Women's Health & Outcomes

At NPEC research on women's health and outcomes in maternity services encompasses various areas, including maternal mortality and morbidity, prenatal care effectiveness, labor and delivery practices, postpartum care quality, maternal mental health, lifestyle factors, maternal-fetal medicine, health disparities, patient-centered care, and health policy.

Wellbeing of Women after Birth

Pregnancy and childbirth are often a positive and fulfilling experience, however for some women this is not always the case. Some women might experience potential traumatic events arising from complications during the pregnancy, birth (or afterwards) which can affect them, their babies and loved ones after birth.
The impact of such traumatic events often remains silent and at times overlooked. There is very little research that has focused on how to effectively identify women affected by them and ensure the required and adequate supports are provided.
This study will provide a better understanding of women’s experiences and enhance the supports, ensuring that individuals are provided with the care they require after birth. This research is being conducted by the National Perinatal Epidemiological Centre (NPEC) in University College Cork, based in Cork University Maternity Hospital (CUMH) with Prof. Richard Greene as the Principal Investigator and in collaboration with the Perinatal Mental Health Services, the Social Work Team.

Development of a care pathway following a Primary Postpartum Haemorrhage

Care Pathway Development following Primary Postpartum Haemorrhage

The aim of this research is to identify a structured approach that incorporates the woman’s physical, informational and emotional needs following a Primary Postpartum Haemorrhage.
The care pathway would be developed from listening to the woman’s experience and including staff midwives professional experience of optimum care for women. This may enhance the woman’s experience and also assist midwives in the clinical area with their daily care.

Healthcare Professionals Awareness of Postpartum Depression and its Impact on Infant Mental Health

Studies on infant mental health have shown that early infant and childhood experiences are important in determining an individual’s mental and physical health throughout their life.
Maternal postpartum depression is known to have negative impacts on an infant’s mental health. This can manifest in the form of attachment insecurity, behavioural problems, and impaired social and emotional development. However, early identification and appropriate intervention can prevent future health issues for both mother and infant.
The current study aims to address these aspects. This project will explore the level of knowledge and perceptions held by health professionals on postpartum depression and infant mental health.
This project will give a clearer understanding of the perceptions, attitudes and level of knowledge held by health professionals on postpartum depression and infant mental health. It will also indicate potential need for further awareness and training. It is essential that healthcare professionals have appropriate understanding of theseissues, to adequately inform and support mothers who might be experiencing postpartum depression.

Quantification of Obstetric Blood Loss

Postpartum haemorrhage (PPH) is heavy bleeding after birth. If heavy bleeding does occur, it is important that it is recognized very quickly so that a minor haemorrhage doesn’t become a Massive/Major Obstetric Hemorrhage (MOH), which can be life-threatening.
In association with the Stryker Instruments Innovation Centre in Cork, we are developing a machine to assist midwives or doctors in measuring blood loss rapidly and accurately.

Experiences in an Early Pregnancy Unit in a tertiary maternity hospital in Ireland

The aim of this project is to assess the level of satisfaction of both service users attending, and staff working in, the dedicated Early Pregnancy Unit (EPU) at Cork University Maternity Hospital (CUMH). This will ensure that the unit and the care being provided is addressing the needs of its service users and the staff involved.
In 2007, the dedicated early pregnancy unit (EPU) at Cork University Maternity Hospital (CUMH) was established.
The clinic operates Monday to Friday, in the mornings, and reviews over five thousand women per annum. The EPU is staffed by one administrator, one non consultant hospital doctor and two midwife sonographers and is dedicated to the assessment of early pregnancy and its complications. Women are referred to the unit from their general practitioner or from other clinical areas of the CUMH based on symptoms/signs concerning for early pregnancy complications.
A confidential and anonymous survey was developed to gather the perceptions of those accessing the EPU, their level of satisfaction with it and their views/suggestions for improvement. Additionally, staff working on the EPU were also asked to complete a survey, again to gather their experiences and perceptions of working in the EPU and their views/suggestions for improvement of this service.
The information from this study, will provide relevant information on the views of, not only the individuals using the EPU, but also those working in it. This will allow us to identify areas for improvement in service provision and ensure high-quality of care. By analysing staff’s views and satisfaction on their working conditions, it will be possible to identify potential issues and address these contributing to improved wellbeing at work for this staff and ultimately benefit future patient care.

Retrospective review of tubal ectopic pregnancy in a tertiary maternity unit in Ireland

Ectopic pregnancy is where a pregnancy develops in an abnormal location. Most ectopic pregnancies occur within the fallopian tube (tubal ectopic pregnancy) and untreated may result in serious complications including blood transfusion, injury at surgery and even death. Ectopic pregnancy remains the leading international cause of death in the first trimester of pregnancy.
Our aim is to identify and review the diagnosis and management of tubal ectopic pregnancy in a maternity unit in the Republic of Ireland.
Data (from 2020 – 2022) was gathered from the electronic health records of women diagnosed with tubal ectopic pregnancy. Details on the socio-demographic and characteristics of the women and pregnancy, information on the care they were provided and their outcomes was analysed.
Through recognition of adverse outcomes associated with ectopic pregnancy it is possible to identify areas for improvement in service provision, staff education and ultimately benefit future patient care and outcomes.

To Operate or not to Operate? Challenges in diagnosis and management of an interstitial ectopic pregnancy

A 44 year old woman presented for routine early pregnancy ultrasound where findings were suspicious for a tubal ectopic pregnancy. A diagnostic laparoscopy and uterine curettage were both negative. A subsequent transvaginal ultrasound confirmed a non-viable interstitial ectopic pregnancy. Conservative management was employed as she remained haemodynamically stable with reducing serum βhCG. Following ten weeks, her serum βhCG normalised and she was discharged.
Interstitial ectopic pregnancy is a rare form of tubal ectopic pregnancy where implantation occurs within the proximal tubal segment that lies within the muscular uterine wall. Diagnosis may be challenging and is often delayed, thus resulting in increased morbidity than with other forms of tubal ectopic pregnancy. Management of interstitial ectopic pregnancy has traditionally been surgical with laparotomy and uterine wedge resection. Earlier diagnosis of smaller, non-ruptured haemodynamically stable cases has facilitated medical management approaches, while in non-viable cases conservative management has emerged as a treatment option.

Planned Home Births in Ireland Research

Exploring maternal pushing techniques and perineal trauma in Home Births: A comparative analysis of Irish and American women, 2012-2021
Maternal and infant outcomes of women who labour at home in Ireland: Insights from a Planned Home Births National Clinical Audit, 2012-2021
Comparing Maternal and Neonatal Outcomes of Planned Home Births and Hospital Births in the Republic of Ireland: A Retrospective Cohort Study, 2012-2021

Systemic methotrexate in early pregnancy.

Systemic methotrexate in early pregnancy

Methotrexate (MTX) is a medication used to treat early pregnancy complications such as ectopic pregnancies, where the embryo implants outside the uterus.
This study aimed to review the use of MTX in the first trimester at Cork University Maternity Hospital and to assess the outcomes for patients.
This study concluded that MTX works well for treating tubal ectopic pregnancies. However, extra caution is needed when using MTX for other pregnancy issues to make sure it's safe and effective.

New Mothers’ Experiences and Opinions of Breastfeeding Supports Provided by Hospital Staff at CUMH

Learn more about this project

Ireland has one of the lowest breastfeeding initiation rates around the world. Despite a consistent message from Irish Health Professionals that exclusive breast feeding is beneficial for both mother and baby Ireland’s breastfeeding rates remain stubbornly low.
The primary aim of the research is to identify hospital staff practices at Cork University Maternity Hospital that positively impact breastfeeding initiation rates, based on the lived experiences of new mothers. Secondary objectives include exploring women's opinions on breastfeeding, cultural and lifestyle factors, and effective educational sources.
The study will employ a qualitative design using Reflexive Thematic Analysis. Semi-structured interviews will be conducted, recorded, transcribed, and analyzed to identify key themes related to breastfeeding practices and experiences.

National Perinatal Epidemiology Centre

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