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Midwives making every week count

five midwives stood in front of a decorative wall in a NHW birth-suite
Emma Quarrell (Nurse Unit Manager), Dr Amelia Bock (Obstetrician), Danielle Dalrymple (front, midwife and Team Leader of the Every Week Counts Preterm Collaborative NHW), Andrea Hogan (Antenatal Clinic Coordinator) and Jacqui Webb (Nurse Unit Manager)

Northeast Health Wangaratta is participating in the National Preterm Birth Prevention Collaborative to reduce the rate of preterm and early-term births in the region.

Nationally, 1 in 12 pregnancies end early and more than 26,000 babies are born before term (40 weeks) each year.

The National partnership brings together 62 hospitals that aim to reduce the rate of preterm and early term birth by 20 per cent by March 2024. It follows a successful rollout in other states.

NHW supports the birth of more than 700 babies every year and said that providing evidence to assist mothers in making informed choices about the timing of birth is critical, such as the benefits of timely birth to a baby’s neurodevelopment and performance at school age, and the decreased risk of a newborn needing to spend time in special care or require readmission to hospital in the first year of life.

In 2022, 5.2% of babies were delivered before 37 weeks (preterm) and 34.7% of babies were delivered between 37 and 38+6 weeks (early term)  at NHW.

Preterm (23- 37 weeks’ gestation) and early term (37 and 38 weeks’ gestation) births increase the risk of life-changing adverse health events for babies, mothers, and their families. Preterm birth is the leading cause of death and disability in children up to five years of age in developed countries and is a major contributor to the global burden of disease. Preterm Births have been estimated to cost the Australian government $1.4 billion dollars yearly.

Executive Director of Clinical Services and Chief Nursing/Midwifery Officer of NHW, Bernadette Hammond said that preterm births occurred for many reasons and while some are necessary, the evidence supports that some are preventable.

“With new approaches, this rate can be reduced and provide better outcomes for mothers and babies,” Bernadette said.

“Our aim is to ensure we are having these conversations with mothers about the benefits of reducing those preterm and early birth rates where it is safe for them and their baby.”

“As part of the national collaborative, our midwives are being guided through communicating evidence-based changes to improve the quality and safety of care through increased screening and key interventions to safely lower the rate of preterm birth.”

NHW Collaborative Lead Midwife Danielle Dalrymple, said NHW had implemented some evidence-based changes since attending learning sessions around better screening of women at risk, and changes to the monitoring of cervical length (neck of the womb) at routine ultrasound, which can lead to better monitoring and use of preventative measures.

“We are already seeing some positive results with an increase in reporting of cervical length, which is an early indicator of potential preterm birth, allowing us to implement strategies to reduce the risk of preterm or early birth,” Danielle said.

“Alongside our new induction guideline NHW has initiated more rigorous reviews on optimal timing of planned births and we are encouraging women to be part of shared decision-making with their care, by having those important conversations.

“We are building understanding of preterm birth risk factors and the need for early engagement to services through our early pregnancy care clinic and connecting with GPs in the region.

“We encourage women to book into NHW as early as 10 weeks.”

NHW representatives Danielle Dalrymple, Emma Quarrell and Jacqui Webb recently attended the final Collaborative learning session in Brisbane and said they will explore further innovations and ideas to help empower women and families and educate health professionals in the region and support co-design of preterm birth prevention pathways.

Sub-regional Director of Obstetrics for the Central Hume, Dr Amelia Bock said that a systematic approach would drive optimal care.

“Embedding a systematic approach to our patients’ pregnancy care ensures that women get high quality, evidence-based care,” she said.

“We hope these endeavours will make the pathway smoother for parents and reduce some of the potential long-term implications of early and preterm birth.”