Healthy lifestyle modules embedded in Monash University midwifery degree

Educating the next generation of midwives

Six healthy lifestyle modules will be embedded in the undergraduate midwifery curriculum at Monash University from 2020 to evaluate the real impact of the work on students’ capability and motivation in providing pregnant women with healthy lifestyle advice.

This project, which is a part of the larger program of research Using health promotion and lifestyle improvement to reduce the burden of obesity before and in pregnancy, led by Professor Helena Teede and Professor Helen Skouteris, began by mapping the midwifery curricula nationally, the results of which were published recently.

“This was a big scoping exercise mapping the current midwifery curricula from Australian universities to identify strengths and deficits in the teaching of preconception and antenatal weight management. We unpacked the curricula content and realised there was little weight management advice taught explicitly to midwifery students.”

“It’s very difficult to change the lifestyle behaviours of pregnant women if the importance of healthy lifestyle in prevention of unhealthy gestational weight gain and adverse pregnancy outcomes is not perceived by midwives.”

“Midwives have the loudest voice because they are out there in the community, working with clients before and during pregnancy. They know what does and doesn’t work and we didn’t want to just ‘tell’ them what they should do.”

“We saw that it was imperative to embed healthy lifestyle factors at the source; with our midwives. These are the people on the frontline, the carers and educators with direct access and a great ability to educate women, around pregnancy. But we have to educate the educators first.

“Equally, some behaviours can become embedded after working on the ground for a long time, so it was important to realise that this is an opportunity to make real change with the next generation of midwives. They can really be the ‘voice’ for change – in motivation, lifestyle behaviours and engagement, in getting feedback from their clients,” said Professor Skouteris.

Starting close to home, the project looked at the undergraduate midwifery curriculum at Monash University and consulted with academics, midwives, current students, and pregnant women in order to ascertain what the gaps were and how they might be addressed.

“This is very much a pilot program, but already the feedback from all those consulted has been overwhelmingly positive. We’ve included components on nutrition, physical activity and how midwives can motivate women, with both normal and complex pregnancies, to be engaged.

“We will be following their progress during their course just before they step into the field and once they’re in the field. Our hope is to follow each cohort longitudinally. To make sure that we are on the right track with the best content and delivery approach, we will seek students’ insights halfway through the modules and upon completion.

“Most importantly, we are hoping to roll these changes out across the country into other midwifery degrees. Real change will come from scale.

“Additionally, the project has also co-developed the Health in Preconception, Pregnancy, and Postpartum Consumer and Community Involvement framework (HiPPP CCI) with consumers – women with lived experience of weight and lifestyle issues in preconception, pregnancy and/or postpartum) and stakeholders (researchers and clinicians).

“The ‘co-development’ aspect is important; we need to ensure that HiPPP research and initiatives are conducted in partnership with the people most affected by the research,” said Professor Skouteris.

Given that research shows that ‘off the shelf’ frameworks offer little transferability, the HiPPP CCI framework has been co-designed to look at the barriers preventing women from engaging in healthy lifestyles at pre-conception, pregnancy and postpartum. This will help us to create opportunities for real, meaningful involvement.

Our focus is on the project, but it’s imperative to work globally on maternal obesity, as well as nurture our next generation of researchers.

Professor Helena Teede

“A manuscript describing this process has been submitted for peer-review,” said Professor Skouteris.

In terms of ‘capacity-building’, or helping to develop the skills of early- to mid-career researchers, the project has established the HiPPP EMCR National Collective, led by early career HiPPP researcher Dr Briony Hill, which already has around 23 members, and six mentors.

“The priority areas identified include building partnerships and collaborations, and implementation including knowledge mobilisation – a growing area that helps to translate research and clinical work into meaningful results.

“We’re excited to be leading this real community of practice and we’ve already had interest from international colleagues who’d like to join the network,” said Professor Skouteris.

The International Diabetes Federation recently invited Professor Helena Teede and the HiPP Global Alliance to join the Federation of International Gynaecology and Obstetrics (FIGO).

“FIGO has member societies in 132 countries and aims to develop and translate guidelines and optimise maternal nutrition around health in preconception, pregnancy and postpartum internationally,” said Professor Teede.

“This is a huge personal honour for me and, more importantly, it shows the impact of the work of our team and the project. It means that we can build our international collaborations and our community of practice. Our focus is on the project, but it’s imperative to work globally on maternal obesity, as well as nurture our next generation of researchers.”

This project is due to finalise in August, 2020.

Read more: Online portal to support women’s healthy lifestyles around pregnancy in the workplace