Professor Vicki Flenady

Honorary Professor

Mater Research Institute-UQ
Faculty of Medicine

Honorary Professor

Mater Clinical Unit
Faculty of Medicine

Overview

Professor Vicki Flenady is the Director of the Centre of Research Excellence in Stillbirth (Stillbirth CRE), based at Mater Research – The University of Queensland. She is a nationally and internationally renowned clinical perinatal epidemiologist with specific expertise in stillbirth.

Professor Flenady has over 150 publications (including more than 30 Cochrane systematic reviews) with more than 50 in the last five years. She has also authored four book chapters and numerous state-wide and hospital clinical outcome reports. She led two papers in The Lancet Stillbirths Series in 2011 (one an accompanying research paper) and co-authored all others as a member of the series steering committee overseeing the production and dissemination of the series of six papers, two supplemental papers, and five commentaries. She is a member of the Study Group for The Lancet’s 2016 Ending Preventable Stillbirths series, leading one paper and co-authoring all others (five in total). Other key research publications as lead/senior author include a suite of papers on the development of global indicators for maternity and newborn care and evaluation of classification systems for the development of a new WHO classification system for stillbirth and neonatal death. She has also authored or co-authored books and developed many national and state guidelines pertaining to stillbirth and neonatal death.

Professor Flenady's successful bid to establish Australia's first Stillbirth CRE has formally brought together parents, parent advocates, health care professionals, researchers, professional colleges, and policy makers, to reduce stillbirths and improve the quality care for women and families after stillbirth. A collaboration of academic institutions and not-for-profit organisation, The Stillbirth CRE is an Australia-wide initiative aiming to reduce the rate of stillbirthin Australia and ensure quality, respectful care for all families who experience the tragedy of stillbirth.

Professor Flenady is currently leading two NHMRC funded studies; a large-scale cluster randomised controlled trial testing the role of a mobile phone app for women on decreased fetal movements in reducing stillbirth, and a multisite study to identify causes of stillbirth and the value of recommended investigations for stillbirth. Through the Perinatal Society of Australia and New Zealand (PSANZ), Vicki leads a collaboration promoting best practice in perinatal mortality through bi-national guidelines and clinician education with a major focus on investigation into the causes of stillbirth and bereavement care.

Professor Flenady has won a number of awards including: the 2008 National Institute of Clinical Studies evidence into practice award for implementing the Perinatal Society of Australia and New Zealand Perinatal Mortality Audit Guidelines; the 2011 Eileen Potter Award for Translating Research Into Practice; the 2016 Excellence in Research Award Mater Medical Research institute; the 2013 the Medal of Distinction Women’s Healthcare Australasia honouring her outstanding contribution at a national level to improving health of women through service provision, leadership and advocacy; and the 2018 Distinguished researcher award from the International Stillbirth Alliance.

Research Impacts

At the core of Professor Flenady's research program is the translation of research into clinical practice change. Through PSANZ and the Stillbirth CRE, she has authored key clinical practice guidelines relating to perinatal health, including the care of women who report decreased fetal movements during pregnancy, and recommended clinical practice following stillbirth or neonatal death (available at the Stillbirth CRE website). Professor Flenady was recognised for her role in implementing these guidelines into practice with a National Institute of Clinical Studies evidence into practice award in 2008.

Also together with PSANZ and the Stillbirth CRE, Professor Flenady has convened education programs for clinicians around the detection and management of fetal growth restriction, and around clinical practice following stillbirth or neonatal death, via the IMproving Perinatal Mortality Review and Outcomes Via Education (IMPROVE) workshops.

Most recently, Professor Flenady led the Stillbirth CRE's collaborative submission to the Select Committee on Stillbirth Research and Education inquiry and report on the future of stillbirth research and education in Australia. She was a witness at the Brisbane public hearing together with members of the Stillbirth CRE executive committee. The written submission can be downloaded here and transcript for the Brisbane public hearing downloaded here.

Publications

  • Flenady, Vicki, Gordon, Adrienne and Bauman, Adrian (2017) Stillbirth prevention: the challenges of public campaigns. BJOG, 125 2: 253-253. doi:10.1111/1471-0528.14964

  • Flenady, Vicki, Wojcieszek, Aleena M., Ellwood, David, Hopkins Leisher, Susannah , Erwich, Jan Jaap H. M., Draper, Elizabeth S., McClure, Elizabeth M., Reinebrant, Hanna E., Oats, Jeremy, McCowan, Lesley, Kent, Alison L., Gardener, Glenn, Gordon, Adrienne, Tudehope, David, Siassakos, Dimitrios, Storey, Claire, Zuccollo, Jane, Dahlstrom, Jane E., Gold, Katherine J., Gordijn, Sanne, Pettersson, Karin, Masson, Vicki, Pattinson, Robert, Gardosi, Jason, Khong, T. Yee, Froen, J. Frederik and Silver, Robert M. (2017) Classification of causes and associated conditions for stillbirths and neonatal deaths. Seminars in Fetal and Neonatal Medicine, 22 3: 176-185. doi:10.1016/j.siny.2017.02.009

  • Flenady, Vicki, Wojcieszek, Aleena M., Fjeldheim, Ingvild, Friberg, Ingrid K., Nankabirwa, Victoria, Jani, Jagrati V., Myhre, Sonja, Middleton, Philippa, Crowther, Caroline, Ellwood, David, Tudehope, David, Pattinson, Robert, Ho, Jacqueline, Matthews, Jiji, Ortega, Aurora Bermudez, Venkateswaran, Mahima, Chou, Doris, Say, Lale, Mehl, Garret and Froen, J. Frederik (2016) eRegistries: indicators for the WHO Essential Interventions for reproductive, maternal, newborn and child health. BMC Pregnancy and Childbirth, 16 1: . doi:10.1186/s12884-016-1049-y

  • Heazell, Alexander E. P., Siassakos, Dimitrios, Blencowe, Hannah, Burden, Christy, Bhutta, Zulfiqar A., Cacciatore, Joanne, Dang, Nghia, Das, Jai, Flenady, Vicki, Gold, Katherine J., Mensah, Oliva K., Millum, Joseph, Nuzum, Daniel, O'Donoghue, Keelin, Redshaw, Maggie, Rizvi, Arjumand, Roberts, Tracy, Saraki, H. E. Toyin, Storey, Claire, Wojcieszek, Aleena M. and Downe, Soo (2016) Stillbirths: economic and psychosocial consequences. The Lancet, 387 10018: 604-616. doi:10.1016/S0140-6736(15)00836-3

  • Flenady, Vicki, Wojcieszek, Aleena M., Middleton, Philippa, Ellwood, David, Erwich, Jan Jaap, Coory, Michael, Khong, T. Yee, Silver, Robert M., Smith, Gordon C. S., Boyle, Frances M., Lawn, Joy E., Blencowe, Hannah, Hopkins Leisher, Susannah, Gross, Mechthild M., Horey, Dell, Farrales, Lynn, Bloomfield, Frank, McCowan, Lesley, Brown, Stephanie J., Joseph, K S, Zeitlin, Jennifer, Reinebrant, Hanna E., Ravaldi, Claudia, Vannacci, Alfredo, Cassidy, Jillian, Cassidy, Paul, Farquhar, Cindy, Wallace, Euan, Siassakos, Dimitrios, Heazell, Alexander E. P., Storey, Claire, Sadler, Lynn, Petersen, Scott, Froen, J. Frederik and Goldenberg, Robert L. (2016) Stillbirths: Recall to action in high-income countries. The Lancet, 387 10019: 691-702. doi:10.1016/S0140-6736(15)01020-X

  • Flenady, Vicki (2015). Epidemiology of fetal and neonatal death. In T. Yee Khong and Roger D. G. Malcomson (Ed.), Keeling's fetal and neonatal pathology 5th ed. (pp. 141-164) Cham, Switzerland: Springer International Publishing. doi:10.1007/978-3-319-19207-9_6

  • Ibiebele, I., Coory, M., Boyle, F. M., Humphrey, M., Vlack, S. and Flenady, V. (2014) Stillbirth rates among indigenous and non-indigenous women in Queensland, Australia: is the gap closing?. BJOG: An International Journal of Obstetrics and Gynaecology, 122 11: 1476-1483. doi:10.1111/1471-0528.13047

  • Flenady, Vicki, Reinebrant, Hanna E., Liley, Helen G., Tambimuttu, Eashan G. and Papatsonis, Dimitri N. M. (2014) Oxytocin receptor antagonists for inhibiting preterm labour (Review). Cochrane Database of Systematic Reviews, 2014 6: . doi:10.1002/14651858.CD004452.pub3

  • Flenady, Vicki, Koopmans, Laura, Middleton, Philippa, Froen, J. Frederik, Smith, Gordon C., Gibbons, Kristen, Coory, Michael, Gordon, Adrienne, Ellwood, David, McIntyre,Harold David, Fretts, Ruth and Ezzati, Majid (2011) Major risk factors for stillbirth in high-income countries: A systematic review and meta-analysis. Obstetrical and Gynecological Survey, 66 8: 483-485. doi:10.1097/OGX.0b013e318235215c

  • Pattinson, Robert, Kerber, Kate, Buchmann, Eckhart, Friberg, Ingrid K., Belizan, Maria, Lansky, Sonia, Weissman, Eva, Mathai, Matthews, Rudan, Igor, Walker, Neff, Lawn, Joy E., The Lancet's Stillbirths Series steering committee and Flenady, Vicki (2011) Stillbirths: how can health systems deliver for mothers and babies?. The Lancet, 377 9777: 1610-1623. doi:10.1016/S0140-6736(10)62306-9

  • Goldenberg, Robert L., McClure, Elizabeth M., Bhutta, Zulfiqar A., Belizan, Jose M., Reddy, Uma M., Rubens, Craig E., Mabeya, Hillary, Flenady, Vicki and Darmstadt, Gary L. (2011) Stillbirths: The vision for 2020. Lancet, 377 9779: 1798-1805. doi:10.1016/S0140-6736(10)62235-0

  • Flenady, Vicki, Middleton, Philippa, Smith, Gordon C., Duke, Wes, Erwich, Jan Jaap, Khong, T. Yee, Neilson, Jim, Ezzati, Majid, Koopmans, Laura, Ellwood, David, Fretts, Ruth and Froen, J. Frederik (2011) Stillbirths: The way forward in high-income countries. Lancet, 377 9778: 1703-1717. doi:10.1016/S0140-6736(11)60064-0

  • Bhutto, Zulfiqar A., Yakoob, Mohammad Yawar, Lawn, Joy E., Rizvi, Arjumand, Friberg, Ingrid K., Weissman, Eva, Buchmann, Eckhart, Goldenberg, Robert L., The Lancet’s Stillbirths Series steering committee and Flenady, Vicki (2011) Stillbirths: what difference can we make and at what cost?. The Lancet, 377 9776: 1523-1538. doi:10.1016/S0140-6736(10)62269-6

  • Lawn, Joy E., Blencowe, Hannah, Pattinson, Robert, Cousens, Simon, Kumar, Rajesh, Ibiebele, Ibinabo, Gardosi, Jason, Day, Louise T., Stanton, Cynthia, The Lancet's Stillbirths Series steering committee and Flenady, Vicki (2011) Stillbirths: Where? When? Why? How to make the data count?. The Lancet, 377 9775: 1448-1463. doi:10.1016/S0140-6736(10)62187-3

  • Flenady, Vicki, Koopmans, Laura, Middleton, Philippa, Frøen, J. Frederik, Smith, Gordon C., Gibbons, Kristen, Coory, Michael, Gordon, Adrienne, Ellwood, David, McIntyre, Harold David, Fretts, Ruth and Ezzati, Majid (2011) Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. The Lancet, 377 9774: 1331-1340. doi:10.1016/S0140-6736(10)62233-7

View all Publications

Supervision

  • Doctor Philosophy

  • Doctor Philosophy

  • Doctor Philosophy

View all Supervision

Available Projects

  • The psychosocial impact on mothers and families and society is substantial, yet the care received by parents in Australia is highly variable. Studies show parents’ needs are frequently unmet. Parents face many critical decisions following stillbirth and more support and guidance is needed, particularly around autopsy consent. For those embarking on subsequent pregnancies, there is a five-fold increased risk of stillbirth. Heightened anxiety and fear in subsequent pregnancies is common, yet there is little guidance for clinicians on the optimal clinical care for these women. The additional economic costs of stillbirth need to be quantified for efficient health service planning. This is a suite of studies around the implementation of best practice for immediate care after a stillbirth and in subsequent pregnancies that follow.

    Please see further details by clicking on the study title.

  • The Stillbirth CRE is leading the development of a bundle of care to address the priority evidence practice gaps in stillbirth prevention for implementation across maternity services. This work is being done in partnership with health departments of New South Wales, Victoria, and Queensland and key stillbirth advocacy organisations, Stillbirth Foundation Australia and Still Aware.

    The proposed bundle of care for Australian hospitals is being modeled on the Saving Babies Lives bundle in the United Kingdom, which addresses commonly identified areas of substandard care.

    A 20% reduction in stillbirth rates has been seen in the UK and Scotland, where a care bundle has been implemented. We believe that implementation of a similar care bundle in Australia will result in at least the same reduction in stillbirth. We think the bundle will also reduce serious adverse outcomes in liveborn babies, improve health outcomes among mothers, increase mothers' satisfaction with car, and be cost-effective.

    Bundle of care elements currently:

    1. Improving detection and management of fetal growth restriction (FGR)
    2. Improving awareness and management of decreased fetal movement (DFM)
    3. Reducing smoking in pregnancy
    4. Improving awareness of maternal safe sleeping position
    5. Improving decision-making around timing of birth for women with risk factor

    Please see further details by clicking on the study title.

  • A stillborn child is devastating for the mother, father and family often resulting in profound and long-lasting adverse psychosocial effects. There are over 2.6 million stillbirths each year globally and progress in reducing these deaths has been extremely slow. Maternal reporting of decreased fetal movements (DFM) is strongly associated with stillbirth and has been proposed as a simple, inexpensive screening tool for stillbirth. However maternal awareness of DFM and clinical management of women who report DFM is often suboptimal. Preliminary data suggests that interventions to increase awareness of DFM may reduce stillbirth rates. Mobile phone applications are increasingly used as an information source by pregnant women.

    The aim of the MBM trial is evaluate the effectiveness of a mobile phone program for women combined with an educational program for clinicians (MBM package) in reducing late gestation stillbirth rates

    MBM is a stepped wedge cluster randomised controlled trial with sequential introduction of the intervention into 8 groups of 3-4 hospitals at four month intervals over a total of three years.

    Women with a singleton pregnancy without a major fetal abnormality attending for antenatal care and midwives and doctors providing maternity care at 26 maternity hospitals in Australia and New Zealand.

    The primary outcome is stillbirth at 28 weeks or more gestation. Secondary outcomes include: a) composite measure of adverse neonatal outcomes; b) health service utilisation measures; c) woman’s psychosocial outcomes and health seeking behaviour and acceptability; and d) clinical intervention for women with DFM aligned with best practice recommendations.

    Sample size: 256,700 births over three years

    There are numerous opportunities for PhD and masters projects within this large scale trial.

View all Available Projects

Publications

Featured Publications

  • Flenady, Vicki, Gordon, Adrienne and Bauman, Adrian (2017) Stillbirth prevention: the challenges of public campaigns. BJOG, 125 2: 253-253. doi:10.1111/1471-0528.14964

  • Flenady, Vicki, Wojcieszek, Aleena M., Ellwood, David, Hopkins Leisher, Susannah , Erwich, Jan Jaap H. M., Draper, Elizabeth S., McClure, Elizabeth M., Reinebrant, Hanna E., Oats, Jeremy, McCowan, Lesley, Kent, Alison L., Gardener, Glenn, Gordon, Adrienne, Tudehope, David, Siassakos, Dimitrios, Storey, Claire, Zuccollo, Jane, Dahlstrom, Jane E., Gold, Katherine J., Gordijn, Sanne, Pettersson, Karin, Masson, Vicki, Pattinson, Robert, Gardosi, Jason, Khong, T. Yee, Froen, J. Frederik and Silver, Robert M. (2017) Classification of causes and associated conditions for stillbirths and neonatal deaths. Seminars in Fetal and Neonatal Medicine, 22 3: 176-185. doi:10.1016/j.siny.2017.02.009

  • Flenady, Vicki, Wojcieszek, Aleena M., Fjeldheim, Ingvild, Friberg, Ingrid K., Nankabirwa, Victoria, Jani, Jagrati V., Myhre, Sonja, Middleton, Philippa, Crowther, Caroline, Ellwood, David, Tudehope, David, Pattinson, Robert, Ho, Jacqueline, Matthews, Jiji, Ortega, Aurora Bermudez, Venkateswaran, Mahima, Chou, Doris, Say, Lale, Mehl, Garret and Froen, J. Frederik (2016) eRegistries: indicators for the WHO Essential Interventions for reproductive, maternal, newborn and child health. BMC Pregnancy and Childbirth, 16 1: . doi:10.1186/s12884-016-1049-y

  • Heazell, Alexander E. P., Siassakos, Dimitrios, Blencowe, Hannah, Burden, Christy, Bhutta, Zulfiqar A., Cacciatore, Joanne, Dang, Nghia, Das, Jai, Flenady, Vicki, Gold, Katherine J., Mensah, Oliva K., Millum, Joseph, Nuzum, Daniel, O'Donoghue, Keelin, Redshaw, Maggie, Rizvi, Arjumand, Roberts, Tracy, Saraki, H. E. Toyin, Storey, Claire, Wojcieszek, Aleena M. and Downe, Soo (2016) Stillbirths: economic and psychosocial consequences. The Lancet, 387 10018: 604-616. doi:10.1016/S0140-6736(15)00836-3

  • Flenady, Vicki, Wojcieszek, Aleena M., Middleton, Philippa, Ellwood, David, Erwich, Jan Jaap, Coory, Michael, Khong, T. Yee, Silver, Robert M., Smith, Gordon C. S., Boyle, Frances M., Lawn, Joy E., Blencowe, Hannah, Hopkins Leisher, Susannah, Gross, Mechthild M., Horey, Dell, Farrales, Lynn, Bloomfield, Frank, McCowan, Lesley, Brown, Stephanie J., Joseph, K S, Zeitlin, Jennifer, Reinebrant, Hanna E., Ravaldi, Claudia, Vannacci, Alfredo, Cassidy, Jillian, Cassidy, Paul, Farquhar, Cindy, Wallace, Euan, Siassakos, Dimitrios, Heazell, Alexander E. P., Storey, Claire, Sadler, Lynn, Petersen, Scott, Froen, J. Frederik and Goldenberg, Robert L. (2016) Stillbirths: Recall to action in high-income countries. The Lancet, 387 10019: 691-702. doi:10.1016/S0140-6736(15)01020-X

  • Flenady, Vicki (2015). Epidemiology of fetal and neonatal death. In T. Yee Khong and Roger D. G. Malcomson (Ed.), Keeling's fetal and neonatal pathology 5th ed. (pp. 141-164) Cham, Switzerland: Springer International Publishing. doi:10.1007/978-3-319-19207-9_6

  • Ibiebele, I., Coory, M., Boyle, F. M., Humphrey, M., Vlack, S. and Flenady, V. (2014) Stillbirth rates among indigenous and non-indigenous women in Queensland, Australia: is the gap closing?. BJOG: An International Journal of Obstetrics and Gynaecology, 122 11: 1476-1483. doi:10.1111/1471-0528.13047

  • Flenady, Vicki, Reinebrant, Hanna E., Liley, Helen G., Tambimuttu, Eashan G. and Papatsonis, Dimitri N. M. (2014) Oxytocin receptor antagonists for inhibiting preterm labour (Review). Cochrane Database of Systematic Reviews, 2014 6: . doi:10.1002/14651858.CD004452.pub3

  • Flenady, Vicki, Koopmans, Laura, Middleton, Philippa, Froen, J. Frederik, Smith, Gordon C., Gibbons, Kristen, Coory, Michael, Gordon, Adrienne, Ellwood, David, McIntyre,Harold David, Fretts, Ruth and Ezzati, Majid (2011) Major risk factors for stillbirth in high-income countries: A systematic review and meta-analysis. Obstetrical and Gynecological Survey, 66 8: 483-485. doi:10.1097/OGX.0b013e318235215c

  • Pattinson, Robert, Kerber, Kate, Buchmann, Eckhart, Friberg, Ingrid K., Belizan, Maria, Lansky, Sonia, Weissman, Eva, Mathai, Matthews, Rudan, Igor, Walker, Neff, Lawn, Joy E., The Lancet's Stillbirths Series steering committee and Flenady, Vicki (2011) Stillbirths: how can health systems deliver for mothers and babies?. The Lancet, 377 9777: 1610-1623. doi:10.1016/S0140-6736(10)62306-9

  • Goldenberg, Robert L., McClure, Elizabeth M., Bhutta, Zulfiqar A., Belizan, Jose M., Reddy, Uma M., Rubens, Craig E., Mabeya, Hillary, Flenady, Vicki and Darmstadt, Gary L. (2011) Stillbirths: The vision for 2020. Lancet, 377 9779: 1798-1805. doi:10.1016/S0140-6736(10)62235-0

  • Flenady, Vicki, Middleton, Philippa, Smith, Gordon C., Duke, Wes, Erwich, Jan Jaap, Khong, T. Yee, Neilson, Jim, Ezzati, Majid, Koopmans, Laura, Ellwood, David, Fretts, Ruth and Froen, J. Frederik (2011) Stillbirths: The way forward in high-income countries. Lancet, 377 9778: 1703-1717. doi:10.1016/S0140-6736(11)60064-0

  • Bhutto, Zulfiqar A., Yakoob, Mohammad Yawar, Lawn, Joy E., Rizvi, Arjumand, Friberg, Ingrid K., Weissman, Eva, Buchmann, Eckhart, Goldenberg, Robert L., The Lancet’s Stillbirths Series steering committee and Flenady, Vicki (2011) Stillbirths: what difference can we make and at what cost?. The Lancet, 377 9776: 1523-1538. doi:10.1016/S0140-6736(10)62269-6

  • Lawn, Joy E., Blencowe, Hannah, Pattinson, Robert, Cousens, Simon, Kumar, Rajesh, Ibiebele, Ibinabo, Gardosi, Jason, Day, Louise T., Stanton, Cynthia, The Lancet's Stillbirths Series steering committee and Flenady, Vicki (2011) Stillbirths: Where? When? Why? How to make the data count?. The Lancet, 377 9775: 1448-1463. doi:10.1016/S0140-6736(10)62187-3

  • Flenady, Vicki, Koopmans, Laura, Middleton, Philippa, Frøen, J. Frederik, Smith, Gordon C., Gibbons, Kristen, Coory, Michael, Gordon, Adrienne, Ellwood, David, McIntyre, Harold David, Fretts, Ruth and Ezzati, Majid (2011) Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. The Lancet, 377 9774: 1331-1340. doi:10.1016/S0140-6736(10)62233-7

Book Chapter

  • Flenady, Vicki (2015). Epidemiology of fetal and neonatal death. In T. Yee Khong and Roger D. G. Malcomson (Ed.), Keeling's fetal and neonatal pathology 5th ed. (pp. 141-164) Cham, Switzerland: Springer International Publishing. doi:10.1007/978-3-319-19207-9_6

Journal Article

Conference Publication

Grants (Administered at UQ)

PhD and MPhil Supervision

Current Supervision

  • Doctor Philosophy — Principal Advisor

  • Doctor Philosophy — Principal Advisor

  • Doctor Philosophy — Principal Advisor

  • Doctor Philosophy — Principal Advisor

    Other advisors:

  • Doctor Philosophy — Associate Advisor

    Other advisors:

  • Doctor Philosophy — Associate Advisor

    Other advisors:

  • Doctor Philosophy — Associate Advisor

  • Doctor Philosophy — Associate Advisor

    Other advisors:

Completed Supervision

Possible Research Projects

Note for students: The possible research projects listed on this page may not be comprehensive or up to date. Always feel free to contact the staff for more information, and also with your own research ideas.

  • The psychosocial impact on mothers and families and society is substantial, yet the care received by parents in Australia is highly variable. Studies show parents’ needs are frequently unmet. Parents face many critical decisions following stillbirth and more support and guidance is needed, particularly around autopsy consent. For those embarking on subsequent pregnancies, there is a five-fold increased risk of stillbirth. Heightened anxiety and fear in subsequent pregnancies is common, yet there is little guidance for clinicians on the optimal clinical care for these women. The additional economic costs of stillbirth need to be quantified for efficient health service planning. This is a suite of studies around the implementation of best practice for immediate care after a stillbirth and in subsequent pregnancies that follow.

    Please see further details by clicking on the study title.

  • The Stillbirth CRE is leading the development of a bundle of care to address the priority evidence practice gaps in stillbirth prevention for implementation across maternity services. This work is being done in partnership with health departments of New South Wales, Victoria, and Queensland and key stillbirth advocacy organisations, Stillbirth Foundation Australia and Still Aware.

    The proposed bundle of care for Australian hospitals is being modeled on the Saving Babies Lives bundle in the United Kingdom, which addresses commonly identified areas of substandard care.

    A 20% reduction in stillbirth rates has been seen in the UK and Scotland, where a care bundle has been implemented. We believe that implementation of a similar care bundle in Australia will result in at least the same reduction in stillbirth. We think the bundle will also reduce serious adverse outcomes in liveborn babies, improve health outcomes among mothers, increase mothers' satisfaction with car, and be cost-effective.

    Bundle of care elements currently:

    1. Improving detection and management of fetal growth restriction (FGR)
    2. Improving awareness and management of decreased fetal movement (DFM)
    3. Reducing smoking in pregnancy
    4. Improving awareness of maternal safe sleeping position
    5. Improving decision-making around timing of birth for women with risk factor

    Please see further details by clicking on the study title.

  • A stillborn child is devastating for the mother, father and family often resulting in profound and long-lasting adverse psychosocial effects. There are over 2.6 million stillbirths each year globally and progress in reducing these deaths has been extremely slow. Maternal reporting of decreased fetal movements (DFM) is strongly associated with stillbirth and has been proposed as a simple, inexpensive screening tool for stillbirth. However maternal awareness of DFM and clinical management of women who report DFM is often suboptimal. Preliminary data suggests that interventions to increase awareness of DFM may reduce stillbirth rates. Mobile phone applications are increasingly used as an information source by pregnant women.

    The aim of the MBM trial is evaluate the effectiveness of a mobile phone program for women combined with an educational program for clinicians (MBM package) in reducing late gestation stillbirth rates

    MBM is a stepped wedge cluster randomised controlled trial with sequential introduction of the intervention into 8 groups of 3-4 hospitals at four month intervals over a total of three years.

    Women with a singleton pregnancy without a major fetal abnormality attending for antenatal care and midwives and doctors providing maternity care at 26 maternity hospitals in Australia and New Zealand.

    The primary outcome is stillbirth at 28 weeks or more gestation. Secondary outcomes include: a) composite measure of adverse neonatal outcomes; b) health service utilisation measures; c) woman’s psychosocial outcomes and health seeking behaviour and acceptability; and d) clinical intervention for women with DFM aligned with best practice recommendations.

    Sample size: 256,700 births over three years

    There are numerous opportunities for PhD and masters projects within this large scale trial.

  • Knowledge of the causes and contributing factors in stillbirth is crucially important to parents to understand why their baby died and is also the cornerstone of future prevention of stillbirths. Contributing factors relating to care are identified in a small, but important, proportion of stillbirths. Currently, data quality to understand the important contributors for stillbirth is often suboptimal due to under-investigation, inadequate classification and clinical audit of the circumstances surrounding the death.

    The focus of this work is on developing an evidence-based stillbirth investigation protocol and enhancements to the existing Perinatal Society of Australia and New Zealand stillbirth and neonatal deaths classification system and audit mechanisms.

    Please see further details by clicking on the study title.

  • This specific project is aligned with the fifth element of the 'Safe Baby Bundle' (SBB) and will explore novel strategies to help translate best-evidence into practice for timing of birth for women with risk factors at term. Research shows that women want to engage in their care and that women’s engagement is associated with better outcomes for mothers and babies. Shared decision-making is “an approach where clinicians and patients share the best available evidence when faced with the task of making decisions, and where patients are supported to consider options, to achieve informed preferences. Students working on this project will carry out a research project nested within the SBB initiative. Additionally, a systematic review will be undertaken to summarise the world literature on the value of shared decision making around timing of birth for women with stillbirth risk factors at term.

  • The currently high proportion of unexplained stillbirths is a major barrier to identifying strategies to reduce the stillbirth rate. Many stillbirths are under investigated and the unexplained stillbirth represents a heterogeneous population including those missed diagnosis and those that are yet to be explained through future research. The current lack of evidence for recommended testing is a significant barrier to understanding the causes of stillbirth. Students working on this project analyse the data pertaining to detailed examination of causes of death in a cohort of an estimated 650 stillbirths, and the value of recommended stillbirth investigations including autopsy and placental examination according to presenting scenario. The value of the yield from autopsy will be ascertained from the perspective of the clinician and the parent. A systematic review will be undertaken to summarise the world literature on the value of investigations for stillbirths. Further, detailed review of placental findings will inform revisions to the national classification system for stillbirth.