Professor Caroline Homer
Director of the UTS Centre for Midwifery, Child and Family Health, Professor Caroline Homer is making a significant contribution to a growing body of midwifery research in Australia by leading two new projects being funded by the NHMRC. She will also take a Chief Investigator role on a third project being led by ACU.
Caroline’s projects, which attracted over $1 million in NHMRC Project Grant funding in the fourth funding round for 2011, will provide an evidence base for significant midwifery issues that impact the health and wellbeing of mothers and their babies.
The first project looks at the impact of birthplace on neonatal and maternal health care outcomes for low-risk pregnancies. Caroline will lead a team of researchers from Australia and the UK in comparing morbidity and mortality rates in births planned to take place at home, in birth centres or in stand-alone midwifery units versus births planned for traditional hospital labour wards.
Australia is one of only a few developed countries not to endorse home birthing as a safe option for women with low-risk pregnancies. Caroline says that while a lot of research has been done into types of maternity care, there remains a dearth of data on the comparative safety of different birth environments.
"There’s considerable uncertainty about the outcomes for healthy women who choose to give birth in different settings," she says.
"A better understanding of the outcomes associated with different places of birth will assist in the appropriate design of maternity services in Australia."
The second project will look continuity of midwifery care, where a woman receives care from the same midwife or midwifery team through pregnancy, birth and postnatal periods. Specifically, the project seeks to find whether continuity of care can play a role in supporting women to attempt a vaginal birth after a caesarean section (VBAC).
Rates of caesarean sections (CS) in Australia are at an all-time high, and so too are the costs and the health risks that accompany the procedure. CS has been associated with maternal complications such as haemorrhage, bladder and bowel damage and a range of other health complications, while babies born by CS are at risk of respiratory distress syndrome and a number of other serious complications.
"There’s no doubt that CS is an essential procedure that can save the lives of women and babies [in high risk situations. However, one in three women in Australia will have a CS and many of these are unnecessary from a health care perspective,”] Caroline says.
"A huge proportion of women who have a CS will repeat the procedure for subsequent births. If we can educate and support women to attempt VBAC when and where appropriate, this will go a long way towards lowering the rate of CS and increasing positive outcomes for mothers and their babies."
The ACU-led project will measure the effect of sterile water injections on women’s pain in labour and the impact of these injections on CS rates.
The projects will commence in 2012.