Background: Women from a refugee background who resettle in high-income countries experience poorer perinatal outcomes in comparison to women from host countries. There is a paucity of research on how best to improve these outcomes.
Aim: To report on the effectiveness of an Australian Refugee Midwifery Group Practice service on perinatal outcomes.
Methods: We used inverse probability of treatment weighting to balance confounders and calculate treatment effect and compare maternal and neonatal outcomes for women from a refugee background who received Refugee Midwifery Group Practice care (n = 625), to those receiving standard care (n = 634) at a large tertiary hospital (1 January 2016–31 December 2019).
Prespecified primary outcomes included: proportion of women attending ≥ 5 antenatal visits, preterm birth (<37 weeks), spontaneous onset of labour, epidural analgesia in the first stage of labour, normal birth (term, spontaneous onset, vertex, spontaneous vaginal birth, no epidural, no episiotomy), and exclusively breast-feeding at discharge.
Findings: Women who received Refugee Midwifery Group Practice care were more likely to have spontaneous onset of labour (adjusted odds ratio 2·20, 95% CI 1·71–2·82; p < 0·0001), normal birth (1·55, 1·23–1·95; p < 0·0001), and less likely to use epidural analgesia (0·67, 0·50–0·89; p = 0·0067) and have a preterm baby (0·60, 0·36–0·99; p = 0·047). There was no difference between groups in women attending ≥ 5 antenatal visits and exclusive breastfeeding at discharge from hospital.
Discussion: A Refugee Midwifery Group Practice is feasible and clinically effective. Conclusion: Similar services could potentially improve outcomes for women from a refugee background who resettle in high-income countries.