Dr Bradfield, a Senior Midwifery Research Fellow at Curtin University and King Edward Memorial Hospital, is the recipient of a 2022 CRE HiPP Practising Health Professional Capacity Building award.

She is using the award funds to build an education program that will help midwives around Australia to better fulfil their range of work.

According to the 2021 State of the World’s Midwifery report, “midwives can meet about 90% of the need for essential sexual, reproductive, maternal, newborn and adolescent health interventions across the life course.”

“This means that the range of practice for midwives is from menarche to menopause,” said Dr Bradfield. “But when we look around the world, as well as more locally in Australia, the scope where midwives tend to be employed is almost entirely around the pregnancy and immediate postnatal space.

“Midwives are particularly well placed to provide preconception care (PCC) and interconception care (ICC), that is the care in between pregnancies, as we are experts in primary sexual and reproductive care. 

“We can also provide health promotion around maintaining health states, including promoting healthy eating and physical activity to support women to be their healthiest weight at the time of conception. This means that they can enter pregnancy in their most well state.

“Pregnancy is not an illness. For some illness may develop, but by and large most people experience pregnancy as a state of wellness. 

“And midwives are really well placed to be influencing the maintenance of those wellness states and preparing people to consider conception and pregnancy … even if that is several years away for them.

“So it makes sense for us to be working to scope,” she said. 

With more and more Australian midwives working in primary health care settings, including in rural health, Dr Bradfield believes that many of them already have the skills and experience to provide preconception and interconception care and advice. But many may be lacking in confidence. 

She recently led a study that surveyed midwives working in a public tertiary maternity hospital in WA. This research found that although midwives were both eager and able to provide sexual and reproductive health care, over 90% indicated they want more training in this area. Midwives also want lifestyle health education that enables them to embed this into their practice efficiently and effectively.

Dr Bradfield’s education program aims to fill this gap. As well as broadening and refreshing their knowledge, “it’s about confidence building and helping midwives to understand that this really is their scope and that they do have the capacity,” she said.

Much of the needs analysis work has been completed, and development of the education program is already underway. 

She envisages that the program will be delivered online in an on-demand format. With a background in rural midwifery, Dr Bradfield fully understands the time and distance constraints that many Australian midwives face in terms of undertaking professional development.

“We want it to be accessible to as many people as possible,” she said. 

Under this award Dr Bradfield will be mentored by CRE HiPP Director Professor Helen Skouteris. She will also link in with the Preconception Health Network (PHN), led by Associate Professor Jacqueline Boyle and Professor Kirsten Black.

Dr Bradfield is particularly excited about the opportunities for national, international and cross-disciplinary collaboration that are developing through this project.

“Multidisciplinary collaborative research is absolutely the sweet spot of research, as we are pooling the strengths of a variety of individuals for the betterment of health outcomes for women and their families,” she said.

“The ‘global village’ that has opened up since COVID has really confirmed for us that we don’t need to be physically in the same room in order to collaborate on the research that is really important.

“This also means that the findings can be transferred quickly to multiple sites, so the impact of the research can be widely distributed.”

It is this potential for wide-ranging outcomes that motivates her the most.

“I’m thrilled about the work that’s going to be progressed through this award. Helping Australian midwives to feel more confident realising their scope in the preconception and interconception space will flow onto increasing women’s access to sexual and reproductive health care,” she said.

“This helps keep women well and helps them to become well prior to falling pregnant. That’s a fantastic investment in health outcomes for women, children and their families and communities around the world.”

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