Senior Clinical Lecturer
As a senior clinical lecturer in obstetrics, my work aims to improve women's experiences and outcomes of birth, ensuring informed consent in the delivery of safe maternity care.
My research interests include intrapartum care, particularly the role and potential implications of caesarean delivery. My PhD work as part of a Wellcome Trust Research Training Fellowship, reflected this. The programme of work included primary qualitative research, synthesis of qualitative literature, epidemiological research using multiple linked Scottish datasets, and health services research employing postal questionnaires. The high impact papers published as a result of this work relate to offspring health outcomes following planned caesarean delivery and key beliefs which influence women's birth preferences after caesarean delivery.
My research goals include identification of opportunities to facilitate positive birth choices, and to establish the optimal role of caesarean delivery.
I am an honorary consultant obstetrician at Aberdeen Maternity Hospital with leadership roles in labour ward and obstetric risk management. I have been a member of the NICE Antenatal Care guideline committee since 2018.
Previous research has involved retrospective cohort studies of pregnancy outcomes following stillbirth, substance-misuse, induction of labour, operative deliveries performed by midwives and assessment of the content of web-based information on birth options after caesarean section.
Recent work has involved investigating offspring outcomes of caesarean delivery through systematic review and population-based cohort studies using whole of Scotland data. This work has provided some reassurance that prelabour planned caesarean section does not appear to impact on the long-term health of children in a clinically meaningful way.
Studies of influences on women's birth mode preferences after caesarean section utilised meta-ethnography and psycological theory-based questionnaires. This led to increased understanding of the importance of conversations held between doctors and women at the time of their first CS and how even small passing comments made by staff can influence future birth preferences. It highlighted that a woman's understanding of why an initial caesarean was needed can substantially impact upon her belief in the likely success of a future attempt to give birth vaginally.
My current work focuses on developing decision support tools to aid women forming a plan for how to give birth to their first baby. This involves working closely with women to establish their information needs and preferences in terms of timing, format and sources of information.
I continue to research the long-term health outcomes of children born by pre-labour caesarean section compared with a plan for vaginal birth, with current work focusing on the risk of renal calculi formation in childhood and early adulthood.
At the University of Aberdeen I have ongoing collaborations with colleagues in medical statistics, health services research unit, health psychology, health economics, the Rowett Institute and sociology.
Elsewhere in the UK, I have recent collaborations with clinical and academic colleagues at the University of Edinburgh, Imperial College London, Newcastle University Hospitals NHS Trust, St George's Hospital London and the London School of Tropical Medicine.
Internationally I am working with colleagues at Albert Einstein College in New York, Monash University and the University of Adelaide in Australia, NUI Galway and Trinity College Dublin in Ireland.
Wellcome Trust Mode of delivery after caesarean section: An investigation of offspring risks and factors influencing women's attitudes towards delivery options. Research Training Fellowship Supervisors: Allan J, Gillies K, McLernon D, Bhattacharya S, Norman J. 2013-16 £220,774
National Institute of Health Research grant ‘Offspring renal calculi following elective caesarean’ £11,595, 2017-2018 This award is funding research costs including data access and statistical support.
Wellbeing of Women Research scholarship (co-applicant as supervisor of Dr Andrea Woolner). £19,939, 2015-2018. This award is funding research costs, including data access and statistical support.
Medical Research Scotland Vacation scholarship (main applicant to propose supervision of medical student Miss Anna Rose). £1500, Summer 2016. This award funded a medical student to perform a systematic review.
MRC Proximity2Discovery Grant funding to explore embedding of prediction tools into electronic maternity records via focus groups with third parties and meetings with industry partners. £1200, 2018
Medical Research Scotland Vacation scholarship (main applicant to propose supervision of medical student Miss Catriona Young). £1800, Summer 2019. This award funded a medical student to perform a population-based cohort study of outcomes of prolonged second stage of labour.
Wellcome Trust Institutional Strategic Support Fund. £11275. Shared decision-making in planning childbirth - Multi-stakeholder research agenda-setting workshop. 2019.