Miranda S Cumpston, Anneliese Arno, Shaira N Baptista, Shannon Barnes, Zoe Bradfield, Samantha P Chakraborty, Caroline S E Homer, Stefan C Kane, Nisha Khot, Steve McDonald, Steven McGloughlin, Tanya Millard, Jeremy J N Oats, Loyal Pattuwage, Matthew Quigley, Abdulbasit Seid, Rachel Silk, Alecia Staines, Anneliese Synnot, Alison Teate, Heath White, Tari Turner, LEAPP Guideline Development Group
For most high-priority clinical conditions in Australia, there are no up-to-date evidence-based guidelines available to support clinical decision-making. Guideline developers and funders should invest more energy and resources into planning for updates and ensuring that methods and processes are optimised to facilitate this, such as considering a living approach.
INTRODUCTION: The Living Evidence for Australian Pregnancy and Postnatal Care (LEAPP) program was established in 2023 to update and transition the Australian Pregnancy Care Guidelines into living guidelines and to establish new, living Australian Postnatal Care Guidelines. The program is a collaboration of the Australian Living Evidence Collaboration (ALEC), the Australian College of Midwives, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and 23 other Australian health organisations. The guidelines are developed using methods designed to meet the National Health and Medical Research Council standards. Clinical questions are prioritised by clinician and lived experience input. For each prioritised question, evidence is reviewed using systematic methods (existing published reviews or conducted de novo), contextual factors such as feasibility and equity are considered and new or updated recommendations are drafted. A lived experience panel and multidisciplinary clinical panels review draft recommendations. Unanimous endorsement by all 25 partner organisations is required before publication. Surveillance searches are conducted for most topic areas every 6 months. New and updated content is progressively added to the published guidelines.
RECOMMENDATIONS: As of August 2026 (version 11), the Australian Pregnancy Care Guidelines include 277 recommendations on more than 80 topics; 229 are new or updated since 2023. The new Australian Postnatal Care Guidelines include 149 recommendations on more than 20 topics. The guidelines are published online at https://livingevidence.org.au/living-guidelines/leapp/.
CHANGES IN MANAGEMENT AS A RESULT OF THE GUIDELINE: New or updated recommendations include continuity of care, assessment and support on vaping, increased testing for syphilis, reduced testing for proteinuria, guidance on progesterone and cervical cerclage to prevent preterm birth, bereavement support, assessment and support for psychological birth trauma, screening for family violence, side sleeping in later pregnancy and a recommendation against vitamin D.