This project was funded between January 2019 and March 2020.

  • Project led by North Bristol NHS Trust, in partnership with the University of Bristol and the National Childbirth Trust.
  • Aiming to improve birth experience and subsequent symptoms of stress, anxiety and trauma.
  • Will develop and implement an innovative antenatal intervention at three community midwifery hubs, introducing key ideas around labour and delivery, and providing the opportunity for coping strategies for birth.

Many women have a very different birth experience to what they expected, which can contribute to anxiety and distress. Up to 1.5% of women experience post-traumatic stress disorder at six months following birth, and up to 50% of women suffer stress-related symptoms at two months after Caesarean section and 24% at six weeks after vaginal delivery.

Research has shown that having information about labour, birth and the postnatal period, and feeling in control during labour, are associated with positive psychological outcomes. 

Some antenatal education is currently offered to women and their partners as part of routine care. However, many women do not attend these classes and the content and delivery is variable within and between areas. 

ACE is a patient-focused intervention that will educate and support women to develop and use coping strategies. It will also equip the midwifery workforce at North Bristol NHS Trust to deliver interactive, skills-based education and enable them to better support patients. 

The project aims to improve patient experience, psychological outcomes and staff satisfaction with care. 

Focus groups will be held with women and staff to identify current expectations of labour and birth, and to understand how women would like to use coping strategies. 

The two interventions (one for women; one for staff) will then be implemented in three community midwifery hubs. Around 50 women in each area will attend. Community midwives will deliver the intervention in addition to usual care. A project midwife will deliver the staff training intervention.

Contact information

For more information about this project, please contact Dr Abi Merriel, NIHR Academic Clinical Lecturer in Obstetrics and Gynaecology, North Bristol NHS Trust. 

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