Sue Kildea

Sue Kildea
Charles Darwin University | CDU · Molly Wardaguga Research Centre

About

179
Publications
42,776
Reads
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3,087
Citations
Additional affiliations
March 2019 - October 2020
Charles Darwin University
Position
  • Professor
March 2014 - March 2019
Mater Research Institute and University of Queensland
Position
  • Managing Director
March 2014 - March 2019
The University of Queensland
Position
  • Professor

Publications

Publications (179)
Article
Introduction The efficacy and safety of sterile water injections to manage labour back pain was demonstrated in recent clinical trials. Varying the number of injections used in the procedure from four to two has been cited as a means of possibly reducing the injection pain while maintaining analgesic effect. However, it is not known if the pain rel...
Article
Introduction Partograms with visual prompts such as Action lines are universally used to monitor labour progress. The Action line assumes a minimum rate of cervical dilation in the active phase of labour of 1 cm per hour. However, recent studies have demonstrated that normal labour progression is very variable and new partograms have been design to...
Article
Full-text available
Background Exposure to adverse experiences during pregnancy, such as a natural disaster, can modify development of the child with potential long-term consequences. Elemental hair analysis may provide useful indicators of cellular homeostasis and child health. The present study investigated (1) if flood-induced prenatal maternal stress is associated...
Article
This qualitative study explores the experiences and perceptions of new and expectant First Nations fathers in an urban setting in Australia. Little is known about the experiences of First Nations men as fathers, including their transition to fatherhood and their strengths and challenges as fathers. Eight First Nations men who were expectant or new...
Article
Background Globally, 10% of all births are preterm. Access to human milk via manual breast expression is required to reduce the incidence of adverse outcomes related to prematurity. However, there is little evidence to recommend optimum timing to commence breast expression in mothers of preterm infants or the most effective method. Research Aims (...
Article
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Background Strategies to improve outcomes for Australian First Nations mothers and babies are urgently needed. Caseload midwifery, where women have midwife-led continuity throughout pregnancy, labour, birth and the early postnatal period, is associated with substantially better perinatal health outcomes, but few First Nations women receive it. We a...
Article
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The COVID-19 pandemic has impacted perinatal mental health globally. We determined the maternal factors and pandemic-related experiences associated with clinically significant perinatal (pregnant and post-partum) depressive symptoms in Australian women. Participants (n = 2638; pregnant n = 1219, postnatal n = 1419) completed an online survey (Augus...
Article
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Background: The safety of waterbirth is contested because of the lack of evidence from randomized trials and conflicting results. This research assessed the feasibility of a prospective study of waterbirth (trial or cohort). Methods: We conducted a prospective cohort study at an Australian maternity hospital. Eligible women with uncomplicated pr...
Article
Background Documentation and assessment of progress in labour using a partograph is recommended by the World Health Organisation to assist in the timely recognition of labour dystocia. Recent studies have tested new designs of partographs that aim to account for more variable rates of labour progress. However, other studies have suggested that poor...
Article
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Background Up to 80% of women use some form of pharmacological analgesia during labour and birth. The side effects of pharmacological agents are often incompatible with the concurrent use of non-pharmacological pain-relieving strategies, such as water immersion, ambulation and upright positioning, or may have negative effects on both the mother and...
Article
Background Recent trials demonstrated the safety and efficacy of sterile water injections to provide relief from labour back pain. While four injections is the most common approach variations in technique, such as employing two injections, are also used. Aim To determine if the analgesic effect of two sterile water injections is clinically equival...
Article
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Background The Australian Nurse Family Partnership Program (ANFPP) is an evidence-based, home visiting program that offers health education, guidance, social and emotional support to first-time mothers having Aboriginal and/or Torres Strait Islander (First Nations) babies. The community-controlled sector identified the need for specialised support...
Article
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In this study we examine whether specific ‘anxiety-maintaining’ parenting behaviors (i.e., overinvolvement and/or negativity) exacerbate the effects of disaster-related prenatal maternal stress (PNMS) on school-age anxiety symptoms. Women (N = 230), pregnant at the time of the 2011 Queensland Floods, reported on their experience of flood-related PN...
Article
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Context: Little is known about sexual and reproductive health (SRH) access and health promotion for First Nations peoples in Australia. This study aimed to better understand community preferences, knowledge and access to contraception and SRH services, and use this understanding to make recommendations which support approaches led by local Aborigi...
Article
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In this call to action, a coalition of Indigenous and non-Indigenous researchers from Australia, Aotearoa New Zealand, United States and Canada argue for the urgent need for adequately funded Indigenous-led solutions to perinatal health inequities for Indigenous families in well-resourced settler-colonial countries. Authors describe examples of suc...
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Background There is an urgency to redress unacceptable maternal and infant health outcomes for First Nations families in Australia. A multi-agency partnership between two Aboriginal Community-controlled health services and a tertiary hospital in urban Australia designed, implemented, and evaluated the new Birthing in Our Community (BiOC) service. I...
Article
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Background & problem Birthing On Country (BOC) is an international movement for returning childbirth to First Nations peoples and their communities. The RISE Framework was developed to guide evidence-based BOC implementation but has not yet been tested in a remote Australian community setting. Aim To test the transferability and acceptability of t...
Article
Background Limited research has evaluated distinct aspects of disaster experience as predictors of affective symptoms. In this study, we examined the extent to which maternal depression and anxiety over time were predicted by (1) objective hardship from a flood during pregnancy, (2) peritraumatic distress and (3) cognitive appraisal of the flood's...
Article
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Background: About a third of women experience severe back pain during labour. Injecting small volumes of intracutaneous sterile water into the lumbar region can be used to relieve this pain, however the procedure is controversial and previous reviews call for high quality trials to establish efficacy. We evaluated the impact on birth outcomes and...
Article
Background The fetal programming hypothesis suggests that prenatal maternal stress (PNMS) influences aspects of fetal development, such as the Hypothalamic Pituitary Adrenal (HPA) axis, enhancing susceptibility to emotional problems. No study (to our knowledge) has investigated this pathway considering development of preschool anxiety symptoms. Usi...
Article
Introduction This study investigated how coping strategies moderated the impact of disaster-related objective hardship on subjective distress in pregnant women. Methods The objective hardship (exposure severity), subjective distress (Peritraumatic Distress Inventory, Peritraumatic Dissociative Experiences Questionnaire and Impact of Event Scale-Re...
Article
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Background: The measurement and interpretation of patient experience is a distinct dimension of health care quality. The Midwives @ New Group practice Options (M@NGO) randomized control trial of caseload midwifery compared with standard care among women regardless of risk reported both clinical and cost benefits. This study reports participants' p...
Article
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Remote-living Aboriginal and Torres Strait Islander women experience a higher burden of influenza infection during pregnancy than any other Australian women. Despite recommendations of inactivated influenza vaccination (IIV) in pregnancy, uptake and safety data are scarce for this population. We examined uptake of IIV in pregnancy and report advers...
Article
Australian policy encourages multiagency partnerships between hospitals and Aboriginal Community Controlled Health Organisations to improve the health of Aboriginal and Torres Strait Islander people. Service planners remain unsure about how to implement such partnerships in maternity care, and there is a lack of appropriate tools designed to gauge...
Article
Background: Birthing on Country is an international movement to return maternity services to First Nations communities and community control for improved health and wellbeing. Question: How can we implement Birthing on Country services for Aboriginal and/or Torres Strait Islander families across Australia? Methods: We have developed a framewor...
Article
Problem It is not well known how to prepare new multidisciplinary teams aiming to provide culturally safe maternity care for Aboriginal and Torres Strait Islander families in an urban setting. Background National policies recommend increasing the Aboriginal and Torres Strait Islander workforce and cultural competencies of the non-Indigenous workfo...
Article
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It is not known whether alterations to temperamental characteristics associated with prenatal maternal stress (PNMS) exposure account for the development of childhood anxiety symptomatology (internalizing behaviors and anxiety symptoms). The QF2011 Queensland flood study examined whether (1) toddler temperamental characteristics explained the assoc...
Article
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Background: Prevention of avoidable preterm birth in Aboriginal and Torres Strait Islander (Indigenous) families is a major public health priority in Australia. Evidence about effective, scalable strategies to improve maternal and infant outcomes is urgently needed. In 2013, a multiagency partnership between two Aboriginal Community Controlled Hea...
Article
Problem: Women increasingly present to hospital in early labour, but admission before active labour contributes to overuse of interventions, poorer clinical and psychological outcomes, and higher healthcare costs. Background: Innovative models of early labour care have so far not improved birth outcomes. Aim: To examine if reconfiguring the ea...
Article
Objectives: The aim of this systematic review was to identify the effectiveness of breast massage as a treatment for women with breastfeeding problems. More specifically, the objective was to identify if breast massage as an intervention led to less pain or increased milk supply, or assisted in a reduction or resolution of blocked ducts, breast en...
Article
This study utilized a natural disaster to investigate the effects of prenatal maternal stress (PNMS) arising from exposure to a severe flood on maternally reported infant social–emotional and behavioral outcomes at 16 months, along with potential moderation by infant sex and gestational timing of flood exposure. Women pregnant during the Queensland...
Article
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Background: With persisting maternal and infant health disparities, new models of maternity care are needed to meet the needs of Aboriginal and Torres Strait Islander people in Australia. To date, there is limited evidence of successful and sustainable programs. Birthing on Country is a term used to describe an emerging evidence-based and communit...
Article
The 5-HTTLPR polymorphism of the serotonin transporter has been shown to play a role in autism spectrum disorders (ASD). Moreover, disaster-related prenatal maternal stress (PNMS) has also been shown to be associated with ASD. However, no study to date has examined whether these two factors, either individually or in combination, are predictive of...
Article
Background: The use of sterile water injections (SWI) for the relief of pain in labour is popular amongst midwives in countries such as Sweden and Australia. Anecdotal reports suggest the procedure is used less commonly in the United Kingdom (UK) and that a number of barriers to introducing the practice may exist. Objective: The objective of this s...
Article
Background: Awareness of the impact of the built environment on health care outcomes and experiences has led to efforts to redesign birthing environments. The Birth Unit Design Spatial Evaluation Tool was developed to inform such improvements, but it has only been validated with caseload midwives and women birthing in caseload models of care. Aim...
Article
Aim: To compare the effect of directed or spontaneous maternal pushing effort on duration of second stage labour, perineal injury and neonatal condition at birth. Methods: A retrospective cross-sectional design provided data for term women with singleton, cephalic presentation experiencing a non-operative vaginal birth without regional analgesia...
Technical Report
Full-text available
This report was a part of the Remote Area Birthing Project in the Northern Territory which aimed to develop an approach to birthing in the Top End which would improve birth outcomes and experiences for Aboriginal people and improve the quality of hospital and remote community based services. This consultation was with remote based Aboriginal women...
Article
It is possible that findings suggesting a link between prenatal maternal stress (PNMS) and anxiety symptoms in offspring are confounded by postnatal and/or shared mother–child heritability effects. Following exposure to a natural disaster, the Queensland Flood Study investigated the unique and additive effects of various types of disaster-related P...
Article
This prospective, longitudinal cohort study examined the effects of flood‐related stress in pregnancy on the trajectory of children's motor development; and the moderating effects of gestational timing of the flood or sex of the child. Women who were pregnant during a severe flood reported on their objective flood‐related experiences, emotional rea...
Article
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Background Research shows that continuity of midwifery carer in pregnancy improves maternal and neonatal outcomes. This study examines whether midwifery group practice (MGP) care during pregnancy affects infant neurodevelopment at 6-months of age compared to women receiving standard hospital maternity care (SC) in the context of a natural disaster....
Article
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In 2012, a tertiary neonatal intensive care unit (NICU) transitioned from an open plan (OP) to a dual occupancy (DO) NICU. The DO design aimed to provide a developmental appropriate, family-centered environment for neonates and their families. During planning, staff questioned the impact DO would have on staff workflow and activity. To explore the...
Article
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Poor postnatal mental health is a major public health issue, and risk factors include experiencing adverse life events during pregnancy. We assessed whether midwifery group practice, compared to standard hospital care, would protect women from the negative impact of a sudden-onset flood on postnatal depression and anxiety. Women either received mid...
Article
Background: Clinicians hand position and advised pushing techniques may impact on rates of perineal injury. Objective: To assess the association of four techniques used in management of second stage with risk of moderate and severe perineal injury. Design: Retrospective cross-sectional study. Setting: A metropolitan maternity hospital and a...
Article
We investigated the effects of a natural disaster (a sudden flood) as a source of prenatal maternal stress (PNMS) on the placental glucocorticoid system and glucose transporters. Whether the gestational age at the time of the flood moderated these effects was also evaluated. Placental samples were collected from participants in the 2011 Queensland...
Article
Full-text available
Backgound Partographs are used in many labour settings to provide a pictorial overview of a woman’s cervical dilation pattern in the first stage of labor and to alert clinicians to slow progress possibly requiring intervention. Recent reviews called for large trials to establish the efficacy of partographs to improve birth outcomes whilst highlight...
Article
Full-text available
Background: The right to refuse medical treatment can be contentious in maternity care. Professional guidance for midwives and obstetricians emphasises informed consent and respect for patient autonomy, but there is little guidance available to clinicians about the appropriate clinical responses when women decline recommended care. Objectives: W...
Article
Background: About 30% of women in labour suffer from lower back pain. Studies of sterile water injections for management of low back pain have consistently shown this approach to be effective. The objective of this evidence-based guide is to facilitate the clinical use of sterile water injections to relieve lower back pain in labouring women. Met...
Article
Aim: The aim of this study was to investigate the maternity care factors associated with exclusive breastfeeding duration at three months and six months postpartum in a setting without BFHI accrediation. Methods: A prospective cohort design. Participants from one tertiary maternity hospital were eligible if they intended to exclusively breastfee...
Article
Background: Prenatal maternal stress exposure has been linked to sub-optimal developmental outcomes in toddlers, while maternal emotional availability is associated with better cognitive and language abilities. It is less clear whether early care-giving relationships can moderate the impact of prenatal stress on child development. The current stud...
Article
Problem: There is increasing demand for capacity building among the Aboriginal and Torres Strait Islander (Indigenous) maternal and infant health workforce to improve health outcomes for mothers and babies; yet few studies describe the steps taken to mentor novice Indigenous researchers to contribute to creating a quality evidence-base in this spa...
Article
Introduction: In Australia, many small birthing units have closed in recent years, correlating with adverse outcomes including a rise in the number of babies born before arrival to hospital. Concurrently, a raft of national policy and planning documents promote continued provision of rural and remote maternity services, articulating a strategic in...
Article
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Developing high quality and culturally responsive maternal and infant health services is a critical part of ‘closing the gap’ in health disparities between Aboriginal and Torres Strait Islander people and other Australians. The National Maternity Services Plan led work which describes and recommends Birthing on Country best practice maternity care...
Article
Objective: To explore midwives' experiences of administering sterile water injections (SWI) to labouring women as analgesia for back pain in labour. Design: A qualitative study, which generated data through semi-structured focus group interviews with midwives. Data were analysed thematically. Setting: Two metropolitan maternity units in Queens...
Article
Full-text available
Background: pregnant women, like all competent adults, have the right to refuse medical treatment, although concerns about maternal and fetal safety can make doing so problematic. Empirical research about refusal of recommended maternity care has mostly described the attitudes of clinicians, with women's perspectives notably absent. Design: femi...
Article
Background: The teenage pregnancy rate is high among Indigenous Australian women, yet little is known about their pregnancy outcomes. Moreover, against a background of extreme social disadvantage, the relative importance of age as a risk factor for adverse outcomes among Indigenous pregnancies is unclear. We compared perinatal outcomes for Indigen...
Article
Fetal exposure to prenatal maternal stress can have lifelong consequences, with different types of maternal stress associated with different areas of child development. Fewer studies have focused on motor skills, even though they are strongly predictive of later development across a range of domains. Research on mechanisms of transmission has ident...
Article
Objective: To identify the risk factors for preterm birth, low birthweight and small for gestational age babies among remote-dwelling Aboriginal women. Methods: The study included 713 singleton births from two large remote Aboriginal communities in Northern Territory, Australia in 2004-2006 (retrospective cohort) and 2009-2011 (prospective cohor...
Article
Objective: This study examined the effects of disaster-related prenatal maternal stress on infant temperament and whether the sex of the infant or the timing of the stressor in pregnancy would moderate the effects. Methods: Mothers' objective experiences of a sudden-onset flood in Queensland, Australia, their subjective emotional reactions, and...
Article
Full-text available
Background In Australia the health outcomes of remote dwelling Aboriginal infants are comparable to infants in developing countries. This research investigates service quality, from the clinicians? perspective and as observed and recorded by the researcher, in two large Aboriginal communities in the Top End of northern Australia following health sy...