Improving women’s perinatal mental health

Griffith midwives and antenatal clients Photo of Students Jan Robinson (right), Julie Oliver (left) with mum to be, Tiffany Shipp

Addressing the barriers that can prevent midwives helping mothers overcome a fear of childbirth is the focus of a new study at Griffith University.

With a Queensland Government grant of over $119,000, the team is building on its previous research which has found that many midwives either seek improved skills to address women’s emotional needs or alternatively, that organisational structured processes may thwart them.

“It is already well understood that around one in four women report being fearful about their upcoming birth and this may be associated with a variety of factors such as anxiety, depression and stress, as well as isolation and poor social support,” says Professor Jenny Gamble from Griffith’s Menzies Health Institute Queensland.

“We also know from prior work that an evidence-based intervention in the form of counselling provided by a midwife, can significantly lower these levels of fear and enhance the overall childbirth experience for a woman.

“What we want to do in this two year, three phase study is to translate these results into ‘everyday’ midwifery practice.”

With support from the multidisciplinary maternity team at the Gold Coast University Hospital – whereby clinicians will be asked to complete self-administered surveys – the study will initially review the enablers and barriers to organisational change.

“This will include, for example the scheduling of antenatal appointments, clinical protocols, skill mix and similar factors that may impact integration of midwife skills to practice,” says Professor Gamble. “Based on our findings a number of implementation strategies to support change will be identified and acted on to support phase 2 of the study.”
The second phase will take approximately 25 midwives to attend a five day training program teaching them the skills required to integrate structured counselling into their practice.

“For the final phase, we will be assessing the changes or trends in levels of fear, depression and birth mode across the service,” says Professor Gamble. “Assessing how successful the midwives have been in translating their learning into midwifery practice will be key to us then implementing strategies that best support them as they learn to use an evidence-based counselling approach in their day-to-day practice.

“Unfortunately, in our current fragmented health systems, we restrict midwives’ ability to offer these kinds of services. In this study, we’re building on these important skills and aiming to free them from the organisational constraints that they may encounter.”

Professor Gamble says that the aim is to continue momentum with a widespread uptake of evidence-based counselling to improve pregnant women’s emotional health and facilitate normal childbirth.