Professor Maralyn Foureur

Professor Maralyn Foureur

Joint Chair and Professor

School of Nursing and Midwifery

Delivering new research for mums and midwives

During her impressive 40-year research career, Professor Maralyn Foureur’s work has contributed to globally significant advancements in maternity care and midwifery for women and their support teams.

Image of Maralyn Foureur

Professor Maralyn Foureur is an internationally esteemed researcher and clinician in the field of maternity care and midwifery. Her work is highly acclaimed for its contribution to maternity care advancements in Australian hospitals. In fact, in the mid-1990s, Maralyn’s PhD study introduced an entirely new model of maternity care into Australia known as “continuity of care”, which is now championed as best practice in our country and many others worldwide.

Maralyn’s current research explores the impact of the built environment—specifically, birth units within Australian hospitals—on the birth experiences of women and their support teams, and therefore birth outcomes. For women and their families, Maralyn’s research is making a personal impact that will last generations.

“My work helps midwives and other maternity care staff who need excellent knowledge and skills to support women well during childbirth. I want to make childbirth a positive and enriching experience for mothers, who will then take on the role of nurturing the next generation.”

Seamless, personalised care

Maralyn’s PhD research in the mid-1990s was ahead of its time. Her randomised controlled trial was the first project to explore “continuity of care” within midwifery—not just for low-risk women, but for all. What she uncovered would help revolutionise Australia’s approach to midwifery care in the years that followed.

“My PhD had a major impact in Australia and internationally. This model enables women to meet a small group of midwives during pregnancy, one of whom will provide her with care throughout her labour and birth and in the early days with her new baby.”

Maralyn’s PhD research established the effectiveness of this new model,

“Women overwhelmingly regard continuity of midwifery care during pregnancy, childbirth and the early postnatal period as the gold standard of care models. It meets their needs for a knowledgeable professional companion to guide them and their family through the unknown experience of childbirth.

“Women report feeling listened to and supported so that they never feel like just another patient having a baby, but that their care is highly, individually tailored to meet their needs.”

Together with evidence from 15 similar studies, Maralyn’s work now informs health policy across Australia and is cited by globally respected entities such as the Cochrane Collaboration and the World Health Organization. The studies demonstrated that women who were provided with continuity of care were 24 per cent less likely to experience preterm birth or early pregnancy loss.

At the University of Newcastle and elsewhere, continuity of care is now the primary model taught to midwifery students. It forms a significant part of their clinical placement experience; at the University of Newcastle, Bachelor of Midwifery students participate in a minimum of 10 relationship-based continuity of care experiences with childbearing women over the course of their studies.

By the time students step into the workforce, they are expertly equipped to provide women and families with the highest level of personalised care.

“Students want to be able to learn within this model of care so that their education needs are individually met, and they are well-supported. Midwives also love working in this way and feel their professional skills are well-utilised when working in continuity of care.”

Creating space for new life

In the past decade, Maralyn’s research focus has shifted from continuity of care to the architecture and design of birth units in Australian hospitals.

Maralyn explains that the built environment can have a significant impact on a woman’s neurophysiology during childbirth. Despite this, Maralyn remains one of very few researchers who are exploring ways to improve birthing spaces for women and their support teams.

“For staff, walking into a well-designed birth unit helps them to feel supported, calm and confident, to think clearly and carry out their work efficiently and effectively.

“We want to provide women and their families—and the staff who care for them—with an environment that is more likely to result in positive birth experiences for all.”

Many women who give birth in the Hunter region will ultimately be able to see Maralyn’s work firsthand. Her research is influencing the design of maternity units across the region, including the newly planned birth units at John Hunter Hospital and Maitland Hospital. It also guided the best practice design of maternity units further afield, such as the Royal North Shore Hospital in Sydney.

“My birth unit design research is considered world-leading. I really enjoy the creative process of designing research, designing birth units, and also designing education so that others can learn the creative process too.”

Maralyn’s research—from continuity of care to birth unit design—has made Newcastle a national leader in maternity services and midwifery models of care research. Her work is helping to continually improve best practice and build a robust base of evidence that can benefit women, families, staff and communities.

“I love being a researcher and partnering with other brilliant researchers in nursing, midwifery and medical sciences to answer the myriad of questions and challenges we face in health services across our region, nationally and internationally.

“Together, we are working to improve the health and wellbeing of our communities, and this makes me proud.”

Image of Maralyn Foureur

Delivering new research for mums and midwives

During her impressive 40-year research career, Professor Maralyn Foureur’s work has contributed to globally significant advancements in maternity care and midwifery for women and their support teams.

Read more

Career Summary

Biography

Maralyn is Professor of Nursing and Midwifery Research, a Joint Clinical Chair of the University of Newcastle and Hunter New England Local Health District (HNELHD). She also holds Adjunct Professorial appointments at University of Technology Sydney, Victoria University of Wellington, New Zealand and Sydansk Universitat (University of Southern Denmark).

She is a leading Australian midwifery researcher with a national and international reputation established over a 30year career in clinical practice and research. Her ground breaking 1995 RCT testing the effectiveness of continuity of midwifery care for women of all risk led the way for a further 4 RCTs of variations on the model in NSW, QLD and Victoria. This body of research has subsequently enabled the model to be translated into health policy in every state and territory in Australia and is cited in international reviews including the Cochrane Collaboration and WHO documents. Continuity of care has become the foundational model of health service delivery underpinning the educational preparation of midwifery professionals throughout Australia.

In the past 10 years Professor Foureur has been, or is currently, Chief Investigator on four NHMRC Project Grants (2 RCTs, 2 Cohort studies), an ARC Discovery Grant and a NSW Ministry of Health, Translational Research Grant. She has over 150 publications with 70 in the past 5 years. Her current research interests are in the areas of neuro-leadership, neurophysiology and genomics and she is internationally regarded as an expert in the interdisciplinary field of Birth Unit Design. The major focus of her current role is the development of the translational research capacity and capability of the nursing and midwifery workforce of the HNELHD.

She has supervised over 40 Doctoral, Masters and Honours students to successful completion of their degrees-in fields as diverse as nursing, midwifery, public health, health informatics, complementary health, interdisciplinary health education, health architecture and design; in universities in Australia, New Zealand and Denmark.


Qualifications

  • Doctor of Philosophy, University of Newcastle
  • Graduate Diploma in Clinical Epidemiology, University of Newcastle

Keywords

  • Birth Unit Design
  • Clinical Epidemiology
  • Models of Care and Health Outcomes
  • Neuroscience and architecture
  • Nursing and Midwifery

Languages

  • English (Mother)
  • French (Working)

Fields of Research

Code Description Percentage
111006 Midwifery 50
111099 Nursing not elsewhere classified 50

Professional Experience

UON Appointment

Title Organisation / Department
Joint Chair and Professor University of Newcastle
School of Nursing and Midwifery
Australia

Academic appointment

Dates Title Organisation / Department
1/06/2018 - 24/12/2018 Chair: Maternal, Newborn and Women's Heath Clinical Academic Group Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
Australia
24/01/2018 - 24/12/2018 Director Centre for Midwifery, Child and Family Health University of Technology Sydney
Faculty of Health
Australia
24/07/2011 - 24/12/2012 Professor of Midwifery University of Technology Sydney
Australia
10/01/2011 - 20/12/2018 Professor of Midwifery Research University of Technology Sydney
Faculty of Health
Australia
24/08/2007 - 24/06/2011 Joint Clinical Chair: Professor of Midwifery University of Technology Sydney
Australia
24/08/2006 - 24/08/2007 Associate Professor Research University of Technology Sydney
Australia
24/06/1998 - 24/08/2006 Joint Clinical Chair: Professor of Midwifery Victoria University of Wellington
New Zealand
24/03/1996 - 24/06/1998 Senior Lecturer Victoria University of Wellington
New Zealand
24/02/1995 - 24/12/1995 Lecturer: Course Coordinator Graduate Diploma in Midwifery School of Nursing and Midwifery University of Newcastle
Australia
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Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Chapter (2 outputs)

Year Citation Altmetrics Link
2006 Wood PJ, Foureur M, 'A clean front passage: Dirt, douches and disinfectants at St Helens Hospital, Wellington, New Zealand, 1907-1922', Exploring the Dirty Side of Women's Health 26-37 (2006)
DOI 10.4324/9780203967348
Citations Scopus - 1
2004 Wood PJ, Foureur M, 'Exploring the maternity archive of the St Helens Hospital, Wellington, New Zealand, 1907-22: An historian and midwife collaborate', New Directions in Nursing History: International Perspectives 179-193 (2004)
DOI 10.4324/9780203403631
Citations Scopus - 1

Journal article (118 outputs)

Year Citation Altmetrics Link
2019 Fealy S, Davis D, Foureur M, Attia J, Hazelton M, Hure A, 'The return of weighing in pregnancy: A discussion of evidence and practice', Women and Birth, (2019)
DOI 10.1016/j.wombi.2019.05.014
Co-authors Alexis Hure, Michael Hazelton, Shanna Fealy, John Attia
2019 Coates D, Homer C, Wilson A, Deady L, Mason E, Foureur M, Henry A, 'Indications for, and timing of, planned caesarean section: A systematic analysis of clinical guidelines', Women and Birth, (2019)

© 2019 Australian College of Midwives Background: There has been a worldwide rise in planned caesarean sections over recent decades, with significant variations in practice betwee... [more]

© 2019 Australian College of Midwives Background: There has been a worldwide rise in planned caesarean sections over recent decades, with significant variations in practice between hospitals and countries. Guidelines are known to influence clinical decision-making and, potentially, unwarranted clinical variation. The aim of this study was to review guidelines for recommendations in relation to the timing and indications for planned caesarean section as well as recommendations around the process of decision-making. Method: A systematic search of national and international English-language guidelines published between 2008 and 2018 was undertaken. Guidelines were reviewed, assessed in terms of quality and extracted independently by two reviewers. Findings: In total, 49 guidelines of varying quality were included. There was consistency between the guidelines in potential indications for caesarean section, although guidelines vary in terms of the level of detail. There was substantial variation in timing of birth, for example recommended timing of caesarean section for women with uncomplicated placenta praevia is between 36 and 39 weeks depending on the guideline. Only 11 guidelines provided detailed guidance on shared decision-making. In general, national-level guidelines from Australia, and overseas, received higher quality ratings than regional guidelines. Conclusion: The majority of guidelines, regardless of their quality, provide very limited information to guide shared decision-making or the timing of planned caesarean section, two of the most vital aspects of guidance. National guidelines were generally of better quality than regional ones, suggesting these should be used as a template where possible and emphasis placed on improving national guidelines and minimising intra-country, regional, variability of guidelines.

DOI 10.1016/j.wombi.2019.06.011
Citations Scopus - 1
Co-authors Dominiek Coates
2019 McLaughlin K, Jensen ME, Foureur M, Gibson PG, Murphy VE, 'Fractional exhaled nitric oxide-based asthma management: The feasibility of its implementation into antenatal care in New South Wales, Australia.', Aust N Z J Obstet Gynaecol, (2019)
DOI 10.1111/ajo.13061
Co-authors Megan Jensen, Vanessa Murphy, Peter Gibson
2019 Lorentzen I, Andersen CS, Jensen HS, Fogsgaard A, Foureur M, Lauszus FF, Nohr EA, 'Study protocol for a randomised trial evaluating the effect of a birth environment room versus a standard labour room on birth outcomes and the birth experience', Contemporary Clinical Trials Communications, 14 (2019)

© 2019 The Authors Introduction: In the last decade, there has been an increased interest in exploring the impact of the physical birth environment on birth outcomes. The birth en... [more]

© 2019 The Authors Introduction: In the last decade, there has been an increased interest in exploring the impact of the physical birth environment on birth outcomes. The birth environment might have an important role in facilitating the production of the hormone oxytocin that causes contractions during labour. Oxytocin is released in a safe, secure and confidence-inducing environment, and environments focused on technology and medical interventions to achieve birth may disrupt the production of oxytocin and slow down the progress of labour. An experimental ¿birth environment room¿ was designed, inspired by knowledge from evidence-based healthcare design, which advocates bringing nature into the room to reduce stress. The purpose is to examine whether the ¿birth environment room¿, with its design and decor to minimise stress, has an impact on birth outcomes and the birth experience of the woman and her partner. Materials and methods: A randomised controlled trial will recruit 680 nulliparous women at term who will be randomly allocated to either the ¿birth environment room¿ or a standard room. The study will take place at the Department of Obstetrics and Gynecology at Herning Hospital, with recruitment from May 2015. Randomisation to either the ¿birth environment room¿ or standard room takes place just before admission to a birth room during labour. The primary outcome is augmentation of labour, and the study has 80% power to detect a 10% difference between the two groups (two-sided a = 0.05). Secondary outcomes are duration of labour, use of pharmacological pain relief, mode of birth, and rating of the birth experience by women and their partners. Trial registration: NCT02478385(10/08/2016).

DOI 10.1016/j.conctc.2019.100336
2019 Coates D, Homer C, Wilson A, Deady L, Mason E, Foureur M, Henry A, 'Induction of labour indications and timing: A systematic analysis of clinical guidelines', Women and Birth, (2019)

© 2019 Australian College of Midwives Background: There is widespread and some unexplained variation in induction of labour rates between hospitals. Some practice variation may st... [more]

© 2019 Australian College of Midwives Background: There is widespread and some unexplained variation in induction of labour rates between hospitals. Some practice variation may stem from variability in clinical guidelines. This review aimed to identify to what extent induction of labour guidelines provide consistent recommendations in relation to reasons for, and timing of, induction of labour and ascertain whether inconsistencies can be explained by variability guideline quality. Method: We conducted a systematic search of national and international English-language guidelines published between 2008 and 2018. General induction of labour guidelines and condition-specific guidelines containing induction of labour recommendations were searched. Guidelines were reviewed and extracted independently by two reviewers. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation II Instrument. Findings: Forty nine guidelines of varying quality were included. Indications where guidelines had mostly consistent advice included prolonged pregnancy (induction between 41 and 42 weeks), preterm premature rupture of membranes, and term preeclampsia (induction when preeclampsia diagnosed =37 weeks). Guidelines were also consistent in agreeing on decreased fetal movements and oligohydramnios as valid indications for induction, although timing recommendations were absent or inconsistent. Common indications where there was little consensus on validity and/or timing of induction included gestational diabetes, fetal macrosomia, elevated maternal body mass index, and twin pregnancy. Conclusion: Substantial variation in clinical practice guidelines for indications for induction exists. As guidelines rated of similar quality presented conflicting recommendations, guideline variability was not explained by guideline quality. Guideline variability may partly account for unexplained variation in induction of labour rates.

DOI 10.1016/j.wombi.2019.06.004
Citations Scopus - 1
Co-authors Dominiek Coates
2019 Scarf VL, Yu S, Viney R, Lavis L, Dahlen H, Foureur M, Homer C, 'The cost of vaginal birth at home, in a birth centre or in a hospital setting in New South Wales: A micro-costing study', Women and Birth, (2019)

© 2019 Australian College of Midwives Background: Women want greater choice of place of birth in New South Wales, Australia. It is perceived to be more costly to health services f... [more]

© 2019 Australian College of Midwives Background: Women want greater choice of place of birth in New South Wales, Australia. It is perceived to be more costly to health services for women with a healthy pregnancy to give birth at home or in a birth centre. It is not known how much it costs the health service to provide care for women planning to give birth in these settings. Aim: The aim of this study was to determine the direct cost of giving birth vaginally at home, in a birth centre or in a hospital for women at low risk of complications, in New South Wales. Methods: A micro-costing design was used. Observational (time and motion) and resource use data collection was undertaken to identify the staff time and resources required to provide care in a public hospital, birth centre or at home for women with a healthy pregnancy. Findings: The median cost of providing care for women who plan to give birth at home, in a birth centre and in a hospital were similar (AUD $2150.07, $2100.59 and $2097.30 respectively). Midwifery time was the largest contributor to the cost of birth at home, and overhead costs accounted for over half of the total cost of BC and hospital birth. The cost of consumables was low in all three settings. Conclusion: In this study, we have found there is little difference in the cost to the health service when a woman has an uncomplicated vaginal birth at home, in a birth centre or in a hospital setting.

DOI 10.1016/j.wombi.2019.06.003
2019 Menke S, Jenkinson B, Foureur M, Kildea S, 'Is the Birthing Unit Design Spatial Evaluation Tool valid for diverse groups?', Women and Birth, 32 372-379 (2019)

© 2018 Australian College of Midwives Background: Awareness of the impact of the built environment on health care outcomes and experiences has led to efforts to redesign birthing ... [more]

© 2018 Australian College of Midwives Background: Awareness of the impact of the built environment on health care outcomes and experiences has led to efforts to redesign birthing environments. The Birth Unit Design Spatial Evaluation Tool was developed to inform such improvements, but it has only been validated with caseload midwives and women birthing in caseload models of care. Aim: To assess the content validity of the tool with four new participant groups: Birth unit midwives, Aboriginal or Torres Strait Islander women; women who had anticipated a vaginal birth after a caesarean; and women from refugee or culturally and linguistically diverse backgrounds. Methods: Participants completed a Likert-scale survey to rate the relevance of The Birth Unit Design Spatial Evaluation Tool's 69 items. Item-level content validity and Survey-level validity indices were calculated, with the achievement of validity set at >0.78 and >0.9 respectively. Results: Item-level content validity was achieved on 37 items for birth unit midwives (n = 10); 35 items for Aboriginal or Torres Strait Islander women (n = 6); 33 items for women who had anticipated a vaginal birth after a caesarean (n = 6); and 28 items for women from refugee or culturally and linguistically diverse backgrounds (n = 20). Survey-level content validity was not demonstrated in any group. Conclusion: Birth environment design remains significant to women and midwives, but the Birth Unit Design Spatial Evaluation Tool was not validated for these participant groups. Further research is needed, using innovative methodologies to address the subconscious level on which environment may influence experience and to disentangle the influence of confounding factors.

DOI 10.1016/j.wombi.2018.09.009
2019 Homer CSE, Cheah SL, Rossiter C, Dahlen HG, Ellwood D, Foureur MJ, et al., 'Maternal and perinatal outcomes by planned place of birth in Australia 2000 - 2012: A linked population data study', BMJ Open, 9 (2019)

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Objective To compare perinatal and ma... [more]

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Objective To compare perinatal and maternal outcomes for Australian women with uncomplicated pregnancies according to planned place of birth, that is, in hospital labour wards, birth centres or at home. Design A population-based retrospective design, linking and analysing routinely collected electronic data. Analysis comprised ¿ 2 tests and binary logistic regression for categorical data, yielding adjusted ORs. Continuous data were analysed using analysis of variance. Setting All eight Australian states and territories. Participants Women with uncomplicated pregnancies who gave birth between 2000 and 2012 to a singleton baby in cephalic presentation at between 37 and 41 completed weeks' gestation. Of the 1 251 420 births, 1 171 703 (93.6%) were planned in hospital labour wards, 71 505 (5.7%) in birth centres and 8212 (0.7%) at home. Main outcome measures Mode of birth, normal labour and birth, interventions and procedures during labour and birth, maternal complications, admission to special care/high dependency or intensive care units (mother or infant) and perinatal mortality (intrapartum stillbirth and neonatal death). Results Compared with planned hospital births, the odds of normal labour and birth were over twice as high in planned birth centre births (adjusted OR (AOR) 2.72; 99% CI 2.63 to 2.81) and nearly six times as high in planned home births (AOR 5.91; 99% CI 5.15 to 6.78). There were no statistically significant differences in the proportion of intrapartum stillbirths, early or late neonatal deaths between the three planned places of birth. Conclusions This is the first Australia-wide study to examine outcomes by planned place of birth. For healthy women in Australia having an uncomplicated pregnancy, planned births in birth centres or at home are associated with positive maternal outcomes although the number of homebirths was small overall. There were no significant differences in the perinatal mortality rate, although the absolute numbers of deaths were very small and therefore firm conclusions cannot be drawn about perinatal mortality outcomes.

DOI 10.1136/bmjopen-2019-029192
2019 Braye K, Foureur M, de Waal K, Jones M, Putt E, Ferguson J, 'Group B streptococcal screening, intrapartum antibiotic prophylaxis, and neonatal early-onset infection rates in an Australian local health district: 2006-2016', PLOS ONE, 14 (2019) [C1]
DOI 10.1371/journal.pone.0214295
Co-authors John Ferguson
2019 McLaughlin K, Jensen M, Foureur M, Murphy VE, 'Antenatal asthma management by midwives in Australia Self-reported knowledge, confidence and guideline use', Women and Birth, (2019)

© 2019 Australian College of Midwives Background: Asthma affects approximately 12.7% of pregnant women in Australia. Increased maternal and infant morbidity is closely associated ... [more]

© 2019 Australian College of Midwives Background: Asthma affects approximately 12.7% of pregnant women in Australia. Increased maternal and infant morbidity is closely associated with poorly controlled asthma during pregnancy. Midwives are well placed to provide antenatal asthma management but data on current asthma management during pregnancy is not available, nor is the use of guidelines for clinical practice by this health professional group. Aim: To explore self-reported antenatal asthma management provided by midwives across Australia and how this reflects guideline recommendations. Method: An online survey was developed and distributed throughout Australia via the Australian College of Midwives, social media and healthcare facilities. Results: Responses from 371 midwives were obtained. Ten percent of midwives rated their knowledge as ¿good¿ and 1% as ¿very good¿, with 39% ¿poor¿ or ¿very poor¿. Being ¿somewhat¿ or ¿not at all¿ confident to provide antenatal asthma management was noted by 87% of midwives. Clinical guidelines were referred to by 50% of midwives and 40% stated that their main role was to refer women to other healthcare professionals. Only 54% reported that a clear referral pathway existed. Most respondents (>90%) recognised key recommendations for asthma management such as smoking cessation, appropriate vaccinations, and the continuation of prescribed asthma medications. Conclusion: Although midwives appear aware of key clinical recommendations for optimal antenatal asthma management, low referral to clinical practice guidelines and lack of knowledge and confidence was evident. Further research is required to determine what care pregnant women with asthma are actually receiving and identify strategies to improve antenatal asthma management by midwives.

DOI 10.1016/j.wombi.2019.04.007
Co-authors Vanessa Murphy, Megan Jensen
2019 Blix E, Maude R, Hals E, Kisa S, Karlsen E, Nohr EA, et al., 'Intermittent auscultation fetal monitoring during labour: A systematic scoping review to identify methods, effects, and accuracy', PLoS ONE, 14 (2019)

© 2019 Blix et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reprod... [more]

© 2019 Blix et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background Intermittent auscultation (IA) is the technique of listening to and counting the fetal heart rate (FHR) for short periods during active labour and continuous cardiotocography (CTC) implies FHR monitoring for longer periods. Although the evidence suggests that IA is the best way to monitor healthy women at low risk of complications, there is no scientific evidence for the ideal device, timing, frequency and duration for IA. We aimed to give an overview of the field, identify and describe methods and practices for performing IA, map the evidence and accuracy for different methods of IA, and identify research gaps. Methods We conducted a systematic scoping review following the Joanna Briggs methodology. Med-line, EMBASE, Cinahl, Maternity & Infant Care, Cochrane Library, SveMed+, Web of Science, Scopus, Lilacs and African Journals Online were searched for publications up to January 2019. We did hand searches in relevant articles and databases. Studies from all countries, international guidelines and national guidelines from Denmark, United Kingdom, United States, New Zealand, Australia, The Netherlands, Sweden, Denmark, and Norway were included. We did quality assessment of the guidelines according to the AGREEMENT tool. We performed a meta-analysis assessing the effects of IA with a Doppler device vs. Pinard device using methods described in The Cochrane Handbook, and we performed an overall assessment of the summary of evidence using the GRADE approach. Results The searches generated 6408 hits of which 26 studies and 11 guidelines were included in the review. The studies described slightly different techniques for performing IA, and some did not provide detailed descriptions. Few of the studies provided details of normal and abnormal IA findings. All 11 guidelines recommended IA for low risk women, although they had slightly different recommendations on the frequency, timing, and duration for IA, and the FHR characteristics that should be observed. Four of the included studies, comprising 8436 women and their babies, were randomised controlled trials that evaluated the effect of IA with a Doppler device vs. a Pinard device. Abnormal FHRs were detected more often using the Doppler device than in those using the Pinard device (risk ratio 1.77; 95% confidence interval 1.29¿2.43). There were no significant differences in any of the other maternal or neonatal outcomes. Four studies assessed the accuracy of IA findings. Normal FHR was easiest to identify correctly, whereas identifying periodic FHR patterns such as decelerations and saltatory patterns were more difficult. Conclusion Although IA is the recommended method, no trials have been published that evaluate protocols on how to perform it. Nor has any study assessed interrater agreements regarding interpretations of IA findings, and few have assessed to what degree clinicians can describe FHR patterns detected by IA. We found no evidence to recommend Doppler device instead of the Pinard for IA, or vice versa.

DOI 10.1371/journal.pone.0219573
2019 Braye K, Foureur M, de Waal K, Jones M, Putt E, Ferguson J, 'Epidemiology of neonatal early-onset sepsis in a geographically diverse Australian health district 2006-2016', PLOS ONE, 14 (2019) [C1]
DOI 10.1371/journal.pone.0214298
Co-authors John Ferguson
2019 Mollart L, Stulz V, Foureur M, 'Midwives personal views and beliefs about complementary and alternative medicine (CAM): A national survey', Complementary Therapies in Clinical Practice, 34 235-239 (2019) [C1]

© 2018 Elsevier Ltd Complementary and Alternative Medicine/Therapies (CAM) options have increasingly been used by pregnant women, however literature describing midwives¿ views and... [more]

© 2018 Elsevier Ltd Complementary and Alternative Medicine/Therapies (CAM) options have increasingly been used by pregnant women, however literature describing midwives¿ views and beliefs towards CAM is sparse. This study aimed to investigate Australian midwives¿ views and beliefs about CAM. Methods: A national survey of Australian College of Midwives midwife members (n = 3552) (UTSHREC 2015000614) included questions on midwives¿ views and support of CAM, and beliefs using a validated CAM Health Belief Questionnaire (CHBQ). Results: The response rate was 16%. Most respondents believed women should have the right to choose CAM (93.3%); and didn't view CAM a threat to public health (91.7%). Nearly half (49.5%) believed that their hospital/service did not have guidelines/procedures on CAM. The CHBQ mean score was 45.43 (SD9.98). Conclusion: Most respondents agreed with the fundamental beliefs of CAM. This study confirms the need for a national CAM policy for midwives; and research on midwives¿ CAM training.

DOI 10.1016/j.ctcp.2018.12.008
Co-authors Lyndall Mollart
2019 Coates D, Foureur M, 'The role and competence of midwives in supporting women with mental health concerns during the perinatal period: A scoping review', Health and Social Care in the Community, 27 e389-e405 (2019) [C1]

© 2019 John Wiley & Sons Ltd Perinatal mental health problems are linked to poor outcomes for mothers, babies and families. Despite a recognition of the significance of this... [more]

© 2019 John Wiley & Sons Ltd Perinatal mental health problems are linked to poor outcomes for mothers, babies and families. Despite a recognition of the significance of this issue, women often do not receive the care they need and fall between the gap of maternity and mental health services. To address this, there is a call for reform in the way in which perinatal mental healthcare is delivered. This paper responds to this by exploring the role and competence of midwives in delivering mental healthcare. Using a scoping review methodology, quantitative and qualitative evidence were considered to answer the research question ¿what is the nature of the evidence relevant to the provision of mental health interventions by midwives?¿ To identify studies, the databases PubMed, Maternity and Infant Care, Science Citation Index, Social Sciences Citation Index, Medline, Science Direct and CINAHL were searched from 2011 to 2018, and reference lists of included studies were examined. Studies relevant to the role of midwives in the management and treatment of perinatal mental health issues were included; studies focussed on screening and referral were excluded. Thirty papers met inclusion criteria, including studies about the knowledge, skills, and attitudes of midwives and student midwives; the effectiveness of educational interventions in improving knowledge and skills; the delivery of counselling or psychosocial interventions by midwives; and barriers and enablers to embedding midwife-led mental healthcare in practice. Synthesis of the included studies indicates that midwives are interested in providing mental health support, but lack the confidence, knowledge and training to do so. This deficit can be addressed with appropriate training and organisational support, and there is some evidence that midwife-led counselling interventions are effective. Further research is needed to test midwife-led interventions for women with perinatal mental health problems, and to develop and evaluate models of integrated perinatal mental healthcare.

DOI 10.1111/hsc.12740
Co-authors Dominiek Coates
2019 Mollart L, Skinner V, Adams J, Foureur M, 'Midwives' personal use of complementary and alternative medicine (CAM) influences their recommendations to women experiencing a post-date pregnancy', WOMEN AND BIRTH, 32 E286-E287 (2019)
DOI 10.1016/j.wombi.2018.07.001
Co-authors Lyndall Mollart
2018 Mollart L, Skinner V, Adams J, Foureur M, 'Midwives personal use of complementary and alternative medicine (CAM) influences their recommendations to women experiencing a post-date pregnancy', Women and Birth, 31 44-51 (2018) [C1]

© 2017 Australian College of Midwives Complementary and Alternative Medicine (CAM) have increasingly been used by pregnant women with a steady rise in interest by midwives. Litera... [more]

© 2017 Australian College of Midwives Complementary and Alternative Medicine (CAM) have increasingly been used by pregnant women with a steady rise in interest by midwives. Literature describing CAM and self-help options midwives recommend to women experiencing a post-date pregnancy is sparse. This study aimed to investigate if Australian midwives¿ personal CAM use impacts on discussions and recommendations of CAM/Self-help strategies. Methodology/design: A survey of a national midwifery association midwifery members (n = 3,552) was undertaken at a midwifery conference (October 2015) and via e-bulletins (November 2015¿March 2016). The self-administered survey included questions on what self-help and CAM strategies midwives discuss and recommend to women with a post-date pregnancy, midwives¿ confidence levels on discussing or recommending CAM, midwives¿ own personal use of CAM. Findings: A total of 571 registered midwives completed the survey (16%). Demographics (age, years as a midwife, state of residence) reflected Australian midwives and the midwifery association membership. Most respondents discuss (91.2%) and recommend (88.6%) self-help/CAM strategies to women with a post-date pregnancy. The top five CAM recommended were Acupuncture (65.7%), Acupressure (58.1%), Raspberry Leaf (52.5%), Massage (38.9%) and Hypnosis/Calmbirthing/Hypnobirthing (35.7%). Midwives were more likely to discuss strategies if they personally used CAM (p <.001), were younger (p <.001) or had worked less years as midwives (p =.004). Midwives were more likely to recommend strategies if they used CAM in their own pregnancies (p =.001). Conclusion: Midwives¿ personal use of CAM influenced their discussions and recommendations of CAM/self-help strategies to women experiencing a post-date pregnancy. This study has implications for inclusion of CAM in midwifery education curricula.

DOI 10.1016/j.wombi.2017.06.014
Citations Scopus - 3Web of Science - 3
Co-authors Lyndall Mollart
2018 Kennedy HP, Cheyney M, Dahlen HG, Downe S, Foureur MJ, Homer CSE, et al., 'Asking different questions: A call to action for research to improve the quality of care for every woman, every child', Midwifery, 65 16-17 (2018)
DOI 10.1016/j.midw.2018.06.015
Citations Scopus - 1
2018 Minooee S, Cummins A, Foureur M, 'Shoulder dystocia and range of head-body delivery interval (HBDI): The association between prolonged HBDI and neonatal outcomes: Protocol for a systematic review', European Journal of Obstetrics and Gynecology and Reproductive Biology, 229 82-87 (2018)

© 2018 Elsevier B.V. Objective: Shoulder dystocia (SD) is an obstetric emergency which if not carefully diagnosed and managed, can contribute to lifelong neonatal morbidities. Des... [more]

© 2018 Elsevier B.V. Objective: Shoulder dystocia (SD) is an obstetric emergency which if not carefully diagnosed and managed, can contribute to lifelong neonatal morbidities. Despite current guidelines on the definition of SD (impaction of the fetal shoulder behind the maternal symphysis pubis and need for ancillary manoeuvres or head-body delivery interval (HBDI) >60 s) its accurate diagnosis requires clinical expertise as well as overall consideration of feto-maternal condition. Based on the literature available, our study aims to determine (1) the range of HBDI as an indicator of SD and (2) the neonatal complications occurring following prolonged HBDI in normal or SD-complicated births. Study design: A comprehensive literature search will be conducted in the following databases MEDLINE, CINAHL and Scopus (Elsevier) as well as international obstetric guidelines to find English language published data since 1970 that evaluate HBDI, prolonged HBDI and associated neonatal outcomes. Retrospective/prospective observational studies and randomized controlled trials will be recruited. As heterogeneity in definitions of SD among studies is expected, we will categorize our results according to the following two definitions: 1-Bony obstruction of fetal shoulder behind the maternal symphysis pubis or less commonly, posterior shoulder on sacral promontory and need for ancillary manoeuvres or 2- Head-body delivery interval (HBDI)> 60 s). Two reviewers will independently identify eligible studies, assess risk of bias and extract data based on predefined checklists. Outcomes of interest will be the HBDI in normal and SD-complicated births and associated neonatal consequences. Discussion: Findings of this systematic review will provide reliable information regarding (1) the interval between birth of the head and birth of the shoulders and (2) neonatal outcomes attributed to either true SD or prolonged HBDI. Our findings will add to the knowledge of whether prolonged HBDI is an appropriate definition for SD and whether/what level of prolongation of HBDI results in adverse neonatal outcomes. This increased understanding will better inform the clinical practice of midwives and obstetricians.

DOI 10.1016/j.ejogrb.2018.08.016
2018 Kennedy HP, Cheyney M, Dahlen HG, Downe S, Foureur MJ, Homer CSE, et al., 'Asking different questions: A call to action for research to improve the quality of care for every woman, every child', BIRTH-ISSUES IN PERINATAL CARE, 45 222-231 (2018)
DOI 10.1111/birt.12361
Citations Scopus - 13Web of Science - 13
2018 Hogan R, Orr F, Fox D, Cummins A, Foureur M, 'Developing nursing and midwifery students' capacity for coping with bullying and aggression in clinical settings: Students' evaluation of a learning resource', Nurse Education in Practice, 29 89-94 (2018)

© 2017 Elsevier Ltd An innovative blended learning resource for undergraduate nursing and midwifery students was developed in a large urban Australian university, following a numb... [more]

© 2017 Elsevier Ltd An innovative blended learning resource for undergraduate nursing and midwifery students was developed in a large urban Australian university, following a number of concerning reports by students on their experiences of bullying and aggression in clinical settings. The blended learning resource included interactive online learning modules, comprising film clips of realistic clinical scenarios, related readings, and reflective questions, followed by in-class role-play practice of effective responses to bullying and aggression. On completion of the blended learning resource 210 participants completed an anonymous survey (65.2% response rate). Qualitative data was collected and a thematic analysis of the participants' responses revealed the following themes: ¿Engaging with the blended learning resource¿; ¿Responding to bullying¿ and ¿Responding to aggression¿. We assert that developing nursing and midwifery students' capacity to effectively respond to aggression and bullying, using a self-paced blended learning resource, provides a solution to managing some of the demands of the clinical setting. The blended learning resource, whereby nursing and midwifery students were introduced to realistic portrayals of bullying and aggression in clinical settings, developed their repertoire of effective responding and coping skills for use in their professional practice.

DOI 10.1016/j.nepr.2017.12.002
Citations Scopus - 3
2018 Kennedy HP, Cheyney M, Dahlen HG, Downe S, Foureur MJ, Homer CSE, et al., 'Asking Different Questions: A Call to Action for Research to Improve the Quality of Care for Every Woman, Every Child', Journal of Midwifery and Women's Health, 63 516-517 (2018)
DOI 10.1111/jmwh.12902
Citations Scopus - 1
2018 Atchan M, Davis D, Foureur M, 'An instrumental case study examining the introduction and dissemination of the Baby Friendly Health Initiative in Australia: Participants perspectives', Women and Birth, 31 210-219 (2018)

© 2017 Australian College of Midwives Background: Australia experiences high breastfeeding initiation but low duration rates. UNICEF introduced the global breastfeeding strategy, ... [more]

© 2017 Australian College of Midwives Background: Australia experiences high breastfeeding initiation but low duration rates. UNICEF introduced the global breastfeeding strategy, the Baby-Friendly Hospital Initiative, to Australia in 1992, transferring governance to the Australian College of Midwives (ACM) in 1995. In 2017 23% of facilities were registered as ¿baby-friendly¿ accredited. Aim: To examine the introduction and dissemination of the Baby-friendly Hospital Initiative into the Australian national setting. Methods: An instrumental case study was conducted containing two components: analysis of historical documents pertaining to the Initiative and participant's interviews, reported here. A purposive sampling strategy identified 14 participants from UNICEF, ACM, maternity and community health services, the Australian government and volunteer organisations who took part in in-depth interviews. Thematic analysis explored participants¿ perceptions of factors influencing the uptake and future of the since renamed Baby Friendly Health Initiative (BFHI) and accreditation programme, BFHI Australia. Two broad categories, enablers and barriers, guided the interviews and analysis. Findings: Participants revealed a positive perception of the BFHI whilst identifying that its interpretation and expansion in Australia had been negatively influenced by intangible government support and suboptimal capacity building. BFHI's advocacy agenda competed with BFHI Australia's need for financial viability. Widespread stakeholder collaboration and tangible political endorsement was seen as a way to move the strategy forward. Conclusion: Dissemination of BFHI Australia is hampered by multi-level systems issues. Prioritisation, stakeholder collaboration and adequate resourcing of the BFHI is required to create a supportive and enabling environment for Australian women to determine and practice their preferred infant feeding method.

DOI 10.1016/j.wombi.2017.08.130
Citations Scopus - 1
2018 Kennedy HP, Cheyney M, Dahlen HG, Downe S, Foureur MJ, Homer CSE, et al., 'Asking different questions: A call to action for research to improve the quality of care for every woman, every child', Women and Birth, 31 242-243 (2018)
DOI 10.1016/j.wombi.2018.06.011
Citations Scopus - 3
2018 Davis D, Davey R, Williams LT, Foureur M, Nohr E, Knight-Agarwal C, et al., 'Optimizing Gestational Weight Gain With the Eating4Two Smartphone App: Protocol for a Randomized Controlled Trial', JMIR RESEARCH PROTOCOLS, 7 (2018)
DOI 10.2196/resprot.9920
Co-authors Lauren Williams
2018 Davis D, Brown WJ, Foureur M, Nohr EA, Xu F, 'Long-Term Weight Gain and Risk of Overweight in Parous and Nulliparous Women', Obesity, 26 1072-1077 (2018)

© 2018 The Obesity Society Objective: In longitudinal studies, women gain significant amounts of weight during young adulthood, pointing to pregnancy as an important trigger for w... [more]

© 2018 The Obesity Society Objective: In longitudinal studies, women gain significant amounts of weight during young adulthood, pointing to pregnancy as an important trigger for weight gain. Studies examining the effect of parity vary in their findings and are complicated by multiple potential confounders. This study examines the association between parity and long-term weight gain in a cohort of young women participating in the Australian Longitudinal Study on Women's Health (ALSWH). Methods: A sample of 8,009 parous and nulliparous women was drawn from this cohort and allocated to one of six parity groups (0-5+). Weight gain and factors associated with BMI = 25 over a 16-year period were identified by using generalized linear equations. Results: Median BMI increased by between 2.95 and 4.9 units over 16 years, with women of parity 5 + showing the biggest gain. Associations between several variables and a BMI = 25 (controlling for multiple demographic and behavioral factors) demonstrated no effect for parity but significant effects for survey year, no paid job, and depression. University education and high levels of physical activity were protective. Conclusions: In this sample, parity was not associated with a BMI = 25 over a 16-year period.

DOI 10.1002/oby.22174
2018 Jepsen I, Juul S, Foureur MJ, Sørensen EE, Nohr EA, 'Labour outcomes in caseload midwifery and standard care: A register-based cohort study', BMC Pregnancy and Childbirth, 18 (2018)

© 2018 The Author(s). Background: Research on caseload midwifery in a Danish setting is missing. This cohort study aimed to compare labour outcomes in caseload midwifery and stand... [more]

© 2018 The Author(s). Background: Research on caseload midwifery in a Danish setting is missing. This cohort study aimed to compare labour outcomes in caseload midwifery and standard midwifery care. Methods: A historical register-based cohort study was carried out using routinely collected data about all singleton births 2013-2016 in two maternity units in the North Denmark Region. In this region, women are geographically allocated to caseload midwifery or standard care, as caseload midwifery is only available in some towns in the peripheral part of the uptake areas of the maternity units, and it is the only model of care offered here. Labour outcomes of 2679 all-risk women in caseload midwifery were compared with those of 10,436 all-risk women in standard midwifery care using multivariate linear and logistic regression analyses. Results: Compared to women in standard care, augmentation was more frequent in caseload women (adjusted odds ratio (aOR) 1.20; 95% CI 1.06-1.35) as was labour duration of less than 10 h (aOR 1.26; 95% CI 1.13-1.42). More emergency caesarean sections were observed in caseload women (aOR 1.17; 95% CI 1.03-1.34), but this might partly be explained by longer distance to the maternity unit in caseload women. When caseload women were compared to women in standard care with a similar long distance to the hospital, no difference in emergency caesarean sections was observed (aOR 1.04; 95% CI 0.84-1.28). Compared to standard care, infants of caseload women more often had Apgar =7 after 5 min. (aOR 1.57; 95% CI 1.11-2.23) and this difference remained when caseload women were compared to women with similar distance to the hospital. For elective caesarean sections, preterm birth, induction of labour, dilatation of cervix on admission, amniotomy, epidural analgesia, and instrumental deliveries, we did not obseve any differences between the two groups. After birth, caseload women more often experienced no laceration (aOR 1.17; 95% CI 1.06-1.29). Conclusions: For most labour outcomes, there were no differences across the two models of midwifery-led care but unexpectedly, we observed slightly more augmentation and adverse neonatal outcomes in caseload midwifery. These findings should be interpreted in the context of the overall low intervention and complication rates in this Danish setting and in the context of research that supports the benefits of caseload midwifery. Although the observational design of the study allows only cautious conclusions, this study highlights the importance of monitoring and evaluating new practices contextually.

DOI 10.1186/s12884-018-2090-9
2018 Scarf VL, Rossiter C, Vedam S, Dahlen HG, Ellwood D, Forster D, et al., 'Maternal and perinatal outcomes by planned place of birth among women with low-risk pregnancies in high-income countries: A systematic review and meta-analysis', Midwifery, 62 240-255 (2018)

© 2018 The Author(s) Background: The comparative safety of different birth settings is widely debated. Comparing research across high-income countries is complex, given difference... [more]

© 2018 The Author(s) Background: The comparative safety of different birth settings is widely debated. Comparing research across high-income countries is complex, given differences in maternity service provision, data discrepancies, and varying research techniques and quality. Studies of births planned at home or in birth centres have reported both better and poorer outcomes than planned hospital births. Previous systematic reviews have focused on outcomes from either birth centres or home births, with inconsistent attention to quality appraisal. Few have attempted to synthesise findings. Objective: To compare maternal and perinatal outcomes from different places of birth via a systematic review of high-quality research, and meta-analysis of appropriate data (Prospero registration CRD42016042291). Design: Reviewers searched CINAHL, Embase, Maternity and Infant Care, Medline and PsycINFO databases to identify studies comparing selected outcomes by place of birth among women with low-risk pregnancies in high-income countries. They critically appraised identified studies using an instrument specific to birth place research and then combined outcome data via meta-analysis, using RevMan software. Findings: Twenty-eight articles met inclusion criteria, yielding comparative data on perinatal mortality, mode of birth, maternal morbidity and/or NICU admissions. Meta-analysis indicated that women planning hospital births had statistically significantly lower odds of normal vaginal birth than in other planned settings. Women experienced severe perineal trauma or haemorrhage at a lower rate in planned home births than in obstetric units. There were no statistically significant differences in infant mortality by planned place of birth, although most studies had limited statistical power to detect differences for rare outcomes. Differences in location, context, quality and design of identified studies render results subject to variation. Conclusions and implications for practice: High-quality evidence about low-risk pregnancies indicates that place of birth had no statistically significant impact on infant mortality. The lower odds of maternal morbidity and obstetric intervention support the expansion of birth centre and home birth options for women with low-risk pregnancies.

DOI 10.1016/j.midw.2018.03.024
Citations Scopus - 20
2018 McLaughlin K, Foureur M, Jensen ME, Murphy VE, 'Review and appraisal of guidelines for the management of asthma during pregnancy', Women and Birth, 31 e349-e357 (2018) [C1]

© 2018 Australian College of Midwives Background: Asthma affects 12.7% of pregnancies in Australia. Poorly controlled asthma is associated with increased maternal and infant morbi... [more]

© 2018 Australian College of Midwives Background: Asthma affects 12.7% of pregnancies in Australia. Poorly controlled asthma is associated with increased maternal and infant morbidity and mortality. Optimal antenatal management of asthma during pregnancy has the potential to reduce complications relating to asthma. Evidence-based clinical practice guidelines help to translate health research findings into practice and when implemented can improve health outcomes. National and International guidelines currently provide recommendations for optimal asthma care in pregnancy. Aim: To appraise the existing asthma in pregnancy guidelines with respect to their evidence for recommendations, consistency of recommendations and appropriateness for clinical practice. Method: The Appraisal of Guidelines for Research and Evaluation (AGREE II) tool was used to appraise four English language asthma in pregnancy guidelines, published or updated between 2007 and 2016. The recommendations, range and level of evidence was analysed. Results: Two of the four guidelines scored highly in most domains of the appraisal. Many of the recommendations made in the appraised guidelines were consistent. Due to the lack of randomised controlled trials involving pregnant women with asthma, most recommendations were evidenced by consensus and expert opinion rather than high quality meta-analysis, systematic reviews of randomised controlled trials. Conclusion: The recommended antenatal asthma management was generally consistent among the guidelines but lacked clarity in some areas which then leave them open to interpretation. More randomised controlled trials involving pregnant women with asthma are required to fortify the recommendations made and asthma management guidelines should be included in Australian Antenatal Care Guidelines as they currently are not.

DOI 10.1016/j.wombi.2018.01.008
Citations Scopus - 2Web of Science - 2
Co-authors Megan Jensen, Vanessa Murphy
2018 Braye K, Ferguson J, Davis D, Catling C, Monk A, Foureur M, 'Effectiveness of intrapartum antibiotic prophylaxis for early-onset group B Streptococcal infection: An integrative review', WOMEN AND BIRTH, 31 244-253 (2018)
DOI 10.1016/j.wombi.2017.10.012
Citations Scopus - 3Web of Science - 2
Co-authors John Ferguson
2017 Fealy SM, Taylor RM, Foureur M, Attia J, Ebert L, Bisquera A, Hure AJ, 'Weighing as a stand-alone intervention does not reduce excessive gestational weight gain compared to routine antenatal care: a systematic review and meta-analysis of randomised controlled trials', BMC PREGNANCY AND CHILDBIRTH, 17 (2017) [C1]
DOI 10.1186/s12884-016-1207-2
Citations Scopus - 9Web of Science - 9
Co-authors Rachael Taylor, Alexis Hure, Shanna Fealy, John Attia, Lyn Ebert
2017 Fletcher R, May C, Kay-Lambkin F, Gemmill AW, Cann W, Nicholson JM, et al., 'SMS4dads: Providing information and support to new fathers through mobile phones a pilot study', Advances in Mental Health, 15 121-131 (2017) [C1]
DOI 10.1080/18387357.2016.1245586
Citations Scopus - 7Web of Science - 7
Co-authors Richard Fletcher, Geoff Skinner, Frances Kaylambkin
2017 Monk AR, Grigg CP, Foureur M, Tracy M, Tracy SK, 'Freestanding midwifery units: Maternal and neonatal outcomes following transfer', Midwifery, 46 24-28 (2017)

© 2017 Elsevier Ltd Background the viability of freestanding midwifery units in Australia is restricted, due to concerns over their safety, particularly for women and babies who, ... [more]

© 2017 Elsevier Ltd Background the viability of freestanding midwifery units in Australia is restricted, due to concerns over their safety, particularly for women and babies who, require transfer. Aim to compare the maternal and neonatal birth outcomes of women who planned, to give birth at freestanding midwifery units and subsequently, transferred to a tertiary maternity unit to the maternal and neonatal, outcomes of a low-risk cohort of women who planned to give birth in, tertiary maternity unit. Methods a descriptive study compared two groups of women with low-risk singleton, pregnancies who were less than 28 weeks pregnant at booking: women who, planned to give birth at a freestanding midwifery unit (n=494) who, transferred to a tertiary maternity unit during the antenatal, intrapartum or postnatal periods (n=260) and women who planned to give, birth at a tertiary maternity unit (n=3157). Primary outcomes were mode, of birth, Apgar score of less than 7 at 5¿minutes and admission to, special care nursery or neonatal intensive care. Key findings the proportion of women who experienced a caesarean section was lower, among the freestanding midwifery unit women who transferred during the, intrapartum/postnatal period compared to women in the tertiary maternity, unit group (16.1% versus 24.8% respectively). Other outcomes were, comparable between the cohorts. Rates of primary outcomes in relation to, stage of transfer varied when stratified by parity. discussion these descriptive results support the provision of care in freestanding, midwifery units as an alternative to tertiary maternity units for women, with low risk pregnancies at the time of booking. A larger study, powered, to determine statistical significance of any differences in outcomes, is, required.

DOI 10.1016/j.midw.2017.01.006
Citations Scopus - 2
2017 Hammond A, Homer CSE, Foureur M, 'Friendliness, functionality and freedom: Design characteristics that support midwifery practice in the hospital setting', Midwifery, 50 133-138 (2017)

© 2017 Elsevier Ltd Objective to identify and describe the design characteristics of hospital birth rooms that support midwives and their practice. Design this study used a qualit... [more]

© 2017 Elsevier Ltd Objective to identify and describe the design characteristics of hospital birth rooms that support midwives and their practice. Design this study used a qualitative exploratory descriptive methodology underpinned by the theoretical approach of critical realism. Data was collected through 21 in-depth, face-to-face photo-elicitation interviews and a thematic analysis guided by study objectives and the aims of exploratory research was undertaken. Setting the study was set at a recently renovated tertiary hospital in a large Australian city. Participants participants were 16 registered midwives working in a tertiary hospital; seven in delivery suite and nine in birth centre settings. Experience as a midwife ranged from three to 39 years and the sample included midwives in diverse roles such as educator, student support and unit manager. Findings three design characteristics were identified that supported midwifery practice. They were friendliness, functionality and freedom. Friendly rooms reduced stress and increased midwives' feelings of safety. Functional rooms enabled choice and provided options to better meet the needs of labouring women. And freedom allowed for flexible, spontaneous and responsive midwifery practice. Conclusion hospital birth rooms that possess the characteristics of friendliness, functionality and freedom offer enhanced support for midwives and may therefore increase effective care provision. Implications for practice new and existing birth rooms can be designed or adapted to better support the wellbeing and effectiveness of midwives and may thereby enhance the quality of midwifery care delivered in the hospital. Quality midwifery care is associated with positive outcomes and experiences for labouring women. Further research is required to investigate the benefit that may be transmitted to women by implementing design intended to support and enhance midwifery practice.

DOI 10.1016/j.midw.2017.03.025
Citations Scopus - 4
2017 Patterson J, Foureur M, Skinner J, 'Remote rural women's choice of birthplace and transfer experiences in rural Otago and Southland New Zealand', Midwifery, 52 49-56 (2017)

© 2017 Elsevier Ltd Background Birth in primary midwife-led maternity units has been demonstrated to be a safe choice for well women anticipating a normal birth. The incidence of ... [more]

© 2017 Elsevier Ltd Background Birth in primary midwife-led maternity units has been demonstrated to be a safe choice for well women anticipating a normal birth. The incidence of serious perinatal outcomes for these women is comparable to similarly low risk women, who choose to birth in hospital. New Zealand women have a choice of Lead Maternity Carer (LMC) and birthplace; home, primary birthing unit, or a base hospital, though not all women may have all these choices available locally. Women in rural and rural remote areas can also choose to birth in their rural primary maternity unit. A percentage of these women (approx. 15¿17%) will require transfer during labour, an event which can cause distress and often loss of midwifery continuity of care. Objective To explore retrospectively the choice of birth place decisions and the labour and birth experiences of a sample of women resident in remotely zoned, rural areas of the lower South Island of New Zealand. Design A purposive sample of women living in remote rural areas, recruited by advertising in local newspapers and flyers. Individual semi-structured interviews were digitally recorded using a pragmatic interpretive approach. The data (transcripts and field notes) were analysed using thematic and content analysis. Ethical approval was obtained from the Health and Disability Ethics Committee (HEDC) MEC/06/05/045. Participants Thirteen women consented to participate. Each was resident in a remote rural area having given birth in the previous 18 months. The women had been well during their pregnancies and at the onset of labour had anticipated a spontaneous vaginal birth. Setting Rural remote zoned areas in Otago and Southland in the South Island of New Zealand Findings Five women planned to birth in a regional hospital and eight chose their nearest rural primary maternity unit. All of the women were aware of the possibility of transfer and had made their decision about their birthplace based on their perception of their personal safety, and in consideration of their distance from specialist care. Themes included, deciding about the safest place to give birth; making the decision to transfer; experiencing transfer in labour, and reflecting on their birth experience and considering future birthplace choices. Conclusions and implications for practice and policy The experiences of the women show that for some, distance from a base hospital influences their place of birth decisions in remote rural areas of New Zealand and increases the distress for those needing to transfer over large distances. These experiences can result in women choosing, or needing to make different choices for subsequent births; the consequences of which impact on the future sustainability of midwifery services in remote rural areas, a challenge which resonates with maternity service provision internationally. While choices about birth place cannot be reliably predicted, creative solutions are needed to provide rural midwifery care and birth options for women and more timely and efficient transfer services when required.

DOI 10.1016/j.midw.2017.05.014
Citations Scopus - 1
2017 Harte JD, Homer CSE, Sheehan A, Leap N, Foureur M, 'Using video in childbirth research: Ethical approval challenges', NURSING ETHICS, 24 177-189 (2017)
DOI 10.1177/0969733015591073
2017 Jepsen I, Mark E, Foureur M, Nøhr EA, Sørensen EE, 'A qualitative study of how caseload midwifery is experienced by couples in Denmark', Women and Birth, 30 e61-e69 (2017)

© 2016 Australian College of Midwives Background Caseload midwifery is expanding in Denmark. There is a need for elaborating in-depth, how caseload midwifery influences the partne... [more]

© 2016 Australian College of Midwives Background Caseload midwifery is expanding in Denmark. There is a need for elaborating in-depth, how caseload midwifery influences the partner and the woman during childbirth and how this model of care influences the early phases of labour. Aim To follow, explore and elaborate women's and their partner's experiences of caseload midwifery. Methods Phenomenology of practice was the analytical approach. The methodology was inspired by ethnography, and applied methods were field observations followed by interviews. Ten couples participated in the study. Most of the couples were observed from the onset of labour until childbirth. Afterwards, the couples were interviewed. Findings The transition from home to hospital in early labour was experienced as positive. During birth, the partner felt involved and included by the midwife. The midwives remembered and recognized the couple's stories and wishes for childbirth and therefore they felt regarded as ¿more than numbers¿. Irrespective of different kinds of vulnerability or challenges among the participants, the relationship was named a professional friendship, characterised by equality and inclusiveness. One drawback of caseload midwifery was that the woman was at risk of being disappointed if her expectations of having a known midwife at birth were not fulfilled. Key conclusions From the perspective of women and their partners, attending caseload midwifery meant being recognised and cared for as an individual. The partner felt included and acknowledged and experienced working in a team with the midwife. Caseload midwifery was able to solve problems concerning labour onset or gaining access to the labour ward.

DOI 10.1016/j.wombi.2016.09.003
Citations Scopus - 7
2017 Atchan M, Davis D, Foureur M, 'An historical document analysis of the introduction of the Baby Friendly Hospital Initiative into the Australian setting', Women and Birth, 30 51-62 (2017)

© 2016 Australian College of Midwives Background Breastfeeding has many known benefits yet its support across Australian health systems was suboptimal throughout the 20th Century.... [more]

© 2016 Australian College of Midwives Background Breastfeeding has many known benefits yet its support across Australian health systems was suboptimal throughout the 20th Century. The World Health Organization launched a global health promotion strategy to help create a ¿breastfeeding culture¿. Research on the programme has revealed multiple barriers since implementation. Aim To analyse the sociopolitical challenges associated with implementing a global programme into a national setting via an examination of the influences on the early period of implementation of the Baby Friendly Hospital Initiative in Australia. Methods A focused historical document analysis was attended as part of an instrumental case study. A purposeful sampling strategy obtained a comprehensive sample of public and private documents related to the introduction of the BFHI in Australia. Analysis was informed by a ¿documents as commentary¿ approach to gain insight into individual and collective social practices not otherwise observable. Findings Four major themes were identified: ¿a breastfeeding culture¿; ¿resource implications¿; ¿ambivalent support for breastfeeding and the BFHI¿ and ¿business versus advocacy¿. ¿A breastfeeding culture¿ included several subthemes. No tangible support for breastfeeding generally, or the Baby Friendly Hospital Initiative specifically, was identified. Australian policy did not follow international recommendations. There were no financial or policy incentives for BFHI implementation. Conclusions Key stakeholders¿ decisions negatively impacted on the Baby Friendly Hospital Initiative at a crucial time in its implementation in Australia. The potential impact of the programme was not realised, representing a missed opportunity to establish and provide sustainable standardised breastfeeding support to Australian women and their families.

DOI 10.1016/j.wombi.2016.07.004
Citations Scopus - 3
2017 Adams C, Dawson A, Foureur M, 'Competing Values Framework: A useful tool to define the predominant culture in a maternity setting in Australia', Women and Birth, 30 107-113 (2017)

© 2016 Australian College of Midwives Objective To identify the predominant culture of an organisation which could then assess readiness for change. Design An exploratory design u... [more]

© 2016 Australian College of Midwives Objective To identify the predominant culture of an organisation which could then assess readiness for change. Design An exploratory design using the Competing Values Framework (CVF) as a self-administered survey tool. Setting The Maternity Unit in one Australian metropolitan tertiary referral hospital. Subjects All 120 clinicians (100 midwives and 20 obstetricians) employed in the maternity service were invited to participate; 26% responded. Main outcome measure The identification of the predominant culture of an organisation to assess readiness for change prior to the implementation of a new policy. Results The predominant culture of this maternity unit, as described by those who responded to the survey, was one of hierarchy with a focus on rules and regulations and less focus on innovation, flexibility and teamwork. These results suggest that this unit did not have readiness to change. Conclusion There is value in undertaking preparatory work to gain a better understanding of the characteristics of an organisation prior to designing and implementing change. This understanding can influence additional preliminary work that may be required to increase the readiness for change and therefore increase the opportunity for successful change. The CVF is a useful tool to identify the predominant culture and characteristics of an organisation that could influence the success of change.

DOI 10.1016/j.wombi.2016.09.005
Citations Scopus - 4
2017 Jepsen I, Juul S, Foureur M, Sørensen EE, Nøhr EA, 'Is caseload midwifery a healthy work-form? A survey of burnout among midwives in Denmark', Sexual and Reproductive Healthcare, 11 102-106 (2017)
DOI 10.1016/j.srhc.2016.12.001
Citations Scopus - 13
2017 Dean S, Foureur M, Zaslawski C, Newton-John T, Yu N, Pappas E, 'The effects of a structured mindfulness program on the development of empathy in healthcare students', NursingPlus Open, 3 1-5 (2017)
DOI 10.1016/j.npls.2017.02.001
Citations Scopus - 5
2017 Foureur M, Turkmani S, Clack DC, Davis DL, Mollart L, Leiser B, Homer CSE, 'Caring for women wanting a vaginal birth after previous caesarean section: A qualitative study of the experiences of midwives and obstetricians', WOMEN AND BIRTH, 30 3-8 (2017)
DOI 10.1016/j.wombi.2016.05.011
Citations Scopus - 5Web of Science - 6
Co-authors Lyndall Mollart
2016 Bowden C, Sheehan A, Foureur M, 'Birth room images: What they tell us about childbirth. A discourse analysis of birth rooms in developed countries', Midwifery, 35 71-77 (2016)

© 2016 Elsevier Ltd. Objective: this study examined images of birth rooms in developed countries to analyse the messages and visual discourse being communicated through images. De... [more]

© 2016 Elsevier Ltd. Objective: this study examined images of birth rooms in developed countries to analyse the messages and visual discourse being communicated through images. Design: a small qualitative study using Kress and van Leeuwen's (2006) social semiotic theoretical framework for image analysis, a form of discourse analysis. Setting/participants: forty images of birth rooms were collected in 2013 from Google Images, Flickr, Wikimedia Commons and midwifery colleagues. The images were from obstetric units, alongside and freestanding midwifery units located in developed countries (Australia, Canada, Europe, New Zealand, United Kingdom and the United States of America). Main findings: findings demonstrated three kinds of birth room images; the technological, the 'homelike', and the hybrid domesticated birth room. The most dominant was the technological birth room, with a focus on the labour bed and medical equipment. The visual messages from images of the technological birth room reinforce the notion that the bed is the most appropriate place to give birth and the use of medical equipment is intrinsically involved in the birth process. Childbirth is thus construed as risky/dangerous. Key conclusions and implications for practice: as images on the Internet inform and persuade society about stereotypical behaviours, the trends of our time and sociocultural norms, it is important to recognise images of the technological birth room on the Internet may be influential in dictating women's attitudes, choices and behaviour, before they enter the birth room.

DOI 10.1016/j.midw.2016.02.003
Citations Scopus - 2
2016 Jepsen I, Mark E, Nøhr EA, Foureur M, Sørensen EE, 'A qualitative study of how caseload midwifery is constituted and experienced by Danish midwives', Midwifery, 36 61-69 (2016)

© 2016 Elsevier Ltd. Objective: the aim of this study is to advance knowledge about the working and living conditions of midwives in caseload midwifery and how this model of care ... [more]

© 2016 Elsevier Ltd. Objective: the aim of this study is to advance knowledge about the working and living conditions of midwives in caseload midwifery and how this model of care is embedded in a standard maternity unit. This led to two research questions: 1) What constitutes caseload midwifery from the perspectives of the midwives? 2) How do midwives experience working in caseload midwifery? Design and setting: phenomenology of practice was the analytical approach to this qualitative study of caseload midwifery in Northern Denmark. The methodology was inspired by ethnography, and applied methods were field observations followed by interviews. Participants: thirteen midwives working in caseloads were observed during one or two days in the antenatal clinic and were interviewed at a later occasion. Findings: being recognised and the feeling of doing high quality care generate high job satisfaction. The obligation and pressure to perform well and the disadvantages to the midwives' personal lives are counterbalanced by the feeling of doing a meaningful and important job. Working in caseload midwifery creates a feeling of working in a self-governing model within the public hospital, without losing the technological benefits of a modern birth unit. Midwives in caseload midwifery worked on welcoming and including all pregnant women allocated to their care; even women/families where relationships with the midwives were challenging were recognised and respected. Key conclusions: caseload midwifery is a work-form with an embedded and inevitable commitment and obligation that brings forward the midwife's desire to do her utmost and in return receive appreciation, social recognition and a meaningful job with great job satisfaction. There is a balance between the advantages of a meaningful job and the disadvantages for the personal life of the midwife, but benefits were found to outweigh disadvantages. Implications for practice: In expanding caseload midwifery, it is necessary to understand that the midwives' personal lives need to be prepared for this work-form. The number of women per full time midwife has to be surveilled as job-satisfaction is dependent on the midwives' ability of fulfilling expectations of being present at women's births.

DOI 10.1016/j.midw.2016.03.002
Citations Scopus - 13
2016 Mondy T, Fenwick J, Leap N, Foureur M, 'How domesticity dictates behaviour in the birth space: Lessons for designing birth environments in institutions wanting to promote a positive experience of birth', Midwifery, 43 37-47 (2016)

© 2016 Elsevier Ltd Background limited efforts have been made to understand the complex relationships between women&apos;s experiences of birth and the influence of the design and... [more]

© 2016 Elsevier Ltd Background limited efforts have been made to understand the complex relationships between women's experiences of birth and the influence of the design and environment of a birth space. Domestic aesthetics in a birth space are believed to be an important aspect of optimal birth unit design. Aim to explore the concept of domesticity within the birth space. The specific objectives were to explore, describe and compare birth spaces with different domestic characteristics and subsequently, how laboring women worked within these spaces during the labour process. This project was situated within a larger ongoing body of work exploring birth unit design. Method a qualitative approach, using the techniques of video ethnography and reflexive interviewing, was used. Video data consisted of films of the labours of six Australian women who gave birth in 2012. Filming took place in two different tertiary hospitals in Sydney NSW (n=5 women), as well as a stand-alone Birth Centre (n=1 woman). Video footage of a woman labouring at home was used to compare and contrast women's experiences. Latent content analysis was used to analyse the data set. In addition there were 17 one-hour video-reflexive interviews that were audio-taped and fully transcribed (nine interviews with women and/or their support people and eight with midwives). Field note data accompanied both the video recording as well as the reflexive interviews. Findings in general, women labouring in conventional hospital labour and birth rooms acted and interacted with the environment in a passive way. The spaces clearly did not resemble homely or ¿domestic¿ spaces. This forced women to adapt to the space. In essence all but one of the women labouring and birthing in these spaces took on the role of a ¿patient¿. One participant responded quite differently to the conventional hospital space. ¿Domestication of the space¿ was the mechanism this woman used to retain a sense of ownership within the birth space. In contrast, in the domestic birth environments (Birth Centre and home) women effortlessly claimed ownership of the space, expressing their identity in a myriad of ways. In these domestic spaces, women were not required to change or modify their birth spaces as the design, furnishings and semiotics of the space openly encouraged them to be active, creative and take ownership of the space. Conclusion the findings of this study add to the existing literature on birth unit design and more specifically contribute to an understanding of how the features of domesticity within the birth setting may shape the experience of labouring women and their care providers. The evidence gained from the study will assist in the ongoing movement to humanise birth spaces and develop further understandings of how home-like birth spaces should look. Those designing, building, furnishing, managing, accessing and working in Birthing Services could all benefit from the consideration of how environments designed for the care of birthing women, may be affecting the outcomes and experiences of women and their families.

DOI 10.1016/j.midw.2016.10.009
Citations Scopus - 2
2016 Atchan M, Davis D, Foureur M, 'A methodological review of qualitative case study methodology in midwifery research', Journal of Advanced Nursing, 72 2259-2271 (2016)

© 2016 John Wiley &amp; Sons Ltd Aim: To explore the use and application of case study research in midwifery. Background: Case study research provides rich data for the analysis... [more]

© 2016 John Wiley & Sons Ltd Aim: To explore the use and application of case study research in midwifery. Background: Case study research provides rich data for the analysis of complex issues and interventions in the healthcare disciplines; however, a gap in the midwifery research literature was identified. Design: A methodological review of midwifery case study research using recognized¿templates, frameworks and reporting guidelines facilitated comprehensive analysis. Data Sources: An electronic database search using the date range January 2005¿December 2014: Maternal and Infant Care, CINAHL Plus, Academic Search Complete, Web of Knowledge, SCOPUS, Medline, Health Collection (Informit), Cochrane Library Health Source: Nursing/Academic Edition, Wiley online and ProQuest Central. Review Methods: Narrative evaluation was undertaken. Clearly worded questions reflected the problem and purpose. The application, strengths and limitations of case study methods were identified through a quality appraisal process. Results: The review identified both case study research's applicability to midwifery and its low uptake, especially in clinical studies. Many papers included the necessary criteria to achieve rigour. The included measures of authenticity and methodology were varied. A high standard of authenticity was observed, suggesting authors considered these elements to be routine inclusions. Technical aspects were lacking in many papers, namely a lack of reflexivity and incomplete transparency of processes. Conclusion: This review raises the profile of case study research in midwifery. Midwives will be encouraged to explore if case study research is suitable for their investigation. The raised profile will demonstrate further applicability; encourage support and wider adoption in the midwifery setting.

DOI 10.1111/jan.12946
Citations Scopus - 7
2016 Townsend B, Fenwick J, Thomson V, Foureur M, 'The birth bed: A qualitative study on the views of midwives regarding the use of the bed in the birth space', WOMEN AND BIRTH, 29 80-84 (2016)
DOI 10.1016/j.wombi.2015.08.009
Citations Scopus - 4Web of Science - 5
2016 Maude RM, Skinner JP, Foureur MJ, 'Putting intelligent structured intermittent auscultation (ISIA) into practice', WOMEN AND BIRTH, 29 285-292 (2016)
DOI 10.1016/j.wombi.2015.12.001
Citations Scopus - 2Web of Science - 1
2016 Mollart L, Skinner V, Foureur M, 'A feasibility randomised controlled trial of acupressure to assist spontaneous labour for primigravid women experiencing a post-date pregnancy', Midwifery, 36 21-27 (2016) [C1]
DOI 10.1016/j.midw.2016.02.020
Citations Scopus - 4Web of Science - 4
Co-authors Lyndall Mollart
2016 Mollart L, Adams J, Foureur M, 'Pregnant women and health professional's perceptions of complementary alternative medicine, and participation in a randomised controlled trial of acupressure for labour onset', Complementary Therapies in Clinical Practice, 24 167-173 (2016) [C1]
DOI 10.1016/j.ctcp.2016.06.007
Citations Scopus - 4Web of Science - 3
Co-authors Lyndall Mollart
2015 Patterson J, Skinner J, Foureur M, 'Midwives' decision making about transfers for 'slow' labour in rural New Zealand', MIDWIFERY, 31 606-612 (2015)
DOI 10.1016/j.midw.2015.02.005
Citations Scopus - 8Web of Science - 9
2015 Harte JD, Sheehan A, Stewart SC, Foureur M, 'Childbirth Supporters Experiences in a Built Hospital Birth Environment: Exploring Inhibiting and Facilitating Factors in Negotiating the Supporter Role', Health Environments Research and Design Journal, 9 135-161 (2015)

© 2016, © The Author(s) 2016. Objective: To explore inhibiting and facilitating design factors influencing childbirth supporters¿ experiences. Background: Birthing women benefit f... [more]

© 2016, © The Author(s) 2016. Objective: To explore inhibiting and facilitating design factors influencing childbirth supporters¿ experiences. Background: Birthing women benefit from the continuous, cooperative presence of supporters. However, little research has investigated how birth room design facilitates or inhibits supporters¿ role navigation. Methods: We conducted an exploratory video ethnographic single case study of childbirth supporters¿ experiences, within an Australian hospital birth environment. Video, field notes, and video-cued reflexive interviews with the woman, her midwives, and supporters were thematically analyzed using ethnographic/symbolic interactionist perspectives to frame supporters¿ understandings. Results: Findings suggest supporters¿ experiences are complex, made more complicated by sparse understanding or accommodation of their needs in the built environment. Supporters¿ presence and roles are not facilitated by the physical space; they experience ¿an unbelonging paradox¿ of being needed, yet uncertain and ¿in the way¿ during ¿tenuous nest-building¿ activities. Conclusions: Suggested design guidelines to facilitate supporters¿ well-being and their roles in designed hospital birth spaces are provided.

DOI 10.1177/1937586715622006
Citations Scopus - 10
2015 Catling CJ, Medley N, Foureur M, Ryan C, Leap N, Teate A, Homer CSE, 'Group versus conventional antenatal care for women', Cochrane Database of Systematic Reviews, 2015 (2015)

© 2015 The Cochrane Collaboration. Background: Antenatal care is one of the key preventive health services used around the world. In most Western countries, antenatal care traditi... [more]

© 2015 The Cochrane Collaboration. Background: Antenatal care is one of the key preventive health services used around the world. In most Western countries, antenatal care traditionally involves a schedule of one-to-one visits with a care provider. A different way of providing antenatal care involves use of a group model. Objectives: 1. To compare the effects of group antenatal care versus conventional antenatal care on psychosocial, physiological, labour and birth outcomes for women and their babies. 2. To compare the effects of group antenatal care versus conventional antenatal care on care provider satisfaction. Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2014), contacted experts in the field and reviewed the reference lists of retrieved studies. Selection criteria: All identified published, unpublished and ongoing randomised and quasi-randomised controlled trials comparing group antenatal care with conventional antenatal care were included. Cluster-randomised trials were eligible, and one has been included. Cross-over trials were not eligible. Data collection and analysis: Two review authors independently assessed trials for inclusion and risk of bias and extracted data; all review authors checked data for accuracy. Main results: We included four studies (2350 women). The overall risk of bias for the included studies was assessed as acceptable in two studies and good in two studies. No statistically significant differences were observed between women who received group antenatal care and those given standard individual antenatal care for the primary outcome of preterm birth (risk ratio (RR) 0.75, 95% confidence interval (CI) 0.57 to 1.00; three trials; N = 1888). The proportion of low-birthweight (less than 2500 g) babies was similar between groups (RR 0.92, 95% CI 0.68 to 1.23; three trials; N = 1935). No group differences were noted for the primary outcomes small-for-gestational age (RR 0.92, 95% CI 0.68 to 1.24; two trials; N = 1473) and perinatal mortality (RR 0.63, 95% CI 0.32 to 1.25; three trials; N = 1943). Satisfaction was rated as high among women who were allocated to group antenatal care, but this outcome was measured in only one trial. In this trial, mean satisfaction with care in the group given antenatal care was almost five times greater than that reported by those allocated to standard care (mean difference 4.90, 95% CI 3.10 to 6.70; one study; N = 993). No differences in neonatal intensive care admission, initiation of breastfeeding or spontaneous vaginal birth were observed between groups. Several outcomes related to stress and depression were reported in one trial. No differences between groups were observed for any of these outcomes. No data were available on the effects of group antenatal care on care provider satisfaction. We used the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) approach to assess evidence for seven prespecified outcomes; results ranged from low quality (perinatal mortality) to moderate quality (preterm birth, low birthweight, neonatal intensive care unit admission, breastfeeding initiation) to high quality (satisfaction with antenatal care, spontaneous vaginal birth). Authors' conclusions: Available evidence suggests that group antenatal care is positively viewed by women and is associated with no adverse outcomes for them or for their babies. No differences in the rate of preterm birth were reported when women received group antenatal care. This review is limited because of the small numbers of studies and women, and because one study contributed 42% of the women. Most of the analyses are based on a single study. Additional research is required to determine whether group antenatal care is associated with significant benefit in terms of preterm birth or birthweight.

DOI 10.1002/14651858.CD007622.pub3
Citations Scopus - 29Web of Science - 47
2015 Mollart LJ, Adam J, Foureur M, 'Impact of acupressure on onset of labour and labour duration: A systematic review', WOMEN AND BIRTH, 28 199-206 (2015) [C1]
DOI 10.1016/j.wombi.2015.03.007
Citations Scopus - 13Web of Science - 8
Co-authors Lyndall Mollart
2014 Dixon L, Skinner J, Foureur M, 'The emotional journey of labour-Women's perspectives of the experience of labour moving towards birth', MIDWIFERY, 30 371-377 (2014)
DOI 10.1016/j.midw.2013.03.009
Citations Scopus - 12Web of Science - 11
2014 Hammond A, Foureur M, Homer CSE, 'The hardware and software implications of hospital birth room design: A midwifery perspective', MIDWIFERY, 30 825-830 (2014)
DOI 10.1016/j.midw.2013.07.013
Citations Scopus - 22Web of Science - 22
2014 Dahlen HG, Downe S, Kennedy HP, Foureur M, 'Is society being reshaped on a microbiological and epigenetic level by the way women give birth?', Midwifery, 30 1149-1151 (2014)
DOI 10.1016/j.midw.2014.07.007
Citations Scopus - 8
2014 Maude RM, Skinner JP, Foureur MJ, 'Intelligent Structured Intermittent Auscultation (ISIA): evaluation of a decision-making framework for fetal heart monitoring of low-risk women', BMC PREGNANCY AND CHILDBIRTH, 14 (2014)
DOI 10.1186/1471-2393-14-184
Citations Scopus - 12Web of Science - 8
2014 Raymond JE, Foureur MJ, Davis DL, 'Gestational Weight Change in Women Attending a Group Antenatal Program Aimed at Addressing Obesity in Pregnancy in New South Wales, Australia', JOURNAL OF MIDWIFERY & WOMENS HEALTH, 59 398-404 (2014)
DOI 10.1111/jmwh.12089
Citations Scopus - 1Web of Science - 1
2014 Davis Harte J, Leap N, Fenwick J, Homer CSE, Foureur M, 'Methodological insights from a study using video-ethnography to conduct interdisciplinary research in the study of birth unit design', International Journal of Multiple Research Approaches, 8 36-48 (2014)

© eContent Management Pty Ltd. Little is known about how the physical design of a birthing unit can influence the experiences of labour and birth for women, their supporters and m... [more]

© eContent Management Pty Ltd. Little is known about how the physical design of a birthing unit can influence the experiences of labour and birth for women, their supporters and midwives. We proposed that an interdisciplinary approach (disciplines of midwifery, architecture, design, communication and public health) was likely to be the most effective way to better understand the complexities and interactions of design, behaviour, communication and experiences. In this methodological paper we aim to provide a roadmap that other researchers may find helpful when considering the use of video as a data collection technique, especially in the study of the powerful and intimate setting of childbirth. The paper also outlines our process for engaging both researchers and participants in reviewing video footage with the aim to contribute multiple perspectives to the analysis process.

DOI 10.5172/mra.2014.8.1.36
Citations Scopus - 6
2014 Atchan M, Davis D, Foureur M, 'Applying a knowledge translation model to the uptake of the Baby Friendly Health Initiative in the Australian health care system', WOMEN AND BIRTH, 27 79-85 (2014)
DOI 10.1016/j.wombi.2014.03.001
Citations Scopus - 9Web of Science - 8
2014 Hammond AD, Homer CSE, Foureur M, 'Messages from Space: An Exploration of the Relationship between Hospital Birth Environments and Midwifery Practice', HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL, 7 81-95 (2014)
DOI 10.1177/193758671400700407
Citations Scopus - 5Web of Science - 5
2014 Monk A, Tracy M, Foureur M, Grigg C, Tracy S, 'Evaluating Midwifery Units (EMU): a prospective cohort study of freestanding midwifery units in New South Wales, Australia', BMJ OPEN, 4 (2014)
DOI 10.1136/bmjopen-2014-006252
Citations Scopus - 25Web of Science - 24
2014 Homer CSE, Thornton C, Scarf VL, Ellwood DA, Oats JJN, Foureur MJ, et al., 'Birthplace in New South Wales, Australia: An analysis of perinatal outcomes using routinely collected data', BMC Pregnancy and Childbirth, 14 (2014)

Background: The outcomes for women who give birth in hospital compared with at home are the subject of ongoing debate. We aimed to determine whether a retrospective linked data st... [more]

Background: The outcomes for women who give birth in hospital compared with at home are the subject of ongoing debate. We aimed to determine whether a retrospective linked data study using routinely collected data was a viable means to compare perinatal and maternal outcomes and interventions in labour by planned place of birth at the onset of labour in one Australian state.Methods: A population-based cohort study was undertaken using routinely collected linked data from the New South Wales Perinatal Data Collection, Admitted Patient Data Collection, Register of Congenital Conditions, Registry of Birth Deaths and Marriages and the Australian Bureau of Statistics. Eight years of data provided a sample size of 258,161 full-term women and their infants. The primary outcome was a composite outcome of neonatal mortality and morbidity as used in the Birthplace in England study.Results: Women who planned to give birth in a birth centre or at home were significantly more likely to have a normal labour and birth compared with women in the labour ward group. There were no statistically significant differences in stillbirth and early neonatal deaths between the three groups, although we had insufficient statistical power to test reliably for these differences.Conclusion: This study provides information to assist the development and evaluation of different places of birth across Australia. It is feasible to examine perinatal and maternal outcomes by planned place of birth using routinely collected linked data, although very large data sets will be required to measure rare outcomes associated with place of birth in a low risk population, especially in countries like Australia where homebirth rates are low. © 2014 Homer et al.; licensee BioMed Central Ltd.

DOI 10.1186/1471-2393-14-206
Citations Scopus - 32Web of Science - 23
2013 Catling-Paull C, Coddington RL, Foureur MJ, Homer CSE, 'Publicly funded homebirth in Australia: a review of maternal and neonatal outcomes over 6 years', MEDICAL JOURNAL OF AUSTRALIA, 198 616-620 (2013)
DOI 10.5694/mja12.11665
Citations Scopus - 32Web of Science - 31
2013 Catling-Paull C, Coddington RL, Foureur MJ, Homer CSE, 'Publicly funded homebirth in Australia: a review of maternal and neonatal outcomes over 6 years REPLY', MEDICAL JOURNAL OF AUSTRALIA, 199 743-743 (2013)
DOI 10.5694/mja13.11003
Citations Scopus - 1
2013 Dixon L, Skinner J, Foureur M, 'Women's perspectives of the stages and phases of labour', MIDWIFERY, 29 10-17 (2013)
DOI 10.1016/j.midw.2012.07.001
Citations Scopus - 20Web of Science - 21
2013 Stenglin M, Foureur M, 'Designing out the Fear Cascade to increase the likelihood of normal birth', MIDWIFERY, 29 819-825 (2013)
DOI 10.1016/j.midw.2013.04.005
Citations Scopus - 21Web of Science - 22
2013 Monk AR, Tracy SK, Foureur M, Tracy M, 'Evaluating midwifery units (EMU): Lessons from the pilot study', MIDWIFERY, 29 845-851 (2013)
DOI 10.1016/j.midw.2012.08.012
Citations Scopus - 2Web of Science - 2
2013 Dahlen HG, Kennedy HP, Anderson CM, Bell AF, Clark A, Foureur M, et al., 'The EPIIC hypothesis: Intrapartum effects on the neonatal epigenome and consequent health outcomes', MEDICAL HYPOTHESES, 80 656-662 (2013)
DOI 10.1016/j.mehy.2013.01.017
Citations Scopus - 43Web of Science - 40
2013 Atchan M, Davis D, Foureur M, 'The impact of the Baby Friendly health Initiative in the Australian health care system: A critical narrative review of the evidence', Breastfeeding Review, 21 15-22 (2013)

Studies have identified that the practices of maternity facilities and health professionals are crucial to women&apos;s experience of support and breastfeeding &apos;success&apos;... [more]

Studies have identified that the practices of maternity facilities and health professionals are crucial to women's experience of support and breastfeeding 'success'. The Baby Friendly Hospital Initiative (BFHI) was launched globally in 1991 to protect, promote and support breastfeeding. While a direct causal effect has not been established and critics suggest the rhetoric conflicts with women's lived experiences as new mothers, a positive association between the Initiative and breastfeeding prevalence is apparent. Internationally, impact studies have demonstrated that where the Initiative is well integrated, there is an increase in rates of breastfeeding initiation and, to a lesser extent, duration. In consideration of the known health risks associated with the use of artificial baby milks this would suggest that BFHI implementation and accreditation should be a desirable strategy for committed health facilities. However, a variation in both BFHI uptake and breastfeeding prevalence between nations has been reported. This narrative review critically discusses a variety of issues relevant to the uptake and support of breastfeeding and the BFHI, utilising Australia as a case study. Whilst it enjoys 'in principle' policy support, Australia also suffers from a lack of uniformity in uptake and perception of the benefits of BFHI at all levels of the health system. Australian and international studies have identified similar enablers and barriers to implementation.

Citations Scopus - 9
2013 Foureur M, Besley K, Burton G, Yu N, Crisp J, 'Enhancing the resilience of nurses and midwives: Pilot of a mindfulness-based program for increased health, sense of coherence and decreased depression, anxiety and stress', CONTEMPORARY NURSE, 45 114-125 (2013)
DOI 10.5172/conu.2013.45.1.114
Citations Scopus - 128Web of Science - 117
2013 Homer CSE, Besley K, Bell J, Davis D, Adams J, Porteous A, Foureur M, 'Does continuity of care impact decision making in the next birth after a caesarean section (VBAC)? a randomised controlled trial', BMC PREGNANCY AND CHILDBIRTH, 13 (2013)
DOI 10.1186/1471-2393-13-140
Citations Scopus - 6Web of Science - 7
2013 Monk AR, Tracy S, Foureur M, Barclay L, 'Australian primary maternity units: Past, present and future', WOMEN AND BIRTH, 26 213-218 (2013)
DOI 10.1016/j.wombi.2013.06.001
Citations Scopus - 15Web of Science - 15
2013 Hammond A, Foureur M, Homer CSE, Davis D, 'Space, place and the midwife: Exploring the relationship between the birth environment, neurobiology and midwifery practice', WOMEN AND BIRTH, 26 277-281 (2013)
DOI 10.1016/j.wombi.2013.09.001
Citations Scopus - 18Web of Science - 15
2013 Tracy SK, Hartz DL, Tracy MB, Allen J, Forti A, Hall B, et al., 'Caseload midwifery care versus standard maternity care for women of any risk: M@NGO, a randomised controlled trial', The Lancet, 382 1723-1732 (2013) [C1]

Background Women at low risk of pregnancy complications benefit from continuity of midwifery care, but no trial evidence exists for women with identifi ed risk factors. We aimed t... [more]

Background Women at low risk of pregnancy complications benefit from continuity of midwifery care, but no trial evidence exists for women with identifi ed risk factors. We aimed to assess the clinical and cost outcomes of caseload midwifery care for women irrespective of risk factors. Methods In this unblinded, randomised, controlled, parallel-group trial, pregnant women at two metropolitan teaching hospitals in Australia were randomly assigned to either caseload midwifery care or standard maternity care by a telephone-based computer randomisation service. Women aged 18 years and older were eligible if they were less than 24 weeks pregnant at the fi rst booking visit. Those who booked with another care provider, had a multiple pregnancy, or planned to have an elective caesarean section were excluded. Women allocated to caseload care received antenatal, intrapartum, and postnatal care from a named caseload midwife (or back-up caseload midwife). Controls received standard care with rostered midwives in discrete wards or clinics. The participant and the clinician were not masked to assignment. The main primary outcome was the proportion of women who had a caesarean section. The other primary maternal outcomes were the proportions who had an instrumental or unassisted vaginal birth, and the proportion who had epidural analgesia during labour. Primary neonatal outcomes were Apgar scores, preterm birth, and admission to neonatal intensive care. We analysed all outcomes by inten tion to treat. The trial is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12609000349246. Findings Publicly insured women were screened at the participating hospitals between Dec 8, 2008, and May 31, 2011. 1748 pregnant women were randomly assigned, 871 to caseload and 877 to standard care. The proportion of caesarean sections did not differ between the groups (183 [21%] in the caseload group vs 204 [23%] in the standard care group; odds ratio [OR] 0¿88, 95% CI 0¿70-1¿10; p=0¿26). The proportion of women who had elective caesarean sections (before onset of labour) diff ered signifi cantly between caseload and standard care (69 [8%] vs 94 [11%]; OR 0¿72, 95% CI 0¿52-0¿99; p=0¿05). Proportions of instrumental birth were similar (172 [20%] vs 171 [19%]; p=0¿90), as were the proportions of unassisted vaginal births (487 [56%] vs 454 [52%]; p=0¿08) and epidural use (314 [36%] vs 304 [35%]; p=0¿54). Neonatal outcomes did not diff er between the groups. Total cost of care per woman was AUS$566¿74 (95% 106¿17-1027¿30; p=0¿02) less for caseload midwifery than for standard maternity care. Interpretation Our results show that for women of any risk, caseload midwifery is safe and cost-effective.

DOI 10.1016/S0140-6736(13)61406-3
Citations Scopus - 130Web of Science - 120
2013 Mollart L, Skinner VM, Newing C, Foureur M, 'Factors that may influence midwives work-related stress and burnout', WOMEN AND BIRTH, 26 26-32 (2013) [C1]
DOI 10.1016/j.wombi.2011.08.002
Citations Scopus - 70Web of Science - 52
Co-authors Lyndall Mollart
2012 Kassab M, Sheehy A, King M, Fowler C, Foureur M, 'A double-blind randomised controlled trial of 25% oral glucose for pain relief in 2-month old infants undergoing immunisation', INTERNATIONAL JOURNAL OF NURSING STUDIES, 49 249-256 (2012)
DOI 10.1016/j.ijnurstu.2011.09.013
Citations Scopus - 14Web of Science - 13
2012 Homer CSE, Foureur MJ, Allende T, Pekin F, Caplice S, Catling-Paull C, ''It's more than just having a baby' women's experiences of a maternity service for Australian Aboriginal and Torres Strait Islander families', MIDWIFERY, 28 E509-E515 (2012)
DOI 10.1016/j.midw.2011.06.004
Citations Scopus - 29Web of Science - 28
2012 Kassab MI, Roydhouse JK, Fowler C, Foureur M, 'The Effectiveness of Glucose in Reducing Needle-Related Procedural Pain in Infants', JOURNAL OF PEDIATRIC NURSING-NURSING CARE OF CHILDREN & FAMILIES, 27 3-17 (2012)
DOI 10.1016/j.pedn.2010.10.008
Citations Scopus - 14Web of Science - 10
2012 Fenwick J, Hammond A, Raymond J, Smith R, Gray J, Foureur M, et al., 'Surviving, not thriving: a qualitative study of newly qualified midwives' experience of their transition to practice', JOURNAL OF CLINICAL NURSING, 21 2054-2063 (2012)
DOI 10.1111/j.1365-2702.2012.04090.x
Citations Scopus - 39Web of Science - 29
2012 Homer CSE, Ryan C, Leap N, Foureur M, Teate A, Catling-Paull CJ, 'Group versus conventional antenatal care for women', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, (2012)
DOI 10.1002/14651858.CD007622.pub2
Citations Scopus - 30Web of Science - 21
2012 Kassab M, Foster JP, Foureur M, Fowler C, 'Sweet-tasting solutions for needle-related procedural pain in infants one month to one year of age', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, (2012)
DOI 10.1002/14651858.CD008411.pub2
Citations Scopus - 41Web of Science - 29
2012 Hartz DL, Foureur M, Tracy SK, 'Australian caseload midwifery: The exception or the rule', WOMEN AND BIRTH, 25 39-46 (2012)
DOI 10.1016/j.wombi.2011.01.001
Citations Scopus - 25Web of Science - 28
2012 Davis D, Foureur M, Clements V, Brodie P, Herbison P, 'The self reported confidence of newly graduated midwives before and after their first year of practice in Sydney, Australia', WOMEN AND BIRTH, 25 E1-E10 (2012)
DOI 10.1016/j.wombi.2011.03.005
Citations Scopus - 16Web of Science - 12
2012 Catling-Paull C, Foureur MJ, Homer CSE, 'Publicly-funded homebirth models in Australia', WOMEN AND BIRTH, 25 152-158 (2012)
DOI 10.1016/j.wombi.2011.10.003
Citations Scopus - 14Web of Science - 14
2012 Lennox S, Jutel A, Foureur M, 'The Concerns of Competent Novices during a Mentoring Year.', Nursing research and practice, 2012 812542 (2012)
DOI 10.1155/2012/812542
2012 Davis DL, Raymond JE, Clements V, Adams C, Mollart LJ, Teate AJ, Foureur MJ, 'Addressing obesity in pregnancy: The design and feasibility of an innovative intervention in NSW, Australia', Women and Birth, 25 174-180 (2012) [C1]
DOI 10.1016/j.wombi.2011.08.008
Citations Scopus - 22Web of Science - 22
Co-authors Lyndall Mollart
2011 Catling-Paull C, Homer CSE, Foureur M, Azzopardi C, Cameron D, Clarke J, et al., 'Introducing ... the National Publicly Funded Homebirth Consortium', WOMEN AND BIRTH, 24 S36-S37 (2011)
DOI 10.1016/j.wombi.2011.07.116
Citations Web of Science - 1
2011 Homer CSE, Johnston R, Foureur MJ, 'Birth after caesarean section: changes over a nine-year period in one Australian state', MIDWIFERY, 27 165-169 (2011)
DOI 10.1016/j.midw.2009.04.009
Citations Scopus - 17Web of Science - 15
2011 Catling-Paull C, Johnston R, Ryan C, Foureur MJ, Homer CSE, 'Clinical interventions that increase the uptake and success of vaginal birth after caesarean section: a systematic review', JOURNAL OF ADVANCED NURSING, 67 1646-1661 (2011)
DOI 10.1111/j.1365-2648.2011.05635.x
Citations Scopus - 11Web of Science - 11
2011 Catling-Paull C, Johnston R, Ryan C, Foureur MJ, Homer CSE, 'Non-clinical interventions that increase the uptake and success of vaginal birth after caesarean section: a systematic review', JOURNAL OF ADVANCED NURSING, 67 1662-1676 (2011)
DOI 10.1111/j.1365-2648.2011.05662.x
Citations Scopus - 17Web of Science - 20
2011 Atchan M, Foureur M, Davis D, 'The decision not to initiate breastfeeding--women's reasons, attitudes and influencing factors--a review of the literature.', Breastfeeding review : professional publication of the Nursing Mothers' Association of Australia, 19 9-17 (2011)

Breastfeeding is the biological feeding norm for human babies. Encouraging breastfeeding is a primary health promotion strategy, with studies demonstrating the risks of artificial... [more]

Breastfeeding is the biological feeding norm for human babies. Encouraging breastfeeding is a primary health promotion strategy, with studies demonstrating the risks of artificial baby milks. Each year approximately 10% of the women who give birth in New South Wales decide not to initiate breastfeeding, and the demographic characteristics of this group of women have previously been identified. This paper reviews the literature to explore the factors that influence women's decisions about breastfeeding, and their reasons for not initiating breastfeeding. The review revealed there are relatively few studies that explore the experiences of women who decide not to initiate breastfeeding, especially in the Australian context.

Citations Scopus - 21
2011 Patterson JA, Foureur M, Skinner JP, 'Patterns of transfer in labour and birth in rural New Zealand', RURAL AND REMOTE HEALTH, 11 (2011)
Citations Scopus - 18Web of Science - 13
2011 Patterson JA, Foureur M, Skinner JP, 'Reply to Comment on: Patterns of transfer in labour and birth in rural New Zealand', RURAL AND REMOTE HEALTH, 11 (2011)
2011 Sheehy A, Foureur M, Catling-Paull C, Homer C, 'Examining the Content Validity of the Birthing Unit Design Spatial Evaluation Tool Within a Woman-Centered Framework', JOURNAL OF MIDWIFERY & WOMENS HEALTH, 56 494-502 (2011)
DOI 10.1111/j.1542-2011.2011.00059.x
Citations Scopus - 14Web of Science - 13
2011 Foureur MJ, Leap N, Davis DL, Forbes IF, Homer CSE, 'Testing the Birth Unit Design Spatial Evaluation Tool (BUDSET) in Australia: A Pilot Study', HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL, 4 36-60 (2011)
DOI 10.1177/193758671100400205
Citations Scopus - 10Web of Science - 9
2010 Cooke H, Foureur M, Kinnear A, Bisits A, Giles W, 'The development and initiation of the NSW Department of Health interprofessional Fetal welfare Obstetric emergency Neonatal resuscitation Training project', AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY, 50 334-339 (2010)
DOI 10.1111/j.1479-828X.2010.01167.x
Citations Scopus - 2Web of Science - 2
2010 Foureur M, Davis D, Fenwick J, Leap N, Iedema R, Forbes I, Homer CSE, 'The relationship between birth unit design and safe, satisfying birth: Developing a hypothetical model', MIDWIFERY, 26 520-525 (2010)
DOI 10.1016/j.midw.2010.05.015
Citations Scopus - 37Web of Science - 37
2010 Foureur M, Ryan CL, Nicholl M, Homer C, 'Inconsistent Evidence: Analysis of Six National Guidelines for Vaginal Birth After Cesarean Section', BIRTH-ISSUES IN PERINATAL CARE, 37 3-10 (2010)
DOI 10.1111/j.1523-536X.2009.00372.x
Citations Scopus - 34Web of Science - 29
2010 Homer CSE, Catling-Paull CJ, Sinclair D, Faizah N, Balasubramanian V, Foureur MJ, et al., 'Developing an interactive electronic maternity record', British Journal of Midwifery, 18 384-389 (2010)

Women have a strong need to be involved in their own maternity care. Pregnancy hand-held records encourage women&apos;s participation in their maternity care; gives them an increa... [more]

Women have a strong need to be involved in their own maternity care. Pregnancy hand-held records encourage women's participation in their maternity care; gives them an increased sense of control and improves communication among care providers. They have been successfully used in the UK and New Zealand for almost 20 years. Despite evidence that supports the use of hand-held records, widespread introduction has not occurred in Australia. The need for an electronic version of pregnancy hand-held records has become apparent, especially after the introduction of the Electronic Medical Record in Australia. A personal digital assistant (PDA) was developed as an interactive antenatal electronic maternity record that health-care providers could use in any setting and women could access using the internet. This article will describe the testing of the antenatal electronic maternity record.

DOI 10.12968/bjom.2010.18.6.48312
Citations Scopus - 4
2010 Skinner JP, Foureur M, 'Consultation, Referral, and Collaboration Between Midwives and Obstetricians: Lessons From New Zealand', JOURNAL OF MIDWIFERY & WOMENS HEALTH, 55 28-37 (2010)
DOI 10.1016/j.jmwh.2009.03.015
Citations Scopus - 26Web of Science - 23
2010 Wilton DC, Foureur MJ, 'A survey of folic acid use in primigravid women', Women and Birth, 23 67-73 (2010)

A convenience sample of 320 consecutive primigravid women attending the antenatal clinic of a large Sydney tertiary referral hospital were invited to take part in a survey of foli... [more]

A convenience sample of 320 consecutive primigravid women attending the antenatal clinic of a large Sydney tertiary referral hospital were invited to take part in a survey of folic acid use in pregnancy. The aim of the survey was to determine the number of primigravid women who commenced taking folic acid supplementation at least 1 month prior to conception. In addition the survey sought information on women's source of knowledge about the need for folic acid in pregnancy and whether their pregnancy was planned or unplanned. 295 women qualified to be included in the survey. While 88.1% of women took folic acid at some time prior to and/or during the first trimester, only 23.4% were found to have taken folic acid at least 1 month prior to conception. Of women with a planned birth only 34.5% commenced folic acid prior to conception. This survey adds further weight to the decision of the Australian Government to mandate for fortification of bread-making flour with folic acid, due to commence in September 2009. However, even with folic acid fortified food, health professionals need to continue to advise women to take supplements prior to conception and for at least 12 weeks into their pregnancy to prevent neural tube defects. © 2009 Australian College of Midwives.

DOI 10.1016/j.wombi.2009.09.001
Citations Scopus - 12
2010 Foureur MJ, Leap N, Davis DL, Forbes IF, Homer CSE, 'Developing the Birth Unit Design Spatial Evaluation Tool (BUDSET) in Australia: A Qualitative Study', HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL, 3 43-57 (2010)
DOI 10.1177/193758671000300405
Citations Scopus - 13Web of Science - 12
2009 Duke J, McBride-Henry K, Walsh K, Foureur M, 'The expectations of two New Zealand health services of the role of Clinical Chairs in nursing and midwifery', CONTEMPORARY NURSE, 31 129-141 (2009)
DOI 10.5172/conu.673.31.2.129
Citations Scopus - 5Web of Science - 5
2009 Homer C, Ryan C, Leap N, Foureur M, Teate A, 'Group versus conventional antenatal care for pregnant women', Cochrane Database of Systematic Reviews, (2009)
DOI 10.1002/14651858.CD007622
Citations Scopus - 16
2009 Foureur M, Brodie P, Homer C, 'Midwife-centered versus woman-centered care: A developmental phase?', Women and Birth, 22 47-49 (2009)
DOI 10.1016/j.wombi.2009.04.002
Citations Scopus - 7
2009 Mollart L, Newing C, Foureur M, 'Midwives' emotional wellbeing: Impact of conducting a Structured Antenatal Psychosocial Assessment (SAPSA)', Women and Birth, 22 82-88 (2009)

Research problem: To investigate the impact of conducting structured antenatal psychosocial assessments (SAPSA) on midwives&apos; emotional wellbeing. The SAPSA includes screening... [more]

Research problem: To investigate the impact of conducting structured antenatal psychosocial assessments (SAPSA) on midwives' emotional wellbeing. The SAPSA includes screening and assessment tools for domestic violence, childhood trauma, drug and alcohol use, depression, and vulnerability factors. Participants and methods: Registered midwives who had conducted the SAPSA with women during the first hospital booking visit at two hospitals in NSW. Data was collected by means of focus group interviews. Results: Four sub-themes were identified that directly impacted upon the midwives' emotional wellbeing: cumulative complex disclosures, frustration and stress, lack of support for midwives and unhealthy coping strategies. Discussion and conclusions: There was a cumulative emotional effect with some midwives utilising unhealthy strategies to cope with feelings of frustration, inadequacy and vicarious trauma. Establishment of structured referral pathways for women and supportive systems for midwives is essential prior to implementing the SAPSA. Crown Copyright © 2009.

DOI 10.1016/j.wombi.2009.02.001
Citations Scopus - 25
Co-authors Lyndall Mollart
2007 McBride-Henry K, Foureur M, 'A secondary care nursing perspective on medication administration safety', JOURNAL OF ADVANCED NURSING, 60 58-66 (2007)
DOI 10.1111/j.1365-2648.2007.04378.x
Citations Scopus - 17Web of Science - 13
2007 Walsh K, Duke J, 'Designing an effective evaluation plan: A tool for understanding and planning evaluations for complex nursing contexts', CONTEMPORARY NURSE, 25 136-145 (2007)
DOI 10.5172/conu.2007.25.1-2.136
Citations Scopus - 6Web of Science - 4
2007 Maude RM, Foureur MJ, 'It's beyond water: Stories of women's experience of using water for labour and birth', Women and Birth, 20 17-24 (2007)

Purpose: This study aimed to give &apos;voice&apos; to women&apos;s experiences of using water for labour and birth. Participants: Five women from a large urban region in New Zeal... [more]

Purpose: This study aimed to give 'voice' to women's experiences of using water for labour and birth. Participants: Five women from a large urban region in New Zealand, who used water for labour and birth, at home and in hospital. Methods: The study employed an interpretive design using audio-taped conversations as the method of data collection and a thematic analysis of the women's stories. Findings: Data analysis produced two core categories; 'Getting to the water' which revealed the impact of preparing for and anticipating the water; and 'Getting into the water' which provided a sanctuary and a release from pain. Conclusion: The all-encompassing warmth associated with being enveloped in warm water cradled, supported, relaxed, comforted, soothed, sheltered and protected the women; it created a barrier and offered a sense of privacy. Water can be used in any form, even the act of thinking about, preparing for and anticipating the water opened possibilities for these women. The women used water to reduce their fear of pain and of childbirth itself; to cope with pain, not necessarily to remove or diminish pain; and to maintain control over the process of birth. The women indicated that it was not necessary to actually give birth in the water to achieve these benefits. Listening to the stories of women provides us with insights into what is important to them. Women's knowledge contributes an important part of the evidence on which we base our practice. © 2006 Australian College of Midwives.

DOI 10.1016/j.wombi.2006.10.005
Citations Scopus - 23
2006 McBride-Henry K, Foureur M, 'Medication administration errors: Understanding the issues', AUSTRALIAN JOURNAL OF ADVANCED NURSING, 23 33-41 (2006)
Citations Scopus - 54Web of Science - 43
2004 Barton J, Don M, Foureur M, 'Nurses and midwives pain knowledge improves under the influence of an acute pain service', Acute Pain, 6 47-51 (2004)

A recent survey of nurses&apos; and midwives&apos; pain knowledge and attitudes demonstrated that those working regularly with an acute pain service were more knowledgeable about ... [more]

A recent survey of nurses' and midwives' pain knowledge and attitudes demonstrated that those working regularly with an acute pain service were more knowledgeable about analgesics, non-drug pain management and addiction issues. An acute pain service was shown to have a positive influence on pain management practice. A 29-item pain knowledge and attitudes questionnaire which also included questions relating to the impact of an acute pain service was distributed to 600 nurses and midwives. A response rate of 48% (286 valid responses) was achieved. Nurses and midwives who were unaware of an acute pain service in their organisation had significantly lower scores on knowledge about pain management, particularly in relation to the analgesia choices made. This data indicates that an acute pain service has an important influence within health care organisations and can be utilised to lead advancement in pain management practice. © 2004 Elsevier B.V. All rights reserved.

DOI 10.1016/j.acpain.2004.04.003
Citations Scopus - 7
2002 Foureur M, 'Randomised controlled trials in nursing and midwifery: an interview with Maralyn Foureur. Interview by Pamela J. Wood.', Nursing praxis in New Zealand inc, 18 4-16 (2002)

Randomised controlled trials are considered to be one of the best research designs for determining effective care in the clinical setting. Relatively few randomised controlled tri... [more]

Randomised controlled trials are considered to be one of the best research designs for determining effective care in the clinical setting. Relatively few randomised controlled trials, however, have been carried out in nursing or midwifery practice, so few examples of the practical realities of this research methodology are readily accessible. This is the sixth article in a series based on interviews with nursing and midwifery researchers, designed to offer the beginning researcher a first-hand account of the experience of using particular methodologies. This article focuses on the randomised controlled trial as experienced by Maralyn Foureur (RGON, RM, BA, Grad Dip Clin Epidem, PhD) who used this methodology to demonstrate the effectiveness of a continuity of care model in midwifery practice.

Citations Scopus - 3
1999 Rowley M, 'Clinical professorial appointments in nursing.', Nursing praxis in New Zealand inc, 14 2-3 (1999)
Citations Scopus - 1
1995 ROWLEY MJ, HENSLEY MJ, BRINSMEAD MW, WLODARCZYK JH, 'CONTINUITY OF CARE BY A MIDWIFE TEAM VERSUS ROUTINE CARE DURING PREGNANCY AND BIRTH - A RANDOMIZED TRIAL', MEDICAL JOURNAL OF AUSTRALIA, 163 289-293 (1995)
DOI 10.5694/j.1326-5377.1995.tb124592.x
Citations Scopus - 101Web of Science - 83
Co-authors Michael Hensley
1994 ROWLEY M, EPID GD, KOSTRZEWA C, 'A DESCRIPTIVE STUDY OF COMMUNITY INPUT INTO THE EVOLUTION OF JOHN-HUNTER-HOSPITAL-BIRTH-CENTER - RESULTS OF OPEN ENTRY CRITERIA', AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY, 34 31-34 (1994)
DOI 10.1111/j.1479-828X.1994.tb01035.x
Citations Scopus - 1Web of Science - 1
1990 SMITH R, CUBIS J, BRINSMEAD M, LEWIN T, SINGH B, OWENS P, et al., 'MOOD CHANGES, OBSTETRIC EXPERIENCE AND ALTERATIONS IN PLASMA-CORTISOL, BETA-ENDORPHIN AND CORTICOTROPIN RELEASING HORMONE DURING PREGNANCY AND THE PUERPERIUM', JOURNAL OF PSYCHOSOMATIC RESEARCH, 34 53-69 (1990)
DOI 10.1016/0022-3999(90)90008-R
Citations Scopus - 93Web of Science - 83
Co-authors Terry Lewin, Roger Smith
1987 OWENS PC, SMITH R, BRINSMEAD MW, HALL C, ROWLEY M, HURT D, et al., 'POSTNATAL DISAPPEARANCE OF THE PREGNANCY-ASSOCIATED REDUCED SENSITIVITY OF PLASMA-CORTISOL TO FEEDBACK INHIBITION', LIFE SCIENCES, 41 1745-1750 (1987)
DOI 10.1016/0024-3205(87)90603-5
Citations Scopus - 44Web of Science - 45
Co-authors Roger Smith, Terry Lewin
Show 115 more journal articles

Conference (17 outputs)

Year Citation Altmetrics Link
2019 Mclaughlin K, Foureur M, Jensen M, Gibson P, Murphy V, 'Stop, Start or Continue Asthma Medication in Pregnancy: Acceptability of a Biomarker-Based Approach to Antenatal Clinic Obstetricians and Midwives', AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY (2019)
Co-authors Vanessa Murphy, Peter Gibson
2019 Mclaughlin K, Jensen M, Foureur M, Gibson P, Murphy V, 'Are pregnant women with asthma receiving guideline-recommended antenatal asthma management?- A survey of pregnant women in Australia', WOMEN AND BIRTH (2019)
DOI 10.1016/j.wombi.2019.07.207
Co-authors Vanessa Murphy, Megan Jensen, Peter Gibson
2019 Mollart L, Stulz V, Foureur M, 'Passion for complementary alternative medicine/therapies: Midwives' education and training', WOMEN AND BIRTH (2019)
DOI 10.1016/j.wombi.2019.07.226
Co-authors Lyndall Mollart
2019 Mclaughlin K, Jensen M, Foureur M, Gibson P, Murphy V, 'The acceptability and feasibility of a novel asthma management strategy in Australian antenatal clinics-a qualitative descriptive study', WOMEN AND BIRTH (2019)
DOI 10.1016/j.wombi.2019.07.273
Co-authors Vanessa Murphy, Megan Jensen, Peter Gibson
2019 Mclaughlin K, Jensen M, Foureur M, Gibson P, Murphy V, 'KNOWLEDGE AND CONFIDENCE OF HEALTH PROFESSIONALS IN PROVIDING ASTHMA MANAGEMENT IN PREGNANCY: RESULTS OF AN AUSTRALIAN NATIONWIDE SURVEY', RESPIROLOGY (2019)
Co-authors Peter Gibson, Vanessa Murphy
2018 Mollart L, Skinner V, Foureur M, 'The many faces of midwifery: Australian midwives' views, beliefs and attitudes on Complementary and Alternative Medicines (CAM)', WOMEN AND BIRTH (2018)
DOI 10.1016/j.wombi.2018.08.056
Co-authors Lyndall Mollart
2018 Skinner V, Foureur M, Mollart LJ, 'The many faces of midwifery: Australian midwives views, beliefs and attitudes on Complementary and Alternative Medicines (CAM)', The many faces of midwifery: Australian midwives' views, beliefs and attitudes to Complementary and Alternative Medicine (CAM), Perth, Western Australia (2018)
DOI 10.106/j.wombi.2018.08.056
Co-authors Lyndall Mollart
2017 Mollart L, Skinner V, Foureur M, 'Australian midwives and complementary and alternative medicines: What is the practice out there?', WOMEN AND BIRTH (2017)
DOI 10.1016/j.wombi.2017.08.071
Co-authors Lyndall Mollart
2017 McLaughlin K, McCaffery K, Foureur M, Murphy V, 'REVIEW OF ASTHMA IN PREGNANCY GUIDELINES', RESPIROLOGY (2017)
Citations Web of Science - 1
Co-authors Vanessa Murphy
2017 Braye K, Xu F, Ferguson J, Foureur M, 'Is exposing around a third of our birthing population to Intrapartum Antibiotic Prophylaxis (IAP) for prevention of Early Onset Group B Streptococcal infection (EOGBSI) doing more harm than good?', WOMEN AND BIRTH (2017)
DOI 10.1016/j.wombi.2017.08.061
2015 Braye K, Foureur M, 'Group B streptococcus: Are we doing more harm than good?', WOMEN AND BIRTH (2015)
DOI 10.1016/j.wombi.2015.07.133
2013 Mollart L, Foureur M, Skinner V, Shah M, Albert G, 'PREPARE (PRimigravidas Experiencing Postdates Acupressure REsearch', WOMEN AND BIRTH (2013)
DOI 10.1016/j.wombi.2013.08.202
Co-authors Lyndall Mollart
2011 Gatward H, Foureur M, Davis D, 'Reaching for the stars by re-conceptualizing time in childbirth', WOMEN AND BIRTH (2011)
DOI 10.1016/j.wombi.2011.07.042
Citations Web of Science - 23
2011 Cooke H, Foureur M, Giles W, 'Interprofessional education in maternity clinical practice: Is it the way of the future?', WOMEN AND BIRTH (2011)
DOI 10.1016/j.wombi.2011.07.080
2011 Davis D, Foureur M, 'Group based antenatal care for overweight and obese women', WOMEN AND BIRTH (2011)
DOI 10.1016/j.wombi.2011.07.085
2009 Hoang DB, Foureur M, 'Welcome from the technical program chairs', 2009 11th IEEE International Conference on e-Health Networking, Applications and Services, Healthcom 2009 (2009)
DOI 10.1109/HEALTH.2009.5406180
2008 Hoang DB, Lawrence E, Ahmad NF, Balasubramanian V, Homer C, Foureur M, Leap N, 'Assistive Care Loop with Electronic Maternity Records', 2008 10TH IEEE INTERNATIONAL CONFERENCE ON E-HEALTH NETWORKING, APPLICATIONS AND SERVICES, Singapore, SINGAPORE (2008)
Citations Scopus - 8Web of Science - 1
Show 14 more conferences
Edit

Grants and Funding

Summary

Number of grants 10
Total funding $6,590,542

Click on a grant title below to expand the full details for that specific grant.


20191 grants / $750,000

Partnerships in Aged-Care Emergency Services using Interactive Telehealth (PACE-IT) incorporating telehealth visual assessment information sharing and decision making for people living in residential aged care facilties$750,000

Funding body: NSW Health Transalational Research Grants Scheme

Funding body NSW Health Transalational Research Grants Scheme
Project Team

Giles, M., Sumner, C., Foureur, M., et al

Scheme NSW Health Translational Research Grants Scheme
Role Investigator
Funding Start 2019
Funding Finish 2021
GNo
Type Of Funding C1600 - Aust Competitive - StateTerritory Govt
Category 1600
UON N

20171 grants / $350,000

Maternal, Newborn and Women's Health, Clinical Academic Group$350,000

Funding body: Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)

Funding body Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
Project Team

Homer, CSE., Henry, A., Foureur, M., et al

Scheme Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
Role Investigator
Funding Start 2017
Funding Finish 2019
GNo
Type Of Funding C1700 - Aust Competitive - Other
Category 1700
UON N

20122 grants / $1,047,550

Birthplace in Australia: A prospective cohort study$790,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team

Homer, CSE., Ellwood, D., Oats, G., Foureur, MJ., Sibbritt, D., McLachlan, H., Forster, D., Dahlen, H.

Scheme Project Grant
Role Investigator
Funding Start 2012
Funding Finish 2017
GNo
Type Of Funding C1100 - Aust Competitive - NHMRC
Category 1100
UON N

Does Continuity of Midwifery Care Increase Vaginal Birth After Caesarean (VBAC): A Randomised Controlled Trial$257,550

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team

Homer, CSE., Foureur, MJ., Davis, D., Adams, J., Porteous, A.

Scheme Project Grant
Role Investigator
Funding Start 2012
Funding Finish 2015
GNo
Type Of Funding C1100 - Aust Competitive - NHMRC
Category 1100
UON N

20111 grants / $277,992

Theorising the relationship between birth unit design and the communication patterns of labouring women and their maternity care providers$277,992

Funding body: ARC (Australian Research Council)

Funding body ARC (Australian Research Council)
Project Team

Foureur, M., Homer CSE, Fenwick, J,m Davis, D., Sorensen, R., Forbes, I.

Scheme Discovery Project
Role Lead
Funding Start 2011
Funding Finish 2015
GNo
Type Of Funding C1200 - Aust Competitive - ARC
Category 1200
UON N

20102 grants / $715,000

Evaluation of Midwifery Units$670,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team

Tracy, S., Foureur, M., Barclay, L., Tracy, M., Welsh, A.

Scheme Project Grant
Role Investigator
Funding Start 2010
Funding Finish 2013
GNo
Type Of Funding C1100 - Aust Competitive - NHMRC
Category 1100
UON N

Developing Cutting Edge Birth Unit Design: A Feasibility Study$45,000

Funding body: University of Technology Sydney

Funding body University of Technology Sydney
Project Team

Foureur, M., Fenwick, J., Iedema, R., Homer, C., Verghese, G., Davis, D., Pandolfo, B., Leap, N., Forbes, I.

Scheme Seed Grant
Role Lead
Funding Start 2010
Funding Finish 2011
GNo
Type Of Funding Internal
Category INTE
UON N

20093 grants / $3,450,000

Australian Placental Transfusion Study$2,700,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team

Tarnow-Mordi W., Foureur, M., et al

Scheme Project Grant
Role Investigator
Funding Start 2009
Funding Finish 2014
GNo
Type Of Funding C1100 - Aust Competitive - NHMRC
Category 1100
UON N

Multi centre randomised controlled trial of caseload midwifery (M@NGO trial)$550,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team

Tracy, S., Homer, C., Tracy, M., Kildea, S., Foureur, M.

Scheme Project Grant
Role Investigator
Funding Start 2009
Funding Finish 2012
GNo
Type Of Funding C1100 - Aust Competitive - NHMRC
Category 1100
UON N

Introduction and evaluation of a new antenatal maternity service model focusing on weight management for women with a BMI>30 in Northern Sydney Central Coast and South Eastern Sydney Illawarra Area Health Services$200,000

Funding body: NSW Health, Targeted Initiative Grant

Funding body NSW Health, Targeted Initiative Grant
Project Team

Davis, D., Foureur, M., Adams, C., Clements, V., Mollart, L., Raymond, J., Teate, A., Zuschman, A

Scheme Targeted Initiative Grant NSW Health
Role Investigator
Funding Start 2009
Funding Finish 2010
GNo
Type Of Funding C1600 - Aust Competitive - StateTerritory Govt
Category 1600
UON N
Edit

Research Supervision

Number of supervisions

Completed37
Current7

Current Supervision

Commenced Level of Study Research Title Program Supervisor Type
2019 PhD Can a Continuity of Antenatal/Postnatal Model of Undergraduate Clinical Education Increase Student Midwife Engagement and the Development of Relevant Clinical Skills? PhD (Midwifery), Faculty of Health and Medicine, The University of Newcastle Co-Supervisor
2019 PhD Evaluating a model of midwifery education based on continuity of antenatal and postnatal care Midwifery, The University of Newcastle | Australia Co-Supervisor
2018 PhD Shoulder Dystocia and range of head-body delivery interval Midwifery, University of Technology Sydney Co-Supervisor
2018 PhD Gestational Weight Gain in Eastern Ethiopia: Patterns, Determinants and Birth Outcomes and Postpartum weight retention Public Health, University of Technology Sydney Co-Supervisor
2015 PhD Assessing Acceptability of a Novel Antenatal Asthma Management Approach for Pregnant Women PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle Co-Supervisor
2014 PhD Antenatal Weighing and Gestational Weight Gain PhD (CommunityMed & ClinEpid), Faculty of Health and Medicine, The University of Newcastle Co-Supervisor
2014 PhD A study of the management of Group B streptococcal colonisation in pregnant women: Benefits and risks of preventative modalities Midwifery, University of Technology Sydney Principal Supervisor

Past Supervision

Year Level of Study Research Title Program Supervisor Type
2018 PhD Hisotry of the Baby Friendly Health Initiative (BFHI) in Australia Midwifery, University of Technology Sydney Principal Supervisor
2018 Masters Midwives' perceptions of their role in caring for women with, or at risk of, Perinatal Depression Midwifery, University of Technology Sydney Principal Supervisor
2018 PhD Randomised controlled trial of Acupressure for women who are post 41 weeks gestation Midwifery, University of Technology Sydney Principal Supervisor
2017 Professional Doctorate Engaging the clinicians of a maternity health service-an exploration of neuro-leadership in action Midwifery, University of Technology Sydney Principal Supervisor
2017 PhD Continuity of Midwifery Care in Denmark: A Cohort Study Midwifery, University of Southern Denmark Sole Supervisor
2017 PhD How does the birth unit design impact on midwifery practice Midwifery, University of Technology Sydney Principal Supervisor
2016 PhD Birth Unit Design and the Impact on the woman's supporters during labour Midwifery, University of Technology Sydney Principal Supervisor
2016 PhD Evaluation of the NSW Health statewide FONT (Fetal Welfare and Obstetric and Neonatal Emergency Training) program Midwifery, University of Technology Sydney Principal Supervisor
2016 Masters A new model of antenatal preparation for childbirth including Movement Midwifery, University of Technology Sydney Principal Supervisor
2015 PhD Evaluation of Midwifery Units (EMU)-A Cohort Study in Australia Midwifery, The University of Sydney Co-Supervisor
2015 Masters The Caseload Model of Midwifery Student Clinical Education Midwifery, University of Technology Sydney Principal Supervisor
2014 Honours Exploring the non-verbal communication between labouring women and their maternity care providers and how the birth environment influences this communication Midwifery, University of Technology Sydney Co-Supervisor
2014 PhD Humidification in Neonatal Intensive Care-is a randomised controlled trial possible? Nursing, University of Technology Sydney Co-Supervisor
2013 Honours A comparison of oral handover and documented handover to determine the impact on health service funding from the perspective of the medical coder Health Not Elswhere Classified, University of Technology Sydney Principal Supervisor
2013 PhD Multi centre randomised controlled trial of caseload midwifery (M@NGO trial) Midwifery, The University of Sydney Co-Supervisor
2012 Masters Women's Expectations and Experiences of Induction of Labour Midwifery, University of Technology Sydney Principal Supervisor
2012 PhD Development and Testing of a model of Intelligent Structured Intermittent Auscultation (ISIA) of the Fetal Heart Midwifery, Victoria University of Wellington Principal Supervisor
2011 PhD An exploration of women's perspectives on labour progress Midwifery, Victoria University of Wellington Principal Supervisor
2011 Masters Preceptorship in Midwifery- A qualitative study of the way tacit knowledge is transferred between preceptor and student midwife Midwifery, University of Technology Sydney Principal Supervisor
2011 PhD A Randomised controlled trial of oral glucose for pain management prior to 2-month immunisation in healthy infants General Nursing, University of Technology Sydney Principal Supervisor
2011 PhD A descriptive study of a new model of group mentorship for newly graduated midwives Midwifery, Victoria University of Wellington Principal Supervisor
2010 PhD A study of rural midwifery practice and the decision to transfer: A multi method approach Midwifery, Victoria University of Wellington Principal Supervisor
2010 Masters Interdisciplinary Education-a model for collaborative practice in maternity care Midwifery, University of Technology Sydney Principal Supervisor
2010 PhD Segementation of the Maternity Care market from a healthcare marketing approach Public Health, Victoria University of Wellington Principal Supervisor
2009 Masters Women's experience of intrapartum transfer from homebirth to hospital Midwifery, Victoria University of Wellington Principal Supervisor
2007 Honours The development of a consensus statement for Neonatal Developmental Supportive Care in New Zealand Nursing, Victoria University of Wellington Principal Supervisor
2007 Masters Exploring Birth Outcomes for pirmiparous women within the practice of the same midwife-according to their birth environment Midwifery, Victoria University of Wellington Co-Supervisor
2006 PhD The personal mandate to practise midwifery prior to 1990: Domiciliary Midwives and the Domiciliary Midwives Society (Inc) of Aotearoa/New Zealand-An Historical Study Midwifery, Victoria University of Wellington Principal Supervisor
2006 PhD Nursing Immersion Programs in Developing Countries: A Reflective Topical Autobiography Midwifery, Victoria University of Wellington Principal Supervisor
2006 Masters Women Talk: narrative analysis of traumatic birth experience and post traumatic stress disorder (PTSD) Midwifery, Victoria University of Wellington Principal Supervisor
2005 PhD Midwives' understanding of Risk in Maternity Care: A multimethod study Midwifery, Victoria University of Wellington Principal Supervisor
2005 PhD Midwives' use of complementary therapies: A multimethod study Midwifery, Victoria University of Wellington Principal Supervisor
2000 Masters Towards a sustainable model of midwifery practice in a continuity of care setting. The experience of New Zealand midwives Midwifery, Victoria University of Wellington Principal Supervisor
1998 Masters A demographic profile of independent (self employed) midwives in New Zealand/Aotearoa Midwifery, Victoria University of Wellington Principal Supervisor
1998 Masters The jewel in the crown: A case study of the New Zealand College of Midwives Standards Review Process in Wellington Midwifery, Victoria University of Wellington Principal Supervisor
1998 Masters Knowledge levels and attitudes of student nurses regarding pain and pain management Nursing, Victoria University of Wellington Sole Supervisor
1997 Masters Perceived level and sources of stress in beginning Bachelor of Nursing Students Nursing, Victoria University of Wellington Sole Supervisor
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Professor Maralyn Foureur

Position

Joint Chair and Professor
School of Nursing and Midwifery
Faculty of Health and Medicine

Contact Details

Email maralyn.foureur@newcastle.edu.au
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