This project will facilitate further development of a fear of childbirth (FOC)/tokophobia care pathway to include a method for screening for FOC within clinical care, and a programme of training workshops for health professionals in the clinical use of the defined FOC screening method. A key component of this project is that it will be delivered remotely in its entirety from design, to data collection through to dissemination, offering a critical and novel approach to qualitative research in the time of Covid 19 pandemic. The project will take place between April 2021 and April 2022 (12 months).
This is a collaborative project with Humber Teaching NHS.
Funded by East Riding of Yorkshire Clinical Commissioning Group
Contacts: Dr Catriona Jones, Senior Lecturer, Maternal Mental Health and Claire Marshall, Senior Specialist Perinatal Mental Health Nurse, Hull and East Yorkshire Perinatal Mental Health Liaison Service
Perinatal Mental Illness (PMI) spans the spectrum of pregnancy and childbirth and is now acknowledged as a significant global problem and an important public health issue. Specialist Perinatal Mental Health (PMH) service provision is patchy across the United Kingdom (UK). This evaluation explored the impact of a Specialist Perinatal Mental Health (PMH) service on perinatal mental health outcomes and the patient experience. Recovery rates were observed across all outcome measures, and positive experiences were expressed by women who used the service, demonstrating favourably that the service is meeting the ambitions of the Five Year Forward view for mental health.
This is a collaborative project with Humber Teaching NHS
Funded by NHS England
Contact: Dr. Catriona Jones, Senior Lecturer, Maternal Mental Health
Many women experience pain in labour. Pain can be made worse by fear, worry and feeling out of control. High levels of pain can affect how a woman copes in the first few weeks and months after birth. Many women report feeling pain in their stomach and lower back. A low-cost way to help with pain is the use of ice packs, and research has shown that for some women, ice packs can help pain during labour. Ice packs are an option, which might appeal to women as they are simple, they don’t cause side effects and they can be used quickly without having to wait for a doctor to prescribe them. They can be used by the woman herself which can make her feel more in control, especially in terms of how much, and how often they can be used. Most other methods of pain relief have drawbacks, for example, gas and air can make women feel sick, injections can make women and their babies drowsy and affect early breastfeeding, epidurals have been linked to more use of forceps, less ability to push, headaches, backache and low blood pressure.
This work has been undertaken to support a project designed to determine the effectiveness of ice packs on intrapartum pain intensity, birth satisfaction, and perinatal wellbeing. This is a six month project.
Funded by Research Design Service Yorkshire and Humber Public Involvement fund
Contact: Dr. Catriona Jones, Senior Lecturer, Maternal Mental Health
This project is based upon the recent introduction of a pathway of care for women with severe fear of childbirth/tokophobia in the local trust. In Hull and East Riding of Yorkshire, where there is an established perinatal mental health (PMH) service for women and their families, there has been a recognised need for a consistent approach to caring for and supporting women with varying levels of Fear of childbirth (FOC), starting with timely referral. In 2018/2019 a pathway of care was developed using a bottom-up approach, and informed by research and consultation with PMH experts, care providers and patient representatives. The pathway was launched in September 2019.
This project is based on the evaluation of the implementation of the pathway, with the aim of exploring the impact of the pathway since implementation by identifying women who have been allocated to the pathway, and exploring how robust and consistent the systems for identifying women are. The process evaluation uses mixed methods of data collection and analysis. This is a 12 month project.
Contact: Dr. Catriona Jones, Senior Lecturer, Maternal Mental Health
It is widely acknowledged that the maternal intrapartum experience, alongside obstetric, neonatal and maternal outcomes are intrinsically linked to postpartum health and wellbeing, and future decision making around subsequent pregnancy. A negative birth experience has been found to be associated with post-natal depression. A number of studies highlight the positive impact of training on patient safety, showing improved perinatal and obstetric outcomes. In-house multi-professional training focusing on obstetric emergencies has been found to improve the management of birth complications and neonatal outcomes. Training in shoulder dystocia has been associated with reduced incidence of obstetric brachial plexus injury (OBPI), and improved staff confidence in managing unanticipated obstetric emergencies. Interprofessional team training has been shown to enhance inter-professional collaboration, increase confidence and quality of care; training had an enduring impact and participants continued to reflect on their roles within the emergency up to 6 months afterwards.
This evaluation was undertaken to determine both the immediate and sustained impact of multi-professional training in cardiotocograph (CTG) interpretation, and community-based simulation training in obstetric emergencies; childbirth emergencies in the community (CEC). The impact was measured in terms of practitioner knowledge, confidence, and empowerment immediately pre and post training, and at 12 weeks following training. The combined qualitative and quantitative results highlighted that training had a positive impact on knowledge, confidence and empowerment; an impact which was observed across 3 time points. Conclusions: Training in CTG and CEC is effective in improving knowledge, confidence and empowerment across all groups. Furthermore, the provision of training packages in these subject areas facilitates improvements in the longer term. This is a 12 month project.
Contact: Dr. Catriona Jones, Senior Lecturer, Maternal Mental Health
There is strong evidence to suggest that assisting mothers to actively participate in natural, empowering births has important psychobiological benefits for mothers and their babies as they progress into infanthood (Humenick and Howell 2003). Equally, women's negative experiences in the delivery room can have significance for later fear of childbirth. This study explores the preferences of women who are eligible to book to the Fatima Allam Birth Centre and to determine their knowledge, preferences, views and experiences of the concept of midwifery-led care.
A key longer-term aim – outside of the remit of this exploratory study - is to understand locally what factors help or hinder both women in the choices they make, and midwives/other health professionals in the promotion of differing maternity services. This can be explored through approaches which focus on the individual, community, and environmental influences on behaviour. Behaviour change is a central objective in public health interventions (World Health Organization 2002) in line with best health policies based on evidence that enables the public to choose healthier behaviours, especially when they have accurate information from professionals they trust. The midwife-woman relationship is synonymous with one another (Hunter, Berg et al. 2008) and midwives are ideally situated to endorse the positive associations of this birth setting. This is a six month project.
Funded by East Riding of Yorkshire Clinical Commissioning Group
Contact: Dr. Catriona Jones, Senior Lecturer, Maternal Mental Health