Experiences of antenatal care practices to reduce stillbirth: surveys of women and healthcare professionals pre-post implementation of the Safer Baby Bundle
Files
(Published version)
Date
2024
Authors
Andrews, C.
Boyle, F.M.
Pade, A.
Middleton, P.
Ellwood, D.
Gordon, A.
Davies-Tuck, M.
Homer, C.
Griffin, A.
Nicholl, M.
Editors
Advisors
Journal Title
Journal ISSN
Volume Title
Type:
Journal article
Citation
BMC Pregnancy and Childbirth, 2024; 24(1):520-520
Statement of Responsibility
Christine Andrews, Frances M. Boyle, Ashley Pade, Philippa Middleton, David Ellwood, Adrienne Gordon, Miranda Davies-Tuck, Caroline Homer, Alison Griffin, Michael Nicholl, Kirstine SketcherBaker, and Vicki Flenady
Conference Name
Abstract
Background The Safer Baby Bundle (SBB) aimed to reduce stillbirth rates in Australia through improving pregnancy care across five elements; smoking cessation, fetal growth restriction (FGR), decreased fetal movements (DFM), side sleeping in late pregnancy and decision making around timing of birth. We assessed experiences of women and healthcare professionals (HCPs) with antenatal care practices around the five elements. Methods A pre-post study design using online surveys was employed to assess change in HCPs awareness, knowledge, and frequency of performing recommended practices (22 in total) and women’s experiences of care received related to reducing their chance of stillbirth. Women who had received antenatal care and HCPs (midwives and doctors) at services participating in the SBB implementation program in two Australian states were invited to participate. Surveys were distributed over January to July 2020 (pre) and August to December 2022 (post). Comparison of pre-post responses was undertaken using Fisher’s exact, Pearson’s chi-squared or Wilcoxon rank-sum tests. Results 1,225 women (pre-1096/post-129) and 1,415 HCPs (pre-1148/post-267, ≥ 83% midwives) completed the surveys. The frequency of HCPs performing best practice ‘all the time’ significantly improved post-SBB implementation across all elements including providing advice to women on side sleeping (20.4–79.4%, p<0.001) and benefits of smoking cessation (54.5–74.5%, p<0.001), provision of DFM brochure (43.2–85.1%, p<0.001), risk assessments for FGR (59.2–84.1%, p<0.001) and stillbirth (44.5–73.2%, p<0.001). Practices around smoking cessation in general showed less improvement e.g. using the ‘Ask, Advise and Help’ brief advice model at each visit (15.6–20.3%, p=0.088). Postimplementation more women recalled conversations about stillbirth and risk reduction (32.2–50.4%, p<0.001) and most HCPs reported including these conversations in their routine care (35.1–83.0%, p<0.001). Most HCPs agreed that the SBB had become part of their routine practice (85.0%). Conclusions Implementation of the SBB was associated with improvements in practice across all targeted elements of care in stillbirth prevention including conversations with women around stillbirth risk reduction. Further consideration is needed around strategies to increase uptake of practices that were more resistant to change such as smoking cessation support.
School/Discipline
Dissertation Note
Provenance
Description
Access Status
Rights
© The Author(s) 2024, corrected publication 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons. org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.