Midwifery Research Department

Maternity Research

Welcome to the Midwifery Research Department at Liverpool Women’s NHS Foundation Trust! The Midwifery Research Team at Liverpool Women’s Hospital was the first of its kind when Professor Tina Lavender and the Former Obstetric Directorate Manager Julie Riley founded it in 1997. Together, they pioneered a unique approach to undertaking midwifery research by funding clinical midwives to research secondments and developing a capability building model which has meant the department has gone from strength to strength. Since then, the majority of team members are clinically based midwives and the majority of research projects are now externally funded.

Tina Lavender is the Academic Lead and Lisa Baker, the Midwifery Research Co-ordinator.

The main asset of the department has been the commitment, innovation and enthusiasm of the team both past and present. The activities of the team encompass education, research and clinical practice, which have resulted in demonstrable improvements in the maternity care services provided to women locally, nationally and internationally.

Ethos

The ethos of the Midwifery Research Department is to promote evidence-based woman centred care by embarking on ‘real world research’, which stems from practice and experience and feeds back into practice. We value the insight that is gained from listening to women about their views, feelings and experiences of maternity related issues. This holistic philosophy underpins our entire approach to research and practice.

Aims of Department

To undertake programmes of midwifery research that explore maternal expectations, experiences and outcomes within maternity care services.
Inform future service provision for Women's Services
To contribute to changing midwifery practice
Increase the research capability of midwives
To reflect the Public Health Agenda

Research Programs at Liverpool Women’s NHS Foundation Trust

For the full programs of all research, please click here.

Midwifery Research Program

The research theme “Optimising normal birth”, led by the midwifery team is one of 5 themes within the Trust Integrated Research Strategy. The theme is divided into 3 streams with Dr. Tina Lavender being the overall program lead.

Stream 1: Normal Labour Parameters

Dr. Tina Lavender

Professor of Midwifery & Women’s Health

University of Central Lancashire.

www.uclan.ac.uk/facs/health/midwifery/research/index.htm

Stream 2: Childbirth Choices, Experiences and Outcomes

Lisa Baker

Midwifery Research Co-ordinator

Liverpool Women’s Hospital.

Stream 3: Promoting Health and Equality

Dr. Grace Edwards

Consultant Midwife - Liverpool Women’s Hospital

Principle Lecturer - University of Central Lancashire

This research theme replaces the existing NHS R&D Priorities & Needs Programme Involving Maternity Service Users/Improving the Health of the Public, which has been rated strongly by the DOH since its conception in 2000.

Consumer Input

We have good collaboration with consumers and wherever possible, they are involved at various stages of the midwifery research process.

Women have changed the primary outcome of one of our studies
Consumers are involved as steering group members on various research projects
Teenagers assisting with focus groups for a text messaging project

Departmental Structure

The team working in the Department are funded from a variety of sources both internally and externally and the majority are seconded to undertake a specific project. To date, (June 2006), there are 13 ongoing research projects being undertaken by the team. Those currently undertaking research in the department include:

1 Midwife Research Co-ordinator
1 Research Fellow
3 Research Midwives (capability building)
5 Masters Students
2 Masters in Philosophy Students
3 Trial Co-ordinators
2 Research Assistants

Input to Midwifery Practice:

The midwifery research team regularly feeds into practice via the following means:

Input into clinical guidelines
Supplying of evidence to be applied directly to practice
Assistance with literature searching
Input into mandatory training
Application of critical thinking

Midwifery Practice Outcomes

Antenatal breastfeeding workshops found to be ineffective and costly therefore terminated.
Bilirubinometer found to be effective in screening for neonatal jaundice thus saving thousands of pounds in time and resources for the Trust and being more acceptable to women.
Four hour partogram shown to reduce interventions and transfers from Midwifery Led Unit to central Delivery Suite without creating any adverse maternal or neonatal outcomes thus implemented.
Implementation of multi-faceted education and breastfeeding information provision altered following the recommendations of the Breastfeeding and Family Life Study.

Baby's hand

Research Output

The Midwifery Research Team have presented their research findings at a variety of local, national and international conferences including Toronto, North Carolina, Vienna, Tanzania, Sweden, Brisbane and Uganda. The Department won the Liverpool Women’s NHS Foundation Trust “Focusing on Excellence Award” in 2005 for the Research and Evidence in Practice category. Recent research publications are shown below (alphabetical order).

Annual Midwifery Research Conference

Since 1998, the department has held an Annual Midwifery Research conference attended by 100 delegates every October. The findings of our research and those of invited speakers are presented. These days are always well evaluated and prove to be stimulating and thought provoking!

This year, 10th Annual Conference “Midwifery & Women’s Health Matters: Putting Research in Practice” will be held on Tuesday 2nd October 2007 in the Blair Bell Education Centre, Liverpool Women’s Hospital. Click Here for further information about the conference, or for information about the conference or any other aspect of the Midwifery Research Department or please contact: lisa.baker@lwh.nhs.uk or joanna.middleton@lwh.nhs.uk

Research Publications 2004 - date (June 2006)

Peer reviewed Journals

1. Abayomi J, Morrison G, McFadden K, Wood L, Purewal TS. (2005) Can CSII assist women with type 1 diabetes in breastfeeding? Journal of Diabetes Nursing 9;(9):346-51.

2. Baker L, Lavender T, Tincello D (2005) Factors that influence women’s decisions about whether to participate in research: an exploratory study. Birth, 32 (1): 60-6

3. Baker L (2006) Are we discharging women into the community to early? British Journal of Midwifery. 14 (3): 148-9.

4. Baker L. (in press) Ten pitfalls of qualitative research. British Journal of Midwifery.

5. Cattrell R, Lavender T, Wallymahmed A, Kingdon C, Riley J. (2005) Postnatal care: What matters to midwives. British Journal of Midwifery; 13 (4):206-213

6. Bedwell C (2006) Are third degree tears unavoidable. British Journal of Midwifery. 14 (4): 12

7. Houghton G (2006) Bladder filling: an effective technique for managing cord prolapse. British Journal of Midwifery. 14;(2):88-9.

8. Kingdon C, Baker L, Lavender T. A Review of Nulliparous Women’s Views of Planned Cesarean Birth: The Missing Component in the Debate about a Term Cephalic Trial. Birth. accepted 29th August 2005 (in-press).

9. Kingdon C. (2005) Reflexivity: Not just a qualitative methodological research tool. British Journal of Midwifery. 13;(10):622-7.

10. Lavender T, Baker L, Smyth R, Collins S, Spofforth A, Dey P. (2005) Breastfeeding expectations versus reality: a cluster randomised controlled trial. BJOG. 112:1047-53.

11. Lavender T, Briscoe L, Downe S, Kingdon C. Enhancing clients’ rights and quality of care. British Journal of Midwifery 2004; 12 (3):142-3

12. Lavender T, Hart A, Walkinshaw S, Campbell E, Alfirevic Z (2005) Progress of first stage of labour for multiparous women: An observational study. BJOG

13. Lavender T, Thompson S, Wood L. (2005) Supporting teenage mothers with breastfeeding guardians. British Journal of Midwifery. 13;(6):354-9.

14. Lavender T, Chapple J (2004) An evaluation of midwives views of the current system of maternity care in England, Midwifery 20 (4): 324-34

15. Lavender T, Chapple J (2005) How women choose where to give birth. The Practicing Midwife. 8: 10-15

6. Lavender T, Hart A, Walkinshaw S, Campbell E, Alfirevic Z (2005) Progress of first stage of labour for multiparous women: An observational study. BJOG 112:1663-65

17. Lavender T, Osbourne A (2005) Debate: Partograms should not be used in birth centres. BJM, 13 (10) 618-9.

18. Lavender T, Kingdon C, Hart A, Gyte G, Gabbay MB, Neilson JP. (2005) Could a randomised trial answer the controversy relating to elective caesarean section? National survey of Consultant Obstetricians and Heads of Midwifery. British Medical Journal. 331;490-491

19. Lavender T, Baker L, McFadden C. (2006) Breastfeeding and Family Life: An exploratory study. International Journal of Maternal and Child Nutrition Journal. (in-press)

20. Longworth H (2006) Should Fathers in the labour room? Yes for support not intervention. British Journal of Midwifery. 14 (5):288

21. Neilson J, Lavender T, Quenby S, Wray S. (2004) Obstructed labour, British Medical Bulletin, RCOG Press: London

22. Weeks A, Lavender T, Nazziwa E, Mirembe F (2005) Personal accounts of ‘near-miss’ maternal mortalities in Kampala, Uganda, BJOG; 112: 1302-1307

23. Williams A, Lavender T, Richmond DH, Tincello DG (2005) Women’s experiences after a third degree obstetric anal sphincter tear: a qualitative study. Birth 32 (2): 129-36

24. York S, Briscoe L, Walkinshaw S, Lavender T (2005) Why women choose to have a repeat caesarean. BJM, 13: 440-445

Edited Books

Lavender T, Edwards G, Alfirevic Z.(2004) Demystifying qualitative Research: A Resource book for Midwives and Obstetricians. Quay Books. MA Publications.

Edwards G (2004) Outcomes in Maternity Care: Implications for practice, applying the recommendations of the confidential Enquiries. Books for Midwives Press

Book Chapters

Lavender T, Kingdon C (In Press) Keeping birth normal. In: Page L, McCandlish R (Eds) New Midwifery. 2nd edition. Elsevier. London.

Kingdon C. (2004) Why carry out qualitative research? In: Lavender T, Edwards G, Alfirevic Z. Demystifying qualitative research in pregnancy and childbirth. Quay books, Shropshire: MA Healthcare Ltd, 2004.

Walsh D, & Baker L. (2004) How to collect qualitative data. In: Lavender T, Edwards G, Alfirevic Z. Demystifying qualitative research in pregnancy and childbirth. Quay books, Shropshire: MA Healthcare Ltd, 2004.