Maternal care for Aboriginal women
CUCRH has conducted a number of projects to improve the quality of maternal care to Aboriginal women and families. These have been conducted in collaboration with many Aboriginal community controlled organisations.On this page you can read about our work in modelling the clinical outcomes and cost savings from offering community based comprehensive antenatal care. Following that project there is a description of a needs assessment of maternity services for young women living in remote Pilbara communities.
Models for improved maternal care for rural and remote Aboriginal women: evaluation of clinical benefits and cost-effectiveness
This project will quantify the health and cost benefits of providing high quality community-based maternal care to Aboriginal women in non-metropolitan Western Australia. A ‘decision analytic’ model will be made to describe the provision of comprehensive antenatal care at an Aboriginal community controlled health service. We will compare this model to the ‘normal’ model of care provided to Aboriginal women by midwives, general practitioners or community health nurses in the state or private system. Benefits to be compared include greater antenatal care attendance, earlier first presentation to antenatal care, improved maternal outcomes, improved outcomes for the baby and reduced transfer to tertiary hospitals. This will allow potential efficiencies and cost savings to be identified in the choice between alternate care pathways.
Interviews with health care providers and Aboriginal women who have recently given birth will give more in-depth information on the advantages of different antenatal care service models.
Limited evidence is currently available on the differences in maternal and birth outcomes of non-metropolitan Aboriginal women according to the model of maternal care used. This information is lacking because the numbers of women are too small to allow for statistical analysis of differences. The method used in this study overcomes the problem of too few people. The results will help policy makers and managers in Aboriginal community controlled health organisations, WA Country Health Services and WA Health Department to justify offering local comprehensive maternity services through shared services.
The project is consistent with national and state priorities to address the challenges of increasing maternal health care risk, high perinatal mortality, and problematic birth weight (both too low and too high) faced by Aboriginal people. It will suggest practical, evidence based strategies for the provision of antenatal care that is culturally secure and clinically effective, thereby reducing the enormous economic and social costs of adverse maternal and infant outcomes.
The project is scheduled to take 12 months and preliminary results will be available in September 2009. Funding for this project was received from the State Health Research and Advisory Council Research Translation Projects 2008/2009. Further support comes from the Department of Health and Ageing through funding to university departments of rural health.
Remote Indigenous women’s experience of first pregnancy
Pilbara Indigenous Women's Aboriginal Corporation and CUCRH worked together on a project about young Aboriginal women living in remote communities in the east Pilbara. The research team explored the experiences of first pregnancy with the young women to find out about their needs around the time of pregnancy and then while caring for their children.
The project looked at educational, social and community factors to do with pregnancy as well as health. Funding came from the Pilbara Regional Development Scheme.
Aboriginal researchers Sylvia Lockyer and Elaine Kite visited 10 remote communities as part of this project. Support for Sylvia’s involvement came from a rural primary health care research fellowship.
Recommendations from the project, which were endorsed by PIWAC, were:
Better accommodation in Port Hedland
Specific purpose hostel accommodation for Aboriginal women based on the Alukura Model in Alice Springs, NT and the Mookai Rosie Model in Cairns, QLD
Birthing plans to assist young women and families to prepare for the delivery
Birth plans could help to reduce some of the anxieties young expectant mothers experience as well as enable grandmothers and significant family to be present to give support to young women at the time of their baby’s birth
Improved access to family planning information and services
A range of contraceptives and family planning information and services should be offered to young women in remote Aboriginal communities in order that they can make informed choices
More effective ways for promoting healthy mums and babies
Programs such as Strong Women Strong Babies Strong Culture be made available in all remote communities and identification and provision of culturally appropriate health promotion services that result in positive action and health outcomes for mums and babies.
Excitingly, this study helped to gain support for a hostel to be established in South Hedland. It is now a busy service providing important support for women from remote communities. For more information, download the community brochurehere(2.5MB pdf) or contact Sylvia Lockyer in our Port Hedland office.
Alternatively, you can read about the project in:
Lockyer S & Kite E. 2007. Teenage pregnancies in East Pilbara Aboriginal communities. Aboriginal & Islander Health Worker Journal 31(2):26-29.
Art work by Sylvia Lockyer.
