Date: 30 July 2019
Dominique Mylod is a clinical doctorate midwife at the Faculty of Health and Social Sciences, Bournemouth University. The clinical doctorate programme allows clinicians to work clinically for 40% and undertake PhD research for 60% of their time.
In her role as a chief investigator for the Ball Assisted Latent Labour (BALL) trial, Dominique has been researching the use of a birth ball in the latent phase of labour (or ‘early labour’).
“The obvious thing was to address women’s concerns directly, and that is how I came to set up the BALL trial, with the primary outcome to see whether using a birth ball at home in the latent phase of labour reduced women’s pain perception.
“There was a lot of information which supported using the birth ball in active labour, but there was hardly anything about using the birth ball in the latent phase of labour and absolutely nothing that supported using the birth ball at home in the latent phase.”
The trial consisted of two parallel groups of low risk pregnant women. These women were randomly allocated to either the intervention arm or to the control arm.
“The control arm had normal care,” Dominique explains, “they just did what they’d always done. My intervention arm received a birth ball to use at home in early labour.” She adds that intervention arm participants were also asked to watch a 90-second infomercial called ‘Having a Ball in Early Labour’.
“I asked everybody, control and intervention, when they arrived at the hospital to mark their pain on a ten-point visual analogue scale, which went from ‘no pain’ to ‘worst pain imaginable’. The other thing was that I'd primed up all my participants and said ‘Please don’t just think about your physical sensation. I would like you to factor in how you feel at the time’, to get as holistic an evaluation as possible.”
Dominique had previously worked as a chief investigator whilst studying for her MSc degree in Advanced Clinical Practice. “It was qualitative research into midwife’s perceptions of meaningful antenatal education to see what they felt were the enablers and barriers. It was very different to this research because I have had to work with hundreds of people.”
Throughout the BALL trial, Dominique experienced several challenges. “It got off to a slow start because I’m a novice at this and I hadn’t realised that I was going to need a bit of pick up time in terms of recruitment and data collection.” She later comments, “The IT is a personal challenge and learning goal but, in research terms, the recruitment was hugely ambitious. We needed 80% minimum and the fact that we got to 89% is astonishing.”
“I can’t believe how much I’ve learnt. I hope it’s made a contribution to the maternity unit; I could not have done it without the kind, generous staff, and certainly the research setting, which I have become insanely fond of, because the people I met were so lovely and they were so altruistic. So many of my participants said, ‘I’ll do it to help other women.’”
Dominique explains that her research was, “seen as something that had the potential to actually make everybody’s lives easier - hopefully for families and for the staff because women will be arriving in labour in a better frame of mind and possibly having more straightforward labours and births.”
“I’ve got the findings now. I’m writing them up and they will be published. I presented the preliminary findings at the Normal Birth Research Conference, but I am fine-tuning them. As always with research, there are some things that you find that you never bargain for.”
Dominique is currently in the process of collating the results onto an infographic, which will be shared with study participants.
“I’m so excited and proud, particularly because one of the findings is statistically significant. When I found it, I did a tap dance around the conference!
“From the findings that I’ve got, I think there’s a strong case to take it wider, and I want to do other research. I’ve definitely been bitten by the research bug!”
Dominique hopes that her research can make a difference. “It’s about making families’ lives better, promoting normal birth, helping babies arrive better and making happier families with better births. So, as a contribution to national and international public health, the ramifications are huge.”
The BALL study, which has been adopted onto the NIHR CRN Portfolio, is funded by the Wessex Partnership Scheme and sponsored by Bournemouth University.
Special acknowledgements are sent to Dominique's doctorate supervisors:
Professor Vanora Hundley
Professor Sue Way
Dr. Carol Clark