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Improving pregnancy outcomes

Aiming to improve outcomes of women and children during pregnancy.

We are working towards the creation of a national Maternity Learning Health System that brings together women as consumers of care, clinicians and academics to remove silos and enable change. We are using the Learning Health System framework, innovative IT platforms, big data, and novel analyses.

Nationally there are 300,000 pregnancies yearly. Efforts to reduce risks in pregnancy have yielded great benefits, however, we have now tipped the balance between managing risk and causing harm, with only 30% of pregnancies having a spontaneous birth. Intervention rates, harms and costs are rising dramatically year on year and action is vital. 

The Pregnancy Group is currently working to bring the voices, priorities, guidance and shared decision making with women as consumers of healthcare, to the forefront.  This will underpin a National Maternity Learning Health System. This evidence-based approach unlocks the power of research evidence, health data through cutting edge, secure IT and data technology, and best practice implementation approaches to rapidly transform care, in areas that matter to women.

Our activities will be guided by women’s priorities. Leslie Arnott, a long-term maternity consumer advisor has stated 

The current models of care are predominately non-evidence based, and designed to cater for the system and are not woman-centred

Our work is already unpinning the advocacy work of consumer groups, being used to codesign state and national maternity policy. We will continue to place women’s priorities at the centre of our Learning Health System work.

Implementation & Impact

With our partners reaching across 86% of Australian maternity care nationally, will deliver a national Maternity Learning Health System, leveraging world-leading innovation in health data innovation, implementation research and translation, delivering priorities of women, evidence, and healthcare improvement. This is in alignment with the National Women’s Health Strategy 2020 – 2030, conducted with the support of women’s consumer groups, and with a national partnership with Women’s Healthcare Australasia.

Research Streams
Optimising use of Caesarean section

Caesarean section is one of the most common surgeries in Australia with rates increasing from 17% in the early 2000s to above OECD-average at 36%, with rates continuing to rise. Related harm is now evident and reducing caesarean section to align with the World Health Organisation, would save $940 million in the public system annually.

Improving lifetime trajectories of children

Mode and timing of birth have lifelong impacts on children. Preterm and early term birth, and caesarean section birth have risk of neurodevelopmental delays, autism, ADHD, and a suite of other chronic health conditions. By optimising timing of birth and use of caesarean section, we will improve the lifetime trajectories of Australian children with substantive cost savings.

Reducing costs of maternity care

Public maternity care costs rose by 48%, from $2.6 billion to $4.4 billion in six years between 2012 and 2018. Some of these costs are driven by preterm birth and caesarean use, and others by low efficiency. It is estimated overall that 30% of care is unnecessary or of little value, and 10% can cause harm. Through our Learning Health System model, delivery of high value across quality, preferences and cost, is embedded into maternal health care delivery at policy and service levels.

To deliver health impact, we use the following MCHRI platforms
Student Research Projects

This team offers a variety of Honours, Masters and PhD projects for students. There are also a number of short-term research opportunities available. You are encouraged to get in touch regarding potential projects that align with the research areas mchri.awhl@monash.edu.