Study Design
A cohort study of all women receiving antenatal care and planning to
give birth at Monash Health, Victoria’s largest metropolitan
university-affiliated teaching hospital caring for about 10,000 women
per year across three separate hospital sites of different acuity levels
(Clayton, Dandenong and Casey) between January 1st, 2016 and Dec 31st,
2020 was undertaken. Women who gave birth at term or beyond (≥ 37
completed weeks gestation) to a singleton baby and who were booked and
received antenatal care at the health service were included.
Maternal self-reported country of birth was classified into regional
groups, as defined by the United Nations17. As the
change in clinical practice was specific only to women from south Asia,
we then classified women as either as being born in South Asia (SA) if
they were born in Afghanistan, Bangladesh, Bhutan, India, Iran, the
Maldives, Nepal, Pakistan, or Sri Lanka or not (“Other women”).
Data was extracted from the Monash Health Birthing Outcomes System
(BOS). BOS is an electronic database recording all births ≥20 weeks’
gestation. For each birth the attending midwife, supported by routine
data validation, enters 46 data items into BOS. This data is included in
formal state and national perinatal statistics.