal mortality disproportionately impacts Black, Asian and minority ethnic women, and in particular migrant women. Although the explanation for this remains unclear, it is thought to be multidimensional. Improving perinatal mortality is reliant upon raising awareness of stillbirth and its associated risk factors, as well as improving maternity services. The aim of this study was to explore migrant women's awareness of health messages to reduce stillbirth risk, and how key public health messages can be made more accessible. METHOD Two semi-structured focus groups and 13 one to one interviews were completed with a purposive sample of 30 migrant women from 18 countries and across 4 NHS Trusts. RESULTS Participants provided an account of their general awareness of stillbirth and recollection of the advice they had been given to reduce the risk of stillbirth both before and during pregnancy. They also suggested approaches to how key messages might be more effectively communicated to migrant women. CONCLUSIONS Our study highlights the complexity of discussing stillbirth during pregnancy. The women in this study were found to receive a wide range of advice from family and friends as well as health professionals about how to keep their baby safe in pregnancy, they recommended the development of a range of resources to provide clear and consistent messages. Health professionals, in particular midwives who have developed a trusting relationship with the women will be key to ensuring that public health messages relating to stillbirth reduction are accessible to culturally and linguistically diverse communities.
Collapse
Affiliation(s)
- Tomasina Stacey
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom.
- Calderdale and Huddersfield NHS Foundation Trust, Lindley, Huddersfield, United Kingdom.
| | | | - Nisa Almas
- Faculty of Heath Studies, University of Bradford, Bradford, United Kingdom
| | - Charlotte Kenyon
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom
| |
Collapse
|
9
|
Warrilow KA, Gordon A, Andrews CJ, Boyle FM, Wojcieszek AM, Stuart Butler D, Ellwood D, Middleton PF, Cronin R, Flenady VJ. Australian women's perceptions and practice of sleep position in late pregnancy: An online survey. Women Birth 2021; 35:e111-e117. [PMID: 33867299 DOI: 10.1016/j.wombi.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/06/2021] [Accepted: 04/06/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Going-to-sleep in the supine position in later pregnancy (≥28 weeks) has been identified as a risk factor for stillbirth. Internationally, public awareness campaigns have been undertaken encouraging women to sleep on their side during late pregnancy. AIM This study aimed to identify sleep practices, attitudes and knowledge in pregnant women, to inform an Australian safe sleeping campaign. METHODS A web-based survey of pregnant women ≥28 weeks' gestation conducted from November 2017 to January 2018. The survey was adapted from international sleep surveys and disseminated via pregnancy websites and social media platforms. FINDINGS Three hundred and fifty-two women participated. Five (1.6%) reported going to sleep in the supine position. Most (87.8%) had received information on the importance of side-sleeping in pregnancy. Information was received from a variety of sources including maternity care providers (186; 66.2%) and the internet (177; 63.0%). Women were more likely to report going to sleep on their side if they had received advice to do so (OR 2.3; 95% CI 1.0-5.1). Thirteen (10.8%) reported receiving unsafe advice, including changing their going-to-sleep position to the supine position. DISCUSSION This indicates high level awareness and practice of safe late-pregnancy going-to-sleep position in participants. Opportunities remain for improvement in the information provided, and understanding needs of specific groups including Aboriginal and Torres Strait Islander women. CONCLUSION Findings suggest Australian women understand the importance of sleeping position in late pregnancy. Inconsistencies in information provided remain and may be addressed through public awareness campaigns targeting women and their care providers.
Collapse
Affiliation(s)
- K A Warrilow
- NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute - The University of Queensland (MRI-UQ), South Brisbane, Australia.
| | - A Gordon
- NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute - The University of Queensland (MRI-UQ), South Brisbane, Australia; Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - C J Andrews
- NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute - The University of Queensland (MRI-UQ), South Brisbane, Australia
| | - F M Boyle
- NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute - The University of Queensland (MRI-UQ), South Brisbane, Australia; Institute for Social Science Research, The University of Queensland, Brisbane, Australia
| | - A M Wojcieszek
- NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute - The University of Queensland (MRI-UQ), South Brisbane, Australia
| | - D Stuart Butler
- NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute - The University of Queensland (MRI-UQ), South Brisbane, Australia
| | - D Ellwood
- NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute - The University of Queensland (MRI-UQ), South Brisbane, Australia; Griffith University, School of Medicine and Gold Coast University Hospital, Gold Coast, QLD, Australia
| | - P F Middleton
- NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute - The University of Queensland (MRI-UQ), South Brisbane, Australia; SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - R Cronin
- University of Auckland and Counties Manukau Health, Auckland, New Zealand
| | - V J Flenady
- NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute - The University of Queensland (MRI-UQ), South Brisbane, Australia
| |
Collapse
|
10
|
Stillbirth in Australia 5: Making respectful care after stillbirth a reality: The quest for parent-centred care. Women Birth 2020; 33:531-536. [PMID: 33092703 DOI: 10.1016/j.wombi.2020.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/12/2020] [Accepted: 08/19/2020] [Indexed: 02/03/2023]
Abstract
Stillbirth is a tragedy that can leave parents feeling powerless and vulnerable. Respectful and supportive bereavement care is essential to reducing adverse psychosocial impact. Initiatives of the Australian Centre of Research Excellence in Stillbirth are designed to improve care after stillbirth. At their heart are the voices of perinatally bereaved parents and support organisations and shared decision making between parents and health care providers. Priorities in future perinatal bereavement care research include ensuring appropriate care for population groups who experience higher rates of stillbirth and addressing implementation challenges to best practice in respectful and supportive bereavement care within our health systems.
Collapse
|