Abstract
Background
Each year thousands of pregnant women experiencing threatened premature labour are
transferred considerable distances across Australia to access higher level facilities
but only a small proportion of these women go on to actually give birth to a premature
baby. Women from regional areas are required to move away from their home, children
and support networks because of a perceived risk of birthing in a centre without neonatal
intensive care facilities.
Aim
This study examines the experience of women undergoing antenatal transfer for threatened
premature labour in New South Wales and the Australian Capital Territory who do not
give birth during their transfer admission.
Methods
Thirteen semi-structured in-depth interviews were held with women across five tertiary
referral sites across New South Wales and the Australian Capital Territory, and analysed
until saturation for themes.
Findings
Seven urban and six rural women were interviewed. Women and their families were all
negatively affected by antenatal transfer. Factors that helped enable a positive experience
were; enhanced sense of safety in the tertiary unit, and individual qualities of staff.
Factors that contributed to negative experiences were; inadequate and conflicting
information, and no involvement or choice in the clinical decision-making process
to move to another facility.
Conclusions
Antenatal transfer is an extremely stressful experience for women and their families.
The provision of high quality written and verbal information, and the inclusion of
women's perception of risk in the clinical decision making process will improve the
experience for women and their families in NSW and the ACT.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Women and BirthAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Patterns and outcomes of preterm hospital admissions during pregnancy in NSW, 2001–2008.Med. J. Aust. 2012; 196: 261-265
- Statewide Maternal Transfers and the PAL Service: NSW Ambulance Data Report.NSW: NSW Pregnancy and Newborn Services Network (PSN), Westmead2016
- Report from the NSW Health Maternal Transfers Workshop — 18th October 2017.NSW: NSW Government Health, Sydney2017
- Extreme to very preterm infant outcomes.J. Paediatr. Child Health. 2015; 51: 713-721
- Threatened preterm labour: an audit of twelve months of calls to the nsw and act perinatal advice line. What should we do next?.J. Paediatr. Child Health. 2018; 54: 18
- PD2011_025 In: Office of Kids and Families Maternity — Tocolytic Agents for Threatened Preterm Labour Before 34 Weeks Gestation. MoH, Sydney2011: 1-9
- Outcomes of high-risk obstetric transfers in New South Wales and the australian capital territory: the high-risk obstetric transfer study.Aust. N. Z. J. Obstet. Gynaecol. 2015; 55: 434-439
- Time to delivery: transfers for threatened preterm labour and prelabour rupture of membranes in Western Australia.Aust. J. Rural Health. 2018; 26: 42-47
- The burden and outcome of in utero transfers.Acta Paediatr. 2016; 105: 490-493
- The NICU experience: how does it affect the parentsʼ relationship?.J. Perinat. Neonatal Nurs. 2012; 26: 358-359
- Staff and parents’ experience and their perception of the premature baby: developing and implementing holistic care at the NICU.Infant Ment. Health J. 2000; 21: 344
- Accommodating families during a child’s hospital stay: implications for family experience and perceptions of outcomes.Fam. Syst. Health. 2013; 31: 294
- Family integrated care: changing the NICU culture to improve whole-family health.J. Neonatal Nurs. 2018; 24: 1-3
- Keeping parents at the centre of family centred music therapy with hospitalised infants.Aust. J. Music Ther. 2008; 19: 3-24
- The acquisition of parenting occupations in neonatal intensive care: a preliminary perspective.Can. J. Occup. Ther. 2016; 83: 91-104
- Economic consequences of over-diagnosis of threatened preterm labor.Int. J. Gynecol. Obstet. 2018; 141: 200-205
- Development and validation of a tool incorporating cervical length and quantitative fetal fibronectin to predict spontaneous preterm birth in asymptomatic high-risk women.Ultrasound Obstet. Gynecol. 2016; 47: 104-109
- The predictive value of quantitative fibronectin testing in combination with cervical length measurement in symptomatic women.Am. J. Obstet. Gynecol. 2016; 215 (793.e1-.e8)
- NSW Health NSW Perinatal Advice Line (PAL). Ministry of Health, North Sydney2013
- Luckily We Had a Torch’: Contemporary Birthing Experiences of Women in Rural and Remote NSW.2008
- Through the clients eyes: using narratives to explore experiences of care transfers during pregnancy, childbirth, and the neonatal period.BMC Pregnancy Childbirth. 2017; 17
- Role of Perceived Stress in the Occurrence of Preterm Labor and Preterm Birth among Urban Women.J. Midwifery Womens Health. 2014; 59: 374-379
- Reconceptualising risk: perceptions of risk in rural and remote maternity service planning.Midwifery. 2016; 38: 63-70
- Living with the threat of preterm labor: women’s work of keeping the baby in.J. Obstet. Gynecol. Neonatal Nurs. 2006; 35: 700-708
- The impact of resilience on psychological outcomes in women with threatened premature labor and spouses: a cross-sectional study in Southwest China.Health Qual. Life Outcomes. 2017; 15
- Can stress biomarkers predict preterm birth in women with threatened preterm labor?.Psychoneuroendocrinology. 2017; 83: 19-24
- Women’s expectations and experiences of maternity care in NSW — what women highlight as most important.Women Birth. 2014; 27: 214-219
- Satisfaction with team midwifery care for low- and high-risk women: a randomized controlled trial.Birth. 2003; 30: 1-10
- Changing models of public antenatal care in Australia: Is current practice meeting the needs of vulnerable populations?.Midwifery. 2014; 30: 303-309
- What is it about antenatal continuity of caregiver that matters to women?.Birth. 2005; 32: 262-271
- Women’s satisfaction with antenatal care: comparing women in Sweden and Australia.Women Birth. 2013; 26: e9-e14
- The stories of women who are transferred due to threat of preterm birth.Women Birth. 2017; 31: 307-312
- A theoretical model of parents’ experiences of threat of preterm birth in Sweden.Midwifery. 2008; 24: 416-424
- ‘It’s something you have to put up with’— service users’ experiences of in utero transfer: a qualitative study.BJOG. 2015; 122: A66-A
- An evaluation of the financial and emotional impact of in utero transfers upon families: a Scotland-wide audit.Infant. 2010; 6: 38-40
- Web Application for Managing, Analyzing, and Presenting Qualitative and Mixed Method Research Data.8.0.35 ed. SocioCultural Research Consultants, Los Angeles, CA2018
- Using thematic analysis in psychology.Qual. Res. Psychol. 2006; 3: 77-101
- Women’s perspectives of the fetal fibronectin testing process: a qualitative descriptive study.BMC Pregnancy Childbirth. 2014; 14: 190
Article info
Publication history
Published online: December 30, 2019
Accepted:
December 15,
2019
Received in revised form:
December 14,
2019
Received:
June 26,
2019
Identification
Copyright
© 2019 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
