Dr Christine Catling, a midwife for over 25 years, is the Director of Midwifery Studies at UTS. She believes research, innovation and good quality midwifery are pivotal to the well-being of mothers and young families.
Christine has extensive experience in antenatal education, policy development and research, and has published on workforce issues, homebirth, vaginal birth after caesarean section, maternal mortality, vaginal breech birth, maternal and child health in Papua New Guinea, simulation-based learning and vitamin D levels in mothers and neonates.
In 2015 she was the inaugural research fellow for the World Health Organisation Collaborating Centre at UTS. Her PhD explored the influences on women who chose a publicly-funded home birth in Australia.
Australian College of Midwives
Maternity Choices Australia
Perinatal Society of Australia and New Zealand
Can supervise: YES
- Vaginal breech birth
- Maternal and neonatal mortality in Papua New Guinea
- Respectful maternity care
- Maternity workplace culture
Raynor, MD & Catling, C 2017, Myles Survival Guide to Midwifery, Elsevier.
Revision of: Survival guide to midwifery / Diane M. Fraser, Margaret A. Cooper. 2002. 2nd ed.
Coates, D, Makris, A, Catling, C, Henry, A, Scarf, V, Watts, N, Fox, D, Thirukumar, P, Wong, V, Russell, H & Homer, C 2020, 'A systematic scoping review of clinical indications for induction of labour', PLoS ONE, vol. 15, no. 1.View/Download from: UTS OPUS or Publisher's site
© 2020 Coates et al. Background The proportion of women undergoing induction of labour (IOL) has risen in recent decades, with significant variation within countries and between hospitals. The aim of this study was to review research supporting indications for IOL and determine which indications are supported by evidence and where knowledge gaps exist. Methods A systematic scoping review of quantitative studies of common indications for IOL. For each indication, we included systematic reviews/meta-analyses, randomised controlled trials (RCTs), cohort studies and case control studies that compared maternal and neonatal outcomes for different modes or timing of birth. Studies were identified via the databases PubMed, Maternity and Infant Care, CINAHL, EMBASE, and ClinicalTrials.gov from between April 2008 and November 2019, and also from reference lists of included studies. We identified 2554 abstracts and reviewed 300 full text articles. The quality of included studies was assessed using the RoB 2.0, the ROBINS-I and the ROBIN tool. Results 68 studies were included which related to post-term pregnancy (15), hypertension/preeclampsia (15), diabetes (9), prelabour rupture of membranes (5), twin pregnancy (5), suspected fetal compromise (4), maternal elevated body mass index (BMI) (4), intrahepatic cholestasis of pregnancy (3), suspected macrosomia (3), fetal gastroschisis (2), maternal age (2), and maternal cardiac disease (1). Available evidence supports IOL for women with post-term pregnancy, although the evidence is weak regarding the timing (41 versus 42 weeks), and for women with hypertension/preeclampsia in terms of improved maternal outcomes. For women with preterm premature rupture of membranes (24-37 weeks), highquality evidence supports expectant management rather than IOL/early birth. Evidence is weakly supportive for IOL in women with term rupture of membranes. For all other indications, there were conflicting findings and/or insufficient power to provid...
Jittitaworn, W, Fox, D, Catling, C & Homer, CSE 2020, 'Recognising the challenges of providing care for Thai pregnant adolescents: Healthcare professionals' views.', Women and Birth.View/Download from: UTS OPUS or Publisher's site
BACKGROUND:In Thailand, maternal complications and poor neonatal outcomes are common in pregnant adolescents. There are attempts to improve outcomes for this group through specialised antenatal clinics, however, neither the way in which these clinics are provided nor the attitudes of healthcare professionals to pregnant adolescents are known. The aim of this study was to understand the experiences of healthcare professionals in caring for pregnant adolescent women in Thailand. METHODS:A qualitative descriptive design was used. Semi-structured interviews were conducted with 21 healthcare professionals involved in caring for pregnant adolescents across three public hospitals in Bangkok, Thailand. All interviews were analysed thematically. RESULTS:The core concept 'recognising the challenges of providing care for young Thai pregnant women' explained the provision of care. This concept contained three main themes: 1) having an awareness of the political and societal contexts and environment of care; 2) being aware of attitudes and the need to develop psychosocial skills in caring for adolescent women; and 3) having different approaches to caring for pregnant adolescents. A lack of continuity of care was a significant barrier in terms of structure and process. Effective communication was important to provide quality care. CONCLUSION:Healthcare professionals recognised that there were barriers to providing effective care for adolescent women. These findings may inform healthcare professionals and policymakers in Thailand in relation to the systems of care required and addressing the needs of pregnant adolescents. This would enable Thailand to meet the goal in providing a positive pregnancy experience for all women.
Braye, K, Ferguson, J, Davis, D, Catling, C, Monk, A & Foureur, M 2018, 'Effectiveness of intrapartum antibiotic prophylaxis for early-onset group B Streptococcal infection: An integrative review.', Women and Birth, vol. 31, no. 4, pp. 244-253.View/Download from: UTS OPUS or Publisher's site
In some countries, up to 30% of women are exposed to intrapartum antibiotic prophylaxis for prevention of early-onset group B Streptococcal infection. Intrapartum antibiotic prophylaxis aims to reduce the risk of neonatal morbidity and mortality from this infection. The intervention may adversely affect non-pathogenic bacteria which are passed to the newborn during birth and are considered important in optimising health. Since many women are offered intrapartum antibiotic prophylaxis, effectiveness and implications of this intervention need to be established. This review considers clinical trials and observational studies analysing the effectiveness of intrapartum antibiotic prophylaxis.An integrative literature review was conducted. One systematic review, three clinical trials and five observational studies were identified for appraisal.Randomised controlled trials found intrapartum antibiotic prophylaxis effective but all retrieved randomised clinical trials had significant methodological flaws. High quality observational studies reported high rates of effectiveness but revealed less than optimal adherence to screening and administration of the prophylaxis. Scant consideration was given to short term risks, and long-term consequences were not addressed.Studies found intrapartum antibiotic prophylaxis to be effective. However, evidence was not robust and screening and prophylaxis have limitations. Emerging evidence links intrapartum antibiotic prophylaxis to adverse short and longer-term neonatal outcomes.Our review found high quality evidence of the effectiveness of intrapartum antibiotic prophylaxis was limited. Lack of consideration of potential risks of the intervention was evident. Women should be enabled to make informed decisions about GBS management. More research needs to be done in this area.
A number of adverse events in Australia and overseas have highlighted the need to examine the workplace culture in the maternity environment. Little attention has been paid to the midwifery workplace culture in Australia.
The study aimed to explore the midwifery workplace culture from the perspective of midwives themselves.
A qualitative descriptive design was used. Group and individual interviews were undertaken of urban, regional and rural-based midwives in Australia. Data were analysed thematically.
The study showed that both new and experienced midwives felt frustrated by organisational environments and attitudes, and expressed strategies to cope with this. Five themes were identified from the data. These were: Bullying and resilience, Fatigued and powerless midwives, Being ‘hampered by the environment’, and The importance of support for midwifery.
The study discusses the themes in depth. In particular, discussion focusses on how midwifery practise was affected by midwives’ workplace culture and model of care, and the importance of supportive relationships from peers and managers.
This study illuminated both positive and negative aspects of the midwifery workplace culture in Australia. One way to ensure the wellbeing and satisfaction of midwives in order to maintain the midwifery workforce and provide quality care to women and their families is to provide positive workplace cultures.
Simpson, M & Catling, C 2016, 'Understanding psychological traumatic birth experiences: A literature review.', Women and Birth, vol. 29, no. 3, pp. 203-207.View/Download from: UTS OPUS or Publisher's site
Traumatic birth experiences can cause postnatal mental health disturbance, fear of childbirth in subsequent pregnancies and disruption to mother-infant bonding, leading to impaired child development. Some women may develop postnatal Post Traumatic Stress Disorder, which is a particularly undesirable outcome. This paper aimed to gain a better understanding of factors contributing to birth trauma, and the efficacy of interventions that exist in the literature.A literature search was undertaken in April 2015. Articles were limited to systematic reviews or original research of either high to moderate scientific quality. A total of 21 articles were included in this literature review.Women with previous mental health disorders were more prone to experiencing birth as a traumatic event. Other risk factors included obstetric emergencies and neonatal complications. Poor Quality of Provider Interactions was identified as a major risk factor for experiencing birth trauma. Evidence is inconclusive on the best treatment for Post Traumatic Stress Disorder; however midwifery-led antenatal and postnatal interventions, such as early identification of risk factors for birth trauma and postnatal counselling showed benefit.Risk factors for birth trauma need to be addressed prior to birth. Consideration needs to be taken regarding quality provider interactions and education for maternity care providers on the value of positive interactions with women. Further research is required into the benefits of early identification of risk factors for birth trauma, improving Quality of Provider Interactions and how midwifery-led interventions and continuity of midwifery carer models could help reduce the number of women experiencing birth trauma.
Watts, NP, Petrovska, K, Bisits, A, Catling, C & Homer, CSE 2016, 'This baby is not for turning: Women's experiences of attempted external cephalic version', BMC PREGNANCY AND CHILDBIRTH, vol. 16.View/Download from: UTS OPUS or Publisher's site
Petrovska, K, Watts, N, Catling, C, Bisits, A & Homer, C 2015, 'Breeching in the system: expectations and experiences surrounding a planned vaginal breech birth', BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, vol. 122, pp. 205-205.
Moores, A, Catling, C, West, F, Neill, A, Rumsey, M, Kilio Samor, M & Homer, CSE 2015, 'What motivates midwifery students to study midwifery in Papua New Guinea?', Pacific Journal of Reproductive Health, vol. 1, no. 2, pp. 60-67.View/Download from: UTS OPUS or Publisher's site
Introduction: Midwives in Papua New Guinea have a vital role to play in addressing the high maternal and neonatal mortality rate. Attracting applicants in sufficient numbers and quality to study midwifery has been challenging in some countries.
Aim: The aim of this study was to explore the motivation of students to study midwifery in Papua New Guinea. Findings from this study will assist in midwifery workforce recruitment and retention.
Methods: Between 2012-2014, midwifery students (n=298) from the four midwifery schools in Papua New Guinea were surveyed and interviewed on their perceptions regarding their midwifery studies. One part of the data collection process asked the students to describe their motivation to become a midwife with the question: Why did you choose to study midwifery? A content and thematic analysis was undertaken.
Results: 194 (65% response rate) students provided between 1-3 different responses to the question, making a total of 246 responses. Three main themes emerged which were recognising a public need; recognising professional needs; and, building upon experience.
Discussion: Forty-one percent (n=101) of midwifery students in Papua New Guinea studied midwifery because they wanted to help lower the high maternal mortality in the country. This is a unique finding reflecting the reality of maternal and child health in Papua New Guinea and is of great contrast to the motivations of midwifery students in similarly low to middle income countries in the region and globally.
Sibbritt, D, Catling, C, Adams, J, Shaw, A & Homer, CS 2014, 'The self-prescibed use of aromatherapy oils by pregnant women', Women and Birth, vol. 27, no. 1, pp. 41-45.View/Download from: UTS OPUS or Publisher's site
Homer, CSE, Foureur, MJ, Allende, T, Pekin, F, Caplice, S & Catling-Paull, C 2012, ''It's more than just having a baby' women's experiences of a maternity service for Australian Aboriginal and Torres Strait Islander families', Midwifery, vol. 28, no. 4, pp. e509-e515.View/Download from: Publisher's site
Homer, CS, Catling, C, Sinclair, D, Faizah, N, Balasubramanian Appiah, V, Foureur, M, Hoang, DB & Lawrence, EM 2010, 'Developing an interactive electronic maternity record', Birtish Journal of Midwifery, vol. 18, no. 6, pp. 384-389.View/Download from: UTS OPUS or Publisher's site
Women have a strong need to be involved in their own maternity care. Pregnancy hand-held records encourage women's participation in their maternity care; gives them an increased sense of control and improves communication among care providers. They have been successfully used in the UK and New Zealand for almost 20 years. Despite evidence that supports the use of hand-held records, widespread introduction has not occurred in Australia. The need for an electronic version of pregnancy hand-held records has become apparent, especially after the introduction of the Electronic Medical Record in Australia. A personal digital assistant (PDA) was developed as an interactive antenatal electronic maternity record that health-care providers could use in any setting and women could access using the internet. This article will describe the testing of the antenatal electronic maternity record.
Duffield, CM, Roche, MA, Diers, D, Catling, C & Blay, N 2010, 'Staffing, skill mix and the model of care', Journal of Clinical Nursing, vol. 19, no. 15-16, pp. 2242-2251.View/Download from: UTS OPUS or Publisher's site
The study explored whether nurse staffing, experience and skill mix influenced the model of nursing care in medical-surgical wards. Nurses (n=2278, 80.9% response rate) were surveyed using The Nursing Care Delivery System and the Nursing Work Index-Revised. Staffing and skill mix was obtained from the ward roster and other data from the patient record. Models of care were examined in relation to these practice environment and organisational variables.
McMurtrie, JE, Catling, C, Teate, A, Caplice, SL, Chapman, M & Homer, CS 2009, 'The St. George Homebirth Program: An evaluation of the first 100 booked women', The Australian and New Zealand Journal of Obstetrics and Gynaecology, vol. 49, no. 6, pp. 631-636.View/Download from: UTS OPUS or Publisher's site
Background: The St. George Homebirth Program was the first publicly funded homebirth model of care set up in New South Wales. This program provides access to selected women at low obstetric risk the option of having their babies at home. There are only four other publicly funded homebirth programs operating in Australia. Aims: To report the outcomes of the first 100 women booked at the St. George Homebirth Program. Methods: A prospective descriptive study was undertaken. Data were collected on the first 100 women who gave birth between November 2005 and March 2009. Two databases were accessed and missing data were followed up by review of the relevant charts. Results: Of the first 100 booked women, 63 achieved a homebirth, 30 were transferred to hospital or independent midwifery care in the antenatal period and seven were transferred intrapartum. Two women were transferred to hospital in the early postnatal period, one for a postpartum haemorrhage and one for hypotension. One baby suffered mild respiratory distress, was treated in the emergency department and was discharged home within four hours. Conclusion: The St. George Hospital homebirth program has provided reassuring outcomes for the first 100 women it has cared for over the past four years. Wider availability of this service could be achieved provided there is the appropriate close collaboration between providers and effective processes for consultation, referral and transfer. The outcomes of women and babies in publicly funded homebirth programs deserve further study, and the development of a national prospective database of all planned homebirths would contribute to this knowledge.
Duffield, CM, Gardner, G, Chang, AM & Catling, C 2009, 'Advanced nursing practice: A global perspective', Collegian - Journal of Royal College of Nursing, Aust..., vol. 16, no. 2, pp. 55-62.View/Download from: UTS OPUS or Publisher's site
To review the titles, roles and scope of practice of Advanced Practice Nurses internationally. Background: There is a worldwide shortage of nurses but there is also an increased demand for nurses with enhanced skills who can manage a more diverse, complex and acutely ill patient population than ever before. As a result, a variety of nurses in advanced practice positions has evolved around the world. The differences in nomenclature have led to confusion over the roles, scope of practice and professional boundaries of nurses in an international context. Method: CINAHL, MEDLINE, and the Cochrane database of Systematic Reviews were searched from 1987 to 2008. Information was also obtained through government health and professional organisation websites. All information in the literature regarding current and past status, and nomenclature of advanced practice nursing was considered relevant. Findings: There are many names for Advanced Practice Nurses, and although many of these roles are similar in their function, they can often have different titles. Conclusion: Advanced Practice Nurses are critical for the future, provide cost effective care and are highly regarded by patients/clients. They will be a constant and permanent feature of future health care provision. However, clarification regarding their classification and regulation is necessary in some countries.
Aim: To find that changes in models of service delivery together with the dynamic nature of the contemporary health care context have changed the direction and focus of nurses' work. The aim of this paper is to explore some of the drivers for change and their impact and recommend a way forward to optimising nurses' work in the hospital environment. Background: The healthcare workplace has been transformed over the past 20 years in response to economic and service pressures. However, some of these reforms have had undesirable consequences for nurses' work in hospitals and the use of their time and skills. Results: As the pace and complexity of hospital care increases, nursing work is expanding at both ends of the complexity continuum. Nurses often undertake tasks which less qualified staff could do while at the other end of the continuum, are unable to use their high level skills and expertise. This inefficiency in the use of nursing time may also impact negatively on patient outcomes. Conclusions: Nurses' work that does not directly contribute to patient care, engage higher order cognitive skills or provide opportunity for role expansion may decrease retention of well-qualified and highly skilled nurses in the health workforce. Relevance to clinical practice: In this climate of nursing shortages, we need to use nurses in a cost-effective but also, intellectually satisfying manner, to achieve a sustainable nursing workforce.
Murray-Parahi, P, Catling, C & Homer, C 2018, 'A new career pathway for new graduate midwives: Barriers or opportunities?', WOMEN AND BIRTH, ELSEVIER SCIENCE BV, pp. S21-S21.View/Download from: UTS OPUS or Publisher's site
Catling, C 2015, 'Regulation, Association and Education of midwives', International Seminar, Akademi Kebidanan Kartini, Bali.
Catling, C, Coddington, R, Foureur, M & Homer, CSE 2013, 'Publicly-funded homebirth in Australia: A review of maternal and neonatal outcomes for the last six years', New Horizons, Royal North Shore Hospital, Sydney.View/Download from: UTS OPUS
Catling, C 2011, 'Publicly-funded homebirth panel member', Homebirth Australia Conference, Newcastle.
Catling, C 2011, 'Why women choose a publicly-funded homebirth', A Midwifery Odyssey, Australian College of Midwives 17th National Conference, Sydney.
Catling, C 2010, 'What are the influences on women who choose a homebirth? Preliminary results from PhD study', Midwives & Women: A Brilliant Blend: Australia College of Midwives 16th National Conference, Adelaide.
Catling, C 2005, 'Vitamin D levels in pregnant women and their babies in Sydney', 27th Triennial Congress of the International Confederation of Midwives, Brisbane.
Catling, C 2003, 'Consulting with the community', Australian College of Midwives Incorporated 13th Biennial National Conference, Darwin.