Study setting

The SBB initiative, education program and all associated resources have been promoted and made accessible state-wide to all hospitals and healthcare professionals providing maternity care in NSW, VIC and QLD. The initial rollout of the SBB in these jurisdictions is managed through state-specific SBB implementation programs providing targeted support to hospitals recruited to and engaged with these programs. Thus, while all public and private maternity hospitals will be exposed to the SBB initiative through access to eLearning and resources, initially state-wide uptake and implementation will be driven by participation in formal quality improvement programs. These programs provide the opportunity for an in-depth evaluation of such approaches by facilitating collection of comprehensive process and impact data.

This study includes all public and private hospitals providing maternity care in NSW, VIC and QLD. Sites are grouped by level of implementation support into: (1) ‘targeted’ implementers, maternity hospitals recruited to and engaged with state-led SBB implementation programs; (2) ‘non-targeted’ implementers, all other maternity hospitals in each state. For ‘targeted’ implementers, participation was open to maternity hospitals across the three jurisdictions, with those who expressed an interest in joining recruited. Up to August 2020, 83 sites/hospitals were recruited (VIC- 23 sites across all 6 health regions, NSW- 25 sites across 4 Local Health Districts and QLD- 36 sites across 17 Hospital & Health Services). These sites account for approximately half of all births in these states.

Change in stillbirth rates and other important clinical outcomes will be described by state-wide routinely collected perinatal data for all births. Comparisons will be described by state, ‘targeted’ versus ‘non-targeted’ implementers, and between ‘targeted’ implementers. The study population includes women with a singleton pregnancy (28 weeks’ gestation or more) without lethal fetal anomalies attending for antenatal care.

For other aims and objectives, evaluations described here for process, impact, outcome and economic measures apply specifically to ‘targeted’ implementers (unless otherwise stated). The study population for these includes all women attending for antenatal care and healthcare professionals providing maternity care at ‘targeted’ implementer sites.