How was the Listen2Baby Toolkit developed?
The Listen2Baby Toolkit was designed by midwives, obstetricians, service users, and researchers, based on research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research Programme (NIHR134306).
The research and toolkit development was led by a team of researchers and midwives from the University of Oxford, the University of Birmingham and Cardiff University, maternity service users, an obstetrician from Imperial College London, and experts in co-design from The Point of Care Foundation.
The research took place between 2022 and 2026. The research team used experience-based co-design to:
1. Understand about midwives’ experience and the context in which they practice IA.
- We carried out a survey of all UK maternity services about devices, counting methods, training and audit, with responses from 85% of NHS organisations We observed midwives in practice, talking to them about the challenges to practising IA in line with guidance and what works to support their practice, and audited case notes to assess documented IA practice. In seven NHS organisations, we observed practice in 11 maternity units including alongside and freestanding midwifery units and delivery suites. We conducted 306 hours of observation, 98 informal conversations, 37 recorded interviews, 13 observations of midwives using IA during labour, and audited 115 sets of case notes.
2. Understand about women’s experience of IA monitoring
- We interviewed 23 women about their experience.
- We made a short film about their experience.
3. Develop a range of solutions, a ‘toolkit’, to improve IA practice based on what the study found
- We had feedback meetings with midwives, obstetricians and service users about what we found.
- We held a co-design event with midwives, obstetricians, service users, and policy and practice stakeholders to prioritise issues and start thinking about solutions.
- We ran co-design working groups to design solutions to the issues identified.
- We tested drafts of our toolkit with midwives, service users and with policy and practice stakeholders, and modified it in line with their feedback.
- Overall, in addition to the research team, over 40 midwives and obstetricians, 13 service users and 11 policy and practice stakeholders, were involved in designing the Listen2Baby Toolkit.
4. Test our toolkit and carry out initial evaluation of its effectiveness
- We tested our toolkit for feasibility and acceptability in seven NHS organisations.
- We will roll out the toolkit in seven NHS organisations and return to carry out further observation and case note audit
This study is funded by the National Institute for Health and Care Research (NIHR)