The Maternity and Newborn Learning Health Network (MNLHN) brings together consumers, clinicians and researchers to improve safety and quality of healthcare, experiences and outcomes for women receiving maternity care in Victoria. The MNLHN’s goal is to drive safety and quality to improve the maternity care for women, babies, and families by partnering with consumers, clinicians, and researchers.
Consumer lead: Bronwyn Hogan
Bronwyn Hogan, our MNLHN Consumer Lead, is dedicated to creating positive change in Victoria's healthcare system. Bronwyn has a powerful personal story, having experienced loss and other pregnancy complications. She is committed to amplifying patients' and family/carers' voices and encouraging collaboration between patients and health service staff to improve care for all. Bronwyn brings a combination of professional expertise and personal experience to her role, is passionate about rural perspectives, continuous improvement, and empowering others to share their stories.
Clinical lead: Dr Penny Sheehan
Dr. Penny Sheehan, the Clinical Lead of the MNLHN has a keen interest in studying the complexities of labour and working with women at high risk of preterm birth as well as over 20 years of experience in safety and quality in public maternity services, Dr. Sheehan is well placed to enhance care for mothers and newborns. In her role, Dr. Sheehan values consumer involvement and is leading work to ensure a patient-centred approach and safer, more compassionate Victorian maternity care.
Advisory group: The MNLHN Advisory Group is co-chaired by our Consumer Lead, Bronwyn Hogan and our Clinical Lead, Dr Penny Sheehan. Membership consists of clinicians (obstetricians, midwives, neonatologists, neonatal nurses consumers, health system leaders and improvement specialists). The MNLHN Advisory Group drives and facilitates purposeful consumer and sector engagement, provides advice on work of the LHN with a focus on system level issues, and provides advice to support SCV and the Department of Health (DH).
Data group: The MNLHN Data Group is chaired by A/Prof Alexis Shub. Membership consists of clinicians, consumers, data experts, researchers, and academics. The MNLHN Data Group provides expertise on data analytics including identification, interpretation, and use of data to support the work of the LHN.
For more information, contact firstname.lastname@example.org.
Clinical Conversation: Placenta previa and accreta – keeping out of trouble
Join us for our clinical conversation exploring the diagnosis and management of placenta previa and accreta – Tuesday 13 February 2024, 2:00 pm - 3:00 pm AEDT.
Hear from Dr Michael Bethune about the optimal timing of ultrasounds, what features are concerning for acreta, when tertiary ultrasound opinion is required and when an MRI is suggested.
Acting Professor Alexis Shub will discuss the role of Paediatric Infant Perinatal Emergency Retrieval (PIPER) Perinatal transfer for women with placenta previa and antepartum haemorrhage. Based on recently published Victorian data, consideration of which women need to be transferred to a higher level of care, and which women can safely be cared for closer to home will be discussed.
For what to do when it all goes wrong, Dr Neil Israelsohn will share the tips and tricks for surgical management of placenta previa and placenta acreta, and what to do when acreta is diagnosed unexpectedly at caesarean section.
MNLHN Improvement Program
We have now launched our MNLHN Improvement Program, which aims to build improvement capability and drive improved outcomes for women, babies and families. This continues the work done in the Safer Baby and Better Births collaboratives. We are delighted to be working with six maternity services in the MNLHN Improvement Program Pilot phase 1 from October 2023 – January 2024.
We will be seeking Expressions of Interest for the MNLHN Improvement Program Pilot Phase 2 in the New Year. If your health service is interested in learning more or would like to participate, please watch the information session recording and read the Information Pack.
The MNLHN is committed to partnering and engaging with consumers, clinicians, and researchers to drive sustained improvements from previous SCV led large-scale maternity projects.
Reducing severe perineal tears
Women having their first birth vaginally in Victoria are four times more likely to experience a severe perineal laceration (third- or fourth-degree tear) compared to those having a subsequent birth vaginally (Victorian perinatal services performance indicators 2018–19 report). This can have devastating long-term or lifelong impacts on physical and psychological wellbeing. Many of these tears are avoidable.
During 2019 to 2021, SCV teamed up with the Institute for Healthcare Improvement (IHI) and 14 health services to improve outcomes for mothers and their babies, using the IHI’s proven Model for improvement. Drawing on the Women’s Healthcare Australasia Perineal Protection Bundle, SCV working in partnership with maternity services and tested and spread evidence-based care bundles to reduce third- and fourth-degree perineal tear rates.
Work focused on five clinically endorsed interventions:
- Warm compresses
- Encourage a slow controlled birth: using hands on technique
- Correct episiotomy technique used when indicated
- Comprehensive assessment for perineal tears
- Accurate severity grading of perineal tears
Research suggests that many stillbirths may be avoidable and there is low awareness of the risk factors for stillbirth. During 2019 to 2021, SCV teamed up with the Institute for Healthcare Improvement (IHI), the Stillbirth Centre for Research Excellence (CRE) and 15 health services to improve outcomes for mothers and their babies, using the IHI’s proven Model for Improvement.
SCV working in partnership with maternity services, tested and spread evidence-based clinical care to reduce the rates of stillbirth, focussing on five areas of practice:
- promoting smoking cessation
- detection and management of fetal growth restriction (FGR)
- management of decreased fetal movements
- promoting optimal maternal sleep position
- shared decision-making around timing of birth
Future priorities include:
- Postpartum haemorrhage collaborative (coming to the MNLHN in 2024)
- Preterm birth collaborative (coming to the MNLHN in 2024)
- Reducing maternity readmissions
- Birth suite safety culture
|12 December 2023
|Clinical Conversation: Movements really do matter
|14 November 2023
|Women's Health Australasia Perineal protection bundle - The 5 bundle elements
|10 October 2023
|Fetal Growth Restriction
|5 September 2023
|Decision making around timing of birth
|11 July 2023
|Sustaining improvement lessons learned from Health Services
|5 June 2023
|Dhelkaya Health (Castlemaine) - learnings from a new maternity model of care
|13 December 2022
|19 October 2022
|Caesarean section surgical site infections in Victorian hospitals
|10 August 2022
|Interventions for vaccine preventable infections in pregnancy
|13 July 2022
|Reducing pain in newborns during painful procedures: Evidence, practices and education
|11 May 2022
|19 April 2022