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Trial registered on ANZCTR
Registration number
ACTRN12618001353280
Ethics application status
Approved
Date submitted
28/07/2018
Date registered
10/08/2018
Date last updated
1/12/2020
Date data sharing statement initially provided
1/12/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
My Birth Course: An antenatal course of Complementary Medicine (CM) techniques for labour and birth for women having their first baby: a randomized controlled trial.
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Scientific title
My Birth Course: An antenatal package of Complementary Medicine (CM) techniques for labour and birth examining epidural use in primiparous women: a randomized controlled trial.
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Secondary ID [1]
295671
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None
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Universal Trial Number (UTN)
U1111-1216-4512
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Pregnancy
309036
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Labour
309037
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Childbirth
309038
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Medical interventions childbirth
309039
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Condition category
Condition code
Reproductive Health and Childbirth
307929
307929
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0
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Antenatal care
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Reproductive Health and Childbirth
307930
307930
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0
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Childbirth and postnatal care
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
My Birth Course is an antenatal education package consisting of 5 different non-pharmacological (complementary therapy) techniques for the management of pain in normal labor and birth. The workshops are educational sessions with interactive practice of techniques learned over the course. The following concepts and techniques are introduced to the woman during the course: the physiology of birth, the fear-pain-tension cycle, working with pain, the relaxation response, guided visualization and relaxation, active birth- movement, yoga and positions for birth, accupressure, breathing and massage techniques.
Duration of treatment: Participation in a 2-day weekend or a series of 4x (2.5h) evening workshops from 24-36 weeks gestation. Participants can choose which of the scheduled workshops (whether weekend or evening) they wish to attend. Participants document a practice worksheet outlining the tools and techniques (when/where/with whom) they will practice to prepare for labour and birth. Participants are instructed to practice their chosen technique/s regularly but are not prescribed any specific duration or frequency of time to practice.
The workshop will run twice per month over 10-12 months or until recruitment has been achieved. The workshops will be held at the University of South Australia (west campus) Health Clinic. The workshops will be delivered by expert midwifery educators with a minimum of 5 years experience each.
Follow-up will occur within 72 hours of birth. At this time point participants will self report time spent practicing the (complementary therapies) techniques used for labour and birth.
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Intervention code [1]
301994
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Prevention
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Comparator / control treatment
Standard care alone; The free antenatal classes offered to all women at the Women's and Children's Hospital: Preparing for Birth and Parenting http://www.wch.sa.gov.au/services/az/divisions/wab/antenatal_education.html
The program is designed and run by educators from the Women's and Children's Hospital
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Control group
Active
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Outcomes
Primary outcome [1]
306903
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Epidural rate as recorded in the medical records
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Assessment method [1]
306903
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Timepoint [1]
306903
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At birth
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Primary outcome [2]
306910
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Maternal outcome: length of labour (first stage, second stage, third stage) as recorded in the woman's medical records
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Assessment method [2]
306910
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Timepoint [2]
306910
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During labour and birth
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Secondary outcome [1]
350066
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Infant resuscitation at birth from medical records
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Assessment method [1]
350066
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Timepoint [1]
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At birth and early postpartum ( <= 72 hours after birth)
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Secondary outcome [2]
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A change in score in the validated "Attitude to Birth Questionnaire"
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Assessment method [2]
350067
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Timepoint [2]
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Prior to and after antenatal course (both groups)
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Secondary outcome [3]
350068
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The "Capture My Mood" questionnaire ; difference in score
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Assessment method [3]
350068
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Timepoint [3]
350068
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At antenatal course completion (both groups)
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Secondary outcome [4]
350069
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Labour agentry questionnaire (personal control measures)
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Assessment method [4]
350069
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Timepoint [4]
350069
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Within 72 hours of birth
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Secondary outcome [5]
350443
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The validated Warwick Edinburgh Mental Wellbeing Scale (WEMWBS)
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Assessment method [5]
350443
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Timepoint [5]
350443
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At antenatal course completion (both groups)
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Secondary outcome [6]
350448
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Infant admission to NICU/SCN from medical records
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Assessment method [6]
350448
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Timepoint [6]
350448
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At birth <72h
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Secondary outcome [7]
350449
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mode of birth assisted or cesarean section from medical records
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Assessment method [7]
350449
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Timepoint [7]
350449
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time of birth <72h
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Eligibility
Key inclusion criteria
• Gestational age between 24 and 36 weeks of completed pregnancy
• Primiparous
• Singleton pregnancies
• Low to moderate risk as defined by Australian College of Midwives referral guidelines
• Women will have sufficient English for participation in a the workshops
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
• High risk pregnancies
• Congenital abnormalities
• Participation in similar program of complementary antenatal education including ‘Calm Birth’, ‘Hypnobirthing’, ‘Active Birthing’ etc.)
• Participation in midwifery group practice (1:1 Midwifery continuity of care model)
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Once eligible women are consented for the study, randomisation will be undertaken via the ‘Sealed Envelope’ website, with women randomised to CM education program (plus usual care) or usual care alone. Randomisation will occur on a 1:1 basis. Recruitment will take place over 12 months (August 2018-August 2019) or until the target number of participants has been reached.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation will be undertaken via the Sealed Envelope website with computer generated sequence allocation using random block design.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Analysis will be by intention to treat (ITT) for primary and secondary outcome data. A range of statistical techniques will be employed for the data analysis including contingency table and t-test for univariate analysis of categorical and continuous data, respectively; chi-square test for trend analyses; multivariate logistic regression models to assess predictive factors for CM usage and association between CM usage and birth outcomes after adjusting for potential confounding by maternal factors. Labour Agentry Scale measures will be analysed using t-tests for comparison of means. Analyses will be performed in STATA and/or SPSS.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
24/08/2018
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Actual
4/09/2018
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Date of last participant enrolment
Anticipated
8/06/2021
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Actual
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Date of last data collection
Anticipated
8/10/2021
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Actual
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Sample size
Target
200
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Accrual to date
167
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
11528
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Womens and Childrens Hospital - North Adelaide
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Recruitment postcode(s) [1]
23554
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5006 - North Adelaide
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Recruitment postcode(s) [2]
23555
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5006 - North Adelaide Melbourne St
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Funding & Sponsors
Funding source category [1]
300253
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University
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Name [1]
300253
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University of South Australia
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Address [1]
300253
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University of South Australia
GPO Box 2471
Adelaide, South Australia 5001
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Country [1]
300253
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Australia
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Primary sponsor type
University
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Name
University of South Australia
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Address
University of South Australia
GPO Box 2471
Adelaide, South Australia 5001
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Country
Australia
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Secondary sponsor category [1]
299674
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None
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Name [1]
299674
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Address [1]
299674
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Country [1]
299674
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
301074
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Women's and Children's Health Network Human Research Ethics Committee
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Ethics committee address [1]
301074
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Women's & Children's Hospital Level 2 Samuel Way Building 72 King William Road North Adelaide SA 5006
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Ethics committee country [1]
301074
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Australia
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Date submitted for ethics approval [1]
301074
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14/02/2018
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Approval date [1]
301074
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29/05/2018
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Ethics approval number [1]
301074
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HREC/18/WCHN/19
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Ethics committee name [2]
301081
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University of South Australia Human Research Ethics Committee
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Ethics committee address [2]
301081
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University of South Australia GPO Box 2471 South Australia 5001
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Ethics committee country [2]
301081
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Australia
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Date submitted for ethics approval [2]
301081
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02/06/2018
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Approval date [2]
301081
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19/06/2018
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Ethics approval number [2]
301081
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201343
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Summary
Brief summary
The aim of this research is to translate the low-cost ‘Integrative Medicine for Labour & Birth Program’ (My Birth Course) into end-user benefit and to inform health service delivery. The study will be conducted as a randomised controlled trial (RCT). Randomisation will occur between 24-36 weeks’ gestation. Women will be enrolled into the My Birth Course (antenatal education program), in addition to standard care, or receive standard care alone. This RCT will contribute to a prospective meta-analysis design to assess clinical effectiveness and quantify resource use that will affect translation into practice and sustainability. This study extends the finding of the original RCT conducted in Sydney, Australia which demonstrated significant reductions in caesarean section and medical interventions. The unique contribution of this proposal is to extend the generalisability of the findings by recruiting women from a more diverse group of women at a different hospital to determine the real-world effectiveness of an antenatal education intervention when it is delivered through a range of maternity units in Australia and internationally.
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Trial website
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Trial related presentations / publications
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Public notes
At study completion results will contribute to one of five sites contributing to the pooled data prospective meta-analysis study design. Pooled data will be analysed by the national investigator (KL) of the original trial as part of the Cochrane Prospective Meta-Analysis Methods Group http://methods.cochrane.org/pma/welcome
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Contacts
Principal investigator
Name
85794
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Dr Julie Fleet
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Address
85794
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University of South Australia
School of Nursing and Midwifery
GPO Box 2471
Adelaide, South Australia 5001
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Country
85794
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Australia
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Phone
85794
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+61 8 8302 1845
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Fax
85794
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Email
85794
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[email protected]
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Contact person for public queries
Name
85795
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Julie Fleet
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Address
85795
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University of South Australia
School of Nursing and Midwifery
GPO Box 2471
Adelaide, South Australia 5001
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Country
85795
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Australia
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Phone
85795
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+61 8 8302 1845
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Fax
85795
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Email
85795
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[email protected]
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Contact person for scientific queries
Name
85796
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Julie Fleet
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Address
85796
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University of South Australia
School of Nursing and Midwifery
GPO Box 2471
Adelaide, South Australia 5001
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Country
85796
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Australia
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Phone
85796
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+61 8 8302 1845
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Fax
85796
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Email
85796
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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