Choosing your

positions during
labour and
birth:
A decision aid for women
having a vaginal birth
 If you have any concerns about yourself or your baby/babies and want to talk to someone, please call: What is this
»» your family doctor decision aid
about?
»» 13 HEALTH telephone line (13 432 584)
»» Lifeline counselling service (131 114)
»» Stillbirth and Neonatal Death Support (SANDS) helpline (1800 228 655)
»» Pregnancy, Birth & Baby Helpline (1800 882 436)

This decision aid has been written to support women who are planning a vaginal birth to know what to
expect and to have a say in making decisions about positions in labour and birth.
The research and development of this decision aid was conducted by Natasha Hayes, a health researcher at the Queensland Centre for
Mothers & Babies. The Centre is an independent research centre based at The University of Queensland and funded by Queensland Health. This decision aid provides information about two options:
The Centre does not stand to gain or lose anything by the choices you make after reading this decision aid. This decision aid has been
developed to be consistent with International Patient Decision Aid Standards criteria for quality decision aids whereever possible. 1. Being upright
2 Lying down
This decision aid is not meant to give you medical advice or recommend a course of treatment and you should not rely on it to provide
you with a recommended course of treatment. It is not intended and should not be used to replace the advice or care provided by your This decision aid will also answer the following questions:
midwife, your doctor and/or your obstetrician. You should consult and discuss your treatment options with your midwife, your doctor and/
or your obstetrician before making any treatment decisions. »» What are my options?
»» What happens if I choose an upright position?
»» What happens if I choose a lying down position?
The University of Queensland, its employees and affiliates have made reasonable efforts to ensure the content provided is up to date
and accurate. However, it does not guarantee and accepts no liability or responsibility for the accuracy, currency or completeness of the »» Will I always be able to choose?
information contained in this decision aid. To the extent permitted by law, The University of Queensland its employees and affiliates exclude
all liability including negligence for any injury, loss or damage caused by or arising out of any reliance on the content contained in this »» How might I choose between an upright position and a lying down position?
decision aid.
»» What are the differences between being upright and lying down during first stage labour?
Unless otherwise indicated, the content of this decision aid is the property of The University of Queensland. All content is protected by
Australian copyright law and, by virtue of international treaties, equivalent copyright laws in other countries. No material contained within this »» What are the differences between being upright and lying down in second stage labour?
decision aid may be reproduced or copied in any way without the prior written permission of The University of Queensland.
»» How can I make the decision that’s best for me?
Last updated: November 2012
»» How can I ask questions to get more information?

©2012 The University of Queensland, Brisbane Australia. ABN 63942912 684, CRICOS provider No. 00025B

What do the symbols mean?

The information in this decision aid has come from the best scientific studies available to us.
Numbers in brackets [1] indicate a reference to a study that is listed at the back of the decision aid.

We use this symbol when there is something you might like to ask your care provider about.

e-Version 1.3 2
What is labour
and what might
it feel like?
Women describe and rate the intensity of their labour pain very differently. Some women describe and closer together [5]. You may feel stronger pain through the contractions however this will usually
the process of birthing as the most intense physical feeling they have ever experienced, while others lessen between contractions. Women usually say that as they get closer to second stage labour, their
describe their pain as mild or moderate [1, 12]. Having information about labour (the process your body contractions become more painful. The length of first stage labour is different for every woman. For some
goes through when your baby is born) might help you make decisions about managing and working with women, this stage can last less than an hour, for others it may last up to a few days.
your pain.
Some women also experience lower back pain through first stage labour. It is thought that lower back
Some women say that labour pain can feel like period pain, while others disagree [13]. Women generally pain may be associated with a posterior fetal position (when the baby’s back is lying against the woman’s
experience more intense pain as labour progresses, however the pain can increase and decrease spine). However, it is still unclear as to what causes lower back pain during labour [5].
throughout labour [5]
What is second stage labour?
Words such as ‘cramping, aching, tiring, troublesome, pressing, excruciating, throbbing, fearful, and
happy’ have been used to describe how women feel during different stages of labour [2-4]. Each Second stage labour is from the complete dilation of the cervix (10cm) to the birth of your baby. Your
woman’s labour is different and unique. Each woman also has a different threshold for handling different contractions during second stage labour will push your baby from your uterus into your birth canal. When
sensations and pain. your baby is in the birth canal you will usually feel the urge to push your baby out. You may also feel the
pressure of your baby’s head between your legs.
Labour usually happens in three stages: first stage labour, second stage labour and third stage labour.
During second stage labour, your baby usually moves head first down through the birth canal and shows
his or her head through the opening of your vagina. When your baby’s head reaches the opening of your
What is first stage labour? vagina you may feel a hot, stinging sensation as the opening of your vagina stretches. After your baby’s
head has come out of your vagina, his or her shoulders and body will usually follow within the next
The progress of first stage labour is measured by how dilated (open) your cervix is in centimetres. First couple of contractions. The length of second stage labour is different for every woman. For some women
stage labour is from when your cervix starts to dilate to when it has fully dilated to 10cm. The dilation this stage can last for a few minutes, for others it may last over an hour.
(opening) of the cervix allows your baby to move from the uterus into the birth canal (the passage from the
uterus to outside the vagina).

First stage labour includes three phases: early, active and late.

»» Early phase of labour is from when the cervix starts to dilate to 4cm dilation

»» Active phase of labour is from 4cm dilation to about 8cm or 9cm dilation. Women say that the pain
of contractions normally becomes more painful from the active phase of labour onwards.

»» Late (or transitional) phase of labour is from about 8cm or 9cm to 10cm dilation

During the early part of first stage labour, your uterus contracts (tightens) to slowly open up your
cervix, preparing for the birth of your baby. Some women say that contractions feel like a tightening of
the stomach. These contractions may be irregular and quite far apart. Women usually say that these
contractions are not as painful as the contractions during later stages of labour. As you get closer
to second stage labour your contractions will usually become more regular, longer lasting, stronger

Photo courtesy of Rachel Ford

3
What is labour
and what might
it feel like?

What is third stage labour?

Third stage labour is from the birth of your baby to the birth of your placenta. The placenta is an organ
that connects to the wall of a pregnant woman’s uterus. The baby is connected to the placenta by the
umbilical cord. The umbilical cord allows nutrients (eg vitamins and minerals) and oxygen from the
woman to be carried to her baby.

The contractions that you experience through first and second stage labour will continue however are
not usually as intense as in third stage labour. Contractions during third stage labour allow your placenta
to separate from the inside wall of your uterus and also control any excessive bleeding.

The length of third stage labour is different for every woman. For some this stage can last for less than 30
minutes, for others it can last over an hour [6]. More information about third stage labour is provided in
‘Choosing how to birth your placenta: A decision aid for women having a vaginal birth’.

Many women experience afterpains (pains from the uterus contracting after birth). Afterpains can be
quite painful and often become more painful with breastfeeding. You might like to ask your care provider
about pain management options if you experience this.

What are Braxton Hicks contractions?

Before you go into labour you may experience Braxton Hicks contractions. Braxton Hicks contractions
are a tightening of the uterus (womb) which occurs throughout pregnancy. These contractions are not
labour contractions. Not all women feel Braxton Hicks contractions in early pregnancy as they can be
very subtle. As you get closer to giving birth you may experience more noticeable, intense and painful
Braxton Hicks contractions. Sometimes it can be hard to tell if the contractions experienced during
late pregnancy are Braxton Hicks contractions or whether they are the early stages of labour. This is
because Braxton Hicks contractions and early labour contractions can feel very similar. If you experience
contractions that you are worried or confused about, your care provider can help you to work out which
type of contractions you are experiencing.

Photo courtesy of Little Posers Photography

4
What are my choices for managing
and working with pain?

There are many different options for managing and working with pain. Often you can use different The following methods of pain management have not been discussed in other decision aids:
methods of pain management together. Some options however may only be used at certain points in
labour and some can’t be used together. »» Touch and massage
»» Support person
You might like to consider all your options for managing and working with pain before you go into labour »» Aromatherapy
so that you can be prepared. It is okay to change your mind along the way. All women have different »» Acupuncture and acupressure
beliefs, values and preferences, so the method of pain management for one woman may not be the best »» Hypnosis
for you. Therefore, when choosing which method of pain management is best for you, you might like to »» TENS (Transcutaneous Electrical Nerve Stimulation)
think about the following: »» Psychological and breathing methods
»» Heat packs
»» Your beliefs about whether pain should be managed or treated or if pain is a natural process »» Sterile water injections
»» Pethidine
»» The level of control you want over your body during labour and birth eg whether you want to feel »» Morphine
everything or whether you don’t want to feel pain »» Gas (Entonox® or nitrous oxide)

»» Some people classify pain differently: More details about the methods not discussed in this decisions aid will be available on our website in time:
www.havingababy.org.au
›› Physiological pain can be seen as pain from the natural effects of birth as a result of the muscles
in the body moving and working to deliver the baby

›› Abnormal pain can be seen as pain from complications of birth such as tearing

Not all birth places can offer every method of pain management. You might like to talk to your care
provider about what pain management options will be available to you at your planned place of birth and
what methods of pain management can and can’t be used together.

Unfortunately, our decision aids do not cover all methods of managing and working with your pain. When
deciding which methods to include in the book, we talked with women about what was important to
them, considered which methods women often use in Queensland and included some drug methods
and some non-drug methods. This decision aid will discuss in detail two pain management options.
These are: Analgesia: Pain management however you will still be conscious and have sensation

1. Positions in labour and birth Anaesthesia: Total or partial loss of sensation. Anaesthesia can be given to a certain area of the body
2. Having an epidural (local anaesthetic) or to the whole body for total loss of consciousness (general anaesthetic)

5
 What are my
options for
positions in labour?

During labour many women move around to find the positions that help them manage or work with their
pain and allow them to feel most comfortable. There are many positions that can be used during labour
and birth. These positions may also change through labour and birth. In the next few pages we talk
about the differences between being upright and lying down. We have discussed first and second stage
labour separately. All positions in labour can be grouped into two options. These are:

Option 1
Being upright

Option 2
Lying down

Photo courtesy of Little Posers Photography

6
 Option 1 Option 2
What happens if I choose What happens if I choose
an upright position? a lying down position?

Upright positions include any positions where the body is working with gravity to help the baby move Lying down positions include when your body doesn’t use gravity to help the baby move through the
through the birth canal or where the woman’s head is higher than her body. Some examples of upright birth canal and the woman’s head is not higher than the rest of the body. A lying down position could be
positions are standing, kneeling, sitting, leaning, squatting or being on hands and knees. Upright on your back or on your side.
positions can also include moving around such as walking or rocking.

Studies have shown that gravity can help your baby move through the passage of your pelvis [7]. Studies
have also shown that squatting and kneeling opens up the pelvis which may help you birth your baby
more easily [7].

You may wish to have different furniture and birthing equipment available to help support you in different
positions such as:

»» A birthing ball
»» A chair
»» A bench or bed for leaning, sitting or lying
»» A mat for the floor
»» Cushions

Photo courtesy of Little Posers Photography

7
Will I always How might I choose
be able between an upright position
to choose? or lying down position?

You can choose which positions are most comfortable and least painful to you during labour. Some things A number of studies have looked at what happens when women are in an upright position compared
can limit your positions, for example, if your labour is being monitored with an elastic belt around your to being in a lying down position. We have included some of the results of these studies in the next few
abdomen (stomach) or if you have had an epidural. You might like to talk to your care provider about what pages.
things might limit your ability to use all positions during your labour.
Will the results of these studies apply to me?
In some situations, your care provider might suggest one option instead of the other. If this happens, you
can ask your care provider about the reasons for their suggestion and make decisions as a team. If one Every woman’s pregnancy is different, so the possible outcomes of each option might be different for
option is suggested by your care provider instead of another, you can choose to follow their suggestion you. You might like to talk to your care provider who can give you extra information that is suited to your
or choose to say no. Some care providers choose not to offer, or are not comfortable offering, all options unique pregnancy.
to women. If you are not offered all options, or the option you prefer, you can ask to have another care
provider.

Some of the studies we talk about are better quality than others. Whenever we talk about the results of a
study, we give you some idea of the quality, using the following rating:

is given to studies that are high quality. level studies tell us we can be very confident that
choosing to do something causes something else to happen. studies are the very highest
quality of studies.

is given to studies that are medium quality. level studies can tell us we can be moderately
confident that choosing to do something causes something else to happen.

is given to studies that are low quality. level studies can tell us when things tend to happen at
the same time. But level studies can’t tell us that choosing to do something causes something
else to happen.

In the next few pages we talk a lot about the chance of different things happening. If you would like
help understanding what this means, please visit www.havingababy.org.au/chance

8
What are the differences between being upright
and lying down during first stage labour?

Studies have found there is a difference Women who were in Women who were in
between being upright and lying down an upright position... a lying down position...
during first stage labour in:

The length of first On average, women’s labour On average, women’s labour

stage labour [7] lasted 5 hours and 42 minutes lasted 6 hours and 29 minutes

The chance of having an 27 out of every 100 women 32 out of every 100 women
epidural (a type of pain management had an epidural had an epidural
where drugs are used to numb the lower
half of the body) [7]

Women who
had an epidural

Women who did not

have an epidural

The chance of having a vulva (the 29 out of every 100 women 14 out of every 100 women
external female genitals) oedema (a lump or had a vulvar oedema had a vulvar oedema
increase in volume in the vulvar region) after birth[10]

Women who
had a vulvar oedema

Women who did not

have a vulva oedema

9
What are the differences between being upright
and lying down during first stage labour?

Studies have found there is

a difference between being The chance of having a 1st 38 out of every 100 women 57 out of every 100 women
upright and lying down during degree tear (a tear involveing the skin had a 1st degree tear had a 1st degree tear
first stage labour in: only) [10]

Continued...
Women who
had a 1st degree tear

Women who did not

have a 1st degree tear

Studies have found there is no difference

between being upright and lying down The chance of having an augmentation (process of artificially speeding up a woman’s labour after it has already started) using drugs [7]
during first stage labour in:
The chance of having an artificial rupture of membranes (also known as ‘breaking your waters’, when your care provider makes a small hole in the amniotic sac that holds your baby and the
amniotic fluid around your baby) [7]

The chance of having opioids (drugs like morphine or pethidine) for pain management [7]

The length of second stage labour [7]

The chance of having an instrumental birth (where forceps (tongs) and/or a vacuum (suction) cap is used to help pull the baby out of the vagina) [7]

The chance of having a caesarean section [7]

The chance of having a postpartum haemorrhage (losing more than 500ml of blood after birth) [8]

The chance of the baby having a low APGAR score (a score to assess a baby’s well-being after birth, a score lower than 7 means that a baby might need help breathing) five minutes
after birth [7]

The chance of the baby going into the Neonatal Intensive Care Unit (a unit in the hospital for babies who need a high level of special medical care) [9]

10
What are the differences between being upright
and lying down during first stage labour?

Studies are not clear The chance of having a 2nd degree tear (a tear involving the skin and muscles around the vagina but not the anus) during birth [10]
about whether there is
any difference between The chance of having an episiotomy (a cut made to increase the size of the opening of the vagina) [7,10]
being upright and lying
down during first stage The chance of the baby dying between 20 weeks gestation (amount of time in the uterus) and 4 weeks after birth [7]
labour in:

Studies haven’t looked at The chance of having a 3rd degree tear (a tear involving the skin and muscles around the vagina and the anus) during birth
the differences between
being upright and lying Women’s rating the amount of pain during labour
down during first stage
labour in:

11
What are the differences between being upright
and lying down in second stage labour?

Studies have found there is a difference Women who were in Women who were in
between being upright and lying down an upright position... a lying down position...
during second stage labour in:

The chance of having an 35 out of every 100 women 43 out of every 100 women
episiotomy (a cut made to increase had an episiotomy had an episiotomy
the size of the opening of the vagina)
[11]

Women who had

an episiotomy

Women who did not

have an episiotomy

The chance of losing more than 500ml of 7 out of every 100 women had 4 out of every 100 women had
blood [11] a postpartum haemorrhage a postpartum haemorrhage

Women who had a

postpartum haemorrhage

Women who did not have a

postpartum haemorrhage

The chance of having an assisted birth (where 10 out of every 100 women 13 out of every 100 women
forceps (tongs) and/or a vacuum cap (a suction cap) is used to help experienced severe pain at experienced severe pain at
pull hte baby out of the vagina) [11] birth birth

Women who had an assisted birth

Women who did not

have an assisted birth

12
What are the differences between being upright
and lying down in second stage labour?

Studies have found there Women who were in Women who were in
is a difference between an upright position... a lying down position...
being upright and lying
down during second stage
labour in:
The chance of having a 18 out of every 100 women 14 out of every 100 women
Continued... second degree tear (a tear had a second degree tear had a second degree tear
involving the skin and muscles around
the vagina) [11]

Women who had a

second degree tear

Women who did not have

a second degree tear

The chance of abnormal fetal 3 out of every 100 women had abnormal 7 out of every 100 women had abnormal
heart rate patterns [11] fetal heart rate patterns detected fetal heart rate patterns detected

Women who abnormal heart rate patterns

detected

Women who did not have abnormal heart

rate patterns detected

The chance of having drugs for pain management (analgesia and anaesthetic) during second stage labour[11]

Studies have found there The chance of having a caesarean section [11]
is no difference between
being upright and lying The chance of having a severe tear (a 3rd or 4th degree tear) during birth [11]
down during second
stage labour in: The chance of having manual removal of the placenta (when a care provider uses their hand to gently scrape away the placenta from the uterus, through the vagina) [11]

THe chance of the baby dying [11]

The length of second stage labour [11]

13
 How can I make
the decision
that’s best for me?

At the Queensland Centre for Mothers & Babies, we understand that the right decision for you may not be the right decision for others.

When making decisions about their maternity care, some women prefer to get the information and make decisions by themselves or with their families. Other women like to make decisions as a team with their care
providers and some women like their care providers to make decisions for them. This decision is yours to make. You might change your mind about previous decisions if you get more information, if your circumstances
change or your preferences change. For all decisions before, during and after your birth, you are entitled to know your different options, know what happens if you choose different options and choose the option that is
best for you.

Think about the reasons for choosing each When making a decision about which option is best for you, it can be helpful to think about the reasons that you personally might choose each option. We have
option included a table in this decision aid where you can write down both the reasons you might and might not choose each option. You might have come up with your
own ideas or have found information somewhere else.

Think about which reasons Some reasons might matter more to you than others and you might want to give these reasons extra thought when making a decision. There is room in this
matter to you the most decision aid for you to mark how much each reason matters to you in a box. Doing this can also help you talk to other people about what matters to you. You
might like to use a simple star rating like this to mark how important each reason is:

Matters to me a little Matters to me quite a bit Matters to me a lot

Think about whether you’re Once you’ve thought about the reasons for choosing each option and how much each reason matters to you, you might feel that one option is better for you. Or,
leaning towards one option or you might still be unsure and want to think about it some more or ask questions. There is a place to mark what you feel about your options within this decision
the other aid. You can also show this table to your care provider to help you make decisions as a team.

14
How can I make
the decision that’s
best for me?

Reasons I might choose Reasons I might choose

an upright position... a lying down position...

At the moment, I am leaning towards…

An upright I’m A lying down

position unsure position

15
How can I ask
questions to get
more information?

Asking your care provider questions can help you get the information you want and need. Below are some questions you might want to ask My Notes
your care provider to get more information during your pregnancy:

Are there guidelines at my planned place of birth for positioning during labour and birth?

What are the possible outcomes in my unique pregnancy of being in an upright position?

What are the possible outcomes in my unique pregnancy of being in a lying down position?

Is there anything that will restrict my positioning and movement in first and second stage labour?

16
 Where did this
information
come from?
The information in this decision aid has come from the best scientific studies available to us. A list of these studies is included below:

[1] Jones, L., Othman, M., Dowswell, T., Alfirevic, Z., Gates, S., Newburn, M, Jordan, S., Lavender, T., Neilson, J.P. Pain management for women in labour: an overview of systematic. reviews. Cochrane Database of Systematic Reviews 2012, Issue 3. Art. No.: CD009234. doi:
10.1002/14651858.CD009234.pub2.

[2] Chang, M.Y., C.-H. Chen, and K.-F. Huang, A Comparison of Massage Effects on Labor Pain Using the McGill Pain Questionnaire. Journal of Nursing Research, 2006. 14(3): p.190-197.

[3] Brown, S.T., D. Campbell, and A. Kurtz, Characteristics of labor pain at two stages of cervical dilation. Pain, 1989. 39(3): p. 289-295.

[4] Gaston-Johansson, f., G. Fridh, and K. Turner-Norvell, Progression of labor pain in primiparas and multiparas. Nursing Research, 1988. 37(2): p. 86-90.

[5] Lowe, N.K., The nature of labor pain. American Journal of Obstetrics and Gynecology, 2002. 186(5, Supplement 1): p. S16-S24.

[6] National Collaborating Centre for Women's and Children's Health, Intrapartum care: Care of healthy women and their babies during childbirth. September 2007.

[7] Lawrence A, Lewis L, Hofmeyr GJ, Dowswell T, Styles C. Maternal positions and mobility during first stage labour. Cochrane Database of Systematic Reviews 2009, Issue 2. Art. No.: CD003934. DOI: 10.1002/14651858.CD003934.pub2.

[8] McManus, T.J. and A.A. Calder, Upright posture and the efficiency of labour. Lancet, 1978. 1(8055): p. 72-4.

[9] MacLennon, A.H., C. Crowther, and R. Derham, Does the option to ambulate during spontaneous labour confer any advantage or disadvantage? Journal of Maternal-Fetal Medicine, 1994. 3: p. 43-8.

[10] Schirmer, J., Fustinoni, S. M., de Oliveira Basile A. L, Perineal outcomes on the left lateral versus vertical semi-sitting birth positions: A randomized study, Acta Paulista de Enfermagem, 2011, 24(6): p. 745-50.

[11] Gupta JK, Hofmeyr GJ, Shehmar M. Position in the second stage of labour for women without epidural anaesthesia. Cochrane Database of Systematic Reviews 2012, Issue 5. Art. No.: CD002006. DOI: 10.1002/14651858.CD002006.pub3.

[12] Melzack, R. The Myth of Painless Childbirth. Operative Obstetrics and Anesthesia, 1984. 19(321): p. 297-298.

[13] McCrea, B. H. and Wright, M. E. Satisfaction in childbirth and perceptions of personal control in pain relief during labour. Journal of Advanced Nursing, 1999. 29(4): p. 877–884. doi: 10.1046/j.1365-2648.1999.00961.x

17
17
My
questions
and notes

18
 Other decision aids
Acknowledgements • Choosing your model of care

The Queensland Centre for Mothers & Babies would also like to acknowledge the families in Queensland for their generosity in contributing many of the beautiful • Choices about first semester
photos contained in these decision aids. We would also like to thank the following organisations and individuals for their contribution to the development of this decision aid,
ultrasound scans
or other decision aids we’ve developed.

• Choosing how to birth your baby: for

Organisations Individuals women without a previous caesarean
section
Australian College of Midwives Maternity Coalition Queensland Maternal and Lana Bell
(ACM) Perinatal Quality Council Dr Wendy Brodribb • Choosing how to birth your baby: for
Maternity Unit, Primary, Deirdrie Cullen women with a previous caesarean
Caboolture Hospital Community and Extended Care Royal Australian and New Rachel Ford section
Branch, Queensland Health Zealand College of Obstetricians Dr Glenn Gardener
Central Maternity & and Gynaecologists (RANZCOG) Professor Geoffrey Mitchell • Choosing how you labour will start
Neonatal Clinical Network Midwives Information & Rosalie Potter
Resource Service (MIDIRS), UK Redland Hospital Dr Camille Raynes-Greenow • Monitoring your baby during labour
Ethnic Communities Assoc. Professor Allison Shorten
Council of Queensland Midwifery Advisory Committee, Sexual Health and HIV Service Hayley Thompson • Choices about epidural
Office of the Chief Nursing Assoc. Professor Lyndal Trevena
Friends of the Birth Centre Officer, Queensland Health Southern Queensland Maternity • Choices about episiotomy
Queensland Association Inc & Neonatal Clinical Network
• Birthing your placenta
Midwifery Advisor,
General Practice Queensland Queensland Health Statewide Maternity &
• Using a bath or pool during first stage
Neonatal Clinical Network
labour
Griffith University Northern Queensland Maternity
& Neonatal Clinical Network Stillbirth and Neonatal Death
• Choices about clamping your baby’s
Herston Multimedia Unit Support (SANDS) Network umbilical cord
Preventative Health,
Mater Mothers’ Hospital Queensland Health The University of Queensland

Queensland Centre for Mothers & Babies

The University of Queensland
Brisbane, QLD 4072
Australia

www.havingababy.org.au

info@havingababy.org.au

19
The Queensland Centre for Mothers & Babies is an independent centre based at The University of Queensland and funded by the Queensland Government.

© 2011 The University of Queensland, Brisbane Australia. ABN 63942912 684, CRICOS Provider No. 00025B