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Maternal, Child and Family Health - All Projects

The REDUCE Study

Maternal mortality and severe morbidity are doubled following CS compared with vaginal birth, and neonatal respiratory distress requiring oxygen is 2-7 times more common. CS costs €739 (elective) or €1180 (emergency) more than vaginal birth. This research team previously tested an intervention in Ireland, Germany and Italy ("OptiBIRTH") designed to increase vaginal birth after caesarean section (VBAC), thus reducing repeat CS in women who had CS before. The REDUCE study aimed to apply this knowledge to develop a similar intervention designed to reduce the number of unnecessary CSs in Ireland, which would have health benefits for both mothers and babies. The team aimed to develop an intervention using information from a review of 101 systematic reviews of trials, and evidence-based national guidelines, aimed at reducing CS rates, and feedback from women, their partners and clinicians in 8 focus group interviews (FGIs). As a result of the COVID-19 pandemic, the intervention did not go ahead.

Dissemination: In progress

The impact of COVID-19 on pregnant women's clinical and experiential outcomes – a before and after study with an alongside qualitative design: Aug 2020-Dec 2020

This project explores the possible impact that COVID-19 has had on maternal and neonatal clinical outcomes. It also explores women’s experience of maternity care during the COVID-19 pandemic. Funded by Trinity College Dublin - COVID19 Response Funding.

Team

  • Professor Valerie Smith (Professor in Midwifery)
  • Dr Sunita Panda (Lecturer UCC)
  • Dr Deirdre O’Malley (Assistant Professor in Midwifery)
  • Ms Paula Barry (Practice Development Co-Ordinator, The Coombe Women and Infants University Hospital)
  • Ms Nora Vallejo (Advanced Midwife Practitioner)

Dissemination: In progress

An online survey to determine the antenatal education needs of primigravid women attending the CWIUH to inform a programme of antenatal education offered by midwives

In March 2020, all CWIUH antenatal class services ceased in response to the onset of the COVID-19 pandemic and in line with HSE recommendations. The CWIUH parent education team has since designed and developed interactive online classes comprising video presentations, and a live discussion platform for women and their partners to interact in a virtual capacity with healthcare professionals. As part of our commitment to developing the programme of antenatal education offered by midwives, we are conducting an online survey to identify the antenatal education needs of primigravid women attending the CWIUH in the absence of face-to-face antenatal education classes.

Team

  • Professor Vivienne Brady (Assistant Professor in Midwifery)

Dissemination: In progress

TechChild

TechChild: Just because we can, should we? An anthropological perspective on the initiation of technology dependence to sustain a child's life
TechChild is a 5-year project exploring the initiation of technology dependence and is funded by the European Research Council.

TechChild team

  • Dr Denise Alexander (Postdoctoral Research Fellow)
  • Dr Mary Quirke (Postdoctoral Research Fellow)
  • Kate Masterson (Doctor researcher)
  • Katie Hill (Doctoral researcher)
  • Dr Carmel Doyle (Assistant Professor in Nursing)

Publications

  • Brenner M., Alexander D., Quirke M.B., Eustace-Cook J., Leroy P., Berry J., Healy M., Doyle C. & Masterson K. (2021) A systematic concept analysis of `technology dependent': challenging the terminology. European Journal of Pediatrics 180(1), 1-12.   http://www.tara.tcd.ie/handle/2262/93504
  • Alexander D., Eustace-Cook J. & Brenner M. (2020) Approaches to the initiation of life-sustaining technology in children: a scoping review of changes over time. Journal of Child Health Care September 2020, 1-14. https://journals.sagepub.com/doi/10.1177/1367493520961884

Risk factors for and outcomes associated with reduced fetal movements in pregnancy: a matched cohort study

The project is a large case-control cohort study comparing risk factors and outcomes in pregnant women with reduced fetal movements (cases) and those without reduced fetal movements (controls). The study is being conducted as a doctoral project and at one maternity unit in Ireland.

Team

  • Prof. Valerie Smith (Professor in Midwifery)
  • Louise Gallagher (Assistant Professor, School of Nursing & Midwifery)
  • Lorraine Carroll (Lecturer/Assistant Professor School of Nursing, Midwifery and Health Systems)

Project outputs

  • Carroll L., Gallagher L. & Smith V. (2019) Risk factors for reduced fetal movements in pregnancy: a systematic review and meta-analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology 243, 72-82. https://doi.org/10.1016/j.ejogrb.2019.09.028 

The impact of COVID-19 on clinical outcomes for pregnant women

The impact of COVID-19 on pregnant women’s clinical and experiential outcomes – a before and after study with an alongside qualitative design. 
This is a two-phase project. In the first phase, pregnant women’s clinical outcomes (e.g. mode of birth, induction of labour, breastfeeding rates, etc.) for four months before COVID-19 were compared with outcomes four months during COVID-19 to assess any impact that COVID-19 practice changes might have had on these outcomes. The study was carried out in one maternity unit in Ireland. In phase two, interviews took place with 19 women who gave birth 4-6 weeks after the full national COVID-19 lockdown to gain insight and understanding of their experiences and views of maternity care during this time.

Team

  • Prof. Valerie Smith (Professor in Midwifery)
  • Dr. Deirdre O’Malley (Assistant Professor in Midwifery)
  • Dr. Sunita Panda (Lecturer, UCC)
  • Ms. Nora Vallejo (Advanced Midwife Practitioner)
  • Ms. Paula Barry (Midwife, Coombe Hospital)

Project outputs: In progress

An evidence synthesis project is aligned with this project, involving a synthesis of qualitative data on women’s and healthcare providers views and experiences of maternity care during COVID-19. The protocol for the project is published.

  • Smith V., Flaherty S.J., Matvienko-Sikar K. & Delaney H. (2021) Maternity care during COVID-19: a protocol for a qualitative evidence synthesis of women’s and maternity care providers’ views and experiences. HRB Open Research 4, 21. https://doi.org/10.12688/hrbopenres.13233.1

Maternity Early Warning Systems

This is an evidence synthesis project on i) the effectiveness and ii) the experiences of maternity early warning systems in practice

Team

  • Effectiveness team: Valerie Smith, Jane Sandall, Louise Kenny, Declan Devane
  • Experiences team: Valerie Smith, Kumar Chitambaram, Deirdre O’Malley

Dissemination: In progress

  • Smith V., Kenny L.C., Sandall J. & Devane D. (2019) Physiological track‐and‐trigger/early warning systems for use in maternity care. Cochrane Database of Systematic Reviews 6, CD013276. https://doi.org/10.1002/14651858.CD013276

The MAMMI Study

The MAMMI (Maternal Morbidity and Maternity health In Ireland) Study is a longitudinal cohort study examining the health and health issues of first-time mothers in Ireland. The study began recruitment in 2012 in 3 maternity hospitals and is led by Dr. Deirdre Daly. The aim of the study is to identify the existence, extent, prevalence and risk factors of maternal morbidity in first time mothers.  

Team

  • Prof. Déirdre Daly (Assistant Professor, School of Nursing & Midwifery)
  • Prof. Cecily Begley (Chair of Nursing & Midwifery)
  • Prof. Valerie Smith (Professor in Midwifery)
  • Prof. Agnes Higgins (Professor in Mental Health, School of Nursing & Midwifery)
  • Prof. Mike Clarke (Director of Campus Infrastructure, TCD)
  • Prof. Margaret Carroll (Associate Professor in Midwifery, School of Nursing and Midwifery- retired)

Publications

  • Daly D., Carroll M., Barros M. & Begley C. (2019) Stop, think, reflect, realise - first-time mothers' views on taking part in longitudinal maternal health research. Health Expectations 22(3), 415 – 425. http://dx.doi.org/10.1111/hex.12861.
  • Daly D., Carroll M., Barron M.N. & Begley C. (2019) ‘First-time mothers’ experiences of taking part in longitudinal maternal health research surveys.’ Trinity Health and Education International Research Conference (THEconf2019). Trinity College Dublin, Dublin, 6-7 March, 88 - 88
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  • Daly D, Barros M, Carroll M, Begley C. (2019) 'Stop, think, reflect, realise – first-time mothers’ experiences of taking part in longitudinal maternal health research.', Conference proceedings, 21st Congress of the Nordic Federation of Midwives. Reykjavik, Iceland, 2-4 May, 5 – 6. https://www.njfcongress.is/wp-content/uploads/2019/04/NJF-2019-Abstractbook.pdf.
  • Daly D., Clarke M., Carroll M. & Begley C. (2018) ‘The MAMMI study - mixing methods and maximising potential from a cohort study.’ Maternity Care Research Symposium - Twenty-one years of research in maternity care - how far have we come?. School of Nursing and Midwifery, Trinity College Dublin, 27 February.
  • Carroll M., Moran P., Begley C., Clarke M. & Daly D. (2018) ‘The MAMMI study (Maternal health And Maternal Morbidity in Ireland).’ Maternity Care Research Symposium - Twenty-one years of research in maternity care - how far have we come?. School of Nursing and Midwifery, Trinity College Dublin, 27 February.
  • Daly D., Wuytack F., Moran P., Begley. C. (2018) ‘Co-producing maternal health research with women – the MAMMI study processes.’ SPHeRE (Structured Population and Health services Research Education) conference. Dublin, Ireland, 11 January.
  • Carroll M., Daly D., Clarke M. & Begley C. (2018) ‘The MAMMI study (Maternal health And Maternal Morbidity in Ireland): Sharing the Findings with the women who took part/are taking part.’ Sharing the Findings Seminar. Oranmore, Galway, 28 April.
  • Daly D., Wuytack F., Moran P. & Begley C. (2018) Co-conducting maternal health research with women - developing the MAMMI study processes, Thinking Participatively Research Conference. Edmonton, Canada, 21 June. URL
  • Daly D., Carroll M., Begley C., Clarke M., (2016) ‘MAMMI Study (Maternal health And Maternal Morbidity in Ireland): What women are telling us about their health before, during and after their first pregnancy…and what you helped achieve.’ Coombe Women and Infants University Hospital, 8 January 2016.
  • Daly D., Begley C. & Clarke M. (2012) ‘The multiple meanings of maternal morbidity.’ Eight Annual Cochrane in Ireland Conference. Dublin City University (DCU) Dublin, 27 January.
  • Maguire R., Mayock P., Daly D., Begley C. & Clarke M. (2012) ‘Considerations Pregnant Women Take Into Account When Deciding to Participating in Research: The MAMMI Study.’ All Ireland Midwifery Conference. Armagh City, Armagh, 18 October.
  • Daly D., Begley C. & Clarke M. (2011) ‘The multiple meanings of maternal morbidity.’ 12th Annual Research Conference. School of Nursing and Midwifery, Trinity College Dublin, 9 – 10 November, p30-
    URL
  • Daly D., Begley C. & Clarke M. (2011) ‘The multiple meanings of maternal morbidity.’ 12th Annual Interdisciplinary Research Conference: Transforming Healthcare through Research: Transforming Healthcare through Research. Trinity College Dublin, 9-10 November.

The MAMMI Study - Urinary Incontinence strand

The aim of this MAMMI study strand, which was funded the Health Research Board (HRB), is to identify the existence, extent, prevalence and associated risk factors of urinary incontinence (UI), one marker of maternal morbidity, in primiparous women antenatally and at 3 and 6 months postpartum.
Objectives

  • To identify the existence, extent and prevalence of urinary incontinence (UI) up to 6 months postpartum for women having their first baby.
  • To identify associated factors for UI including but not limited to: age, BMI, infant birth weight and perineal trauma
  • To identify the health service-seeking behaviours of a sub-sample of women experiencing UI.
  • To identify risk factors for UI that may be amenable to intervention.

Team

  • Prof. Déirdre Daly (Assistant Professor, School of Nursing & Midwifery)
  • Professor Mike Clarke (Director of Campus Infrastructure, TCD)
  • Prof. Cecily Begley (Chair of Nursing & Midwifery)

Dissemination

  • Daly D., Cusack C. & Begley C. (2019) Learning about pelvic floor muscle exercises before and during pregnancy: a cross-sectional study. International Urogynecology Journal 30(6), 965 – 975. http://dx.doi.org/10.1007/s00192-018-3848-3.
  • Daly D., Clarke M. & Begley C. (2018) Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, type, and risk factors. International Urogynecology Journal 29, 353 – 362. http://dx.doi.org/10.1186/s13063-017-2401-x
  • Carroll M., Daly D., Clarke M. & Begley C. (2016). ‘Anal Incontinence in Nulliparous women before and during Pregnancy Findings from the MAMMI study.’ Healthcare Interdisciplinary Research Conference (HIRC). School of Nursing and Midwifery Trinity College Dublin, 3 November.
  • Daly D., Clarke M. & Begley C. (2015) Risk factors for urinary incontinence (UI) in primiparous women before, during and after pregnancy: early findings from the MAMMI (Maternal health And Maternal Morbidity in Ireland) study UI strand. 5th International Nursing and Midwifery Conference 2015. National University of Ireland, Galway, 30 - 31 March, pp43 - 43
    URL
  • Daly D., Begley C. & Clarke M. (2014) ‘Urinary incontinence (UI) and faecal incontinence (FI) in primiparous women before and during pregnancy.’ OPTIMISE2014 Conference: Optimising Childbirth across Europe: An interdisciplinary maternity care conference. Vrije Universiteit Brussels, Belgium, 9 -10 April, 215 – 216. http://hdl.handle.net/2262/82209.
  • Daly D., Begley C. & Clarke M. (2014) ‘Stress urinary incontinence (SUI) before and during early pregnancy - the help and advice-seeking behaviour of primiparous women.’ OPTIMISE2014 Conference: Optimising Childbirth across Europe: An interdisciplinary maternity care conference. Vrije Universiteit Brussel, Belgium, 9 - 10 April, 89 – 90. http://hdl.handle.net/2262/82216.
  • Daly D., Begley C. & Clarke M. (2013) ‘Faecal and urinary incontinence before and during pregnancy - preliminary findings from the MAMMI Study.’ 4th International Nursing and Midwifery Conference 2013. National University of Ireland, Galway, 15-16 April.
  • Daly D., Begley C. & Clarke M. (2012) ‘Urinary incontinence (UI) in primiparous women before and during pregnancy.’ 13th Annual Interdisciplinary Research Conference (Doctoral Colloquium). Trinity College Dublin, 6 November, pp1. http://programme.exordo.com/airc2012/delegates/presentation/73/.

The MAMMI Study- Caesarean section strand

The Caesarean section strand of the MAMMI Study explored the outcomes for women giving birth for the first time and the factors influencing the decision-making process for performing CS. The project was funded by the Health Research Board.

Team

  • Dr. Sunita Panda (Lecturer, UCC)
  • Prof. Cecily Begley (Chair of Nursing & Midwifery)
  • Prof. Déirdre Daly (Assistant Professor, School of Nursing & Midwifery)

Publications

  • Panda S., Begley C. & Daly D. (2020) Influence of women's request and preference on rising rate of caesarean section - a comparison of reviews. Midwifery 88, 102765. doi: 10.1016/j.midw.2020.102765.
  • Begley K., Daly D., Panda S. & Begley C. (2019) Shared decision‐making in maternity care: Acknowledging and overcoming epistemic defeaters. Journal of Evaluation in Clinical Practice 25(6), 1113 – 1120. http://dx.doi.org/10.1111/jep.13243.
  • Panda S., Begley C. & Daly D. (2018) Clinicians' views of factors influencing decision-making for caesarean section: a systematic review and metasynthesis of qualitative, quantitative and mixed methods studies, PLoS ONE 13(7), pe0200941. https://doi.org/10.1371/journal. pone.0200941.
  • Panda S., Begley C. & Daly D. (2016) Readmission following caesarean section: Outcomes for women in an Irish maternity hospital. British Journal of Midwifery 24(5), 322 – 328. http://dx.doi.org/10.12968/bjom.2016.24.5.322.

The MAMMI Study – Pelvic Girdle Pain strand

The Pregnancy-related Pelvic Girdle Pain Strand (PPGP) was a mixed methods study that examined the prevalence of, and risk and prognostic factors for PPGP in first-time mothers in Ireland, and explored the experiences and health-seeking behaviours of mothers with persistent PPGP postpartum.

Team

  • Dr. Francesca Wuytack
  • Prof. Cecily Begley (Chair of Nursing & Midwifery)
  • Prof. Déirdre Daly (Assistant Professor, School of Nursing & Midwifery)
  • Dr Elizabeth Curtis (Assistant Professor in General Nursing, TCD)

Dissemination

  • Wuytack F., Daly D. & Begley C. (2020) Risk factors for Pregnancy-related Pelvic Girdle Pain, a Scoping Review. BMC Pregnancy and Childbirth 20(1), 739.
  • Wuytack F., Daly D., Curtis E. & Begley C. (2018) Prognostic factors for pregnancy-related pelvic girdle pain, a systematic review, Midwifery 66, 70 – 78. https://doi.org/10.1016/j.midw.2018.07.012
  • Wuytack F., Curtis E. & Begley C. (2015) The health-seeking behaviours of first-time mothers with persistent pelvic girdle pain after childbirth in Ireland: a descriptive qualitative study. Midwifery 31, 1104 – 1109.
  • Wuytack F., Curtis E. & Begley C. (2015) Experiences of First-Time Mothers with Persistent Pelvic Girdle Pain after Childbirth: Descriptive Qualitative Study. Physical Therapy 95(10), 1354 – 1364.

The MAMMI Study- Sexual Health strand

The aim of this study was to identify the prevalence, and experience, of sexual health issues in primiparous women in Ireland antenatally and up to 12 months postpartum. The sexual health strand of the MAMMI Study was funded by the Health Research Board.

Team

  • Dr. Deirdre O’Malley (Assistant Professor in Midwifery)
  • Prof. Valerie Smith (Professor in Midwifery)
  • Prof. Agnes Higgins (Professor in Mental Health, School of Nursing & Midwifery)
  • Prof. Cecily Begley (Chair of Nursing & Midwifery)
  • Prof. Déirdre Daly (Assistant Professor, School of Nursing & Midwifery)

Dissemination

  • O'Malley D., Smith V. & Higgins A. (2019) Women's solutioning and strategising in relation to their postpartum sexual health: a qualitative study. Midwifery 77, 53 – 59.
  • Malley D., Higgins A., Begley C., Daly D. & Smith V. (2018) Prevalence of and risk factors associated with sexual health issues in primiparous women at 6 and 12 months postpartum; a longitudinal prospective cohort study (the MAMMI study). BMC Pregnancy and Childbirth 18, 196 - 208. https://doi.org/10.1186/s12884-018-1838-6.
  • O’Malley D., Higgins A. & Smith V. (2015) Postpartum sexual health: a principle based concept analysis. Journal of Advanced Nursing 71(10), 2247 – 2257. http://dx.doi.org/10.1111/jan.12692.
  • O'Malley D. & Smith V. (2013) Altered sexual health after childbirth: Part I Potential risk factors. The Practising Midwife 16, 30 – 32.
  • O'Malley D. & Smith V. (2013) Altered sexual health after childbirth: Part II. The Practising Midwife 16(2), 26 – 28.

The MAMMI Study – Mental health strand

The mental health strand of the MAMMI Study examines the prevalence of mental health issues, such as anxiety and depression of first-time mothers in Ireland.

Team

  • Prof. Agnes Higgins - Principal Investigator. (Professor in Mental Health, School of Nursing & Midwifery)
  • Louise Rafferty
  • Prof. Cecily Begley (Chair of Nursing & Midwifery)
  • Prof. Déirdre Daly (Assistant Professor, School of Nursing & Midwifery)
  • Prof. Margaret Carroll (Associate Professor in Midwifery, School of Nursing and Midwifery- retired)

Disssemination: In progress

MAMMI-SIM strand: (Second baby survey, Intervention to improve urinary incontinence outcomes, Measuring costs)

Funded by the Health Research Board ICE Awards, MAMMI-SIM formed an interdisciplinary maternal health research team that supported 3 post-doctoral researchers (biostatistics, midwifery, health economics) to develop skills and competencies required for successful interdisciplinary and trans-sectoral health-services research. aspects: The MAMMI-SIM project is comprised of 3 strands:

Second baby survey: This involved following up with the MAMMI study cohort to explore maternal health and health issues following the birth of their second baby.

Intervention for women with urinary incontinence: Developing a feasibility intervention for women experiencing UI, and preparing a funding proposal for a trial to test the intervention. Unfortunately, as a result of the COVID-19 pandemic and ensuing public health guidelines, it was not possible to conduct the feasibility intervention.

Measuring costs of morbidity to women and services: Assessing costs of postnatal morbidity to the health-service and women. MAMMI-SIM will ascertain which women in future might need different care, or more support, intervention or treatment following birth, and costs of such care, from which improvements in maternity services can be implemented.

Team

  • Prof. Cecily Begley (PI) (Chair of Nursing & Midwifery)
  • Prof. Déirdre Daly (Assistant Professor, School of Nursing & Midwifery)
  • Dr. Patrick Moran (Senior Research Fellow in Health Economics) May 2017 – December 2019
  • Dr. Sunita Panda (Research Fellow) Jan 2020 – May 2021
  • Dr. Francesca Wuytack (Research Fellow in Epidemiology) May 2017 – March 2021
  • Prof. Charles Normand (Professor of Health Policy and Management)
  • Prof. Michael Turner (UCD School in Medicine)
  • Prof Declan Devane (Professor of Midwifery, NUIG)
  • Dr Paul Corcoran (Senior Lecturer in Perinatal Epidemiology, UCC)
  • Dr Tony Fitzgerald (Senior Lecturer in Biostatistics, UCC)
  • Dr Brenda Lynch (Lecturer in Economics, UCC)
  • Kathleen Hannon, Research Assistant

Dissemination

  • Moran P., Daly D., Wuytack F., Carroll M., Turner M., Normand C. & Begley C. (2020) Predictors of choice of public and private maternity care among nulliparous women in Ireland, and implications for maternity care and birth experience. Health Policy 124(5), 556-562. https://doi.org/10.1016/j.healthpol.2020.02.008
  • Moran P., Normand C., Gillen P., Wuytack F., Turner M., Begley C. & Daly D. (2020) Economic implications of reducing caesarean section rates - analysis of two health systems, PLOS One 15(7): e0228309. https://doi.org/10.1371/journal.pone.0228309.
  • Moran PS, Wuytack F, Turner M, Normand C, Brown S, Begley C, et al. (2020) Economic burden of maternal morbidity – A systematic review of cost-of-illness studies. PLoS ONE 15(1): Jan 16 e0227377. https://doi.org/10.1371/journal.pone.0227377
  • Wuytack F, Daly D, Begley C.  Risk factors for Pregnancy-related Pelvic Girdle Pain, a Scoping Review   BMC Pregnancy and Childbirth. 2020 Nov 27;20(1):739.   doi: 10.1186/s12884-020-03442-5

Perspectives of Partners of Women who experience Mental Health Issues in the Postnatal Period

The study developed a grounded theory that conceptualizes the perspective and needs of the partners of mothers who experience postnatal mental distress. The objectives of the study were:

  • To identify how partners of postnatal mothers understand postnatal mental distress and possible associated behaviours.
  • To explore the impact postnatal mental distress has on partners and their relationships.
  • To identify the strategies that partners use to respond to the mothers mental distress.

The project was funded by the Health Research Board (HRB).

Team

  • Jill Atkinson (PhD student)
  • Agnes Higgins (Principal Supervisor)
  • Margaret Carroll (Co supervisor)

Dissemination

  • Atkinson J., Smith V., Carroll M., Sheaf G. & Higgins A. (2021) Perspectives of partners of mothers who experience mental distress in the postnatal period: A systematic review and qualitative evidence synthesis, Midwifery 93, 102868. http://dx.doi.org/10.1016/j.midw.2020.102868.

Mind Mothers: An analysis of the needs and practices of midwives, public health nurse and practice nurses in relation to perinatal mental health

Funded by Health Service Executive and Nursing and Midwifery Planning Unit, the Mind Mothers study consisted of 3 work packages:

  • an analysis of nurses and midwives practice and policy in relation to perinatal mental health in Ireland;
  • the development of a best practice guide to support midwifery and nursing practice and
  • the development of an online learning package to support perinatal mental health care based on the analysis.

Team

  • Professor Agnes Higgins (PI)
  • Prof. Margaret Carroll
  • Deirdre Madden
  • Elaine McGoldrick
  • Ailish Gill
  • Mark Monahan

Publications

  • Higgins A., Downes C., Monahan M., Gill A., Lamb S.A. & Carroll M. (2018) Barriers to midwives and nurses addressing mental health issues with women during the perinatal period: The Mind Mothers study. Journal of Clinical Nursing 27(9-10), 1872-1883. http://dx.doi.org/10.1111/jocn.14252.
  • Carroll M., Downes C., Gill A., Nagal U., Madden D., Monahan M. & Higgins A. (2018) Knowledge, confidence, skills and practices among Midwives in the Republic of Ireland in relation to perinatal mental health care: The Mind Mothers study. Midwifery 64, 29 – 37. https://doi.org/10.1016/j.midw.2018.05.006.
  • Higgins A., Downes C., Carroll M., Gill A. & Monahan M. (2017) There is more to perinatal mental health care than depression: public health nurses’ reported engagement and competence in perinatal mental health care. Journal of Clinical Nursing 27(3-4), E476 - E487.https://doi.org/10.1111/jocn.13986.
  • Higgins A., Carroll M., Gill A., Downes C. & Monahan M. (2017) 'Perinatal Mental Health Care: Best Practice Principles for Midwives, Public Health Nurses and Practice Nurses.' Mind Mothers Project, Dublin, Health Service Executive, 1 – 32.
  • Higgins A., Carroll M., Downes C., Monahan M., Gill A., Madden D., McGoldrick E. & Nagel U. (2017) Perinatal mental health: an exploration of practices, policies, processes and education needs of midwives and nurses within maternity and primary care services in Ireland. Mind Mothers study, Dublin, Health Service Executive, 2017, 1 – 200.
  • Downes C., Carroll M., Gill A., Monahan M. & Higgins A. (2017) Practice nurses’ knowledge and competence in relation to perinatal mental health care. Practice Nursing 28(12), 542 – 551. https://doi.org/10.12968/pnur.2017.28.12.542.

Factors which enable Irish women to continue breastfeeding for six months: an international comparison with Sweden and Australia: June 2015- May 2016

National data from Ireland suggests that less than 7% of breastfeeding women are breastfeeding at 6 months (Begley et al, 2008), reflecting low initiation and continuation rates in this context. This study explored Irish, Swedish and Australian women’s perceptions of what enables women to continue breastfeeding at 6 months postpartum.

This exploratory qualitative study, which was funded by Curtin University, Australia, used critical incident techniques which have been used to evaluate consumer expectations and perceptions in health care (Kemppainen, 2000). Women who breastfed a recent child for a minimum of six months were invited to participate. Recruitment occurred through advertisements in local newspapers and on social networking platforms. Sampling was purposive initially in all sites, followed by snowball sampling.347 women participated in digitally recorded telephone interviews (64 in Ireland, 130 in Sweden and 153 in Australia). The critical incidents demonstrated that across the three contexts there are varying results surrounding enablers related to continuation of breastfeeding.  

Team

  • Prof. Louise Gallagher (Assistant Professor in Midwifery)
  • Vivienne Brady
  • Yvonne L. Hauck
  • Lesley Kuliukas
  • Charlotta Dykes 
  • Christine Rubertsson

Dissemination

  • Hauck T.L., Kuliukas L., Gallagher L., Brady V., Dykes C. & Rubertsson C. (2020) Helpful and challenging aspects of breastfeeding in public for women living in Australia, Ireland and Sweden: a crosssectional study. International Breastfeeding Journal 15(38), p1 – 14. https://doi.org/10.1186/s13006-020-00281-0.
  • Hauck Y.L., Blixt I., Hildingsson I., Gallagher L., Rubertsson C., Thomson B. & Lewis L. (2016) Australian, Irish and Swedish women’s perceptions of what assisted them to breastfeed for six months: exploratory design using critical incident technique. BMC Public Health 16, 1067
    TARA - Full Text  URL

The effects of frenotomy on breastfeeding variables in newborn infants with ankyloglossia

A before and after prospective comparative cohort study was carried out to determine the associated effects (if any) that frenotomy may have on breastfeeding variables in infants with ankyloglossia, and, to determine factors that influence breastfeeding women’s decision-making in choosing frenotomy for their infants.

Team

  • Prof. Louise Gallagher (Assistant Professor in Midwifery)
  • Kathryn Muldoon (Assistant Professor, School of Nursing & Midwifery)
  • Denise McGuinness (Lecturer/Assistant Professor in Midwifery)
  • Prof. Valerie Smith (Professor in Midwifery)

Dissemination

  • Muldoon K., Gallagher L., McGuinness D. & Smith V. (2017) Effect of frenotomy on breastfeeding variables in infants with ankyloglossia (tongue-tie): a prospective before and after cohort study. BMC Pregnancy and Childbirth 17(373), p1-9. http://dx.doi.org/10.1186/s12884-017-1561-8.
  • Muldoon K., Gallagher L., Mc Guinness D. & Smith V. (2016) ‘Frenotomy and the associated effect on breastfeeding variables in newborn infants with ankyloglossia (tongue-tie).’ Nutrition and Nurture in Infancy and Childhood: Bio-Cultural Perspectives. Dalarna, Sweden, 23 - 25 August.

Risk factors for and outcomes associated with reduced fetal movements in pregnancy: a matched cohort study: 2017-2021

A prospective matched cohort study exploring risk factors and pregnancy, labour and birth, and neonatal outcomes in women experiencing reduced fetal movements at or beyond 28 weeks of pregnancy.

Team

  • Carroll Lorraine (PhD studentship)
  • Prof. Louise Gallagher
  • Prof. Valerie Smith

Dissemination

  • Smith V., Muldoon K., Brady V. & Delaney H. (2021) Assessing fetal movements in pregnancy: A qualitative evidence synthesis of women’s views, perspectives and experiences. BMC Pregnancy and Childbirth 21(1), p1 - 14
    URL
  • Carroll L., Gallagher L. & Smith V. (2019) Risk factors for reduced fetal movements in pregnancy: A systematic review and meta-analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology 243, 72 – 82. https://doi.org/10.1016/j.ejogrb.2019.09.028.

The REDUCE Study

The REDUCE Study is a feasibility study and Cluster randomised pilot-feasibility trial, using an implementation research approach, aimed at reducing caesarean section rates, safely in Ireland). This project is funded by the HRB DIFA 2017.

Team

  • Prof. Cecily Begley (Chair of Nursing & Midwifery)
  • Prof. Valerie Smith (Professor in Midwifery)
  • Prof. Louise Gallagher (Assistant Professor in Midwifery)
  • Prof. Margaret Carroll (Associate Professor in Midwifery, School of Nursing and Midwifery- retired)
  • Ms. Julie Horgan (Midwife and Research Assistant)
  • Ms. Kathleen Hannon (Research Assistant)

Publications

Dissemination ongoing.

  • Smith V., Gallagher L., Carroll M., Hannon K. & Begley C. (2019) Antenatal and intrapartum interventions for reducing caesarean section, promoting vaginal birth, and reducing fear of childbirth: An overview of systematic reviews. PLoS ONE 14(10), e0224313. https://doi.org/10.1371/journal.pone.0224313.

Breastfeeding Support Groups in Ireland: A mixed methods investigation from a Cultural Historical Activity Theory perspective

A mixed methods study which investigated the role and impact of Breastfeeding Support Groups from the mothers’ perspective. (PhD studentship) (2014-2019)

Team

  • Elizabeth McCarthy Quinn
  • Louise Gallagher
  • Jan de Vries

Dissemination

  • McCarthy Quinn E., Gallagher L. & de Vries J. (2019) A qualitative exploration of breastfeeding support groups in Ireland from the women's perspectives. Midwifery 78, 71 – 77. https://doi.org/10.1016/j.midw.2019.08.001.

OptiBIRTH

Improving the organisation of maternal health service delivery, and optimising childbirth, by increasing vaginal birth after caesarean section (VBAC) through enhanced women-centred care (OptiBIRTH).

This study addressed the widespread concern over rising Caesarean section rates throughout Europe, particularly routine CS following a previous CS, despite calls for increased vaginal births after Caesarean (VBAC). VBAC is associated with lower maternal mortality than repeat CS, less overall morbidity for mothers and babies, and is the preferred option for the majority of women. VBAC rates in Ireland, Germany, and Italy are significantly lower (29-36%) than those in the Netherlands, Norway, and Sweden (45-55%).

Funded by the EU Commission FP7 Framework Programme, OptiBIRTH was a cluster randomised trial in Ireland, Germany, and Italy, with 15 clusters of 120 women in each, to increase VBAC rates from 33% to 53% through a complex intervention designed to increase women-centred care and women's involvement in their care. The multi-national, multi-disciplinary research team for this project developed from the ESF-funded workshop: "Promoting Normality in Childbirth" held in the School in March 2010, and from the COST Action, (IS0907: Childbirth Cultures, Concerns, and Consequences: Creating a Dynamic EU Framework for Optimal Maternity Care), which started in June 2010. The team consisted of 11 partner institutions from 8 countries, and included service users, midwives, obstetricians, neonatologist, epidemiologist, sociologist, psychologist, bioethicist, health economist and a 'high-tech' small industry.

 

Team

Lead institution: Trinity College Dublin, Ireland

  • Prof Cecily Begley, (Lead investigator)
  • Prof. Valerie Smith
  • Prof. Deirdre Daly
  • Prof. Joan Lalor
  • Janine Stockdale
  • David Prendergast
  • Chris Fitzpatrick
  • Michael Turner
  • Jan Miletin
  • Patricia Hughes
  • Beverley Beech (Association for Improvements in Maternity Services)
  • Coombe Hospital

 
UK Co-applicant institutions and lead investigators:

  • Prof Ingela Lundgren (University of Gothenburg, Sweden)
  • Marianne Nieuwenhuijze (Zuyd University, The Netherlands)
  • Prof Katri Vehviläinen-Julkunen (University of Eastern Finland, Finland)
  • Prof Marlene Sinclair (University of Ulster, UK)
  • Hugh Wiseman (Entando, UK)
  • Prof Mike Clarke (Queen's University of Belfast, UK)
  • Prof Mechthild Gross (Medizinische Hochschule Hannover, Germany)
  • Prof Declan Devane (National University Ireland, Galway, Ireland)
  • Prof Sandra Morano (Universita Degli Studi Di Genova, Italy)
  • Prof Koen Putman (Vrije Universiteit Brussel, Belgium)

Publications

  • Clarke M., Devane D., Gross M.M., Morano S., Lundgren I., Sinclair M., Putman K., Beech B., Katri Vehviläinen-Julkunen K, Nieuwenhuijze M, Wiseman H, Smith V., Daly D., Savage G., Newell J., Simpkin A., Grylka-Baeschlin S., Healy P., Nicoletti J., Lalor J., Carroll M., van Limbeek E., Nilsson C., Stockdale J., Fobelets M. & Begley C. (2020) OptiBIRTH: a Cluster Randomised Trial of a Complex Intervention to Increase Vaginal Birth After Caesarean Section. BMC Pregnancy and Childbirth 20, 143, https://doi.org/10.1186/s12884-020-2829-y
  • Lundgren I., Morano S., Nilsson C., Sinclair M. & Begley C. (2020) Cultural perspectives on vaginal birth after previous Caesarean section in countries with high and low rates – a hermeneutic study. Women and Birth 33(4), pe339 - e347. https://doi.org/10.1016/j.wombi.2019.07.300.
  • Fobelets M., Beeckman K., Healy P., Grylka-Baeschlin S., Nicoletti J., Devane D., Gross M.M., Morano S., Daly D., Begley C. & Putman K. (2019) Health economic analysis of a cluster-randomised trial (OptiBIRTH) designed to increase rates of vaginal birth after caesarean section. British Journal of Obstetrics and Gynaecology 126(8), 1043 – 1051. http://dx.doi.org/10.1111/1471-0528.15673.
  • Grylka-Baeschlin S., Clarke M., Begley C., Daly D., Healy P., Nicoletti J., Devane D., Morano S., Krause G., Karch A., Savage G. & Gross M. (2019) Labour characteristics of women achieving successful vaginal birth after caesarean section in three European countries. Midwifery 74, 36 – 43. http://dx.doi.org/10.1016/j.midw.2019.03.013.
  • Fobelets M., Beeckman K., Buyl R., Healy P., Grylka-Baeschlin S., Nicoletti J., Canepa M., Devane D., Gross M.M., Morano S., Daly D., Begley C. & Putman K. (2019) Preference of birth mode and postnatal health related quality of life after one previous caesarean section in three European countries. Midwifery 79, 1-8. http://dx.doi.org/10.1016/j.midw.2019.102536.
  • Healy P., Smith V., Savage G., Clarke M., Devane D., Gross M.M., Morano S., Daly D., Grylka-Baeschlin S., Nicoletti J., Sinclair M., Maguire R., Carroll M. & Begley C. (2018) Process Evaluation for OptiBIRTH, a Randomised Controlled Trial of a Complex Intervention designed to increase rates of vaginal birth after caesarean section. Trials 19(9). http://dx.doi.org/10.1186/s13063-017-2401-x.
  • Fobelets M., Beeckman K, Faron G, Daly D, Begley C, Putman K. (2018) Vaginal birth after caesarean versus elective repeat caesarean delivery after one previous caesarean section: a cost-effectiveness analysis in four European countries. BMC Pregnancy and Childbirth 18(1), 92 – 101. http://dx.doi.org/10.1186/s12884-018-1720-6.
  • Nilsson C., Lalor J., Begley C., Carroll M., Gross M.M., Grylka-Baeschlin S., Lundgren I., Matterne A., Morano S., Nicoletti J. & Healy P. (2017) Vaginal birth after caesarean: Views of women from countries with low VBAC rates. Women and Birth 30, 481 – 490. http://dx.doi.org/10.1016/j.wombi.2017.04.009.
  • Lundgren I., Healy P., Carroll M., Begley C., Matterne A., Gross M.M., Grylka-Baeschlin S., Nicoletti J., Morano S., Nilsson C. & Lalor J. (2016) Clinicians’ views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section): a study from countries with low VBAC rates. BMC Pregnancy and Childbirth 16(350), 1-10. http://dx.doi.org/10.1186/s12884-016-1144-0.
  • Clarke M., Savage G., Smith V., Daly D., Devane D., Gross M.M., Grylka-Baeschlin S., Healy P., Morano S., Nicoletti J. & Begley C. (2016) Improving the organisation of maternal health service delivery and optimising childbirth by increasing vaginal birth after caesarean section through enhanced women-centred care (OptiBIRTH trial): study protocol for a randomised controlled trial (ISRCTN10612254). Trials 16(542), 1 – 9. https://tcdlocalportal.tcd.ie/pls/webapps/10.1186/s13063-015-1061-y.
  • Lundgren I., Healy P., Carroll M., Begley C., Matterne A., Gross M.M., Grylka-Baeschlin S., Nicoletti J., Morano S., Nilsson C. & Lalor J. (2016) Clinicians' views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section): a study from countries with low VBAC rates. BMC Pregnancy and Childbirth 16(1), 350 – 359. http://dx.doi.org/10.1186/s12884-016-1144-0.
  • Nilsson C., Lundgren I., Smith V., Vehvilinen-Julkunen K., Nicoletti J., Devane D., Bernloehr A., van Limbeek E., Lalor J. & Begley C. (2015) Women-centred interventions to increase vaginal birth after caesarean section (VBAC): A systematic review. Midwifery 31, 657 – 663. http://hdl.handle.net/2262/75575.

A survey to determine the prevalence, frequency and volume of colostrum (first breast milk) secreted during pregnancy

July 2019- Feb 2020

Team

  • Professor Vivienne Brady, Assistant Professor in Midwifery

Dissemination: In progress

Perineal Repair by Midwives in Ireland: A National Survey

Perineal Repair by Midwives in Ireland: A National Survey of Skills, Knowledge, Attitude and Experience.

Team

  • Professor Margaret Dunlea, Assistant Professor in Midwifery

Publications

In progress

An ethnographic study of service users’ and service providers’ experiences of what they consider to be the nature and impact of the shared care model of antenatal care

The aim and objectives of the study were to explore service users’ and service providers’ experiences of what they consider to be the nature and impact of the shared care model of antenatal care. Women of various parities and midwives and GPs were invited to participate in non-structured interviews. The findings provide insight into the nature and impact of the current system of antenatal care in Ireland (shared care) from the perspective of women, GPs, and midwives.

Team

  • Professor Margaret Dunlea, Assistant Professor in Midwifery
  • Vivienne Brady
  • Prof. Cecily Begley
  • Jo Murphy-Lawless

Publications

  • In progress

Respectful and disrespectful care in the Czech Republic: an online survey

This study explored how maternity care is provided in the Czech Republic using a qualitative, descriptive design method. Midwives and doulas working in the Czech Republic, selected purposively for their interest and enthusiasm in improving practice, were asked to complete an online survey consisting of open and closed questions. A similar survey designed for women to complete was circulated in 2018.

Team

  • Prof Deirdre Daly
  • Natalie Sedlicka (Midwife and Manager for Association for Birth Houses and Centres (APODAC), Czech Republic)
  • Prof Cecily Begley

Dissemination

Irish and New Zealand midwives' expertise in preserving the perineum intact: The 'MEPPI' study.

The aim of this study was to explore the views of a sample of midwives in Ireland and New Zealand on preserving the perineum intact.
This involved:

  • identifying midwives in two countries, Ireland and New Zealand, who practise preserving the perineum intact, with ‘no suture’ rates for primparous women, for the previous 3 years, of greater than 40%, episiotomy rates of less than 9.5 %, and serious perineal tear rates of less than 3.1%. To
  • interviewing a purposive sample of these midwives in each country in order to ascertain their views of what skills they employ to preserve the perineum intact, what factors assist in keeping the perineum intact, and how, in their opinion, they obtain such good maternal outcomes.

Team

  • Prof Cecily Begley (PI)
  • Prof Valerie Smith (Trinity College Dublin)
  • Dr Lesley Dixon (New Zealand College of Midwives)
  • Karen Guilliland (New Zealand College of Midwives)
  • Collette McCann (Our Lady of Lourdes Hospital, Drogheda)
  • Mary Reilly (Cavan General Hospital)

Dissemination

  • Smith V., Dixon L., Guilllard K., McCann C., Keegan C., Reilly M. & Begley C. (2017) Irish and New Zealand Midwives’ expertise at preserving the perineum intact (the MEPPI study): perspectives on preparations for birth. Midwifery 55, 83 – 89. http://dx.doi.org/10.1016/j.midw.2017.09.011.