Mother and Infant Research Unit MIRU Department of Health Sciences University of York November 2005

Mother and Infant Research Unit Staff and funding ~ 20 staff/students –3 academic posts, 1 support post university funded –9 research staff –4 support staff –1 NHS secondment –4 PhD students Collaborations with academic, professional, NHS, consumer colleagues locally, nationally, internationally External income –~ £1 million total –~ £500k annually Sources –NHS R&D –NICE –ESRC –MRC –FSA –DH –Health Foundation –Local NHS Trusts

Mother and Infant Research Unit …. to contribute to improvement in the health and well-being of childbearing women, their babies and families

Maternal and Infant Health Many interventions with the ‘best chance of reducing health inequalities in mental and physical health relate to parents, particularly present and future mothers, and children’ (Acheson 1998)

Mother and Infant Research Unit Research Education (undergraduate midwifery programmes, Masters, PhD) Practice development Capacity building – NHS/university Policy advice – national/international

Mother and Infant Research Unit Core themes/values Inequalities in health – public health Views and experiences of women and families Organisation of maternity services Community development Development of research methods

Mother and Infant Research Unit Main topics Maternal and child nutrition Screening in pregnancy and postnatally Wellbeing before, during and after birth – childbirth main current interest

Maternal and Child Nutrition Formula feeding and early weaning increase: –diseases in infancy: gastroenteritis, otitis media, urinary tract infection… –diseases in childhood: diabetes, respiratory tract infections… –diseases in adulthood: cardiovascular disease… –obesity –cancer in the mother: breast, ovarian…. UK and Ireland – lowest breastfeeding rates in Europe Lowest rates in low income groups

Public Health Collaborating Centre for Maternal and Child Nutrition Addressing inequalities in health by improving maternal and child nutrition Supported by the National Institute for Health and Clinical Excellence

Public Health Collaborating Centre for Maternal and Child Nutrition Core groups: Centre for Reviews and Dissemination, York Nutritional Epidemiology Group, Leeds Health Services Research Centre, Coventry Partners: Academics, professional and consumer groups Sentinel sites: Leeds, West Midlands, North East London

Maternal and Child Nutrition Topics for current and future work –Welfare food programmes report to be published 2006 –Breastfeeding national guidance document out for consultation –Preventing obesity –Formula feeding –Weaning –Healthy eating for pre-school children

Mother and Infant Research Unit Maternal and child nutrition Screening in pregnancy and postnatally Wellbeing before, during and after birth

Labour and birth Internationally: major issues of maternal and infant mortality and morbidity Nationally: issues include interventions in labour, physical, mental and emotional sequelae of birth; and health service resource use

Early Labour Support and Assessment trial (ELSA) ….to compare midwifery support and assessment for women in their own home in early labour, versus standard care in hospital

Early Labour Support and Assessment trial (ELSA) Collaborators –Centre for Health Economics, York –National Perinatal Epidemiology Unit, Oxford –Centre for Research in Primary Care, Leeds –Sheffield and Leeds NHS Teaching Hospital Trusts –National Childbirth Trust –Royal College of Midwives Funded by NHS R&D Service Delivery and Organisation programme

Early Labour Support and Assessment trial (ELSA) Outcomes include caesarean section and instrumental birth, women’s wellbeing and views, and health service resource use Plan to recruit 3500 women (2500+ so far) 6 Trusts in Yorkshire, 11 clinical sites Recruitment and intervention by midwives – 450 community midwives, 900+ hospital midwives involved

Other childbirth studies Long term sequelae of caesarean section – –near completion OPAL – OPtions for Assessment and support in early Labour – national survey of services – –complete 2006 EMERALD – proposal to examine birth centres and midwifery-led units

Challenges and opportunities Masters in Maternal and Child Health Integrating education and research for staff and students Opportunities for collaboration in York: eg Centre for Child Development and Wellbeing Capacity building Stability and productivity - funding issues

Future plans New proposals: –birth centres –postnatal depression –practice development – conduct and evaluation International R&D –Ongoing discussions International capacity building