BACKGROUND:
Digital innovation is essential to scale midwifery-led, woman-centred care. The Maternity Clinical Decision Support Tool (Mat-CDST), developed by a team of digital health experts and led by a midwife-researcher, is a fully automated, integrated, medical device that incorporates the ICHOM Pregnancy and Childbirth Set. It tracks changes in women’s health at five timepoints from booking to six months postpartum. Implementing digital health technology within complex health systems is challenging and the best approach to maximise success is unclear.

OBJECTIVES:
To implement and evaluate Mat-CDST in one large tertiary maternity service in Australia to inform feasibility, acceptability, appropriateness and scalability.

METHODS:
Our study is guided by Implementation Science methodology and informed by significant national stakeholder engagement. Mat-CDST collects outcome data directly from women via five digital surveys triggered by clinical appointments. It screens and tracks changes in outcomes including incontinence, mental health, quality of life, breastfeeding intent, success and confidence, mother-infant bonding, and birth satisfaction. It is further enhanced with validated tools to routinely screen for fear of birth and birth trauma. Evidence-informed algorithms generate real-time clinical recommendations and alerts, integrated into the electronic medical record. A mixed-methods evaluation is underway, focusing on the nuanced barriers to digital health technology experienced by a range of socially disadvantaged cohorts.

RESULTS:
Preliminary findings show improved clinical efficiency, enhanced shared decision-making, and increased satisfaction among women and clinicians. The tool reduces administrative burden, supports adherence to clinical guidelines, and enables timely, personalised care. Early data further demonstrates improved detection and response to psychosocial risks.

CONCLUSIONS:
Mat-CDST demonstrates how digital tools can empower midwives, personalise care, and improve outcomes at scale. Its implementation offers a replicable model for integrating the ICHOM Set into routine maternity care globally.

KEY MESSAGE:
Digital innovation can supports midwives to deliver value-based, woman-centred care and improve maternal outcomes, but targeted implementation strategies are key to success. Digital technology/AI 2