A better start to life: Risk factors for, and prevention of, preterm birth in Australian First Nations women – A narrative review

Abstract

The unacceptable discrepancies in health outcomes between First Nations and non‐Indigenous Australians begin at birth. Preterm birth (birth before 37 completed weeks of gestation) is a major contributor to adverse short‐ and long‐term health outcomes and mortality. Australian First Nations infants are more commonly born too early. No tangible reductions in preterm births have been made in First Nations communities. Factors contributing to high preterm birth rates in Australian First Nations infants are reviewed and interventions to reduce preterm birth in Australian First Nations women are discussed. More must be done to ensure Australian First Nations infants get a better start to life. This can only be achieved with ongoing and improved research in partnership with Australian First Nations peoples.

The lives of women and babies matter: A call for action in Indigenous and First Nations women’s health and wellbeing

“…The issue highlights the voices of those usually not heard in research, in clinical care, and in health service design, [1][2][3][4][5][6] and calls out the silence and invisibility commonly imposed on Indigenous women. [7][8][9][10][11] This Special Issue includes calls from Indigenous researchers through Indigenous-led and -conducted research; and calls from Indigenous women, either through telling the stories of their health and healthcare journeys, 1,12,13,14 or through risk factors and health outcomes being made visible in quantitative data, 8,15,16 or through looking at existing literature in new ways. 7,9,10,11…”

“…[7][8][9][10][11] This Special Issue includes calls from Indigenous researchers through Indigenous-led and -conducted research; and calls from Indigenous women, either through telling the stories of their health and healthcare journeys, 1,12,13,14 or through risk factors and health outcomes being made visible in quantitative data, 8,15,16 or through looking at existing literature in new ways. 7,9,10,11…”

“…The articles in this special edition use positive approaches. This is done in order to empower women in healthcare, 12 to develop and trial culturally safe and community-based approaches, 2,6 to partner with communities, 3,5 to employ Indigenous methods and knowledge, 8,14 to privilege Indigenous voices, 4,9,10,11 to move towards risk assessment and management tailored to Indigenous populations and context, 15,16 and to explore women's experiences in new ways. 1,9,13 Much of the research responds to the silence/invisibility of First Nations and Indigenous women by challenging the norms of women's healthcare provision, such as persistent discrepancies in structural/social determinants of health, healthcare access and health outcomes, systemic racism, and trauma.…”

“…Preterm birth was investigated by Brown et al 10 and Edmonds et al 8 Brown et al 10 First Nations peoples. In support of this, the authors state "the voices of our First Nations Australians must be heard to guide efforts in improving health outcomes".…”

“…In support of this, the authors state "the voices of our First Nations Australians must be heard to guide efforts in improving health outcomes". 10 Edmonds et al 8 linked maternity, mortality, and hospital data in Aotearoa New Zealand, positioning Māori as the norm (or reference group) to explore preterm birth and how the maternity system results in advantage for privileged populations.…”