Informed Birth
Vol. 26 No 3 | Spring 2024
College
Updates From Our Research and Policy Team
Prof Cindy Farquhar
MB ChB, MD, FRCOG, FRANZCOG, CREI, MPH, MNZM, PMMRC

Acknowledging the theme of informed birth, RANZCOG clinical guidance statements and guidelines that help inform this topic include:

  • C-Obs 2 Home Birth (updated July 2023)
  • C-obs 31 Care in Labour (updated March 2024)
  • C-Obs 39 Caesarean Birth on Maternal Request (updated July 2023)
  • C-Obs 38 Birth After Previous Caesarean Section (update currently underway)

This quarter the team have received approval to rename all College clinical statements developed using an evidence-based process to Clinical Guidelines. By using a singular term, RANZCOG is brought into alignment with other medical colleges. We also hope it is now clearer to members which of RANZCOG’s clinical guidance documents are new or updated.

All evidence-based College statements published since 2022 (new process) will be known as clinical guidelines and the working parties convened to support this work known as Guideline Development Groups (GDGs). Please note this name change does not apply to all other RANZCOG guidance, including endorsed content, position statements, general statements (C-Gen), training, workforce, and practice issues statements (C-Trg, WPI) and clinical guidance statements that receive an interim update only (title change to clinical guideline to be applied at next opportunity for full update).

New and updated RANZCOG guidelines

The Research and Policy Team and Women’s Health Committee have published two new guidelines this quarter:

C-Obs 53 Substance use in pregnancy – this new guideline combines two previous statements: Smoking in pregnancy and Substance use in pregnancy. There are nine recommendations and 10 Good Practice Points providing advice to clinicians about the use of alcohol, nicotine (smoking and vaping) and other drugs (including opioids, cannabis, amphetamines, cocaine, benzodiazepines and volatile substances (inhalants) during pregnancy.

C-Gyn 3 Contraception Guideline – these new “signposting” guidelines have been adapted by the RANZCOG guideline development group from 14 guidelines of the Faculty of Sexual and Reproductive Health of the Royal College of Obstetricians (RCOG), including:

  • Combined hormonal contraception
  • Intrauterine contraception
  • Progestogen-only pills
  • Progestogen-only implants
  • Progestogen-only injectables
  • Barrier methods
  • Fertility awareness methods
  • Quick starting contraception
  • Emergency contraception
  • Male and female tubal ligation
  • Contraception after pregnancy
  • Contraception and young people
  • Contraception for women aged over 40
  • Overweight and obesity

C-Obs 63 Reproductive Carrier Screening – interim update to provide information about changes to MBS in Australia following addition of new item numbers for three genetic conditions- cystic fibrosis, spinal muscular atrophy and Fragile X.

Thank you to all fellows, trainees, midwives, community representatives involved in developing and updating this work. We would also like to thank RANZCOG members who provided consultation feedback, the Women’s Health Committee (particularly Dr Scott White, WHC Chair) who oversee guideline development and the work of our team and College Council for review and approval of the final documents.

These new guidelines are now available on RANZCOG’s website.

Why and when does RANZCOG signpost to other organisation’s guidelines?

We can ‘signpost’ where we identify high quality evidence-based guidelines developed by other external organisations, such as the Faculty of Sexual and Reproductive Health (UK). Signposting is a pragmatic approach to evidence work and avoids duplication of effort. Signposting guidelines are assessed for methodological quality. The members of the guideline development group each assessed these guidelines for local context and made recommendations for adapting. The FSRH has approved our changes.

We hope these guidelines will be helpful to RANZCOG members and we would love to have your feedback about the value of these guidelines.

Attention all RANZCOG Trainees

From February 2025, there will be an advanced training module on Evidence Based Medicine. This is an opportunity to work with the Research and Policy Team on RANZCOG Guidelines. Please contact Professor Farquhar (using the email address below) if you are interested in this provisional module.

Updating patient information pamphlets at RANZCOG

We are also responsible for updating the very useful patient information pamphlets (known as PIPs). If you come across anything you think needs updating, please get in touch with us. We plan to update them after each guideline is completed, but in the interim, we will update any areas that are highlighted to us as out of date.

 

Research and Policy Team. (L-R) Angela Hunter, Kate Smith,
Professor Cindy Farquhar, Katie Coulthard, Michelle D’Almeida

The Research and Policy Team can be contacted at: [email protected]


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