O13 - Implementing midwifery continuity of care for women having a First Nations baby in three Victorian maternity services: clinical outcomes

Della Forster, Touran Shafiei, Helen McLachlan, Michelle Newton, Fiona McLardie-Hore, Pamela (Res) McCalman

Research output: Contribution to conferenceAbstract

Abstract

Aims Evidence-based strategies are needed to redress the higher burden of poor perinatal outcomes experienced by Aboriginal and Torres Strait Islander (First Nations) mothers and babies. Caseload midwifery is associated with improved perinatal outcomes, yet First Nations women have had little access to this model. We explored if implementing culturally specific caseload midwifery would improve maternal and neonatal clinical outcomes for women having a First Nations baby. Methods In partnership with the Victorian Aboriginal Community Controlled Health Organisation, we undertook a research translation project implementing a culturally specific caseload model for women having a First Nations baby in three tertiary hospitals in Melbourne (2017- 2020). Clinical outcome data were analysed using descriptive statistics and logistic regression, exploring differences between First Nations and non-Indigenous mothers and babies before and after model implementation. Outcomes included low birthweight (primary outcome), preterm birth, NICU admission, smoking > 20 weeks and breastfeeding initiation. Results 87% of 1040 women having a First Nations baby were offered the new caseload model during the project (a 21-fold increase in access, from 34 before, to 703), with >90% uptake. Analyses include 101,215 women before implementation and 63,546 after. Outcomes varied by site. Across all sites, 16.1% of First Nations babies were born low birthweight Vs 7.2% of non-Indigenous babies (OR 2.49, 95%CI: 2.12, 2.93) before, and 14.1% Vs 7.1% (OR 2.15, 95%CI: 1.79, 2.57) after model implementation. At the largest site this was 21.4% Vs 7.8% before (OR 3.19, 95%CI: 2.41, 4.21), and 16.1% Vs 7.5% (OR 2.40, 95%CI: 1.90, 3.03) after. Complete clinical outcome data will be presented. Conclusions Clinical outcomes improved across a range of measures, and the ‘gap’ in poor outcomes between First Nations and non-Indigenous women and babies decreased. Scale-up of this model is an important aspect of improving outcomes.
Original languageEnglish
PagesS6-S6
Number of pages1
DOIs
Publication statusPublished - 2023
EventAustralian College of Midwives National Conference: Be the Change - Adelaide, Australia
Duration: 12 Sept 202314 Sept 2023

Conference

ConferenceAustralian College of Midwives National Conference
Country/TerritoryAustralia
CityAdelaide
Period12/09/2314/09/23

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