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 language | English |
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Pages | S6-S6 |
Number of pages | 1 |
DOIs | |
Publication status | Published - 2023 |
Event | Australian College of Midwives National Conference: Be the Change - Adelaide, Australia Duration: 12 Sept 2023 → 14 Sept 2023 |
Conference
Conference | Australian College of Midwives National Conference |
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Country/Territory | Australia |
City | Adelaide |
Period | 12/09/23 → 14/09/23 |