Publications by authors named "Sara Kenyon"
Background: Understanding why children die is important for grieving parents and for informing system improvements aimed at prevention and future care. Many countries have child death review (CDR) process, but little is known about how best to engage parents. The aim of this study was to use experience-based co-design to create a toolkit to support parental involvement in CDR.
View Article and Find Full Text PDFArticle Synopsis
- Implementing research findings into clinical practice is difficult, as shown by the study exploring the BUMPES and RESPITE trials in UK maternity care.
- The study involved interviews with healthcare professionals to understand factors affecting the adoption of these interventions, using a framework that focuses on behavior change.
- While most participants were aware of the trials, the actual implementation was low due to barriers like time constraints and resistance to the changes, indicating a need for broader strategies to integrate evidence into practice.
Objective: To determine the change in English emergency postnatal maternal readmissions 2007-2017 (pre-COVID-19) and the association with maternal demographics, obstetric risk factors and postnatal length of stay (LOS).
Design: National cohort study.
Setting: All English National Health Service hospitals.
Background: Internationally, intermittent auscultation (IA) is recommended for monitoring the fetal heart rate during labour and birth for women with uncomplicated pregnancies. IA can identify changes in the fetal heart rate that may indicate the need for additional care or intervention. IA is a central facet of midwifery practice, but there is little evidence about women's experience of IA.
View Article and Find Full Text PDFBackground: Midwifery continuity of carer (MCoC) is a model of care in which the same midwife or small team of midwives supports women throughout pregnancy, birth and the postnatal period. The model has been prioritised by policy makers in a number of high-income countries, but widespread implementation and sustainability has proved challenging.
Methods: In this narrative review and synthesis of the global literature on the implementation and sustainability of midwifery continuity of carer, we identify barriers to, and facilitators of, this model of delivering maternity care.
Background: Language, communication and understanding of information are central to safe, ethical and efficient maternity care. The National Health Service (NHS) commissioning board, NHS England, describes how healthcare providers should obtain language support through professionally trained interpreters. Providers of interpreters are commissioned to deliver remote/face to face interpretation across the NHS.
View Article and Find Full Text PDFBackground: Ethnic disparities in maternal mortality are consistently reported. This study aimed to investigate the contribution of known risk factors including age, socioeconomic status, and medical comorbidities to observed ethnic disparities in the United Kingdom (UK).
Methods: A cohort of all women who died during or up to six weeks after pregnancy in the UK 2009-2019 were identified through national surveillance.
Objectives: To explore local induction of labour pathways in the UK National Health Service to provide insight into current practice.
Design: National survey.
Setting: Hospital maternity services in all four nations of the UK.
Problem: COVID-19 impacted negatively on maternity care experiences of women and staff. Understanding the emergency response is key to inform future plans.
Background: Before the COVID-19 pandemic, experts highlighted concerns about UK community postnatal care, and its impact on long-term health, wellbeing, and inequalities.
Background: Reasons for ethnic disparities in maternal death in the UK are unclear and may be explained by differences in social risk factors and engagement with maternity services.
Methods: In this retrospective systematic case note review, we used anonymised medical records from MBRRACE-UK for all Other than White, and White European/Other women plus a random sample of White British/Irish women who died in pregnancy or up to 1 year afterwards from 01/01/2015 to 12/31/2017. We used a standardised data extraction tool developed from a scoping review to explore social risk factors and engagement with maternity services.
Background: Ethnic disparities in maternal mortality were first documented in the UK in the early 2000s but are known to be widening. This project aimed to describe the women who died in the UK during or up to a year after the end of pregnancy, to compare the quality of care received by women from different aggregated ethnic groups, and to identify any structural or cultural biases or discrimination affecting their care.
Methods: National surveillance data was used to identify all 1894 women who died during or up to a year after the end of pregnancy between 2009 and 18 in the UK.
Background: Meaningful public involvement in maternity research remains challenging, partly due to the transient nature of pregnancy. This paper reflects on the development, implementation and simple evaluation of an innovative and inclusive approach to engaging and involving pregnant and early postnatal women in research.
Methods: Between January and February 2018, a Research Fellow in Maternity Care, a Professor of Evidence Based Maternity Care, and a Patient and Public Involvement Lead convened for a number of meetings to discuss how public involvement and engagement might be improved for pregnancy-related research.
Objective: To explore views and experiences of community midwives delivering postnatal care.
Design: A descriptive qualitative study design undertaking focus groups with community midwives and community midwifery team leaders.
Setting: All focus groups were carried out in community midwifery care settings, across four hospitals in two NHS organisations, April to June 2018 in the West Midlands, UK.
Objectives: To explore the effect of introducing 24/7 resident labour ward consultant presence on neonatal and maternal outcomes in a large obstetric unit in England.
Design: Retrospective time sequence analysis of routinely collected data.
Setting: Obstetric unit of large teaching hospital in England.
Background: Disparities have been documented in maternal mortality rates between women from different ethnic, age and socio-economic groups in the UK. It is unclear whether there are differential changes in these rates amongst women from different groups over time. The objectives of this analysis were to describe UK maternal mortality rates in different age, ethnic and socio-economic groups between 2009 and 2017, and to identify whether there were changes in the observed inequalities, or different trends amongst population subgroups.
View Article and Find Full Text PDFObjectives: To assess the effectiveness of a brief behavioural intervention based on routine antenatal weighing to prevent excessive gestational weight gain (defined by US Institute of Medicine).
Design: Randomised controlled trial.
Setting: Antenatal clinic in England.
Objectives: Local reviews of the care of women who die in pregnancy and post-birth should be undertaken. We investigated the quantity and quality of hospital reviews.
Design: Anonymised case notes review.
Objective: UK policy is advocating continuity of midwife throughout the antenatal, intrapartum and postnatal period in order to improve outcomes. We explored the working patterns that midwives are willing and able to adopt, barriers to change, and what would help midwives to work in continuity models of care.
Design: A cross-sectional survey.
Background: Multivariate meta-analysis (MVMA) jointly synthesizes effects for multiple correlated outcomes. The MVMA model is potentially more difficult and time-consuming to apply than univariate models, so if its use makes little difference to parameter estimates, it could be argued that it is redundant.
Methods: We assessed the applicability and impact of MVMA in Cochrane Pregnancy and Childbirth (CPCB) systematic reviews.
Objectives: This study compares rapid and traditional analyses of a UK health service evaluation dataset to explore differences in researcher time and consistency of outputs.
Design: Mixed methods study, quantitatively and qualitatively comparing qualitative methods.
Setting: Data from a home birth service evaluation study in a hospital in the English National Health Service, which took place between October and December 2014.
Background: Evidence suggests that home birth is as safe as hospital birth for low risk multiparous women, and is associated with reduced intervention rates and increased rates of normal birth. However the home birth rate in the UK is low, and few women choose this option. The aims of this study were to identify what influences multiparous women's choice of birth place, and to explore their views of home birth.
View Article and Find Full Text PDFObjective: Traditionally two midwives attend home births in the UK. This paper explores the implementation of a new home birth care model where births to low risk women are attended by one midwife and one Midwifery Support Worker (MSW).
Design And Setting: The study setting was a dedicated home birth service provided by a large UK urban hospital.