Objective:
The aim of the present study was to examine selection in a general practice-based pregnancy cohort.

Design:
Survey linked to administrative register data.

Setting and Subjects:
In spring 2015, GPs were recruited in two regions of Denmark and asked to invite all pregnant women in their practice who had their first prenatal care visit before 15 August 2016 to participate in the survey.

Outcome measures:
Characteristics of GPs and the pregnant women were compared at each step in the recruitment process – invitation of the GP, GP agreement to participate, actual GP participation, participation of the woman – with an uncertainty coefficient to quantify the step where the largest selection occurs.

Results:
Significant differences were found between participating and non-participating practices with regards to practice characteristics such as number of patients registered with the practice, age and sex of doctors, and type of practice. Despite these differences, the characteristics of the eligible patients differed little between participating and non-participating practices. In participating practices significant differences were however, observed between recruited and non-recruited patients.

Conclusion:
The skewed selection of patients was mainly caused by a high number of non-participants within practices that actively took part in the study. We recommend a focus on the sampling within participating practices as the most important factor in representative sampling of patient populations in general practice.

1. Only small differences in the characteristics of the eligible patients were observed between participating and non-participating practices but significant differences were however, observed between recruited and non-recruited patients.
2. Comprehensive sampling within participating practices may be the best way to generate representative samples of patients.

Introduction:
During pregnancy moderate exercise is recommended most days of the week. Lack of counselling about the benefits and not engaging in physical activity (PA) lead to low exercise levels.

Objective:
Rate the pattern of PA of the USF Global’s pregnant women. Know the existing PA limitations and their relation with the PA patterns.
Materials and Methods: Cross-sectional observational study with a random sample of pregnant women followed at USF Global, n 33. A questionnaire for sociodemographic, clinical characterization and PA habits was used. For the PA pattern the Score PPAQ was applied. The Mann-Whitney U Test, Kruskall-Wallis Test and Spearman's Rho (IC 95% e p < 0,05) were used.

Results:
Sample with predominantly low/moderate and occupational/domestic PA. Between sociodemographic variables and PA patterns, there are significant differences in total PA between active/non active pregnant women (p 0,035) and in vigorous PA between shift and non-shift working women (p 0,039). Within clinic and PA pattern, we highlight differences in: moderate/total PA between pregnant women who have pregnancy complications and those who haven’t (p 0,022/ p 0,028); and occupational/sports PA between pregnant women who have pregnancy complications and those who haven’t (p 0,007/p 0,032). There is negative correlation between gestational age and occupational/low/moderate/total PA (p 0/p 0,038/p 0,025/p 0,002). Within habits and PA patterns, there are differences in: sedentary PA between those who have previous/current PA habits or not (p 0.049); and sports PA among those who live with someone who encourages PA or not (p 0.048).

Conclusion:
Strategies to raise the practice of PA during pregnancy are imperative. The identified variables are determinant in this community PA pattern. Something that worries is the lack of information pregnant women have about PA. Training family doctors to educate PA during pregnancy is important to enable them to intervene early during follow-up appointments.

1. Importance of physical activity in pregnant women
2. Lack of knowledge of pregnant women about physical activity during pregnancy
3. How to provide an early intervention in pregnancy about the benefits of physical activity

Alcohol use during pregnancy poses several risks to the developing baby, yet results from the National Drug and Alcohol Survey (2019) indicate that just over 1 in 3 women drink alcohol during pregnancy. General practitioners play an important role in asking women who are pregnant or trying to conceive about their alcohol use. This study, supported by the Australian Government and the Foundation for Alcohol Research and Education (FARE) as part of the Every Moment Matters campaign, explored the feasibility of integrating a clinical decision support tool for alcohol screening into general practice clinical software systems, for women who are pregnant or trying to conceive. Through the synthesis of available evidence and drawing extensively on stakeholder interviews with healthcare providers and GP clinical software vendors, we present our findings on criteria to prompt screening in primary and community care settings; acceptable tools and prompts to use in practice; benefits, risks and feasibility of integrating prompts into GP clinical software; and barriers and enablers to successful integration and use of such prompts. This research has broader relevance to the development of GP clinical software systems and integration of decision support tools, the implications of this, and directions for further development will be outlined.
1. Australian Institute of Health and Welfare. 2020. National Drug Strategy Household survey 2019. https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey-2019/contents/summary

1. Understand appropriate criteria to initiate a prompt for alcohol screening for women who are pregnant or planning a pregnancy.
2. Understand how barriers might be overcome to undertaking routine screening for alcohol use among women who are pregnant or planning a pregnancy.
3. Understand how developers of GP clinical software are positioning around integration of prompts and decision support tools into their systems.

Addressing unmet need for caesarean section (CS) in low income countries and overuse of high-income countries, is a global priority.1 In the past three decades CS rates have doubled in Australia from 17.5% in 19902 to 35% in 20183. With rates beyond 10% not showing improvements to maternal or neonatal health outcomes. High rates of induction of labour and epidural analgesia, along with low rates of Vaginal Birth After Caesarean (VBAC) directly, or indirectly are driving CS rates.

In 2021 and in response to 2018 and 2020 Australian Commission on Safety and Quality in Health Care call to reduce non-medically indicated CS rates. Queensland Health, Australia sought to identify factors to address high CS rates resulting in the development of the Queensland Normal Birth Strategy (QNBS).

The QNBS report outlined five key recommendations to achieve reduction in non-medically indicated CS rates and increase normal birth. These were universal access to continuity of carer including homebirth, provision of multi-disciplinary normal birth education, development of co-designed resources to facilitate informed decision making, embed respectful maternity care and positive workplace culture and establish a sustainable Normal Birth Collaborative committee.

In October 2021, the QNBS project commenced scoping these recommendations and developing an implementation plan. The QNBS aims to improve outcomes for mothers and babies, enable midwives to work to full scope practice, improve cohesion and collaboration in maternity services, promote informed decision making for consumers and encourage a reduction in maternal and neonatal morbidity.

An understanding of the Queensland Normal Birthing Strategy

Background
Unprocessed adverse childhood experiences among parents may lead to poor parenting, and Norwegian healthcare professionals are according to guidelines expected to talk to pregnant women about parenthood considering their own upbringing. However, little is known about pregnant women’s thoughts and views on this subject.
Aims
To explore expectant women's reflections on parenthood considering their own childhood experiences.
Methods
In 2022 Norwegian pregnant women were invited via social media to answer a digital questionnaire about their thoughts and concerns about becoming parents, including questions about their own childhood experiences. Multiple-choice questions were analyzed descriptively, while free-text responses were categorized thematically. Preliminary data will be presented.
Results
We recruited 1402 pregnant women from all parts of Norway. Half of them were pregnant for the first time (51 %) and replied that they were “mostly” looking forward to becoming a mother (52 %). Almost all participants (95 %) reported that their own upbringing would have some or high impact on how they would raise their own child. Most women (76 %) reported their own childhood as good/ very good, while 10 % categorized it as difficult/very difficult. Most women provided examples of positive experiences they wanted to pass on to their children. However, a few women (N=29) strongly distanced themselves from their own upbringing, exemplified by the following quote: «My own upbringing will be used as a template of what I don’t want for my child.”
Conclusions
Even though most expectant women identified good childhood experiences that they would pass on to their own children, a minority of the women strongly distanced themselves from their own difficult childhood. Insight into unprocessed adverse childhood experiences among parents may be valuable knowledge for healthcare personnel when providing guidance on parenting

1) to promote GPs understanding of how unprocessed adverse childhood experiences among parents may lead to poor parenting
2) to give insight into expectant women's reflections on parenthood considering their own childhood
3) to provide examples of adverse childhood experiences that pregnant women want to protect their children from

In Australia, General Practitioners (GPs) are permitted to prescribe medication for Early Medical Abortion (EMA) after completing a brief online education program. Despite the brief training required, many GPs do not undertake this training for many reasons, including lack of general abortion care education and lack of peer support for difficult cases.
A small group of EMA iprescribers working in the Australian Capital Territory (ACT) in isolation in their own general practices providing abortion care to patients of their own, and patients refered to them, started an informal Community of Practice via WhatsApp. This was undertaken to allow improved peer support for complex or difficult cases, as well as for peer referral in times of inability to meet patient needs.
We will review the benefits member of the CoP have found from being a part of the group, and encourage others to look at ways that CoP could benefit them in special interests they have.

1. Improved understanding of the importance of Communities of Practice in specialised family medicine
2. Understand the role of Communities of Practices in increasing confidence in special interests
3. Improve understanding of the provision of EMA in Australia