Maternity research priorities in country Western Australia: a Delphi study.

Objective Health research priorities are commonly identified and resourced by strategic leaders. The importance of recognising the expertise of clinician-researchers is being prioritised by a national funding shift towards applied research. There is a dearth of evidence regarding research priorities for maternity care in rural and remote health in Australia. This study aimed to develop an evidence-based consensus of maternity research priorities in regional, rural, and remote areas of Australia's largest rural health service (by land area) in Western Australia. Methods A three-phased Delphi method was selected to achieve an interdisciplinary, evidence-based consensus on maternity research priorities within Western Australian Country Health Service. Results Across three study phases, 432 participants responded. Representation was from seven regions and all stakeholder roles within the regions. Phase 1 included 173 responses yielding 53 concepts categorised under five domains. Phase 2 involved 161 participants who prioritised concepts under domains of (i) workforce and education; (ii) health equity; (iii) Aboriginal health; (iv) logistics and health systems; and (v) clinical. Phase 3 included 96 participants revealing 15 maternity research priorities with the top four ranked concepts: 'recruitment and retention of staff'; 'care for women and families with vulnerabilities', 'models of care offering continuity' and 'systems efficiencies'. Conclusions The novel evidence provided in this study, in conjunction with a strong consensus on research priorities and an interdisciplinary approach, strengthens the findings of this study and amplifies the mandate of action without delay.

The path of determination: exploring the lived experience of breastfeeding difficulties.

Breastfeeding is the method of choice for infants and most women support the statement that 'breast is best'. Although the majority of Australian women do initiate breastfeeding, many also encounter difficulties in what they assume to be an easy, natural process. Additionally, a number of women face difficulties significant enough to warrant additional support from resources such as the Breastfeeding Centre of Western Australia. Managing these difficulties influences mothers' perceptions of their breastfeeding experiences. However, the stories of these women have not been addressed in the literature. This phenomenological study explored the lived experiences of mothers with breastfeeding difficulties, who presented to the Breastfeeding Centre of Western Australia. In-depth interviews with ten women revealed three main themes: 'path of determination, 'staying on the path; and 'coming off the path'. The study contributes to the body of knowledge on infant feeding and provides insight to health care professionals working with breastfeeding women.