‘Choice, culture and confidence’: key findings from the 2012 having a baby in Queensland Aboriginal and Torres Strait Islander survey

Abstract

BackgroundTo describe the maternity care experiences of Aboriginal and/or Torres Strait Islander women in Queensland, Australia and to identify areas for policy and practice improvements.MethodsA culturally-tailored survey requesting both quantitative and qualitative information was completed by respondents either independently (online or in hard copy) or with the assistance of a trained peer-interviewer. Data were analysed using descriptive statistics and thematic analysis.Eligible women were over 16 years of age, identified as Aboriginal and/or Torres Strait Islander, resided in Queensland, and had a live, singleton birth between the first of July 2011 and the first of July 2012.Results187 women of 207 respondents were included in analyses. Women reported high rates of stressful life events in pregnancy, low levels of choice in place of birth and model of care and limited options to carry out cultural practices. High levels of confidence in parenting were also reported. Women were less likely to report being treated with kindness, understanding and respect by maternity care staff than women answering a similar mainstream survey.ConclusionsAboriginal and Torres Strait Islander women have additional needs to mainstream Australian women. This study identified a number of recommendations to improve services including the need to enhance the cultural competence of maternity services; increase access to continuity of midwifery care models, facilitate more choices in care, work with the strengths of Aboriginal and Torres Strait Islander women, families and communities, and engage women in the design and delivery of care.

Access and outcomes of general practitioner obstetrician (rural generalist)‐supported birthing units in Queensland

“…Distance from a maternity unit not only impacts on delivery plans but also increases distress for those having to travel large distances and for those labouring en route . Aboriginal and Torres Strait Islander women, 55% of whom live in outer regional and remote areas of Australia, report high rates of pregnancy stress and low levels of birthing choice . Many rural and remote mothers travel to birth “off country” at between 36 and 38 weeks’ gestation, disrupting their other children, partner's work and increasing emotional and financial strain related to isolation, travel and accommodation …”

“…4 Aboriginal and Torres Strait Islander women, 55% of whom live in outer regional and remote areas of Australia, 8 report high rates of pregnancy stress and low levels of birthing choice. 9 Many rural and remote mothers travel to birth "off country" at between 36 and 38 weeks' gestation, 10 disrupting their other children, partner's work and increasing emotional and financial strain related to isolation, travel and accommodation. 9 The Queensland government implemented the Queensland Health Rural Generalist Pathway (QRGP) in 2007 as a longterm workforce initiative to reverse the downward trend in health service provision, including maternity services, to Queensland's rural and remote communities.…”

“…9 Many rural and remote mothers travel to birth "off country" at between 36 and 38 weeks' gestation, 10 disrupting their other children, partner's work and increasing emotional and financial strain related to isolation, travel and accommodation. 9 The Queensland government implemented the Queensland Health Rural Generalist Pathway (QRGP) in 2007 as a longterm workforce initiative to reverse the downward trend in health service provision, including maternity services, to Queensland's rural and remote communities. 11 This QRGP initiative was specifically designed to train and support rural generalist doctors (qualified and recognised GPs with advanced skills including obstetrics, anaesthetics and emergency medicine) to meet the needs of Queensland's rural and remote communities.…”

Improving Aboriginal Women's Experiences of Antenatal Care: Findings from the Aboriginal Families Study in South Australia

“…Most program evaluation has focused on individual services and relied on the use of historical controls and/or been limited to the use of routinely collected data to monitor shifts in perinatal outcomes over time . Very few studies have sought to gather information from Aboriginal women themselves about their experiences of pregnancy and birthing services .…”

The Experience of Australia's First Nations Men Supporting Their Partners During Childbirth: A Descriptive, Interpretive Study

“…Therefore, it is very unlikely that Australia's First Nations men have experienced intergenerational role-modeling related to being present when their baby is born. Nevertheless, the evolving expectation that men will support their birthing partners, along with the increasing trend toward birthing away from country (Brown et al, 2016;Parker, McKinnon, & Kruske, 2014;Reibel et al, 2015;Varcoe, Brown, Calam, Harvey, & Tallio, 2013) may be transforming the role of Australia's First Nations expectant fathers in the childbirth process.…”