Mater launches new model of care for diabetic pregnant mums

Mater Mothers’ Hospital has launched a new model of care — developed by clinicians and researchers — to support pregnant women with diabetes.

Mothers-to-be with Type 1 and Type 2 diabetes have typically been unable to participate in Midwifery Group Practices (MGP) to receive antenatal care because their pregnancies are deemed to face a higher risk than those of non-diabetic women.

Mater Mother’s new Obstetric Midwifery Group Practice (OMGP) will support diabetic women through a hybrid care model that combines a traditional midwifery group practice with an extra layer of obstetric care.

Mater Associate Professor Shelley Wilkinson said traditional Midwifery Group Practices accept women with low-risk pregnancies and provide excellent outcomes and continuity of care for women and babies.

“Midwifery Group Practices are a brilliant, evidence-based model of care in which low-risk women are allocated a primary midwife who provides their care throughout their pregnancy, labour, birth and postnatal period,” Wilkinson said.

“Unfortunately, many women are unable to participate due to pre-existing illnesses and conditions like Type 1 and Type 2 diabetes, and cardiac and renal complications.”

After collecting nine months of baseline data from women using the current model of care, Mater researchers will review clinical outcomes and analyse the findings to inform the Obstetric Midwifery Group Practice pilot program, which is set to launch later this year.

“We have been looking at things like how many of these babies spent time in the special care nursery,” Wilkinson said.

“We will also survey these women six weeks after they give birth to get their full reflection on the model.”

Mater Mothers’ Hospital Director of Obstetric Medicine Dr Jo Laurie said eligible women will be offered a place in the program when they book their antenatal care.

“The early days of pregnancy are absolutely critical for women with diabetes, as high blood glucose levels during the embryonic stage can lead to problems with the baby,” Laurie said.

“Obstetric Midwifery Group Practice midwives will help navigate the care journey for these higher risk pregnancies, as too often women fall the through the cracks when they’re going to a range of different services.

“In the Obstetric Midwifery Group Practice, a midwife will provide full wraparound care by attending appointments with women when they see members of the treating team, such as the obstetrician and obstetric medicine physician.

“We believe that this will create a better journey for women. And by having the same skilled midwives caring for these more complex women during labour, it will hopefully keep these babies out of the special care nursery and with their mums for that precious early bonding time.”

Researcher Maria Oliveri was diagnosed with Type 1 diabetes after her first child was born and said the clinic would improve the health of women managing their pregnancy and symptoms associated with the disease.

Oliveri, 33, of Morningside, developed Type 1 diabetes after the arrival of her eldest son, Joshua, now six, and is due to give birth to her third baby in October.

“When I gave birth to Joshua, I went through a traditional Midwifery Group Practice and loved it,” Oliveri said.

“When I had my second baby, William, three years ago, I had developed Type 1 diabetes and was referred to a high-risk, obstetrician-led model of care, which is what I am doing for my third baby.

“My first pregnancy was low risk and I felt so empowered as the care focused on my pregnancy and my baby.

“My second pregnancy was very different. I felt my Type 1 diabetes was the focus of my pregnancy. I had to explain my situation to a different doctor each and every time.

“It was somewhat frustrating, and I didn’t feel all of the joy I had felt in my first pregnancy.”

Oliveri, who previously worked as a midwife in an MGP, said Mater’s new practice would give mums a consistency of care they deserved.

“Expectant mums will find comfort in knowing midwives will be part of their journey during pregnancy and birth, as well as follow-up appointments,” she said.

Image caption: Brisbane mum and Mater researcher Maria Oliveri. Image credit: Renae Droop.