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Maternal Health

The Maternity Research theme at Warwick CTU, in collaboration with University Hospitals Coventry and Warwick (UHCW), focuses on the development, implementation and evaluation of interventions to improve maternal and infant health and well-being before, during and after pregnancy. Working across both Warwick Clinical Trials Unit and UHCW our multi-disciplinary team including service users, develop and lead multi-centre randomised controlled trials, and a portfolio of primary and secondary research studies using quantitative and qualitative approaches and evidence synthesis, to generate high quality evidence to meet priority health needs before, during and after pregnancy.

The focus of our research covers issues relevant to the maternal and infant life-course, from understanding how to prevent recurrent early pregnancy miscarriage and pre-term labour, evaluation of interventions during labour to improve maternal and infant outcomes, optimal management of medically complex pregnancies, and how postnatal contacts could be planned and managed to address maternal physical and psychological co-morbidity, including better understanding of breastfeeding support needs.

Our current work is funded by the NIHR HTA programme, NIHR EME programme, NIHR Research for Patient Benefit programme, NIHR Public Health Research programme, Tommy’s Charity, Burdett Trust for Nursing, Department of Health, and NIHR CLAHRC South London.

We have a range of expertise and experience in supervision of post-graduate and post-doctoral students. If you are interested in post-graduate study, including applications for fellowship awards in a relevant area, please contact Professor Bick debra dot bick at warwick dot ac dot uk.

Recent publications:

Quenby S, Gallos ID, Dhillon-Smith RK, Podesek M, Stephenson MD, Fisher JD, Brosens JJ, Brewin J, Ramhorst R, Lucas ES, McCoy RC, Anderson R, Daher S, Regan L, Al-Memar M, Bourne T, MacIntyre DA, Rai R, Christiansen OB, Sugiura-Ogasawara M, Odendaal J, Devall AJ, Bennett PR, Petrou S, Coomarasamy A. Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss. Lancet. 2021 Apr 23:S0140-6736(21)00682-6. doi: 10.1016/S0140-6736(21)00682-6. Epub ahead of print. PMID: 33915094.

Coomarasamy A, Gallos ID, Papadopoulou A, Dhillon-Smith RK, Al-Memar M, Brewin J, Christiansen OB, Stephenson MD, Oladapo OT, Wijeyaratne CN, Small R, Bennett PR, Regan L, Goddijn M, Devall AJ, Bourne T, Brosens JJ, Quenby S. Sporadic miscarriage: evidence to provide effective care. Lancet. 2021 Apr 23:S0140-6736(21)00683-8. doi: 10.1016/S0140-6736(21)00683-8. Epub ahead of print. PMID: 33915095.

Coomarasamy A, Dhillon-Smith RK, Papadopoulou A, Al-Memar M, Brewin J, Abrahams VM, Maheshwari A, Christiansen OB, Stephenson MD, Goddijn M, Oladapo OT, Wijeyaratne CN, Bick D, Shehata H, Small R, Bennett PR, Regan L, Rai R, Bourne T, Kaur R, Pickering O, Brosens JJ, Devall AJ, Gallos ID, Quenby S. Recurrent miscarriage: evidence to accelerate action. Lancet. 2021 Apr 23:S0140-6736(21)00681-4. doi: 10.1016/S0140-6736(21)00681-4. Epub ahead of print. PMID: 33915096.

Da Silva Tanganhito D, Chang YS, Bick D. Breastfeeding experiences and perspectives among women with postnatal depression: A qualitative evidence synthesis. 2019. Women and Birth. Jun 10. pii: S1871-5192(19)30260-4. doi: 10.1016/j.wombi.2019.05.012

Bucknall A, Bick D. Repeat pregnancies in teenage mothers enrolled on the Family Nurse Partnership Programme: An exploratory study. 2019. Journal of Advanced Nursing. Jun 26.doi: 10.1111/jan.14140. [Epub ahead of print]

Chang YS, Beake S, Davies P, Bick D. Breastfeeding experiences and support for women who are overweight or obese: A mixed methods systematic review. 2019. Maternal and Child Nutrition. Jun 25:e12865. doi: 10.1111/mcn.12865. [Epub ahead of print] Review.

Chapman A, Nagle C, Bick D, Lindberg R, Kent B, Calache J, Hutchinson AM. Maternity service organisational interventions that aim to reduce caesarean section: A systematic review and meta-analyses. BMC Pregnancy and Childbirth. 2019 Jul 9;19(1):206. doi: 10.1186/s12884-019-2351-2.

Lever-Taylor B, Johnson S, Bick D, Morant N, Billings J. Experiences of how services supporting women with perinatal mental health difficulties work with their families: A qualitative study in England. BMJ Open. 2019 Jul 24;9(7):e030208. doi: 10.1136/bmjopen-2019-030208.

Baldwin S, Malone M, Sandall J, Bick D. A qualitative exploratory study of first time fathers experiences, mental health and wellbeing needs during transition to fatherhood. BMJ Open Sep 13;9(9):e030792. doi: 10.1136/bmjopen-2019-030792.

Jakes A, Oakeshott P, Bick D. The six – eight week postnatal check. 10 minute consultation. Br Medical Journal. 2019 Dec 2;367:l6482. doi: 10.1136/bmj.l6482

Bick D, Ashworth DC, Mayer F, Taylor C. High-risk Pregnancy due to Mental and Physical Co-morbidity. Glob libr women's med (ISSN: 1756-2228) 2019; DOI 10.3843 (in press).

Trevillion K, Ryan E, Pickles A, Heslin M, Byford S, Milgom J, Nath S, Bick D, Mycroft R, Domony J, Pariante C, Hunter M, Howard L. An exploratory parallel-group randomised controlled trial of antenatal Guided Self-Help (plus usual care) versus usual care alone for pregnant women with depression: DAWN trial. 2020. Journal of Affective Disorders (26115); 187-197.

Bick D, Duff E, Shakespeare J Better Births - But why not better postnatal care? Midwifery. 2019 Nov 9:102574. doi: 10.1016/j.midw.2019.102574. [Epub ahead of print]

Bick D, Taylor C, Avery A, Bhavnani V, Craig V, Healey A, Khazaezadeh N, McMullen S, Oki B, Oteng-Ntim E, O'Connor S, Poston L, Seed P, Roberts S, Ussher M. Protocol for a two-arm feasibility RCT to support postnatal maternal weight management and positive lifestyle behaviour in women from an ethnically diverse inner city population: the SWAN feasibility trial. Pilot Feasibility Stud. 2019 Oct 23;5:117. doi: 10.1186/s40814-019-0497-3. eCollection 2019.

Salmon, V.E, Hay-Smith, E.J.C, Jarvie, R., Dean, S., Frawley, H., Oborn, E., Bayliss, S.E, Bick, D., Davenport, C., Ismail, K.M, MacArthur, C. & Pearson, M. Implementing pelvic floor muscle exercises in the childbearing years: A Critical Interpretive Synthesis of individual, professional, and service issues. Neurology & Urodynamics 2019 Dec 17. doi: 10.1002/nau.24256. [Epub ahead of print]

Griffiths J, Taylor BL, Morant N, Bick D, Howard LM, Seneviratne G, Johnson S. A qualitative comparison of experiences of specialist mother and baby units versus general psychiatric wards. BMC Psychiatry 2019 Dec 16;19(1):401. doi: 10.1186/s12888-019-2389-8.

Bick D, Taylor C, Bhavnani V, Healey A, Seed P, Roberts S, Zasada M, Avery A, Craig V, Khazaezadah N, McMullen S, O'Connor S, Oki B, Oteng Ntim E, Poston L, Ussher M. Lifestyle information and commercial weight management groups to support maternal postnatal weight management and positive lifestyle behaviour: the SWAN feasibility randomised controlled trial. British Journal of Obstetrics and Gynaecology. 2019 Dec 5. doi: 10.1111/1471-0528.16043.

Kelly NM, Keane JV, Gallimore RB, Bick D, Tribe RM. Neonatal weight loss and gain patterns in caesarean section born infants: integrative systematic review. Matern Child Nutr. 2019 Nov 27:e12914. doi: 10.1111/mcn.12914. [Epub ahead of print]

Fernandez Turienzo C, Bick D, Bollard M, Brigante L, Briley A, Coxon K, Cross P, Healey A, Mehta M, Melaugh A, Moulla J, Seed PT, Shennan AH, Singh C, Tribe RM and Sandall J. POPPIE: protocol for a randomised controlled pilot trial of continuity of midwifery care for women at increased risk of preterm birth. Trials. (2019) 20:271

Bick D, Silverio SA, Bye A, Chang YS. Postnatal care following hypertensive disorders of pregnancy: a qualitative study of views and experiences of primary and secondary care clinicians. BMJ Open. 2020 Jan 19;10(1):e034382. doi: 10.1136/bmjopen-2019-034382.

Bye A, Nath S, Ryan EG, Bick D, Easter A, Howard LM, Micali N. Prevalence and clinical characterisation of pregnant women with eating disorders. European Eating Disorders Review. 2020 Mar;28(2):141-155. doi: 10.1002/erv.2719. Epub 2020 Jan 27

Peven K, Purssell E, Taylor C, Bick D, Lopez VK. Breastfeeding support in low and middle-income countries: secondary analysis of national survey data. Midwifery. 2020 Mar;82:102601. doi: 10.1016/j.midw.2019.102601. Epub 2019 Dec 10.

Bick D. COVID-19: 2020 is the International Year of the Midwife. Editorial. Midwifery. 2020 Jun;85:102719. doi: 10.1016/j.midw.2020.102719

Meyer F, Bick D, Taylor C. To what extent does the UK and Irish maternity policy and guidance address integration of services to meet needs of women with co-morbidity? A scoping review. Midwifery. 2020 Sep; 88:102758. doi: 10.1016/j.midw.2020.102758. Epub 2020 May 26.

Taylor C, Zaszada M, Ussher M, Bick D. Barriers and facilitators to uptake and retention of inner-city ethnically diverse women in a postnatal weight management intervention: a mixed methods process evaluation within a feasibility trial. BMJ Open. 2020 Jul 21;10(7):e034747. doi: 10.1136/bmjopen-2019-034747

Bick D, Taylor C, Bhavnani V et al. Lifestyle information and access to a commercial weight management group to promote maternal postnatal weight management and positive lifestyle behaviour: the SWAN feasibility RCT. Public Health Research Volume: 8, Issue: 9, Published in August 2020.

Davie P, Chilcott J, Jones L, Bick D, Silverio S. Indicators of ‘good’ feeding, breastfeeding latch and feeding experiences among healthy women with healthy infants: A qualitative pathway analysis using Grounded Theory. Women and Birth. 2020 Sep 1:S1871-5192(20)30305-X. doi: 10.1016/j.wombi.2020.08.004.

Davie P, Bick D, Chilcott J. The Beliefs About Breastfeeding Questionnaire (BAB-Q): A Psychometric Validation Study. British Journal of Health Psychology. 2021 May;26(2):482-504. doi: 10.1111/bjhp.12498. Epub 2020 Dec 19.

Fernandez Turienzo, Bick D, Briley A et al. Effect of continuity of midwifery care versus standard maternity care for women at increased risk of preterm birth: a hybrid implementation-effectiveness, randomised, controlled pilot trial. PLoS Med. 2020 Oct 6;17(10):e1003350. doi: 10.1371/journal.pmed.1003350. eCollection 2020 Oct.

Peven K, Bick D, Purssell E, Rotevatn TA, Hyldgaard Nielsen J, Taylor C. Evaluating implementation strategies for essential newborn care interventions in low- and low middle-income countries: a systematic review. Health Policy and Planning, Volume 35, Issue Supplement_2, November 2020, Pages ii47–ii65,

Hirsch CR, Meeten F, Gordon C, Newby JM, Bick D, Moulds, ML. Repetitive Negative Thinking and Interpretation Bias in Pregnancy. In press. Clinical Psychology in Europe

Macgregor R, Bick D, Hillman S. COVID and the GP six-week check. Br J General Practice. 2020 Nov 26;70(701):578-579. doi: 10.3399/bjgp20X713573.

Lewis L, Bick D, Demilew J, Howard L. Mental disorders and fear of childbirth: a cohort study of women in an inner-city maternity service. Nath S, Birth. 2021 Mar 17. doi: 10.1111/birt.12532

Carter W, Bick D, Mackintosh N, Sandall J. Maternal help seeking about early warning signs and symptoms of pre-eclampsia: a qualitative study of experiences of women and their families. Midwifery. 2021 Mar 18;98:102992. doi: 10.1016/j.midw.2021.102992

Lok, K, Chow CLY, Shing JSY, Smith R, Lam CO, Bick D, Chang YS. Feasibility, acceptability, and potential efficacy of an innovative postnatal home-based breastfeeding peer support programme in Hong Kong: a feasibility and pilot randomised controlled trial. In Press. International Breastfeeding Journal.

Chang YS, Li KMC, Li KYC, Beake S, Lok KYW, Bick D. Relatively speaking? Partners' and family members' views and experiences of supporting breastfeeding: a systematic review of qualitative evidence. Philos Trans R Soc Lond B Biol Sci. 2021 Jun 21;376(1827):20200033. doi: 10.1098/rstb.2020.0033

Davie P, Bick D, Pasupathy D, Norton S, Chilcot J. Infant feeding practices among macrosomic infants: A prospective cohort study. Maternal and Child Nutrition. 2021 Jun 1:e13222. doi: 10.1111/mcn.13222.

Peven K, Mallick L, Taylor C, Bick D, Day LT, Kadzem L, Purssell E. Equity in newborn care, evidence from national surveys in low- and middle-income countries. Int J Equity Health. 2021 Jun 5;20(1):132. doi: 10.1186/s12939-021-01452-z.

Freed B, Hillman S, Shantikumar S, Bick D, Dale J, Gauly J. The impact of disasters on contraception in OECD member countries: a scoping review. European Journal of Contraception and Reproductive Health Care. 2021 Jun 15:1-10. //

Baldwin S, Bick D. Using framework analysis in health visiting research: Exploring first-time fathers mental health and well-being. In press. Journal of Health Visiting.

Atkinson L, Fallon F, Bick D, Silverio S. Relationships between paternal attitudes, paternal involvement, and infant-feeding outcomes: Mixed-methods findings from a global, on-line survey of English-speaking fathers. In press. Maternal and Child Nutrition.

Howard L et al. The Effectiveness and Cost-Effectiveness of Perinatal Mental Health Services (ESMI). In press. NIHR journals

Peven K, Taylor C, Pursell E, Malick L, Bick D. Distance to available services for newborns at facilities in Malawi: a secondary analysis of survey and health facility data. In press. PLOS One.

Li, C, Li K, Bick D, Chang YS. HIV-positive women's perspectives on breastfeeding with antiretrovirals: a qualitative evidence synthesis. In press. Maternal and Child Nutrition.

Zanganeh, Mandana, Jordan, Mary, Mistry, Hema, 2021. A systematic review of economic evaluations for donor human milk versus standard feeding in infants. Maternal and Child Nutrition

Hunter C, Bick D. (2019) Early-career midwives' experiences of perineal assessment and repair after normal vaginal birth. Br J of Midwifery.

Isaacs R, van Teijlingen E, Wee M, Hundley V, Smith G, Bick D, Gale-Andrews L. (2019). Design errors in vital sign charts used in consultant-led maternity units in the United Kingdom. Int J of Obstetric Anaesthesia.

Domoney J, Fulton E, Stanley N, McIntyre A, Heslin M, Byford S, Bick D, Ramchandani P, MacMillan H, Howard LM, Trevillion K (2019). For Baby’s Sake: Intervention Development and Evaluation Design of a Whole-Family Perinatal Intervention to Break the Cycle of Domestic Abuse. Journal of Family Violence.

Baldwin S, Bick D. (2019) Evidence from a systematic review on first-time fathers’ mental health and well-being needs. Journal of Health Visiting.

Lockwood Estrin G, Ryan EG, Trevillion K, Demilew J, Bick D, Pickles A, Howard L. (2019). Mental disorders in young pregnant women: findings from an early pregnancy cohort. Br J of Psychiatry Open.

Davie P, Bick D, Chilcott J. To What Extent Does Maternal Body Mass Index (BMI) Predict Intentions, Attitudes or Practices of Early Infant Feeding? Maternal and Child Nutrition. 2019 May 6:e12837. doi: 10.1111/mcn.12837. [Epub ahead of print]

Bick D, Ashworth A, Meyer F, Taylor C. High-risk Pregnancy due to Mental and Physical Co-morbidity. Chapter 5. The FIGO Continuous Textbook of Women’s Medicine – Obstetrics Module. Vol 7. DOI 10.3843/GLOWM.00000.

Fernandez Turienzo C, Bick D, Bollard M, Brigante L, Briley A, Coxon K, Cross P, Healey A, Mehta M, Melaugh A, Moulla J, Seed PT, Shennan AH, Singh C, Tribe RM and Sandall J. POPPIE: protocol for a randomised controlled pilot trial of continuity of midwifery care for women at increased risk of preterm birth. Trials. In press.

Research project pages:
Recently completed trials:

The SWAN Study - Click here for details


Members of the Maternity and Obstetrics theme have published a three-paper report published in The Lancet highlights that the current approach to miscarriage care must be improved – see recent publications.

Key People:

Professor Debra Bick - theme lead

Professor Siobhan Quenby

Dr Joanne Fisher

Dr Hema Mistry

Dr Sharin Baldwin

Dr Nithya Sukumar