* The Tilly's Tracks project included pregnant Indigenous women who: were smokers; agreed to participate; attended for their first
antenatal care visit before 20 weeks» gestation; were Townsville residents; did not have mental illness; and were not being treated for the use of any substance other than tobacco.
Of the 302 pregnant Indigenous women, 71.9 % identified as Aboriginal, 17.2 % as Torres Strait Islanders and 10.9 % as both, and 201 (66.6 %) self - reported current tobacco use at their first
antenatal care visit.
Suitable drugs for intermittent preventive treatment during pregnancy (IPTp) must be safe for the mother and the fetus and able to be given during regular
antenatal care visits while providing long - lasting protection.
Not exact matches
The packages had a range of components including additional training for lay health workers and other outreach workers, building community support, community mobilisation,
antenatal and intrapartum home
visits, and home - based
care and treatment.
Other community - based intervention packages that may reduce neonatal mortality include home - based neonatal
care and treatment and education of mothers and
antenatal and postnatal
visits (low - certainty evidence).
Experimental: women randomised to midwife - led
care (MLU) received
antenatal care from midwives and, if desired, from their GPs for some
visits.
One compared volunteer counsellor support in
antenatal and postnatal period to usual
care (Graffy 2004), one compared proactive with reactive telephone support for mothers living in disadvantaged circumstances (Hoddinott 2012), one compared breastfeeding support and encouragement for mothers of preterm infants to usual
care (Junior 2007), one compared home nurse
visits to usual
care for «well» breastfeeding newborns and mothers (Paul 2012), one compared prenatal paediatric home
visits to usual
care (Serwint 1996), and one compared support from a close female confidante to usual
care (Winterburn 2003).
Control: «Routine
antenatal care which also included a home
visit to discuss breastfeeding, although this was without a female confidante», n = 42.
24 randomised and 2 non-randomised trials of intervention packages, including mainly: building community - support or women's groups (9 studies), community mobilisation and
antenatal and postnatal home visitation (7 studies), community mobilisation and home - based neonatal treatment (1 study), training traditional birth attendants who made
antenatal and intrapartum home
visits (2 studies), home - based neonatal
care and treatment (2 studies), and education of mothers and
antenatal and postnatal visitation (2 studies)
Such
visits were dependent on women's risk status during pregnancy (Biro 2000); routine for all women (one to three
visits)(Flint 1989; Harvey 1996; Kenny 1994; MacVicar 1993; McLachlan 2012; Rowley 1995; Waldenstrom 2001), or based on the development of complications (Hicks 2003; Tracy 2013; Turnbull 1996) or
antenatal care from midwives and, if desired by the woman, from the woman's general practitioner (Begley 2011).
Intervention 2: postnatal lactation support: in addition to routine
care, women received 2 postnatal sessions with a LC, 1 in hospital within the first 3 postnatal days (when they received the same printed guides on breastfeeding as the
antenatal education group) and 1 during the first routine postnatal
visit 1 to 2 weeks after the birth.
An assessment of midwife salaries from the first
antenatal visit up to and including labour and delivery
care resulted in a cost of $ 653 for each team
care woman and $ 688 for each routine
care woman.
A difference of least 25 % in access to
antenatal care (of at least four
visits) between the most and least educated and between the richest and poorest.
The importance of the content and quality of routine
antenatal care should not be lost to policymakers when decisions about numbers of
visits with the available resources are being made.»
In all 16 studies, IPV was negatively associated with initiation of
antenatal care, number of
visits or use of a skilled provider.
Second, fewer women
visited the clinic for
antenatal care during the recruitment period than expected, resulting in fewer than expected participants, hence the power of the study to detect differences in characteristics between smokers and non-smokers was reduced — the study only had adequate power to detect differences of about 23 % between groups.
Since 2000 the Townsville Aboriginal and Islander Health Service's Mums and Babies Project increased the numbers of women presenting for
antenatal care (from 40 to over 500
visits per month in 1 year).