Improving Maternal Deterioration Recognition and Escalation Through Midwife-Led Pathways in Tasmania

About the research project

Maternal clinical deterioration remains a significant patient safety concern, with delayed recognition and escalation of care contributing to preventable maternal morbidity and adverse outcomes.¹ Midwives play a critical role in assessing pregnant and postpartum women and are often the first clinicians to identify early signs of deterioration. However, variation in assessment, communication, and escalation practices can hinder timely intervention. These challenges may be particularly pronounced for women with pre-existing chronic medical conditions, mental health conditions, or social complexities, whose care needs and clinical presentations can complicate recognition of deterioration and clinical decision-making. Despite the availability of maternal early warning systems, there is limited evidence to guide recognition and escalation processes for women with chronic and complex conditions within the Tasmanian maternity context.

This doctoral project aims to develop consensus-based, evidence-informed recommendations to support the early recognition and escalation of maternal clinical deterioration among women with chronic and complex conditions in Tasmanian maternity services. Focusing initially on postnatal care, the project will synthesise existing evidence, explore midwives' perspectives, and engage key stakeholders to develop contextually relevant recommendations to strengthen maternity care and patient safety.

The study will be conducted in three phases. Phase 1 will undertake a scoping or systematic review to synthesise evidence relating to the recognition and escalation of maternal clinical deterioration among women with chronic and complex conditions. Phase 2 will explore midwives' understandings of clinical pathways and how these influence decision-making when recognising and escalating physiological deterioration in this population. Qualitative interviews or focus groups with Tasmanian midwives will identify barriers, facilitators, and factors influencing clinical judgement and escalation practices. Phase 3 will integrate findings from the previous phases to develop consensus-based recommendations using a Delphi study involving midwives, nurses, obstetric clinicians, physicians, and health service leaders.

The findings are expected to enhance maternal safety, strengthen midwifery practice, and improve systems for recognising and responding to maternal clinical deterioration across Tasmania.

Reference

1, Ebert L, Massey D, Flenady T, Nolan S, Dwyer T, Reid-Searl K, Ferguson B, Jefford E. (2023). Midwives' recognition and response to maternal deterioration: A national cross-sectional study. Birth,50(2):438-448. doi:10.1111/birt.12665.

Primary supervisor

Meet Professor Melanie Greenwood

Funding

Applicants will be considered for a Research Training Program (RTP) scholarship or Tasmania Graduate Research Scholarship (TGRS) which, if successful, provides:

• a living allowance stipend funded by University of Tasmania of $34,315 per annum for 3.5 years
• a relocation allowance of up to $2,000
• a tuition fees offset covering the cost of tuition fees for up to four years (domestic applicants only)

A tuition fee offset may be offered to eligible international applicants following competitive assessment 

As part of the application process you may indicate if you do not wish to be considered for scholarship funding.

Other funding opportunities and fees

For further information regarding other scholarships on offer, and the various fees for undertaking a research degree, please visit our Scholarships and fees on research degrees page.

Eligibility

Applicants should review the Higher Degree by Research minimum entry requirements.

Ensure your eligibility for the scholarship round by referring to our Key Dates.

Additional eligibility criteria specific to this project/scholarship:

• Current Registered Midwife and/or Registered Nurse with Ahpra.
• Experience in maternal healthcare desirable.

Selection criteria

The project is competitively assessed and awarded. Selection is based on academic merit and suitability to the project as determined by the College.

Additional essential selection criteria specific to this project:

• Current Registered Midwife and/or Registered Nurse with Ahpra.

Additional desirable selection criteria specific to this project:

• Experience in maternal healthcare.

Application process

1. Select your project, and check that you meet the eligibility and selection criteria, including citizenship;
2. Contact Professor Melanie Greenwood to discuss your suitability and the project's requirements; and
3. In your application:
   • Copy and paste the title of the project from this advertisement into your application. If you don’t correctly do this your application may be rejected.
   • Submit a signed supervisory support form, a CV including contact details of 2 referees and your project research proposal.
4. Apply prior to 1 October 2026.

Full details of the application process can be found under the ' How to apply ' section of the Research Degrees website.

Following the closing date applications will be assessed within the College. Applicants should expect to receive notification of the outcome by email by the advertised outcome date.

Apply nowExplore other projects