Ballarat part of national project to reduce premature births

Grampians Health Ballarat is one of 63 hospitals signed up to the Australian Preterm Birth Prevention Alliance which is a world-first attempt to reduce pre-term births as a nation.

Pre-term birth, defined as a baby born before 37 weeks of pregnancy, and early term birth, which occurs between 37 and 39 weeks gestation, can pose significant health risks for both mothers and infants and research has shown babies delivered from 39 weeks have the best health and educational outcomes.

The goal of the alliance, which began in 2022 and runs until March 2024, is to support as many women through to 39 weeks as possible.

Grampians Health clinical director - women and children's services Dr Natasha Frawley said participating hospitals had seven evidence-based strategies they could tailor to their population of pregnant women to help reduce pre-term births.

At Grampians Health Ballarat the focus is on supporting pregnant women to stop smoking, measuring cervical length at a mother-to-be's 20 week scan, avoiding planned births before 39 weeks without a clear medical indication, and for women to see the same care provider for at least half of their ante-natal appointments.

"Defining (full) term as being 37 weeks is actually just based on birthweight data and not based on how baby does or what is the best time to be born for baby and mum," Dr Frawley said.

"In terms of school performance and breast feeding success, it's better if women can get to 39 weeks before having a baby."

A big part of that is shared decision making and improving communication about when the ideal time is for each woman to have their baby, explaining that 39 weeks gives baby the best start at life.

Women who smoke, which has been shown to cause complications during pregnancy and increase the risk of premature labour, are encouraged to quit with Ballarat Base Hospital's pharmacy department partnering to ensure nicotine replacement is available to pregnant women.

A woman's cervix is measured at the 20 week ultrasound and if found to be 25mm or less, which leads to a high chance of pre-term birth, the woman is given a progesterone supplement, a safe hormone that pregnant women naturally produce but sometimes not enough.

"For some people, supplementing with progesterone allows the pregnancy to get to term," Dr Frawley said.

"Not all pharmacists stock progesterone and it's unaffordable for some so to reduce the burden of costs we are getting starter packs from drug companies to allow more access."

Another key to reducing premature birth is continuity of antenatal care, something Dr Frawley admits can be a challenge in a big organisation with a lot of staff.

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"Our aim is to have 50 per cent of pregnancy visits with one care provider ... which has this flow-on effect and while our aim is to reduce pre-term birth, seeing the same provider increases the positive pregnancy experience," Dr Frawley said.

To help achieve this, the hospital has introduced a Birth Liaison Midwife (BLM) who serves as a central coordinator for all planned births at Ballarat and plays a key role in streamlining all the booking requests.

The BLM also reviews the requests against clinical guidelines, and ensures that the timing of birth aligns with medical recommendations rather than calendar availability or workflow issues.

Dr Frawley said the work of the alliance would not only reduce pre-term births, but improve pregnancy outcomes for all women.

On Tuesday, Associate Professor Stefan Kane from Safer Care Victoria, and Professor John Newnham from the Australian Preterm Birth Prevention Alliance visited Ballarat Base Hospital to celebrate the achievements and talk with staff and clinicians.

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