Newsletter: June 2020

In recent months, we have all experienced the significant impacts of COVID-19. The Stillbirth CRE hopes that you and those around you are keeping safe and well during these difficult times.  We understand that the COVID-19 pandemic is worrying for pregnant women and their families, and we have been working to ensure that women are still receiving important messages about stillbirth prevention during COVID-19. 

The Coordinating team, based in Brisbane, is continuing to abide by social distancing recommendations, and we thank you for your understanding as we shift to a remote working environment.  We are mindful of the impact of COVID-19 on those involved in health care delivery and as a response, are limiting our meetings and events over the coming months. We will revisit this later in 2020 when the impacts of COVID-19  have reduced.

Finally, we know these are personally and professionally challenging times, so we would also like to thank everyone for their continued support and commitment toward improving health outcomes for pregnant women and families.

Take care and best wishes from the Stillbirth CRE team.    

COCOON has launched!

The Stillbirth CRE is very excited to share with you the details of COCOON.

This significant new international collaboration seeks to provide the most comprehensive evidence base to date on how the COVID-19 pandemic is changing pregnancy and new parenthood. We are thrilled to be working with Mater Research, Ciao Lapo, Burnet Institute, International Stillbirth Alliance, Stillbirth Foundation Australia, Umamanita, King’s College London, University College Cork, Paternite Famille et Societe and a number of other global partners to deliver this research project.

The global research study involves participants from Australia, Brazil, Canada, Germany, Ireland, Italy, Netherlands, Spain, UK, USA and many others.

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What is COCOON?

COCOON has been developed by a global team of researchers and clinicians to understand how maternity care has changed since the outbreak of COVID-19. We want to understand the psychosocial impact of our response to the outbreak on women and their partners who are having a baby during this challenging time. This study will examine a range of issues including the use of telehealth appointments (via telephone or video call), the impact of isolation and social restrictions, and the challenges and concerns of parents.

We also seek to understand the experiences of the COVID-19 outbreak on parents who have experienced stillbirth or neonatal death during this outbreak. This is one of the few studies world-wide to investigate the impact of COVID-19 on the care of bereaved parents after the death of a baby.

We hope that the COCOON study will help improve future care for all families around the world during this pandemic, and future health crisis.

We would love for you to share this study with your colleagues and parents.

CLICK HERE TO GO TO THE COCOON STUDY

NEWS & POLITICS

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COCOON in the Media 

The COCOON study has already generated national media attention, with the study launch being covered by both Sky News and ABC News.

Stillbirth CRE Director Professor Vicki Flenady told ABC News Brisbane that anecdotal evidence indicates women are feeling anxious about changes in antenatal care, and the impacts of social isolation, and research was needed to investigate this.

"We want to hear about these experiences from women to ensure we are giving them the best care.

"We'll be able to compare the experiences that women are having during this time against the different policies that are in place across countries," she said.

"We hope to learn a lot from that in terms of what's acceptable and what sort of step we need to put in place to support women at this time."

Read the full story here.

 

Burnet Institute and the COVID-19 Taskforce

A COVID-19 Taskforce has been implemented to keep Australian clinicians up-to-date with the latest COVID-19 guidelines and evidence. The ‘living’ guidelines provides up-to-the minute advice to clinicians providing frontline care in this unprecedented global health crisis. To support the Taskforce, researchers from the Burnet Institute conducted a rapid review of maternal and perinatal health recommendations from international and national guideline developers, and identified a number of care practices where conflicting guidance was present. For more information about the COVID-19 Taskforce and guidelines, please click here.

NEWS & POLITICS

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Stillbirth CRE in the Media

The Stillbirth CRE and the Safer Baby Bundle have also received media attention in recent months, featuring in The Guardian - Australia's silent tragedy: a stubbornly high stillbirth rate and the push to change it. Professor Vicki Flenady,  Stillbirth Foundation ambassador Ann-Marie Imrie and Labor senator Kristina Keneally spoke to the Guardian about our push to reduce stillbirth rates in Australia through awareness and education. You can read the article here

 

NEWS & POLITICS

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The draft National Stillbirth Action and Implementation plan is out for comment

The draft National Stillbirth Action plan outlining the Government’s actions to reducing stillbirth in Australia has been released for public consultation. We would like to thank all who have contributed to the development of this plan. Both individuals and organisations across Australia have worked collaboratively to develop a number of actions against the recommendations put forward by the Select Senate Committee on Stillbirth Research and Education.

The National Action plan is available for comment until the 10th July, 2020 and we encourage you to give your feedback here.

 

CAMPAIGNS & MAJOR PROJECTS

Online Grief Support Program for parents after perinatal loss - under development

Now seeking parents and health care providers for co-design

The Stillbirth CRE are recruiting parents and healthcare providers to assist in the co-design and development of our new online bereavement support program for parents following a stillbirth or neonatal death. This study is recruiting parents and healthcare providers for either a brief telephone interview (approx. 15mins) or an in-depth focus group discussion on preliminary content for the program (approx. 60-90mins). This new online program aims to provide an evidence-based support option to help parents navigate grief and build coping strategies and resilience for the longer-term.


If you are a parent who has experienced the death of your baby (stillbirth or neonatal death) in the past two years (but more than two months ago) OR you are a healthcare provider with experience supporting bereaved parents following the death of their baby, you can join the discussion by emailing the research team at: stillbirthcre@mater.uq.edu.au

 

CAMPAIGNS & MAJOR PROJECTS

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Safer Baby Bundle update 

2020 has been a significant year for the implementation of the SBB initiative so far, and we are pleased to announce that the SBB has officially launched in New South Wales! The New South Wales Clinical Excellence Commission has held three SBB learning sessions across 4 local health districts, including the launch event at Westmead Hospital on February 18, 2020, which was attended by NSW Mental Health Minister Bronwyn Taylor. Safer Care Victoria have also continued to make strong progress embedding the SBB care practices through their Safer Baby Collaborative and have hosted two SBB learning sessions since launching in June 2019.

 

Implementation of the SBB across partnering jurisdictions has slowed in recent months due to the impact of COVID-19. Not only has COVID-19 directly affected project timelines, but it has also resulted in cancellations and postponements to planned presentations and events including official SBB launch events in Queensland, Western Australia and the Northern Territory. The SBB initiative is now scheduled to launch in Queensland on the 28th and 29th of October, and on the 3rd of November in Western Australia.


Despite the slowing of implementation, clinicians across the country are continuing to access the SBB eLearning module. To date, over 3,400 users have registered with the Safer Baby Bundle eLearning portal. This is a strong result and includes healthcare professionals from across all Australian states and territories, as well as overseas.


We thank you again for your support of the SBB and ask that you continue to promote the importance of this initiative within your local community, hospital, state or network of contacts.

 

New Safer Baby Bundle COVID-19 Resources

The stillbirth prevention guidance within the SBB continues to be important for women and clinicians, especially within the current COVID-19 context. However, social distancing measures have meant that there have been changes to the way pregnancy care is provided to women.

To ensure that women are still receiving important messages about stillbirth prevention during COVID-19, the SBB team have partnered with The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the Australian College of Midwives (ACM) in the development of new SBB COVID-19 resources for clinicians and women. These resources advise on how to implement and access maternity care across the Safer Baby elements during COVID-19, considering the changes to the way antenatal care is being delivered.

You can access the SBB COVID-19 resources through the Stillbirth CRE website, here.

 

EDUCATION & TRAINING

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An update from last year’s PhD top-up scholarship winners

Roshan Selvaratnam

Roshan’s research investigates the balance between benefit and harm of driving improved detection of fetal growth restriction (FGR), the strongest risk factor for stillbirth. In Victoria, driving hospitals to improve their detection of FGR has led to an improvement in detection and a reduction in statewide stillbirth. However, these improvements came at the cost of increasing early delivery in normally grown babies who were inappropriately suspected of FGR and associated morbidity for those babies. More than half of the babies suspected of FGR were normally grown. This suggests that driving improved detection of FGR may be harmful if not better targeted towards pregnancies at risk. These findings have been published (Selvaratnam et al. BJOG 2020; 127: 581-589). They have also led to Roshan developing a balance measure for the detection of FGR that has since been embedded into the Safer Baby Bundle to monitor the potential harm that may arise from driving improved detection.

 

Tabassum Rahman

Tabassum is a Public Health PhD student at the University of Newcastle. She is investigating smoking cessation during pregnancy and relapse among Indigenous Australian women. Tabassum completed a systematic review on barriers to and enablers of smoking cessation during pregnancy among Indigenous Australian women using the socioecological model. She presented the review findings at the Indigenous smoking and pregnancy Roundtable arranged by the Australian Department of Health as an invited speaker. Tabassum is commencing data collection for a mixed-method study with Indigenous women and a qualitative study with service and policy level stakeholders for the remaining parts of her PhD.

 

Jessica Sexton

In the past year, the NHMRC Stillbirth CRE top-up Scholarship has supported Jess’ attendance at several training seminars and skill development workshops among several conferences and annual meetings in Brisbane, Sydney, and Melbourne. Notably, Jess participated in the 3MT competition and appeared as a PhD student finalist for the 2019 ASMR Postgraduate Research Award. The research that was presented was a spatial analysis of risk factors for stillbirth at Mater Mothers’ Hospital, 1997-2015. Jess and her team developed spatial models and were able to detect clustering for major risk factors using geocoded maternal postcode for place of usual residence. Through this top-up scholarship and support from the advisory team, it has made it possible to disseminate important research in the areas of geospatial and epidemiology of stillbirth in Australia.

 

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Stillbirth CRE & ACM Travel Fellowship Recipient!

Congratulations to Peta Zupp, winner of the Stillbirth CRE & ACM Travel Fellowship. The travel fellowship supports a rural or remotely based midwife to attend the Stillbirth CRE National Stillbirth Forum, an event which promotes the latest stillbirth research and evidence-based interventions in Australia.

Peta has been a midwife for 20 years and is a passionate advocate for delivering quality care to women and families and improving care for women experiencing stillbirth, evidenced by her clinical practice working with women and families. She actively drives local improvements in simple ways such as implementing environmental changes in the maternity ward clinical environment and actively seeking opportunities and resources such as sourcing funding and setting up training including the IMPROVE workshop. She is the midwifery lead for the Safer Baby Bundle and as a midwifery educator actively participates in implementing this across her entire region. She believes that both she, and her entire region, will benefit from attending the forum.

Congratulations Peta!

 

RESEARCH UPDATES

Stillbirth Foundation Australian grant winners

 Congratulations to the following research teams who were awarded with a Stillbirth Foundation Australia grant last month:


• Professor Euan Wallace, Dr Vinayak Smith and their team, who will be undertaking a clinical trial of FetalKicks, a wearable, band-aid size patch to continuously monitor fetal movements.

• Associate Professor Jane Warland and her team, who will be undertaking a new study on birthing grief. This will explore bereaved parents’ experience of the labour and birth of their stillborn baby.

• Associate Professor Fran Boyle and her team at the University of Queensland, who will be testing and piloting the parent-version of the national clinical guidelines on care around the time of stillbirth and neonatal death in a hospital setting.

These projects aim to reduce the incidence of stillbirth and improve the quality of care and support provided to pregnant women, as well as bereaved parents and their families.

Thank you to Stillbirth Foundation Australia and their supporters for making these grants possible.

 

Stillbirth CRE Placental Consortium Update

This Stillbirth CRE Placental consortium is a collaborative group of researchers from all over Australia that are looking at ways to address the major issue of identifying pregnancies at risk of stillbirth. They meet monthly and over the past year have established collaborations between teams to investigate specific research questions, examined ethics and governance issues related to the sharing of biological samples, and developed a RedCap database for researchers to share de-identified meta-data about the biological samples from their own cohorts.  Using these connections, the group has established a pilot project were researchers have shared over 100 placenta tissue samples collected around Australia. Currently they are examining the gene expression from the placenta of babies associated with a small for gestational age (SGA) infants (fetus that is <2500 grams at term or <10th birthweight centile (BWC)) by RNA sequencing. If you would like to join the collaboration, please email stillbirthcre@mater.uq.edu.au.

 

INFORMATION & PUBLICATIONS

Recent data on stillbirth released

The Queensland Maternal and Perinatal Quality Council recently released their Queensland Mothers and Babies 2016-2017 report. For more information, or to read the report, please click here.

 

The Australian Institute of Health and Welfare also recently released the latest data visualisations on Australia's mothers and babies. You can read the summary here.

 

UPCOMING EVENTS

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Inviting you to the 'Focus on Stillbirth Prevention and Care' webinar series!

We are excited to announce the launch of the 2020 National Stillbirth Forum Webinar Series! Join some of Australia’s leading experts on stillbirth prevention and care as they present this 4 part series between 22nd July and 12th August. For more information and to register, please visit the event website.

 

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Women’s Healthcare Australasia (WHA) Safety & Quality in Maternity Care Face to Face Insight Forum 2020

The WHA Safety & Quality in Maternity Care Face to Face Insight Forum will be held in Sydney on 19 & 20 November, 2020. This annual forum brings together senior executive and clinical leaders who are passionate about improving care and outcomes for women and newborns. For more information about the forum, please click here.

 

Australian College of Midwives (ACM) 23rd National Conference Postponed

The 23rd ACM National Conference was to be held in Sydney from 13-15 October, 2020. A new date will be announced via the conference website soon.

 

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ISA/ISPID International Conference Postponed until 2021

The ISA/ISPID International Conference has been postponed from 22-24 of October, 2020 until 11-13 of November, 2021. For more information, please visit the conference website


 

IN THIS #COCOONGLOBAL SPECIAL EDITION ISSUE:

 

  • COCOON: Continuing care in COVID-19 Outbreak: A global survey of New and expectant parent experiences
  • COCOON & Stillbirth CRE in the Media
  • Burnet Institute & the COVID-19 Taskforce
  • Opportunity to provide feedback on the draft of the National Stillbirth Action Plan
  • Development of Online Grief Support Program for parents after perinatal loss
  • Safer Baby Bundle & COVID-19 Resources update
  • Education & Training updates
  • Research updates: SFA grant winners & more!
  • Upcoming events & conferences