COST Action Final Assessment Review (10/12/2014 to 09/12/2018)
IS1405: Building Intrapartum Research Through Health – an interdisciplinary whole system approach to understanding and contextualising physiological labour and birth (BIRTH)
This report is submitted by the Action Rapporteur in fulfilment of the requirements of the rules for COST Action Management, Monitoring and Final Assessment and is confidential to the COST Association and the Management Committee of the Action.
COST Action IS1405 has developed a sustainable, multidisciplinary network of over 120 individuals across 34 countries in the EU and beyond, including South Africa, Australia, Israel, and Chile. The network has been developed through regular meetings, workshops, training schools, and over 40 country to country exchange visits. It includes a high percentage of female (85%) and early stage researchers (60%) and 15 countries targeted by the COST inclusiveness Policy.
The Action has achieved its primary objective to improve maternal and infant wellbeing and the economic sustainability of European maternity services, by advancing scientific knowledge of the normal physiology of labour and birth through a range of disciplinary perspectives. Significant achievements are also evident for the secondary objectives, which included investigations in epigenetics and the hygiene hypothesis in relation to intrapartum events; the mechanics and bioengineering of pregnancy and labour, particularly in relation to maternal and fetal movement; socio-cultural phenomenon that contextualize labour and birth; organizational characteristics, contexts, cultures and variation in rates of interventions in childbirth; and neuro-psycho-social characteristics and effects of labour events.
This has been achieved on the basis of transdisciplinary academic and political debate about new ways of examining optimal maternity care. By December 2018 we had over 300 related outputs, including publications, presentations, workshops, videos, and educational tools, with more in progress. 15 grant applications have been submitted to national and transnational funders, and 12 have been successful to date, totalling over 1.5 million euros, in areas as diverse as psychology, engineering, medical humanities, ethics, and sociology. An unanticipated consequence of the synergy between the diverse scientific and academic disciplines has been the development of new uses of thermal imaging in pregnancy and labour, which are under investigation by members of the Action, including two midwives, an obstetrician, a psychologist, and an engineer (from Greece, the UK and Switzerland), with a prototype device already developed in collaboration with a UK SME.
The intention to learn from the best has been realised in a range of contexts. Two particular examples stand out. In Catalonia (Spain) government maternity care policy, practice, and research has been strongly and sustainably influenced by the work and international links formed in the Action. In Bulgaria, betweencountry exchange visits and input from Action members in Italy and the UK, in particular, have resulted in the offer of new kinds of maternity care to some Bulgarian women, and these initiatives are expanding within the country. These, and other service developments in other countries have been supported by the findings of the unique Babies Born Better survey which is coordinated through the Action, and which, to date, has had responses on the quality of maternity care from over 80,000 women in 66 countries and 23 languages. The survey will continue into the longer term.
Enthusiasm among Action members remains high. This has resulted in the creation of the International Birth Research and Action Association (IBRAA) which is formally registered in Spain. Action activity will continue to grow into the future through this Association.