World’s first living guideline for pregnancy and postnatal care launched
Australia has cemented its place as a global leader in healthcare with the launch of the world’s first ‘living’ clinical guidelines in pregnancy and postnatal care. The creation of the two guidelines was driven by the Australian Living Evidence Collaboration (ALEC), and funded by the Department of Health and Aged Care. The Assistant Minister for Health and Aged Care, The Hon. Ged Kearney MP, helped launch the guidelines at the Perinatal Society of Australia and New Zealand’s Annual Congress in Brisbane.
ALEC’s Academic Director, Monash University Professor Tari Turner, praised ALEC’s Living Evidence for Australian Pregnancy and Postnatal Care (LEAPP) guidelines launch as “a landmark moment for reproductive health globally, and Australian clinicians and consumers. For the first time, clinicians and consumers have continuously updated national guidelines for pregnancy and postnatal care, instead of fragmented and outdated resources,” she said.
Like many other nations, Australia lacks a centralized system for developing national clinical guidelines. As a result, many guidelines are not based on strong evidence, lack transparency, and become outdated by the time they are released. Once published, they often remain unchanged for 5 to 10 years, making it difficult for clinicians to deliver high-quality, up-to-date care.
The ‘living evidence’ model of clinical guidelines refers to the continuous integration of high-quality research as it becomes available. This means that recommendations are revised more frequently, driving better patient care.
Professor Turner strongly believes ‘living evidence’ can modernise Australia’s health and research ecosystems, saying “the Federal Government’s investment in ALEC’s ‘living’ guidelines should be applauded. The new guidelines will improve consistency and effectiveness of lifesaving health care for women and babies in cities, regions and rural areas by upskilling clinicians and recognising women’s lived experience.”
ALEC is part of Monash University’s School of Public Health and Preventive Medicine. A hub of excellence and innovation in the living evidence sphere, the team developed these guidelines with LEAPP partners the Australian College of Midwives and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, supported by 22 LEAPP members.
The views of women with lived experience was an important consideration throughout the project, and 17-member consumer panel was engaged on all draft recommendations. Melanie McKenzie, Deputy Chair of the LEAPP Consumer Panel, said “As a Consumer Panel we really get to shape the tone of the document and prioritise what’s important to us and how it is women-centred…. I really feel heard and valued.”
The Australian Pregnancy Care Guidelines are progressively updating the previous 2020 version which included guidance as old as 2012. The guideline now includes 211 recommendations on more than 60 topics, of which 74 recommendations are new or updated. This includes recommendations on mental health screening, prevention of preeclampsia and, for the first time, preventive care for women at higher risk of preterm birth.
The Australian Postnatal Care Guidelines are the first national postnatal guidelines in Australia, and currently include 48 recommendations across 6 topics, including mental health screening, perineal healing and secondary postpartum haemorrhage.
As ‘living’ guidelines, both guidelines are works in progress and will continue to grow over time. New and updated draft recommendations are published quarterly, and public feedback for ongoing improvement of the guidelines is welcome at any time.
Both guidelines are available online at https://livingevidence.org.au/living-guidelines/leapp.
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