Variation in practice following altered fetal movement v1.0
Research type
Research Study
Full title
Preventing avoidable stillbirth: what influences clinician's practice following women's reports of altered fetal movement?
IRAS ID
235024
Contact name
Julia Clark
Contact email
Sponsor organisation
University of Leicester
Duration of Study in the UK
1 years, 9 months, 27 days
Research summary
Why - The UK’s stillbirth rate has been compared unfavourably to that of other high-income countries. Stillbirth and altered fetal movement are linked to a common pathology, placental insufficiency. Surveys of midwives and obstetricians reveal wide variation in practice relating to altered fetal movement, and poorly managed episodes of altered fetal movement are an important contributory factor to avoidable stillbirth. However, there remains a lack of observational data on how altered fetal movement is managed in practice.
What - This study aims to generate rich data about the situations in which practice relating to the management of altered fetal movement evolves, and generate discussion about facilitators and barriers to the implementation of relevant clinical guidelines.
How, who and where - An ethnographic approach combining observation, interviews and document analysis in two stages at two sites. Between December 2017 and June 2018, the researcher will visit two NHS maternity units twice to observe care interactions relating to altered fetal movement, and related unit-level activity (e.g. training days, team handovers). Observation work will focus on pregnant women attending Day Assessment Units with a primary complaint of altered fetal movement, and will include interactions between women and midwives, and (when required) obstetrician and sonographer input. Approximately 30 cases will be observed at each site, and where possible women will be followed through until discharge / admission. Documented care plans will be reviewed to learn about how observed interactions are captured in the women’s notes. Approximately 20 midwives, obstetricians, and sonographers will also be interviewed at each site, where possible following observation of their work. Interviews with be digitally recorded and transcribed verbatim. Interview transcripts, documents relating to fetal movement (i.e. care pathways, guidelines), women's documented care plans, and field notes will be analysed using modified constant comparison supplemented by analytic mapping.REC name
North East - Tyne & Wear South Research Ethics Committee
REC reference
17/NE/0347
Date of REC Opinion
9 Nov 2017
REC opinion
Favourable Opinion