Overview of the Survey Program

The Queensland Centre for Mothers & Babies (QCMB) conducts a number of population-based surveys to assess the maternity care experiences of women in Queensland.

 

The primary goals of the Having a Baby in Queensland Survey Program are to:

  • inform maternity care quality improvement efforts at the facility and State level
  • monitor changes in maternity care over time, in relation to policy and service changes
  • determine predictors of receiving quality care and consumer satisfaction with care
  • examine associations between maternity care experiences and health outcomes
  • provide feedback about the care received in different birth facilities to maternity care consumers for informed decision-making about place of birth (via ‘Birthplace‘).

The surveys are cross-sectional, and designed to assess the overall experience of maternity care among representative samples of birthing women in Queensland. They ask about women’s experiences of care during pregnancy, labour and birth, and after birth, retrospectively (i.e., at least 3 months after their most recent birth).

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The surveys ask questions across a number of domains, including:

  • Infant characteristics (e.g., gestational age and weight at birth)
  • Maternal characteristics (e.g., pregnancy and birth history, socio-demographic characteristics)
  • Pregnancy:  experience (e.g., scans and tests, complications); care (e.g., health care visits and providers, sources of information and support, satisfaction with care)
  • Labour and birth: planning (preferred place and mode of birth, worries, and travelling for birth); experience (duration of labour, mode of birth, complications); care (place of birth, private care providers, vaginal examinations, infant monitoring, episiotomy, pain relief methods and usefulness, support, emergency transfer, interpersonal communication with health care providers, satisfaction with care, improvements needed in the labour and birth environment)
  • After birth: experience (skin-to-skin contact with infant, infant feeding, recovery); care (both in and out of hospital, e.g., , duration of hospital stay, interpersonal communication with health care providers, satisfaction with care, satisfaction with involvement in neonatal care of infant, improvements needed in the after-birth environment, contact with health care providers after birth)
  • Information provided for decision-making (information about the pros and cons of having ultrasound scans, blood tests, induction of labour, vaginal examinations in labour, infant monitoring in labour, episiotomy, hormone injections to birth the placenta, caesarean birth, epidural use).
  • Patient role in decision making (for decisions about ultrasound scans, blood tests, induction of labour, vaginal examinations in labour, infant monitoring in labour, episiotomy, hormone injections to birth the placenta, caesarean birth, epidural use). 
  • Maternal and infant health after birth (e.g., infant admission to neonatal care, physical and psychological maternal symptoms, (re-)hospitalisation of mother or infant).

    Women are also invited to provide their contact details and consent to be contacted for further research projects.


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Completed, current and planned surveys include:

  1. Having a Baby in Queensland Surveys of women who experience a live single birth (2009, 2010, 2012)
  2. Having a Baby in Queensland Survey of women who experience a multiple birth (2009, 2010, 2012)
  3. Having a Baby in Queensland Survey of women who experience a stillbirth (2010, 2012)
  4. Proactive surveys for women who have ever had a baby in Queensland (ongoing from December 2010)

 
1.  Having a Baby in Queensland Surveys for women with a live birth
The Having a Baby in Queensland 2009 Pilot Survey, the Having a Baby in Queensland 2010 Survey  and the Having a Baby in Queensland 2012 Survey of women who experienced a live birth are available here.

Maternity care consumers are invited to participate in the surveys by the Queensland Registry of Births, Deaths and Marriages. The sample is selected based on live singleton births in a defined period of time, using the Hospital Notifications database with updated details from the Birth Registration database where available at the time of invitation. Women are excluded from the sample if there is a registered neonatal death subsequent to the birth notification or if they have incomplete contact details.

Participants are invited to participate via a mailed invitation package that includes an invitation from the Queensland Registry of Births, Deaths and Marriages, an information brochure about the survey, a hard copy of the survey, a Reply Paid envelope for return, and a translation sheet that provides instructions for information or participation in other languages. Women can choose to complete the survey in a number of ways – by returning the completed hard copy survey by mail, completing the survey online, or completing a shorter survey over the telephone (in any language) with a trained interviewer. Follow-up packages sent two weeks after the initial mail out contain a thank you/reminder letter from QCMB. For the 2012 survey, women also received an introductory postcard with a link to the online survey two weeks’ prior to receiving the hard copy of the survey.

Having a Baby in Queensland 2009 Pilot Survey (live single) 
DATA AVAILABLE NOW

Sampling period: Two weeks (births from 22nd July 2009 to 4th August 2009)
Timing of invitation: Approximately 3 months after birth (first week of November 2009)
Women sampled: 2326
Exclusions: Neonatal death, n=14; Undeliverable (no complete address or returned to sender), n=71
Women invited: 2241
Usable data cases: 772
Usable response rate: 34.45%

Notes:

1. Half of the participants received a thankyou/reminder note and a second copy of the survey after two weeks of the initial invitation. The other half of the sample (randomly selected) received only the thankyou/reminder note at the same time. This protocol was used to assess the effect of a second survey mailing on response. There were no differences in the response rate to the survey according to reminder protocol.
2. There was no active marketing of this survey to encourage participation.

Having a Baby in Queensland Survey 2010 (live single or multiple)
DATA AVAILABLE NOW

Sampling period: Four months (births from 1st February 2010 to 31st May 2010)
Timing of invitation: Approximately 4-5 months after birth (first week of July, August, September, October 2010 for births in February, March, April and May 2010, respectively)
Women sampled: 21,013
Exclusions: Ineligible cases, n=106: Neonatal death, n=67, Undeliverable (no complete address or returned to sender), n=543
Eligible women invited: 20,364
Usable data cases: 7,193
Usable response rate: 35.32%
Marketing: A4 posters and DL leaflets sent to pregnancy care providers (hospital antenatal clinics and general practices). Fridge magnets and DL flyers sent to birth facilities for inclusion in postnatal discharge packages.

Participant flowcharts of eligible women are available for the February to May 2010, single and multiple births sample and for the February and March 2010 single births and February to May 2010 multiple births sample.

Notes:
1. Women were excluded as ineligible cases for the following reasons:
  • Duplicate record in database
  • Recorded as livebirth, but experienced a stillbirth
  • Experienced a neonatal death
  • Birth plurality could not be discerned
2. In the case of multiple births, only data for the first born baby is included in the data file.
3. A set of core survey questions were asked of all women, but women who had their babies in February and March were provided with a 24-page survey that included supplementary questions about infant sex, maternal height and weight, details of their first pregnancy care visit, pregnancy scans and tests, use of QCMB resources, worries during pregnancy, perceived choices for a number of care experiences (mode of birth, reasons for induction of labour, information and decision-making about vaginal examinations during labour, infant monitoring, episiotomy, management of the third stage, epidural use), maternal recovery after birth, and interpersonal communication and decision-making during pregnancy, labour and birth, and after birth.

Women who had their babies in April and May were provided with a 16-page survey including four supplementary questions about satisfaction with involvement in neonatal care, whether their care was received only in Queensland, if they were provided with details of parent’s groups in the community and how they would describe their care providers for labour and birth.

Common (‘core’) questions were consistent across both surveys in how they were asked. All women who had a multiple birth completed both the core and supplementary questions.

4. Marketing materials were provided in March 2010, so women in the sample who birthed in February are unlikely to have been exposed to the marketing strategies during pregnancy and birth.

5. Women who participated were invited to enter a draw to win one of four $200 cash prizes for completing the survey.

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Having a Baby in Queensland Survey 2012 (live single or multiple)
DATA AVAILABLE NOW

Sampling period: Four months (births from 1st October 2011 to 31st January 2012)
Timing of invitation: Approximately 3-4 months after birth (first week of February, March, April, May 2012 for births in October 2011, November 2011, December 2011 and January 2012, respectively)
Women sampled: 19,789
Exclusions: Ineligible cases, n=17; Undeliverable (no complete address or returned to sender), n=578
Eligible women invited: 19,194
Usable data cases: 5,840
Usable response rate: 30.43%
Marketing: A3 & A4 posters and DL leaflets sent to care providers for distribution to women (hospital antenatal clinics and maternity wards, obstetrician’s clinics, child health services and general practices). Birth facilities with low response rates from the 2010 survey (less than 25% of women in the sample period or less than 10 women responding) were visited by QCMB staff to discuss promotion of the survey.

A participant flowchart of eligible women is available for the 2012 sample.

Notes:
1. Women were excluded as ineligible cases for the following reasons:
  • Duplicate record in database
  • Experienced a neonatal death after 28 days
  • Date of birth outside sampling period (due to error in database)
2. Marketing materials were provided from August to December 2011. Sites with previous low response rates received materials initially, followed by birthing facilities and antenatal care services, and finally to services providing postnatal care.
3. Women who participated were invited to enter a draw to win one of four $200 cash prizes for completing the survey.

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2. Having a Baby in Queensland Survey of women who experience a multiple birth

Surveys provided for women who experienced a multiple birth were developed based on the Having a Baby in Queensland survey for women who experienced a live singleton birth, but tailored to the multiple birth experience by asking relevant questions individually for all babies (e.g., date of birth, mode of birth, infant feeding). Copies of the Having a Baby in Queensland 2009 Pilot Survey, the Having a Baby in Queensland 2010 Survey and the Having a Baby in Queensland 2012 survey of women who experienced a multiple birth are available here.

Maternity care consumers who experience a multiple birth are invited to participate in the surveys by the Queensland Registry of Births, Deaths and Marriages. The sample is selected based on live multiple births in a defined period of time, using the Hospital Notifications database with updated details from the Birth Registration database where available at the time of invitation. Women are excluded from the sample if any of their babies were not born alive, if there is a registered neonatal death after birth, or if they have incomplete contact details.

Participants are invited to participate via a mailed invitation package that includes an invitation from the Queensland Registry of Births, Deaths and Marriages, an information brochure about the survey, a hard copy of the survey for women who experienced a multiple birth, a Reply Paid envelope for return, and a translation sheet that provides instructions for information or participation in other languages. Women can choose to complete the survey in a number of ways – by returning the completed hard copy survey by mail, completing the survey online, or completing a shorter survey over the telephone (in any language) with a trained interviewer. Follow-up packages sent two weeks after the initial mail out contained a thank you/reminder letter from QCMB. For the 2012 survey, women also received an introductory postcard with a link to the online survey two weeks’ prior to receiving the hard copy of the survey.

Having a Baby in Queensland 2009 Pilot Survey (Multiple Birth) 
DATA AVAILABLE NOW

Sampling period: Two weeks (births from 22nd July 2009 to 4th August 2009)
Timing of invitation: Approximately 3 months after birth (first week of November 2009)
Women sampled: 49
Exclusions: Neonatal death, n=0; Undeliverable (no complete address or returned to sender), n=4
Women invited: 45
Usable data cases: 24
Usable response rate: 53.33%

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Having a Baby in Queensland Survey 2010 (Multiple Birth) 
DATA AVAILABLE NOW

Sampling period: Four months (births from 1st February 2010 to 31st May 2010)
Timing of invitation: Approximately 4-5 months after birth (first week of July, August, September, October 2010 for births in February, March, April and May 2010, respectively)
Women sampled: 338
Exclusions: Neonatal death, n=12, Undeliverable (no complete address or returned to sender), n=11
Women invited: 315
Usable data cases: 124
Usable response rate: 39.37%
Marketing: A4 posters and DL leaflets sent to pregnancy care providers (hospital antenatal clinics and general practices).  Fridge magnets and DL flyers sent to birth facilities for inclusion in postnatal discharge packages.

Notes: 
1.  Women who participated were invited to enter a draw to win one of four $200 cash prizes for completing the survey.

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Having a Baby in Queensland Survey 2012 (Multiple Birth)
DATA AVAILABLE EARLY 2013
Sampling period: Four months (births from 1st October 2011 to 31st January 2012)
Timing of invitation: Approximately 4-5 months after birth (third week of February, March, April, May 2012 for births in October 2011, November 2011, December 2011 and January 2012, respectively)
Women sampled: TBA
Exclusions: Neonatal death, n=TBA; Undeliverable (no complete address or returned to sender), n=TBA
Women invited: TBA
Usable data cases: TBA
Usable response rate: TBA
Marketing: A3 & A4 posters and DL leaflets sent to care providers for distribution to women (hospital antenatal clinics and maternity wards, obstetrician’s clinics, child health services and general practices). Birth facilities with low response rates from the 2010 survey (less than 25% of women in the sample period or less than 10 women responding) were visited by QCMB staff to discuss promotion of the survey.

Notes:
1. Marketing materials were provided from August to December 2011.  Sites with previous low response rates received materials initially, followed by birthing facilities and antenatal care services, and finally to services providing postnatal care.

2. Women who participated were invited to enter a draw to win one of four $200 cash prizes for completing the survey.

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3. Having a Baby in Queensland Survey of women who experience a stillbirth or a neonatal death

Copies of the 2010 Having a Baby in Queensland Survey for women who experience stillbirth and the 2012 Having a Baby in Queensland Survey for women who experience a stillbirth or neonatal death is available here. The stillbirth survey are tailored to the unique experience of women sampled, with many questions from the live birth surveys removed, and many additional questions included (e.g., finding out their baby had died, support and information provided, care for managing grief associated with infant loss). The surveys take a structured open-ended format to allow women to report the aspects of their experience that were most important to them.

Maternity care consumers who experience a stillbirth (or neonatal death in 2012) are invited to participate in the surveys by the Queensland Registry of Births, Deaths and Marriages. The sample is selected based on stillbirths and/or neonatal deaths in a defined period of time, using the Hospital Notifications database. Women were invited to participate via a mailed invitation package. Invitation packages contained a tailored introductory letter from the Registry of Births, Deaths and Marriages, a tailored information brochure from QCMB describing the project and a translation interpreter services information sheet (NB: Hard copies of the survey were not sent with the invitation). Women were invited to complete the survey online or over the telephone (in any language). Reminder letters were not sent to women who had experienced a stillbirth or neonatal death. Women who participate were invited to enter the draw to win one of four $200 cash prizes for completing the survey.

Having a Baby in Queensland Survey 2010 (Stillbirth)
DATA AVAILABLE NOW

Sampling period: Four months (births from 1st February 2010 to 31st May 2010)
Timing of invitation: Approximately 4-5 months after birth (first week of July, August, September, October 2010 for births in February, March, April and May 2010, respectively)
Women sampled: 100
Exclusions: Undeliverable (no complete address or returned to sender), n=0
Women invited: 100
Usable data cases: 16
Usable response rate: 16.00%
Marketing: A4 posters and DL leaflets sent to pregnancy care providers (hospital antenatal clinics and general practices).  Fridge magnets and DL flyers sent to birth facilities for inclusion in postnatal discharge packages.

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Having a Baby in Queensland Survey 2012 (Stillbirth and Neonatal death)
DATA AVAILABLE EARLY 2013

Sampling period: Four months (births from 1st October 2011 to 31st January 2012)
Timing of invitation: Approximately 4-5 months after birth (third week of February, March, April, May 2012 for births in October 2011, November 2011, December 2011 and January 2012, respectively)
Women sampled: TBA
Exclusions: Multiple birth with one or more live babies, n=TBA; Undeliverable (no complete address or returned to sender), n=TBA
Women invited: TBA
Usable data cases: TBA
Usable response rate: TBA
Marketing: A3 & A4 posters and DL leaflets sent to care providers for distribution to women (hospital antenatal clinics and maternity wards, obstetrician’s clinics, child health services and general practices). Birth facilities with low response rates from the 2010 survey (less than 25% of women in the sample period or less than 10 women responding) were visited by QCMB staff to discuss promotion of the survey.

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4. Proactive surveys for women who have ever had a baby in Queensland

Versions of the Having a Baby in Queensland survey will be available for women who have ever received maternity care in Queensland to complete via on online survey, in December 2010. Data collection will occur on a cumulative basis. Specialised surveys will be available for women who experienced a live single birth, a multiple birth, and a stillbirth in their most recent maternity care experience. The surveys are comparable with those used in the Having a Baby in Queensland 2010 AND 2012 surveys described above.

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