Midwives speaking out on COVID-19: The international confederation of midwives global survey.

Background: Maternity services around the world have been disrupted since the outbreak of the COVID-19 pandemic. The International Confederation of Midwives (ICM) representing one hundred and forty-three professional midwifery associations across the world sought to understand the impact of the pandemic on women and midwives.

Aim: The aim of this study was to understand the global impact of COVID-19 from the point of view of midwives' associations.

Women's unmet needs in early labour: Qualitative analysis of free-text survey responses in the M@NGO trial of caseload midwifery.

Objective: to analyse women's experiences of early labour care in caseload midwifery in Australia.

Design: this study sits within a multi-site randomised controlled trial of caseload midwifery versus standard care. Participant surveys were conducted at 6-weeks and 6-months after birth.

Evaluation of an Australian Aboriginal model of maternity care: The Malabar Community Midwifery Link Service.

Background: The urban-based Malabar Community Midwifery Link Service integrates multidisciplinary wrap-around services along-side continuity of midwifery care for Aboriginal and Torres Strait Islander mothers and babies.

Aim: To evaluate the Malabar Service from 1 January 2007 to 31 December 2014.

Methods: A mixed method design.

The impact of caseload midwifery, compared with standard care, on women's perceptions of antenatal care quality: Survey results from the M@NGO randomized controlled trial for women of any risk.

Background: The measurement and interpretation of patient experience is a distinct dimension of health care quality. The Midwives @ New Group practice Options (M@NGO) randomized control trial of caseload midwifery compared with standard care among women regardless of risk reported both clinical and cost benefits. This study reports participants' perceptions of the quality of antenatal care within caseload midwifery, compared with standard care for women of any risk within that trial.

Newborn self-inflating manual resuscitators: precision robotic testing of safety and reliability.

Aim: A controlled bench test was undertaken to determine the performance variability among a range of neonatal self-inflating bags (SIB) compliant with current International Standards Organisation (ISO).

Introduction: Use of SIB to provide positive pressure ventilation during newborn resuscitation is a common emergency procedure. The United Nations programmes advocate increasing availability of SIB in low-income and middle-income nations and recommend devices compliant with ISO.

Evaluating Maternity Units: a prospective cohort study of freestanding midwife-led primary maternity units in New Zealand-clinical outcomes.

Objective: To compare maternal and neonatal birth outcomes and morbidities associated with the intention to give birth in a freestanding primary level midwife-led maternity unit (PMU) or tertiary level obstetric-led maternity hospital (TMH) in Canterbury, Aotearoa/New Zealand.

Design: Prospective cohort study.

Participants: 407 women who intended to give birth in a PMU and 285 women who intended to give birth at the TMH in 2010-2011.

Collective action for the development of national standards for midwifery education in Australia.

This article describes a sequence of events that led to the development of national standards for the accreditation of Australian midwifery education programmes for initial registration. This process occurred within a climate of polarised opinions about the value of the introduction of three-year degree programmes for midwives who are not nurses (known as the BMid in Australia) and concerns about the invisibility of midwifery within nursing regulation, education, policy and nomenclature. Concerted efforts to develop standards to inform the introduction of BMid programmes through a process of collective action are described.

Freestanding midwifery units: Maternal and neonatal outcomes following transfer.

Background: the viability of freestanding midwifery units in Australia is restricted, due to concerns over their safety, particularly for women and babies who, require transfer.

Aim: to compare the maternal and neonatal birth outcomes of women who planned, to give birth at freestanding midwifery units and subsequently, transferred to a tertiary maternity unit to the maternal and neonatal, outcomes of a low-risk cohort of women who planned to give birth in, tertiary maternity unit.

Methods: a descriptive study compared two groups of women with low-risk singleton, pregnancies who were less than 28 weeks pregnant at booking: women who, planned to give birth at a freestanding midwifery unit (n=494) who, transferred to a tertiary maternity unit during the antenatal, intrapartum or postnatal periods (n=260) and women who planned to give, birth at a tertiary maternity unit (n=3157).

The presence of vaginal Lactobacillus species does not contribute to a measureable difference in amniotic fluid lactate levels collected from the vaginal tract of laboring women.

Introduction: Amniotic fluid lactate research is based on the hypothesis that a relationship exists between fatigued uterine muscles and raised concentrations of the metabolite lactate, which is excreted into the amniotic fluid during labor. To assess potentially confounding effects of lactate-producing organisms on amniotic fluid lactate measurements, we aimed to determine if the presence of vaginal Lactobacillus species was associated with elevated levels of amniotic fluid lactate, measured from the vaginal tract of women in labor.

Material And Methods: Results from this study contribute to a large prospective longitudinal study of amniotic fluid lactate at a teaching hospital in Sydney, Australia.

Women's experiences of transfer from primary maternity unit to tertiary hospital in New Zealand: part of the prospective cohort Evaluating Maternity Units study.

Background: There is worldwide debate regarding the appropriateness and safety of different birthplaces for well women. The Evaluating Maternity Units (EMU) study's primary objective was to compare clinical outcomes for well women intending to give birth in either a tertiary level maternity hospital or a freestanding primary level maternity unit. Little is known about how women experience having to change their birthplace plans during the antenatal period or before admission to a primary unit, or transfer following admission.

Transfer from primary maternity unit to tertiary hospital in New Zealand - timing, frequency, reasons, urgency and outcomes: Part of the Evaluating Maternity Units study.

Objectives: to examine the transfers from primary maternity units to a tertiary hospital in New Zealand by describing the frequency, timing, reasons and outcomes of those who had antenatal or pre-admission birthplace plan changes, and transfers in labour or postnatally.

Design: mixed methods prospective (concurrent) cohort study, which analysed transfer and clinical outcome data (407 primary unit cohort, 285 tertiary hospital cohort), and data from the six week postpartum survey (571 respondents).

Participants And Setting: well, pregnant women booked to give birth in a tertiary maternity hospital or primary maternity unit in one region in New Zealand (2010-2012).

QF2011: a protocol to study the effects of the Queensland flood on pregnant women, their pregnancies, and their children's early development.

Background: Retrospective studies suggest that maternal exposure to a severe stressor during pregnancy increases the fetus' risk for a variety of disorders in adulthood. Animal studies testing the fetal programming hypothesis find that maternal glucocorticoids pass through the placenta and alter fetal brain development, particularly the hypothalamic-pituitary-adrenal axis. However, there are no prospective studies of pregnant women exposed to a sudden-onset independent stressor that elucidate the biopsychosocial mechanisms responsible for the wide variety of consequences of prenatal stress seen in human offspring.

Women׳s birthplace decision-making, the role of confidence: Part of the Evaluating Maternity Units study, New Zealand.

Objective: to explore women׳s birthplace decision-making and identify the factors which enable women to plan to give birth in a freestanding midwifery-led primary level maternity unit rather than in an obstetric-led tertiary level maternity hospital in New Zealand.

Design: a mixed methods prospective cohort design.

Methods: data from eight focus groups (37 women) and a six week postpartum survey (571 women, 82%) were analysed using thematic analysis and descriptive statistics.

A validation study: assessing the reliability of the hand held StatStripXPress lactate meter to test lactate in amniotic fluid.

Background: The level of lactate in amniotic fluid may provide useful clinical information when assessing whether a woman in labour is experiencing labour dystocia. If so, a rapid, reliable method to assess the concentration of amniotic fluid lactate at the bedside will be required in order to be clinically relevant. To assess efficacy, we compared the hand held StatStripXPreass lactate meter (Nova Biomedical) to the reference laboratory analyser ABX Pentra 400 (Horiba) in a controlled environment.

An exploration of influences on women's birthplace decision-making in New Zealand: a mixed methods prospective cohort within the Evaluating Maternity Units study.

Background: There is worldwide debate surrounding the safety and appropriateness of different birthplaces for well women. One of the primary objectives of the Evaluating Maternity Units prospective cohort study was to compare the clinical outcomes for well women, intending to give birth in either an obstetric-led tertiary hospital or a free-standing midwifery-led primary maternity unit. This paper addresses a secondary aim of the study--to describe and explore the influences on women's birthplace decision-making in New Zealand, which has a publicly funded, midwifery-led continuity of care maternity system.

Maternal morbidity of women receiving birth center care in New South Wales: a matched-pair analysis using linked health data.

Background: Around 2 percent of women who give birth in Australia each year do so in a birth center. New South Wales, Australia's largest state, accounts for almost half of these births. Previous studies have highlighted the need for better quality data on maternal morbidity and mortality, to fully evaluate the safety of birth center care.

Caseload midwifery compared to standard or private obstetric care for first time mothers in a public teaching hospital in Australia: a cross sectional study of cost and birth outcomes.

Background: In many countries midwives act as the main providers of care for women throughout pregnancy, labour and birth. In our large public teaching hospital in Australia we restructured the way midwifery care is offered and introduced caseload midwifery for one third of women booked at the hospital. We then compared the costs and birth outcomes associated with caseload midwifery compared to the two existing models of care, standard hospital care and private obstetric care.

Caseload midwifery care versus standard maternity care for women of any risk: M@NGO, a randomised controlled trial.

Background: Women at low risk of pregnancy complications benefit from continuity of midwifery care, but no trial evidence exists for women with identified risk factors. We aimed to assess the clinical and cost outcomes of caseload midwifery care for women irrespective of risk factors.

Methods: In this unblinded, randomised, controlled, parallel-group trial, pregnant women at two metropolitan teaching hospitals in Australia were randomly assigned to either caseload midwifery care or standard maternity care by a telephone-based computer randomisation service.

A pilot study to determine the feasibility of collecting amniotic fluid samples from women during labour and measuring amniotic fluid lactate at point of care.

Background: The level of lactate in amniotic fluid may provide useful clinical information when assessing progress of a woman's labour and if so, a rapid, reliable method to assess amniotic fluid lactate is required in order to be clinically relevant. However, measuring lactate levels in amniotic fluid, using portable, handheld lactate meters may be less accurate than reference laboratory instruments designed to measure lactate levels in aqueous solutions. Prior to conducting a large study, we assessed recruitment, consent and sampling procedures, and the accuracy of a handheld lactate meter to measure lactate in amniotic fluid.

Evaluating midwifery units (EMU): lessons from the pilot study.

Objective: this paper describes the pilot study that was undertaken to test the feasibility of the recruitment plan designed to recruit women who booked to give birth in two freestanding midwifery units in NSW, Australia. The pilot preceded the full prospective cohort study, Evaluating Midwifery Units (EMU), which aimed to examine the antenatal, birth and postnatal outcomes of women planning to give birth in freestanding midwifery units compared to those booked to give birth in tertiary level maternity units in Australia and New Zealand.

Design: a prospective cohort study with two mutually-exclusive cohorts.

Outpatient Foley catheter versus inpatient prostaglandin E2 gel for induction of labour: a randomised trial.

Background: Induction of labour (IOL) is one of the commonest obstetric interventions, with significant impact on both the individual woman and health service delivery. Outpatient IOL is an attractive option to reduce these impacts. To date there is little data comparing outpatient and inpatient IOL methods, and potential safety concerns (hyperstimulation) if prostaglandins, the standard inpatient IOL medications, are used in the outpatient setting.

New Zealand's unique maternity system.

This discussion paper describes New Zealand's maternity system. It includes a brief background of the country and its history, key aspects of the legislative and funding contexts and the framework for the woman centred and midwife-led maternity system itself.

Collaboration in maternity care is achievable and practical.

Background: Enhancing collaboration has been highlighted as a marker for future success in maternity care, although this suggestion comes with little methodological guidance. This study assessed the efficacy of a collaborative partnership between obstetric doctors and midwives providing Midwifery Group Practice (MGP) care.

Methods: A retrospective analysis was undertaken with notes from weekly case review meetings held between the obstetricians and midwives over a 12-month period; audio recordings and a prospective analysis of 16 meetings with verbal contributions of the different professions; the number and types of cases discussed and referred, medical records kept at these meetings and a professional satisfaction questionnaire.