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Harnessing technology to enable mobility in labour and birth for women with increased Body Mass Index (BMI)

Project Member(s): Fox, D., Coddington, R., Scarf, V.

Funding or Partner Organisation: Philips Medizin Systeme Böblingen GmbH
Philips Medizin Systeme Böblingen GmbH

Start year: 2021

Summary: This multi site hybrid RCT will compare standard care (cardiotocograph) with a new form of fetal monitoring, non invasive fetal ECG (NIFECG) in women with a BMI>35. Hybrid RCT Type 1 methodology, following the approach of Curran et al. (2012) will use a hybrid effectiveness-implementation typology. The study design therefore enables a dual focus a priori, testing the effectiveness of a clinical intervention on specified outcomes whilst also collecting data on implementation needs. The primary outcome of interest is to compare operative birth rates and to ascertain whether fetal monitoring with the NIFECG, in comparison to standard CTG care, reduces the incidence of false positive results for fetal hypoxia leading to operative birth for women with BMI>35. Secondary outcomes of interest to implementation needs include clinicians' experiences of using NIFECG, evaluation from routinely collected data of whether invasive fetal scalp electrode use is reduced in the intervention group, comparing women's sense of agency in labour between the groups, and a comparison of midwives' ability to practice woman centred care. A validated tool called the Labour Agentry Scale will be used to measure women's sense of agency and autonomy in labour. An ethnographic component of the study will explore the midwives' ability to practice woman centred care as evaluated against the concept of 'Watchful attendance' (de Jonge et al. 2021). The ethnographic observation will include measurement with a stopwatch of the time midwives spend attending to technologies.

Publications:

Coddington, R, Fox, D, Scarf, V & Catling, C 2023, 'Getting kicked off the program: Women’s experiences of antenatal exclusion from publicly-funded homebirth in Australia', Women and Birth, vol. 36, no. 1, pp. e179-e185.
View/Download from: Publisher's site

Fox, D 1970, 'Beyond the CTG:', Tropical Australian Academic Health Centre: Women's Health Forum, Cairns, Australia.

FOR Codes: Midwifery, Health