A new study shows many midwives receive little or no training on how to communicate to expectant parents; about the importance of maternal and childhood vaccine; in spite of being the most trust source of information on vaccines in the Australian public antenatal system.The research led by the Murdoch Children’s Research Institute found that while midwives support vaccination; some had varying views on whether it was central to their role.

Lead author Dr. Jessica Kaufman said the study found communication practices of midwives focus; primarily on the immunization schedule rather than persuasion, although some shared personal views and actively encouraged vaccination. But Dr. Kaufman said all requested more vaccine education and communication training, to address concerns, as well as more practical resources.

Vaccine Information

“Midwives are expect to provide vaccine information and to recommend maternal pertussis, influenza, and infant hepatitis B vaccinations,” she said. “They are not professionally require to discuss later childhood vaccines; but parents indicate that they would like more information about these vaccines during the antenatal period.

“There is a clear need for communication tools to support midwives to address parents’ questions and concerns. We know that having conversations with parents who are hesitant about vaccines can be very hard.” Dr. Kaufman said until this study little was known about, how midwives communicate about maternal vaccination and childhood vaccines in Australia; and what training and resources they would like to have to support these conversations.

“In Australian public antenatal settings, midwives provide a substantial proportion of care and are; the most highly access and trust sources of vaccine information for expectant parents,” she said.  “However, there are no evidence-based interventions for midwives, to optimize discussions and promote acceptance of maternal and childhood vaccines.”

“Most midwives in the study said they receive little or no training to effectively communicate about; vaccines during their degree programs, especially with regard to childhood vaccines. ” Dr. Kaufman said some midwives felt they lack information, to provide or did not feel confident discussing vaccines in more depth. She said several thought print fact sheets and online resources, such as an educational website or an app for parents with vaccine safety and effectiveness facts would be helpful.

Increasing and sustaining high coverage rates

The study involve interviews with 12 midwives (seven from the Royal Women’s Hospital and five from the King Edward Memorial Hospital in Perth) on their attitudes and values, regarding maternal and childhood vaccination, their perceive role in vaccine advocacy and delivery; and the barriers and enablers to implementing a communication strategy.

Dr. Kaufman said in the study some midwives viewed vaccination as a key feature of their role; while others saw it as a minor or routine element. “All the interview midwives support vaccination but some prefer to defer to other providers to discuss vaccines because; they sought to maintain the trust and rapport they see as unique between midwives and pregnant women” she said. “But some express reservations about pushing vaccination too strongly or sharing personal views.”

“Increasing and sustaining high coverage rates are critical especially as new maternal vaccines for respiratory syncytial virus and group B strep are introduce in coming years. With up to four vaccines available in pregnancy, these decisions and discussions will become even more complex and challenging,” she said.

“This model includes parent and provider reminders, training to improve provider communication and encourage vaccine recommendation, and parent information resources addressing vaccine benefits and disease severity,” she said.