RecruitingACTRN12620000833965

A multidisciplinary group model of maternity care: a feasibility study

PECS – [Perinatal Education Care Support] group model of multidisciplinary maternity care: a feasibility study

Sponsor

La Trobe University

Enrollment

128 participants

Start Date

Aug 12, 2020

Study Type

Interventional

Conditions

Childbirth

Summary

Antenatal care traditionally involves a schedule of one-to-one visits with a care provider, however an emerging way of providing antenatal care involves the use of a group model, which already shows promise in optimising birth outcomes such as preterm birth and low birth weight. Current maternity models such as shared-care or midwife-led care attempt to provide a women-centred philosophy, incorporating continuity of care. Despite best efforts there are shortcomings in antenatal service delivery, including a lack of timely information and professional and emotional support. The evidence largely indicates that women feel unprepared for the psychological, social, and physical challenges, creating risk for mental health problems during a time of unparalleled change. Acquisition of knowledge is important in influencing maternal behaviour and birth outcomes. While the etiology of birth outcomes is complex, psychosocial factors including stress, anxiety, depression, and social support are critical factors that can increase the risk of medical complications and further increases the risk of children having a wide range of adverse outcomes. While antenatal care has traditionally involved a schedule of one-to-one visits, group models of care are emerging as a way of delivering clinical health services to pregnant women, integrating the usual pregnancy health assessment with tailored group education and peer support, thus incorporating broader psychosocial aspects. In promoting health and wellbeing during a time where reconfiguration of service delivery is required. The primary purpose of the current research is to examine a group model of multidisciplinary care. It is hypothesized that a group model comprising care and education provided in-part via telehealth digital technologies for pregnant women that extends into the postpartum period, will provide greater access to care and education, improving perinatal physical and psychosocial health outcomes for mother and infant, in comparison to women receiving standard maternity care.

Eligibility

Sex: FemalesMin Age: 18 YearssMax Age: 40 Yearss

Plain Language Summary

Simplified for easier understanding

Having a first baby is one of life's biggest transitions, bringing physical, emotional, and social changes that can feel overwhelming — especially without adequate support. Traditional antenatal care involves individual one-on-one appointments that often leave women feeling underprepared for the psychological and social challenges of new parenthood. Group models of care, where small groups of pregnant women receive their antenatal check-ups and education together, have shown promise in improving both birth outcomes and emotional wellbeing. This feasibility study is testing a new multidisciplinary group model of care for first-time mothers, delivered partly via telehealth digital technology, that extends support into the postpartum period. The program combines standard pregnancy health assessments with group-based education and peer support. Researchers want to know whether this model is acceptable to women, whether it can be delivered as planned, and whether it may improve physical and psychological health outcomes compared to standard care. You may be eligible if you are pregnant for the first time, at least 18 years old, around 12 weeks pregnant (with a dating scan), medically low-risk, and able to read, understand, and speak English. Women with significant depression or anxiety scores during screening would be directed to appropriate care rather than enrolled.

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Interventions

This feasibility study will investigate the acceptability, demand, practicality and efficacy of a group-based multidisciplinary model of maternity care among a sample of pregnant women experiencing their first pregnancy. Additionally, we will examine whether a group model of care across the perinatal period can influence physical and psychological health of women. This will be achieved by comparing two groups, i.e., women involved in the group intervention with women receiving standard care. Women will be offered a group model of care and education at their booking-in appointment, thus participants have choice and to whether they engage in the group-based intervention, or standard care. The intervention is a group-based model of perinatal care that will consist of education and support provided by a team of allied health professionals, together with medical care from midwives. The education and support are provided by a multidisciplinary team of perinatal health professionals, including, a women’s health physiotherapist, a psychologist, dietitian, yoga instructor and a lactation consultant, in addition to the hospital midwives. The group care model will be offered to women who meet the inclusion criteria (as identified by the outpatient’s manager) at their booking-in appointment. Women involved in the intervention will receive an individual face-to-face booking-in appointment and another individual health visit with the doctor. From this point, the women’s clinical appointments are completed via telehealth virtual visits. At 31-weeks, their clinical visits are in a group online format, combining education. The groups will consist of 8 – 12 women and will run at 31, 34, 36 and 38 weeks and will be 90 minutes in length. There are also four group postnatal education sessions, conducted online. These are held weekly for 90 minutes, beginning at 2 – 4 weeks after birth. The modules are facilitated by key health professionals for open engagement and discussion of topics. The antenatal group-based online education sessions will be provided by a multidisciplinary team, as outlined above. Topics include (but not limited to): important nutrients for the growth and development of a growing fetus, important nutrients for skin integrity (birth), nutrients for breastfeeding. Strategies to deal with common pregnancy discomforts and exercise during pregnancy. Expectations of birth and the changing roles and relationships, challenges of pregnancy, birth and early parenthood. Techniques to manage pain during labour and birth. Breastfeeding attachments techniques and tips for breastfeeding success. In the postnatal group-based online education sessions, topics covered will include: a birth debrief, recovery from birth, e.g. when to resume exercise and associated mother-baby bonding activities, e.g. mother-baby yoga. Alongside the structured clinical care and education, women in the group intervention will have access to an online portal where they will be able to access timely information relevant to each stage of pregnancy and early parenthood. The online portal will be able to capture individual analytics and any women who are not able to make any scheduled online session, will be followed up.