We are proud of the research that has been undertaken at the Women & Children's Health Research Unit, these past projects can be found here. If you would like to know more about our individual past projects please visit the specific research study pages below:
Around one in eight women in the UK require assistance to give birth to their baby vaginally. Currently, doctors use either forceps or a ventouse (a suction cup) to help women have their babies in this manner. This is known as an assisted vaginal birth (AVB). Most mothers and babies do very well after an AVB, and the procedure is usually much better for both mothers and babies than the alternative, an emergency Caesarean section.
However, women and their babies can sometimes be harmed by an AVB. Mothers have a greater tendency to have severe tears of the vagina, and, sometimes, the rectum (back passage) compared to a spontaneous vaginal birth. Mothers may have more pain while healing (usually for one to two weeks) following a birth that has been assisted by forceps or ventouse. Babies may develop bruising over the scalp or face where the forceps or ventouse have been applied. Babies can also, very rarely (around 1 in 1000), sustain more serious harm, such as nerve injuries or bleeding into the brain or eye. Therefore, although AVB is generally very safe and usually better than the alternative (an emergency caesarean section), it is sensible to try to improve the technique to assist a vaginal birth and reduce the risks to both mothers and their babies. Unfortunately, no new types of devices to assist vaginal birth have been introduced into practice since the ventouse in the 1950s.
The BD Odon Device is a new device for AVB that has been designed by a team of midwives, doctors and engineers. The BD Odon Device works by placing a cuff of air which is attached to a sleeve, around the baby’s head. The doctor then gently pulls on this sleeve and air cuff to assist the birth of the baby.
In this study, we would like to use the BD Odon Device to help women give birth in cases where it is necessary to assist the birth of the baby. Our study will evaluate the safety and effectiveness of the BD Odon device and seek the views of women and healthcare professionals on its use. The information gained from the study will be used to plan a large comparative study
The imox study is a multi centre, double blinded, randomised controlled trial which is comparing the three medicines used for the “active management of the third stage of labour.”
The third stage of labour is the period of time between the birth of the baby and the delivery of the placenta. There are 2 ways of managing the third stage of labour, and this study applies to women who are choosing to have an active management of the third stage of labour, following a vaginal birth. Active management involves a one-off injection of a medicine which is designed to help keep the womb contracted thus reducing the risk of a post partum haemorrhage.
The purpose of the study is to find out which of the 3 medicines, that are currently in use, is the most effective and which allows women to feel as well as possible in the first few hours after their birth.
The study was completed in July 2018. The results are in the process of publication.
Parents’ Active Role and ENgagemenT in their Stillbirth and neonatal death review
Aim of the Study
To evaluate how parental engagement in Perinatal (Stillbirth and Neonatal) death hospital reviews could work in practice and to establish a “gold-standard” for this process that could support this parental engagement across the NHS (and internationally).
In the UK, more than 5,000 babies die before or shortly after birth each year. This can result in a wide range of negative outcomes for parents, families and healthcare staff.
Parents are rarely involved in the perinatal death hospital review process that takes place after the death of a baby (the Perinatal Mortality Review or “PNMR) and many are largely unaware that it even takes place. However, engaging parents in this process can help them deal with their grief more effectively. Their unique perspective also has the potential to improve care, going forward, by highlighting good practice and areas for improvement.
The PARENTS Study actively involved parents in the perinatal death review process at NBT’s Southmead Hospital. Involving parents in such a sensitive area is a genuinely novel, yet urgently needed and recommended approach.
The Study was led by our Consultant Senior Clinical Lecturer, Christy Burden, hosted by North Bristol NHS Trust, funded by the Health Foundation and supported by Sands Stillbirth and Neonatal death charity. For more information email PARENTS.Study@nbt.nhs.uk
Results of this research to date:
The impact on patient care was assessed using questionnaires and focus group discussions. The views and experiences of parents, staff and stakeholders was considered to enable the development of a standardised process that is sustainable, useful and has a positive impact on patient care and improve longer term outcomes following bereavement. Approaches such as ours are also helping to promote further transparency and an open culture within the NHS.
The lessons learnt allowed the team to develop a “gold-standard” for engaging bereaved parents in the PNMR following their baby’s death. This gold-standard can be followed using the resources produced as part of the study which are under NBT copyright, to request a copy of the summary and results, please email PARENTS.Study@nbt.nhs.uk.
This improved and innovative review process, that now gives parents the opportunity to be engaged, has been adopted as part of the Perinatal Mortality Review Tool (PMRT), that is being implemented nationally by our collaborators at the National Perinatal Epidemiology Unit (NPEU) at the University of Oxford.
We want MPs and commissioners to invest in parental engagement. Our vision is to have the option for parental involvement mandated in every hospital and properly resourced.