Maternal and Women’s Health

Women and their families should receive the best possible woman-centred care, based on the best available evidence. Families and women should also be able to choose care that is appropriate to their specific situation and local environment. In reality, this is not always the case.

Despite the best efforts of health services, there is significant variation in the standard of care provided. We focus on improving the care women, newborns and families receive, based on the best available evidence locally, nationally and internationally.

We bring together a multidisciplinary group with expertise across academic, healthcare and community arenas to address this variation and improve the outcomes for women, babies and their families. This is being achieved through a broad program of research that takes an inclusive approach in translation to clinical practice, service delivery improvement, education and training, and community and consumer advocacy in collaboration with SPHERE, SPHERE partner organisations, other Clinical Themes as well as professional and community and consumer groups.

Our Vision

To improve the care women, newborns and their families receive, based on the best available evidence, which acknowledges their right to choose care pathways and make decisions appropriate to their personal situation, local healthcare and social environment, in consultation with clinicians and healthcare professionals.

Our Focus

The MNW Clinical Theme adopts an implementation science/quality improvement methodology and a participatory action research approach to working collaboratively with stakeholders and community and consumer representatives as project partners. Our research involves a diagnostics phase, a co-design phase to develop solutions, and an implementation and evaluation phase. This flexible and iterative approach ensures changes are co-produced and adapted to respond to complexities and address implementation barriers in the local context. Clinicians and managers are engaged in all research phases and encouraged to drive practice change, while consumers are engaged as research participants and in reference groups in a participatory approach that is critical in supporting stakeholders to own the process and embed and sustain change.

Four priority areas have been identified by our Clinical Theme members:

Maternal health

The overarching goal of this priority area is to identify and address unwarranted variation in the timing of birth in the case of planned caesarean section and induction of labour. Positive outcomes from these studies are being translated to improvements in clinical practice by piloting and implementing shared decision-making training for midwives and obstetricians working in maternity service planning and delivery. Other priorities of our maternal health researchers include identification and holistic care of high-risk pregnancy (includes collaboration with ELDoH Clinical Theme), and improving maternal and child health after complicated/complex pregnancy.
Newborn health, stillbirth prevention

This is a developing priority area that builds on the work in Maternal Health. We aim to develop opportunities to rigorously assess potential translational research collaborations with partner institutions, such as Neonatology NSW, DOMS and ELDoH Clinical Themes, The Centre for Excellence in Stillbirth, and the Clinical Excellence Commission.
Women’s health

This is a developing priority area that also builds on the work in Maternal Health as well as collaboration with The George Institute for Global Health and other organisations such as the UNSW Women’s Wellbeing Academy.
Clinician research training

A key requirement in our projects is mentoring clinicians as they engage in all phases of the research as part of the investigating team. To facilitate this, the Theme has initiated a Clinical Research Internship Program as a key research capacity building strategy whereby clinicians providing maternity care develop research skills and literacy by participating in applied research. Since its inception, the program has engaged 21 midwives, medical officers, neonatal nurses and allied health clinicians providing maternity, women’s health or newborn care at South Western Sydney and South Eastern Sydney Local Health District hospitals. Interns participate in MNW Clinical Theme-led translational research projects as co-investigators or are supported to undertake a translational research study of clinical importance in their service. These training and education processes contribute to implementation science and translational research by embedding practices of continuous quality improvement and developing a culture of evidence-based care in health practices.

Our Projects

Urbanisation and health during the first 2000 days of life: Building a foundation for health in Sydney’s urban environment

The concept of ‘child-friendly cities’, predominantly focused on those aged 5 through 12, has been used to guide the development of a coherent research and policy framework into how everyday urban environments sets a foundation for health in later life.

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Aboriginal breastfeeding: reclaiming our traditions

This study focuses on a culturally appropriate program to enhance Aboriginal breastfeeding in SWSLHD. The research has been disseminated to Aboriginal health centres as part of the cultural protocol and ethics process for AHMRC (Aboriginal Health and Medical Research Council) [SWSLHD, Liverpool Hospital, WSU].

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Birth in the time of COVID-19

This study aimed to investigate how COVID-19 affected pregnant and postnatal women and health workers and is being replicated internationally. This mixed methods longitudinal cohort study received survey data 2020-2022 (5274 participants), with follow up at two and six months.

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The Birth Experience Study

This is Australia’s largest study on women’s birth experiences, and notably found that 1:10 women (of nearly 9000 participants) felt they experienced a degree of ‘obstetric violence’. This has been widely discussed in light of the current Parliamentary Birth Trauma Inquiry.

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Innovative exergame program to increase physical activity for pregnant women

This collaborative project (with academics from the School of Sport, Exercise and Rehab, the NSW ministry of health and the Faculty of Engineering and IT) explores the views of women and assesses its success in encouraging regular physical activity and reducing pregnancy and birth complications.

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Our Team

The MNW Clinical Theme executive membership comprises senior professionals from applied basic science to clinical practice and health systems and services as well as academics and consumer representatives. Our work combines the intelligence and resources of SWS and SES LHDs, UTS, UNSW and WSU, and is conducted via a number of units with expertise in women’s health, including The National Perinatal Epidemiology and Statistics Unit (The Centre for Big Data Research in Health and UNSW School of Women’s and Children’s Health), UTS Faculty of Health, Collective for Midwifery, Child and Family Health, the Obstetric Medicine Research Group at St George Hospital, and the Women’s Health Initiative Translational Unit at Liverpool Hospital. Our members are involved in a range of state and national activities and bring this experience and knowledge to our work. This includes the NHMRC Council, NHMRC peer review process, National Pregnancy Guidelines development, Australian College of Midwives guideline development, membership on national data and perinatal morbidity and mortality committees, workforce planning at a state and national level, and other committees and working parties.

Executive Committee:

Research Support Officer: Dr Sophie Gates

Co-lead: A/Prof Helen Barrett

Co-lead: A/Prof Deborah Fox

Professor Angela Makris

Associate Professor Amanda Henry

Dr Damian Kotevski

Professor Donna Hartz

Professor Hannah Dahlen

Professor Jennifer Fenwick

Ms Katie Farrell

Collaborators

All research is conducted via respected research centres and healthcare service providers, including Clinical Themes: Aboriginal Health and Wellbeing (AHW), Early Life Determinants of Health (ELDoH), Diabetes, Obesity and Metabolic Disease (DOM), Respiratory, Sleep Environmental and Occupational Health (RSEOH).