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Springall TL, McLachlan HL, Forster DA, Browne J, Chamberlain C. Breastfeeding rates of Aboriginal and Torres Strait Islander women in Australia: A systematic review and narrative analysis. Women Birth 2024; 37:101634. [PMID: 38906086 DOI: 10.1016/j.wombi.2024.101634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2024]
Abstract
BACKGROUND Australian Aboriginal and Torres Strait Islander (referred to hereafter as Aboriginal) women breastfeed at lower rates than non-Aboriginal women, and rates vary across and within Aboriginal populations. AIM To determine rates of breastfeeding initiation and maintenance and compare individually collected survey data with existing routinely collected state and national breastfeeding data for Aboriginal women. METHODS CINAHL, Medline, EMBASE, SCOPUS, PsycINFO, and the Cochrane library were searched for peer-reviewed literature published between 1995 and 2021. Quantitative studies written in English and reporting breastfeeding for Aboriginal women or women having an Aboriginal infant were included. Screening and quality assessment included co-screening 10 % of papers. Two reviewers completed data extraction. A proportional meta-analysis was undertaken for breastfeeding initiation and narrative data synthesis used to summarise breastfeeding maintenance. FINDINGS The initial search identified 12,091 records, with 31 full text studies retrieved, and 27 reports from 22 studies met inclusion criteria. Breastfeeding initiation was 79 % (95 % CI 0.73, 0.85), however, rates were lower than non-Aboriginal women. Maintenance ranged between one week and five years. Rates and definitions varied significantly between studies, with inconsistencies in government collection and reporting of breastfeeding. CONCLUSION Significant variation in definitions and reporting make comparisons difficult. Breastfeeding rates were below recommended targets. Future pattern and trend analyses require standardised measures and definitions. Current collection and reporting of breastfeeding data, particularly routinely collected state-based data, is inadequate to present an accurate picture of current breastfeeding in Australia for Aboriginal women and infants, and to effectively inform interventions and policies.
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Affiliation(s)
- Tanisha L Springall
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.
| | - Helen L McLachlan
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Della A Forster
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia; Maternity Services, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Jennifer Browne
- Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong, Victoria, Australia
| | - Catherine Chamberlain
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia; Centre for Health Equity, The University of Melbourne, Melbourne, Victoria, Australia; NGANGK YIRA: Murdoch University Research Centre for Aboriginal Health and Social Equity, Australia; The Lowitja Institute, Australia
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Huda MM, Callaway LK, Jackson G, Fatima Y, Cumming J, Biswas T, Paz GR, Boyle F, Sly PD, Mamun AA. Time trends, projections, and spatial distribution of low birthweight in Australia, 2009-2030: Evidence from the National Perinatal Data Collection. Birth 2023; 50:76-89. [PMID: 36696404 PMCID: PMC10947513 DOI: 10.1111/birt.12708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 11/15/2022] [Accepted: 01/06/2023] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Infants with low birthweight (LBW, birthweight <2500 g) have increased in many high-resource countries over the past two decades. This study aimed to investigate the time trends, projections, and spatial distribution of LBW in Australia, 2009-2030. METHODS We used standard aggregate data on 3 346 808 births from 2009 to 2019 from Australia's National Perinatal Data Collection. Bayesian linear regression model was used to estimate the trends in the prevalence of LBW in Australia. RESULTS Wefound that the prevalence of LBW was 6.18% in 2009, which has increased to 6.64% in 2019 (average annual rate of change, AARC = +0.76%). If the national trend remains the same, the projected prevalence of LBW in Australia will increase to 7.34% (95% uncertainty interval, UI = 6.99, 7.68) in 2030. Observing AARC across different subpopulations, the trend of LBW was stable among Indigenous mothers, whereas it increased among non-Indigenous mothers (AARC = +0.81%). There is also an increase among the most disadvantaged mothers (AARC = +1.08%), birthing people in either of two extreme age groups (AARC = +1.99% and +1.53% for <20 years and ≥40 years, respectively), and mothers who smoked during pregnancy (AARC = +1.52%). Spatiotemporal maps showed that some of the Statistical Area level 3 (SA3) in Northern Territory and Queensland had consistently higher prevalence for LBW than the national average from 2014 to 2019. CONCLUSION Overall, the prevalence of LBW has increased in Australia during 2009-2019; however, the trends vary across different subpopulations. If trends persist, Australia will not achieve the Sustainable Development Goals (SDGs) target of a 30% reduction in LBW by 2030. Centering and supporting the most vulnerable subpopulations is vital to progress the SDGs and improves perinatal and infant health in Australia.
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Affiliation(s)
- M. Mamun Huda
- Poche Centre for Indigenous HealthThe University of QueenslandQueenslandBrisbaneAustralia
- ARC Life Course CentreThe University of QueenslandQueenslandBrisbaneAustralia
| | - Leonie K. Callaway
- Women's and Newborn ServicesRoyal Brisbane and Women's HospitalQueenslandBrisbaneAustralia
- Faculty of MedicineThe University of QueenslandBrisbaneAustralia
| | - Greg Jackson
- Health Protection Branch, Queensland Department of HealthQueenslandBrisbaneAustralia
- Queensland Alliance for Environmental Health Sciences (QAEHS)The University of QueenslandQueenslandWoolloongabbaAustralia
| | - Yaqoot Fatima
- Poche Centre for Indigenous HealthThe University of QueenslandQueenslandBrisbaneAustralia
- ARC Life Course CentreThe University of QueenslandQueenslandBrisbaneAustralia
- Murtupuni Centre for Rural and Remote HealthJames Cook UniversityQueenslandMount IsaAustralia
| | - Janet Cumming
- Health Protection Branch, Queensland Department of HealthQueenslandBrisbaneAustralia
| | - Tuhin Biswas
- Poche Centre for Indigenous HealthThe University of QueenslandQueenslandBrisbaneAustralia
- ARC Life Course CentreThe University of QueenslandQueenslandBrisbaneAustralia
- Science and Math ProgramAsian University for WomenChattogramBangladesh
| | - Gonzalo R. Paz
- Poche Centre for Indigenous HealthThe University of QueenslandQueenslandBrisbaneAustralia
- ARC Life Course CentreThe University of QueenslandQueenslandBrisbaneAustralia
- Facultad de MedicinaUniversidad del ValleCaliColombia
| | - Fran Boyle
- Poche Centre for Indigenous HealthThe University of QueenslandQueenslandBrisbaneAustralia
| | - Peter D. Sly
- Children's Health Research CentreUniversity of QueenslandSouth BrisbaneAustralia
- WHO Collaborating Centre for Children's Health and EnvironmentQueenslandSouth BrisbaneAustralia
| | - Abdullah Al Mamun
- Poche Centre for Indigenous HealthThe University of QueenslandQueenslandBrisbaneAustralia
- ARC Life Course CentreThe University of QueenslandQueenslandBrisbaneAustralia
- Queensland Alliance for Environmental Health Sciences (QAEHS)The University of QueenslandQueenslandWoolloongabbaAustralia
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Haora P, Roe Y, Hickey S, Gao Y, Nelson C, Allen J, Briggs M, Worner F, Kruske S, Watego K, Maidment SJ, Hartz D, Sherwood J, Barclay L, Tracy S, Tracy M, Wilkes L, West R, Grant N, Kildea S. Developing and evaluating Birthing on Country services for First Nations Australians: the Building On Our Strengths (BOOSt) prospective mixed methods birth cohort study protocol. BMC Pregnancy Childbirth 2023; 23:77. [PMID: 36709265 PMCID: PMC9883816 DOI: 10.1186/s12884-022-05277-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/01/2022] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND With the impact of over two centuries of colonisation in Australia, First Nations families experience a disproportionate burden of adverse pregnancy and birthing outcomes. First Nations mothers are 3-5 times more likely than other mothers to experience maternal mortality; babies are 2-3 times more likely to be born preterm, low birth weight or not to survive their first year. 'Birthing on Country' incorporates a multiplicity of interpretations but conveys a resumption of maternity services in First Nations Communities with Community governance for the best start to life. Redesigned services offer women and families integrated, holistic care, including carer continuity from primary through tertiary services; services coordination and quality care including safe and supportive spaces. The overall aim of Building On Our Strengths (BOOSt) is to facilitate and assess Birthing on Country expansion into two settings - urban and rural; with scale-up to include First Nations-operated birth centres. This study will build on our team's earlier work - a Birthing on Country service established and evaluated in an urban setting, that reported significant perinatal (and organisational) benefits, including a 37% reduction in preterm births, among other improvements. METHODS Using community-based, participatory action research, we will collaborate to develop, implement and evaluate new Birthing on Country care models. We will conduct a mixed-methods, prospective birth cohort study in two settings, comparing outcomes for women having First Nations babies with historical controls. Our analysis of feasibility, acceptability, clinical and cultural safety, effectiveness and cost, will use data including (i) women's experiences collected through longitudinal surveys (three timepoints) and yarning interviews; (ii) clinical records; (iii) staff and stakeholder views and experiences; (iv) field notes and meeting minutes; and (v) costs data. The study includes a process, impact and outcome evaluation of this complex health services innovation. DISCUSSION Birthing on Country applies First Nations governance and cultural safety strategies to support optimum maternal, infant, and family health and wellbeing. Women's experiences, perinatal outcomes, costs and other operational implications will be reported for Communities, service providers, policy advisors, and for future scale-up. TRIAL REGISTRATION Australia & New Zealand Clinical Trial Registry # ACTRN12620000874910 (2 September 2020).
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Affiliation(s)
- Penny Haora
- grid.1043.60000 0001 2157 559XMolly Wardaguga Research Centre, Charles Darwin University, Ann Street, Brisbane, QLD 4000 Australia ,Waminda South Coast Women’s Health & Wellbeing Aboriginal Corporation, Kinghorne Street, Nowra, NSW 2541 Australia
| | - Yvette Roe
- grid.1043.60000 0001 2157 559XMolly Wardaguga Research Centre, Charles Darwin University, Darwin, Australia
| | - Sophie Hickey
- grid.1043.60000 0001 2157 559XMolly Wardaguga Research Centre, Charles Darwin University, Ann Street, Brisbane, QLD 4000 Australia
| | - Yu Gao
- grid.1043.60000 0001 2157 559XMolly Wardaguga Research Centre, Charles Darwin University, Ann Street, Brisbane, QLD 4000 Australia
| | - Carmel Nelson
- grid.492300.cInstitute for Urban Indigenous Health, Cox Road, Windsor, QLD 4030 Australia ,grid.1003.20000 0000 9320 7537Poche Centre for Indigenous Health, University of Queensland, Brisbane, QLD Australia
| | - Jyai Allen
- grid.1043.60000 0001 2157 559XMolly Wardaguga Research Centre, Charles Darwin University, Ann Street, Brisbane, QLD 4000 Australia
| | - Melanie Briggs
- grid.1043.60000 0001 2157 559XMolly Wardaguga Research Centre, Charles Darwin University, Ann Street, Brisbane, QLD 4000 Australia ,Waminda South Coast Women’s Health & Wellbeing Aboriginal Corporation, Kinghorne Street, Nowra, NSW 2541 Australia
| | - Faye Worner
- Waminda South Coast Women’s Health & Wellbeing Aboriginal Corporation, Kinghorne Street, Nowra, NSW 2541 Australia
| | - Sue Kruske
- grid.1043.60000 0001 2157 559XMolly Wardaguga Research Centre, Charles Darwin University, Grevillea Drive, Sadadeen, NT 0870 Australia
| | - Kristie Watego
- grid.492300.cInstitute for Urban Indigenous Health, Cox Road, Windsor, QLD 4030 Australia
| | - Sarah-Jade Maidment
- grid.1043.60000 0001 2157 559XMolly Wardaguga Research Centre, Charles Darwin University, Ann Street, Brisbane, QLD 4000 Australia
| | - Donna Hartz
- grid.1043.60000 0001 2157 559XMolly Wardaguga Research Centre, Charles Darwin University, Ann Street, Brisbane, QLD 4000 Australia
| | - Juanita Sherwood
- grid.1043.60000 0001 2157 559XMolly Wardaguga Research Centre, Charles Darwin University, Ann Street, Brisbane, QLD 4000 Australia
| | - Lesley Barclay
- grid.1043.60000 0001 2157 559XMolly Wardaguga Research Centre, Charles Darwin University, Ann Street, Brisbane, QLD 4000 Australia ,grid.1013.30000 0004 1936 834XThe University of Sydney, Camperdown, NSW 2006 Australia
| | - Sally Tracy
- grid.1013.30000 0004 1936 834XThe University of Sydney, Camperdown, NSW 2006 Australia
| | - Mark Tracy
- grid.1013.30000 0004 1936 834XThe University of Sydney, Camperdown, NSW 2006 Australia
| | - Liz Wilkes
- grid.1043.60000 0001 2157 559XMolly Wardaguga Research Centre, Charles Darwin University, Ann Street, Brisbane, QLD 4000 Australia ,My Midwives Brisbane, Windsor Road, Red Hill, QLD 4059 Australia
| | - Roianne West
- grid.1043.60000 0001 2157 559XMolly Wardaguga Research Centre, Charles Darwin University, Ann Street, Brisbane, QLD 4000 Australia ,Congress of Aboriginal & Torres Strait Islander Nurses and Midwives, Lytton Road, Murarrie, QLD 4172 Australia
| | - Nerida Grant
- grid.1043.60000 0001 2157 559XMolly Wardaguga Research Centre, Charles Darwin University, Ann Street, Brisbane, QLD 4000 Australia
| | - Sue Kildea
- grid.1043.60000 0001 2157 559XMolly Wardaguga Research Centre, Charles Darwin University, Grevillea Drive, Sadadeen, NT 0870 Australia
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Springall TL, McLachlan HL, Forster DA, Browne J, Chamberlain C. Breastfeeding rates of Aboriginal and Torres Strait Islander women in Australia: a systematic review and narrative analysis. Women Birth 2022; 35:e624-e638. [PMID: 35288036 DOI: 10.1016/j.wombi.2022.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/31/2022] [Accepted: 02/24/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Australian Aboriginal and Torres Strait Islander (referred to hereafter as Aboriginal) women breastfeed at lower rates than non-Aboriginal women, and rates vary across and within Aboriginal populations. AIM To determine rates of breastfeeding initiation and maintenance and compare individually collected survey data with existing routinely collected state and national breastfeeding data for Aboriginal women. METHODS CINAHL, Medline, EMBASE, SCOPUS, PsycINFO, and the Cochrane library were searched for peer-reviewed literature published between 1995 and 2021. Quantitative studies written in English and reporting breastfeeding for Aboriginal women or women having an Aboriginal infant were included. Screening and quality assessment included co-screening 10% of papers. Two reviewers completed data extraction. A proportional meta-analysis was undertaken for breastfeeding initiation and narrative data synthesis used to summarise breastfeeding maintenance. FINDINGS The initial search identified 12,091 records, with 31 full text studies retrieved, and 27 reports from 22 studies met inclusion criteria. Breastfeeding initiation was 78% (95% CI 0.71, 0.84), however, rates were lower than non-Aboriginal women. Maintenance ranged between one week and five years. Rates and definitions varied significantly between studies, with inconsistencies in government collection and reporting of breastfeeding. CONCLUSION Significant variation in definitions and reporting make comparisons difficult. Breastfeeding rates were below recommended targets. Future pattern and trend analyses require standardised measures and definitions. Current collection and reporting of breastfeeding data, particularly routinely collected state-based data, is inadequate to present an accurate picture of current breastfeeding in Australia for Aboriginal women and infants, and to effectively inform interventions and policies.
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Affiliation(s)
- Tanisha L Springall
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia; School of Nursing and Midwifery, Griffith University, Meadowbrook, Queensland, Australia.
| | - Helen L McLachlan
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia; School of Nursing and Midwifery, La Trobe University, Bundoora, 3086, Australia.
| | - Della A Forster
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia; Maternity Services, Royal Women's Hospital, Parkville, Victoria, Australia.
| | - Jennifer Browne
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.
| | - Catherine Chamberlain
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia; Centre for Health Equity, The University of Melbourne, Melbourne, Victoria, Australia; Ngangk Yira: Murdoch University Research Centre for Aboriginal Health and Social Equity, Perth, Western Australia; The Lowitja Institute, Melbourne, Victoria, Australia.
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Ingram MA, Brady S, Peacock AS. The barriers to offering non-pharmacological pain management as an initial option for laboring women: A review of the literature. Eur J Midwifery 2022; 6:37. [PMID: 35794877 PMCID: PMC9186088 DOI: 10.18332/ejm/149244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Many women use pharmacological or non-pharmacological pain management (NPPM) during childbirth, however, evidence shows the usage rates of pharmacological pain management are increasing. The shift towards a biomedical approach to birth care opposes the enduring midwifery philosophy of trusting the woman and her body. Identifying midwives’ beliefs and attitudes towards perceived and actual barriers to offering NPPM as an initial option will provide insight into the factors that affect this. METHODS This review of the literature sought to understand midwives’ beliefs and attitudes towards the barriers to offering NPPM as an initial option for laboring women. Peer-reviewed journals were searched for primary research that met the inclusion criteria and explored midwives’ beliefs and attitudes towards the barriers to offering NPPM as an initial option for laboring women. Included studies were evaluated for quality according to the Critical Appraisal Skills Programme (CASP) checklists. RESULTS Thirteen qualitative studies met the inclusion criteria and four main themes of barriers to midwives offering NPPM emerged: health system-related, health facility-related, health practitioner-related, and health consumer-related barriers. CONCLUSIONS The review of the literature highlighted there are barriers that prevent or delay the initial utilization of non-pharmacological methods of pain management in labor by midwives. These findings can be used as a platform to inform further research into this topic.
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Affiliation(s)
- Matilda A. Ingram
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia
- School of Nursing and Midwifery, University of Newcastle, Newcastle, Australia
| | - Susannah Brady
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia
- College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Ann S. Peacock
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia
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Bhat S, Birdus N, Bhat SM. Ethnic variation in causes of stillbirth in high income countries: A systematic review and meta-analysis. Int J Gynaecol Obstet 2021; 158:270-277. [PMID: 34767262 DOI: 10.1002/ijgo.14023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/08/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Inequities in stillbirth rate according to ethnicity persist in high income nations. The objective of the present study is to investigate whether causes of stillbirth differ by ethnicity in high-income nations. METHODS The following databases were searched since their inception to 1 February 2021: Medline, Embase, Scopus, CINAHL, Cochrane Library, and Global Health. Cohort, cross-sectional, and retrospective studies were included. Causes of stillbirth were aligned to the International Classification of Disease 10 for Perinatal Mortality (ICD10-PM) and pooled estimates were derived by meta-analysis. RESULTS Fifteen reports from three countries (72 555 stillbirths) were included. Seven ethnic groups - "Caucasian" (n = 11 studies), "African" (n = 11 studies), "Hispanic" (n = 7 studies), "Indigenous Australian" (n = 4 studies), "Asian" (n = 2 studies), "South Asian" (n = 2 studies), and "American Indian" (n = 1 study) - were identified. There was an overall paucity of recent, high-quality data for many ethnicities. For those with the greatest amount of data - Caucasian, African, and Hispanic - no major differences in the causes of stillbirth were identified. CONCLUSION There is a paucity of high-quality information on causes of stillbirth for many ethnicities. Improving investigation and standardizing classification of stillbirths is needed to assess whether causes of stillbirth differ across more diverse ethnic groups.
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Affiliation(s)
- Saiuj Bhat
- Royal Perth Hospital, Perth, Western Australia, Australia
| | - Nadya Birdus
- Fiona Stanley Hospital, Murdoch, Western Australia, Australia
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Kildea S, Gao Y, Hickey S, Nelson C, Kruske S, Carson A, Currie J, Reynolds M, Wilson K, Watego K, Costello J, Roe Y. Effect of a Birthing on Country service redesign on maternal and neonatal health outcomes for First Nations Australians: a prospective, non-randomised, interventional trial. LANCET GLOBAL HEALTH 2021; 9:e651-e659. [PMID: 33743199 DOI: 10.1016/s2214-109x(21)00061-9] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 12/16/2020] [Accepted: 02/02/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND There is an urgency to redress unacceptable maternal and infant health outcomes for First Nations families in Australia. A multi-agency partnership between two Aboriginal Community-controlled health services and a tertiary hospital in urban Australia designed, implemented, and evaluated the new Birthing in Our Community (BiOC) service. In this study, we aimed to assess and report the clinical effectiveness of the BiOC service on key maternal and infant health outcomes compared with that of standard care. METHODS Pregnant women attending the Mater Mothers Public Hospital (Brisbane, QLD, Australia) who were having a First Nations baby were invited to receive the BiOC service. In this prospective, non-randomised, interventional trial of the service, we specifically enrolled women who intended to birth at the study hospital, and had a referral from a family doctor or Aboriginal Medical Service. Participants were offered either standard care services or the BiOC service. Prespecified primary outcomes to test the effectiveness of the BiOC service versus standard care were the proportion of women attending five or more antenatal visits, smoking after 20 weeks of gestation, who had a preterm birth (<37 weeks), and who were exclusively breastfeeding at discharge from hospital. We used inverse probability of treatment weighting to balance confounders and calculate treatment effect. This trial is registered with the Australian New Zealand Clinical Trial Registry, ACTRN12618001365257. FINDINGS Between Jan 1, 2013, and June 30, 2019, 1867 First Nations babies were born at the Mater Mothers Public Hospital. After exclusions, 1422 women received either standard care (656 participants) or the BiOC service (766 participants) and were included in the analyses. Women receiving the BiOC service were more likely to attend five or more antenatal visits (adjusted odds ratio 1·54, 95% CI 1·13-2·09; p=0·0064), less likely to have an infant born preterm (0·62, 0·42-0·93; p=0·019), and more likely to exclusively breastfeed on discharge from hospital (1·34, 1·06-1·70; p=0·014). No difference was found between the two groups for smoking after 20 weeks of gestation, with both showing a reduction compared with smoking levels reported at their hospital booking visit. INTERPRETATION This study has shown the clinical effectiveness of the BiOC service, which was co-designed by stakeholders and underpinned by Birthing on Country principles. The widespread scale-up of this new service should be prioritised. Dedicated funding, knowledge translation, and implementation science are needed to ensure all First Nations families can access Birthing on Country services that are adapted for their specific contexts. FUNDING Australian National Health and Medical Research Council.
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Affiliation(s)
- Sue Kildea
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia; Mater Research Institute and School of Nursing and Midwifery, University of Queensland, Brisbane, QLD, Australia.
| | - Yu Gao
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia; Mater Research Institute and School of Nursing and Midwifery, University of Queensland, Brisbane, QLD, Australia
| | - Sophie Hickey
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia; Mater Research Institute and School of Nursing and Midwifery, University of Queensland, Brisbane, QLD, Australia
| | - Carmel Nelson
- Poche Centre for Indigenous Health, University of Queensland, Brisbane, QLD, Australia; Institute for Urban Indigenous Health, Windsor, QLD, Australia
| | - Sue Kruske
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia
| | - Adrian Carson
- Poche Centre for Indigenous Health, University of Queensland, Brisbane, QLD, Australia; Institute for Urban Indigenous Health, Windsor, QLD, Australia
| | - Jody Currie
- Aboriginal and Torres Strait Islander Community Health Service Brisbane, Woolloongabba, QLD, Australia
| | - Maree Reynolds
- Department of Mother's, Babies and Women's Health, Mater Hospital, Brisbane, QLD, Australia
| | - Kay Wilson
- Department of Mother's, Babies and Women's Health, Mater Hospital, Brisbane, QLD, Australia
| | - Kristie Watego
- Institute for Urban Indigenous Health, Windsor, QLD, Australia
| | - Jo Costello
- Department of Mother's, Babies and Women's Health, Mater Hospital, Brisbane, QLD, Australia
| | - Yvette Roe
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia; Mater Research Institute and School of Nursing and Midwifery, University of Queensland, Brisbane, QLD, Australia
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O'Connor A, Harris E, Hamilton D, Fisher C, Sachmann M. The experiences of pregnant women attending a specialist service and using methamphetamine. Women Birth 2020; 34:170-179. [PMID: 32061546 DOI: 10.1016/j.wombi.2020.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Pregnant women attending the Specialist Drug and Alcohol Service in Perth use methamphetamine as their primary drug of choice. This is the only tertiary service for pregnant and postnatal women with complex Alcohol and Other Drug Use in Western Australia. It is a midwifery-led multidisciplinary team. Many of the women struggle with addiction, polysubstance use, co-occurring mental health, family and domestic violence, complex trauma and fear of Child Protection and infant removal. Therefore, the aim of this study was to understand the impact of methamphetamine use of pregnant women attending the service and explore and highlight the potential barriers to engagement and follow-up. METHODS A qualitative study informed by phenomenological methods was undertaken using semi-structured interviews with 20 women with methamphetamine use attending the service in order to explore and understand the experience of using methamphetamine in pregnancy and the postpartum period. A thematic analysis was undertaken with data from the women in the study (n=20) to identify key themes. RESULTS Key themes that emerged from the women's experiences detail their resilience and experience with methamphetamine and the impact that methamphetamine has on their life. A key concern for women regarding methamphetamine use and engagement with specialist services was the welfare of their child(ren). Agencies charged with child protection was a barrier to treatment because women feared disclosure of methamphetamine use would result in loss of child custody. Themes highlighted the multiple layers of adversities, and trauma from childhood to adulthood including, co-occurring drug use, mental health and life histories of trauma (abuse, violence, and neglect; intergenerational trauma; intergenerational drug and alcohol use, and child removal), the omnipresence of methamphetamine, and the impact on pregnancy and mothering. CONCLUSION We conclude that understanding the experiences of women and the impact methamphetamine use has on their life is paramount to providing effective and appropriate care to support pregnant women in a trauma-informed and woman-centred approach. Poor engagement in pregnancy care for women with methamphetamine use has significant impacts on mother and infant.
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Affiliation(s)
- Angela O'Connor
- King Edward Memorial Hospital, Australian College of Nursing (ACN), (ACM) Australian College of Midwives, Australia. Angela.O'
| | | | - Dale Hamilton
- King Edward Obstetrics and Gynaecology, FRANZCOG, Australia.
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Kildea S, Hickey S, Nelson C, Currie J, Carson A, Reynolds M, Wilson K, Kruske S, Passey M, Roe Y, West R, Clifford A, Kosiak M, Watego S, Tracy S. Birthing on Country (in Our Community): a case study of engaging stakeholders and developing a best-practice Indigenous maternity service in an urban setting. AUST HEALTH REV 2019; 42:230-238. [PMID: 28384435 DOI: 10.1071/ah16218] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 01/24/2017] [Indexed: 11/23/2022]
Abstract
Developing high-quality and culturally responsive maternal and infant health services is a critical part of 'closing the gap' in health disparities between Aboriginal and Torres Strait Islander people and other Australians. The National Maternity Services Plan led work that describes and recommends Birthing on Country best-practice maternity care adaptable from urban to very remote settings, yet few examples exist in Australia. This paper demonstrates Birthing on Country principles can be applied in the urban setting, presenting our experience establishing and developing a Birthing on Country partnership service model in Brisbane, Australia. An initial World Café workshop effectively engaged stakeholders, consumers and community members in service planning, resulting in a multiagency partnership program between a large inner city hospital and two local Aboriginal Community-Controlled Health Services (ACCHS). The Birthing in Our Community program includes: 24/7 midwifery care in pregnancy to six weeks postnatal by a named midwife, supported by Indigenous health workers and a team coordinator; partnership with the ACCHS; oversight from a steering committee, including Indigenous governance; clinical and cultural supervision; monthly cultural education days; and support for Indigenous student midwives through cadetships and placement within the partnership. Three years in, the partnership program is proving successful with clients, as well as showing early signs of improved maternal and infant health outcomes.
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Affiliation(s)
- Sue Kildea
- Mater Medical Research Institute, Midwifery Research Unit, Level 2 Aubigny Place, Raymond Terrace, South Brisbane, Qld 4101, Australia
| | - Sophie Hickey
- Mater Medical Research Institute, Midwifery Research Unit, Level 2 Aubigny Place, Raymond Terrace, South Brisbane, Qld 4101, Australia
| | - Carmel Nelson
- Institute for Urban Indigenous Health, 23 Edgar Street, Bowen Hills, Qld 4006, Australia
| | - Jody Currie
- Aboriginal and Torres Strait Islander Community Health Service Brisbane Limited, 55 Annerley Road, Woolloongabba, Qld 4102, Australia
| | - Adrian Carson
- Institute for Urban Indigenous Health, 23 Edgar Street, Bowen Hills, Qld 4006, Australia
| | - Maree Reynolds
- Mater Misericordiae Health Services Brisbane Ltd, Raymond Terrace, South Brisbane, Qld 4101, Australia
| | - Kay Wilson
- Mater Misericordiae Health Services Brisbane Ltd, Raymond Terrace, South Brisbane, Qld 4101, Australia
| | - Sue Kruske
- University of Queensland, School of Nursing and Midwifery, St Lucia, Qld 4072, Australia
| | - Megan Passey
- The University of Sydney, University Centre for Rural Health North Coast, 61 Uralba Street, Lismore, NSW 2480, Australia
| | - Yvette Roe
- Institute for Urban Indigenous Health, 23 Edgar Street, Bowen Hills, Qld 4006, Australia
| | - Roianne West
- Griffith University School of Medicine, First Peoples Health Unit, Gold Coast, Qld 4222, Australia
| | - Anton Clifford
- University of Queensland, Queensland Alcohol and Drug Research Centre, Herston Road, Herston, Qld 4006, Australia
| | - Machellee Kosiak
- Australian Catholic University, School of Nursing Midwifery and Paramedicine, 1100 Nudgee Road, Banyo, Qld 4014, Australia
| | - Shannon Watego
- Mater Misericordiae Health Services Brisbane Ltd, Raymond Terrace, South Brisbane, Qld 4101, Australia
| | - Sally Tracy
- University of Sydney, 88 Mallett Street, Camperdown, NSW 2050, Australia
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10
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Kildea S, Hickey S, Barclay L, Kruske S, Nelson C, Sherwood J, Allen J, Gao Y, Blackman R, Roe YL. Implementing Birthing on Country services for Aboriginal and Torres Strait Islander families: RISE Framework. Women Birth 2019; 32:466-475. [DOI: 10.1016/j.wombi.2019.06.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 06/14/2019] [Accepted: 06/15/2019] [Indexed: 01/31/2023]
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11
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Lin IB, Bunzli S, Mak DB, Green C, Goucke R, Coffin J, O'Sullivan PB. Unmet Needs of Aboriginal Australians With Musculoskeletal Pain: A Mixed-Method Systematic Review. Arthritis Care Res (Hoboken) 2019; 70:1335-1347. [PMID: 29245188 DOI: 10.1002/acr.23493] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/05/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Musculoskeletal pain (MSP) conditions are the biggest cause of disability, and internationally, indigenous peoples experience a higher burden. There are conflicting reports about Aboriginal Australians and MSP. We conducted a systematic review to describe the prevalence, associated factors, impacts, care access, health care experiences, and factors associated with MSP among Aboriginal Australians. METHODS We used a systematic search of quantitative and qualitative scientific and grey literature (PROSPERO# CRD42016038342). Articles were appraised using the Mixed Methods Appraisal Tool. Due to study heterogeneity, a narrative synthesis was conducted. RESULTS Of 536 articles identified, 18 were included (14 quantitative, 4 qualitative), of high (n = 11), medium (n = 2), and low (n = 5) quality. Prevalence of MSP in Aboriginal populations was similar to or slightly higher than the non-Aboriginal population (prevalence rate ratio 1.1 for back pain, 1.2-1.5 for osteoarthritis [OA], and 1.0-2.0 for rheumatoid arthritis). Aboriginal people accessed primary care for knee or hip OA at approximately half the rate of non-Aboriginal people, and were less than half as likely to have knee or hip replacement surgery. Communication difficulties with health practitioners were the main reason why Aboriginal people with MSP choose not to access care. No articles reported interventions. CONCLUSION Findings provide preliminary evidence of an increased MSP burden among Aboriginal Australians, and particularly for OA, a mismatch between the disease burden and access to health care. To increase accessibility, health services should initially focus on improving Aboriginal patients' experiences of care, in particular by improving patient-practitioner communication. Implications for care and research are outlined.
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Affiliation(s)
- Ivan B Lin
- University of Western Australia, Geraldton, Western Australia, Australia
| | | | - Donna B Mak
- University of Notre Dame Australia School of Medicine, Fremantle, Western Australia, Australia
| | - Charmaine Green
- University of Western Australia, Geraldton, Western Australia, Australia
| | - Roger Goucke
- Sir Charles Gardner Hospital, Perth, Western Australia, Australia
| | - Juli Coffin
- University of Notre Dame Australia, Broome, Western Australia, Australia
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12
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Kildea S, Gao Y, Hickey S, Kruske S, Nelson C, Blackman R, Tracy S, Hurst C, Williamson D, Roe Y. Reducing preterm birth amongst Aboriginal and Torres Strait Islander babies: A prospective cohort study, Brisbane, Australia. EClinicalMedicine 2019; 12:43-51. [PMID: 31388662 PMCID: PMC6677659 DOI: 10.1016/j.eclinm.2019.06.001] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/24/2019] [Accepted: 06/06/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Prevention of avoidable preterm birth in Aboriginal and Torres Strait Islander (Indigenous) families is a major public health priority in Australia. Evidence about effective, scalable strategies to improve maternal and infant outcomes is urgently needed. In 2013, a multiagency partnership between two Aboriginal Community Controlled Health Organisations and a tertiary maternity hospital co-designed a new service aimed at reducing preterm birth: 'Birthing in Our Community'. METHODS A prospective interventional cohort study compared outcomes for women with an Indigenous baby receiving care through a new service (n = 461) to women receiving standard care (n = 563), January 2013-December 2017. The primary outcome was preterm birth (< 37 weeks gestation). One to one propensity score matching was used to select equal sized standard care and new service cohorts with similar distribution of characteristics. Conditional logistic regression calculated the odds ratio with matched samples. FINDINGS Women receiving the new service were less likely to give birth to a preterm infant than women receiving standard care (6·9% compared to 11.6%). After controlling for confounders, the new service significantly reduced the odds of having a preterm birth (unmatched, n = 1024: OR = 0·57, 95% CI 0·37, 0·89; matched, n = 690: OR = 0·50, 95% CI 0·31, 0·83). INTERPRETATION The short-term results of this service redesign send a strong signal that the preterm birth gap can be reduced through targeted interventions that increase Indigenous governance of, and workforce in, maternity services and provide continuity of midwifery carer, an integrated approach to supportive family services and a community-based hub.
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Affiliation(s)
- Sue Kildea
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, 410 Ann Street, Brisbane City, Queensland 4000, Australia
- Mater Research Institute-University of Queensland, Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia
- Corresponding author at: Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, 410 Ann Street, Brisbane City, Queensland 4000, Australia.
| | - Yu Gao
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, 410 Ann Street, Brisbane City, Queensland 4000, Australia
- Mater Research Institute-University of Queensland, Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia
| | - Sophie Hickey
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, 410 Ann Street, Brisbane City, Queensland 4000, Australia
- Mater Research Institute-University of Queensland, Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia
| | - Sue Kruske
- Institute for Urban Indigenous Health, 22 Cox Rd, Windsor, Queensland 4030, Australia
- School of Nursing, Midwifery and Social Work, University of Queensland
| | - Carmel Nelson
- Institute for Urban Indigenous Health, 22 Cox Rd, Windsor, Queensland 4030, Australia
- Poche Centre for Indigenous Health, University of Queensland
| | - Renee Blackman
- Aboriginal and Torres Strait Islander Community Health Service Brisbane Limited, 55 Annerley Rd, Woolloongabba, Queensland 4102, Australia
- Gidgee Healing Aboriginal Community Controlled Health Service, 28 Miles Street, Mount Isa, Queensland 4825, Australia
| | - Sally Tracy
- The University of Sydney, 88 Mallett Street, Camperdown, New South Wales 2050, Australia
| | - Cameron Hurst
- QIMR Berghofer Medical Research Institute, 300 Herston Rd, Herston, Queensland 4006, Australia
| | - Daniel Williamson
- Aboriginal and Torres Strait Islander Health Branch, Department of Health, 33 Charlotte Street, Brisbane, Queensland 4001, Australia
| | - Yvette Roe
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, 410 Ann Street, Brisbane City, Queensland 4000, Australia
- Mater Research Institute-University of Queensland, Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia
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13
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Jaraba SMR, Garcés-Palacio IC. Association between violence during pregnancy and preterm birth and low birth weight in Colombia: Analysis of the demographic and health survey. Health Care Women Int 2019; 40:1149-1169. [PMID: 30874485 DOI: 10.1080/07399332.2019.1566331] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
To explore the association between low birth weight and preterm birth with violence during pregnancy, we conducted a cross-sectional study by using the 2010 Colombian Demographic and Health Survey. We conducted bivariate analyses, binomial logistic regression, and stratified models by age, and 14,520 women were included. There was no association between violence and low birth weight. Nonetheless, an association with preterm birth in women aged over 35 was observed (OR 1.98, 95%CI 1.23, 3.17). Prenatal care appeared to be a protective factor for both outcomes. This research unexpectedly showed that supplementation with folic acid and iron was associated with preterm birth.
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Affiliation(s)
- Sara Milena Ramos Jaraba
- Grupo de Epidemiologia, Facultad Nacional de Salud Pública, Universidad de Antioquia UdeA, Medellín, Colombia
| | - Isabel C Garcés-Palacio
- Grupo de Epidemiologia, Facultad Nacional de Salud Pública, Universidad de Antioquia UdeA, Medellín, Colombia
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Ireland S, Larkins S, Ray R, Woodward L, Devine K. Adequacy of antenatal steroids, rather than place of birth, determines survival to discharge in extreme prematurity in North Queensland. J Paediatr Child Health 2019; 55:205-212. [PMID: 30151906 DOI: 10.1111/jpc.14184] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/24/2018] [Accepted: 07/08/2018] [Indexed: 12/26/2022]
Abstract
AIM The Townsville Hospital cares for babies in a large geographical area, many of who are outborn, are of Aboriginal or Torres Strait Islander origin and have families who reside in areas of deprivation. This study examined the outcomes of babies born at all locations in North Queensland to assess the predictors of poor outcomes. METHODS A retrospective observational study examined the survival of 313 babies born from 22 completed weeks gestation to 27 + 6 weeks gestation in North Queensland between January 2010 and December 2016. Additional analyses were performed for the 300 non-syndromal babies whose mothers usually resided in North Queensland, studying demographics of gestation, gender, birthweight, Indigenous status, regionality of maternal residence and adequacy of antenatal steroids. Short-term morbidities of intraventricular haemorrhage/periventricular leukomalacia (IVH/PVL), surgical necrotizing enterocolitis, retinopathy of prematurity requiring treatment and chronic lung disease and death were studied in relation to demographic factors and clinical treatment. RESULTS Adequacy of steroids was significantly associated with a decreased mortality odds ratio of 2.872 (95% confidence interval 1.228-6.715), whilst no difference in outcome was seen by retrieval status or ethnic origin. Babies from remote locations were at increased risk for IVH/PVL, 2.334 (1.037-5.255). Male babies suffered more chronic lung disease, 1.608 (1.010-2.561), and IVH/PVL, 2.572 (1.215-5.445). Aboriginal and Torres Strait Islander babies were at lower risk of IVH/PVL. CONCLUSIONS Steroids should be administered wherever there is any possibility of the provision of intensive care for periviable babies. Place of birth and ethnicity of mother should not unduly influence antenatal counselling.
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Affiliation(s)
- Susan Ireland
- Neonatal Unit, The Townsville Hospital, Townsville, Queensland, Australia
| | - Sarah Larkins
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Robin Ray
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Lynn Woodward
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Kirsty Devine
- The Neonatal Unit, Mater Mothers Hospital, Brisbane, Queensland, Australia
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15
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Hickey S, Roe Y, Gao Y, Nelson C, Carson A, Currie J, Reynolds M, Wilson K, Kruske S, Blackman R, Passey M, Clifford A, Tracy S, West R, Williamson D, Kosiak M, Watego S, Webster J, Kildea S. The Indigenous Birthing in an Urban Setting study: the IBUS study : A prospective birth cohort study comparing different models of care for women having Aboriginal and Torres Strait Islander babies at two major maternity hospitals in urban South East Queensland, Australia. BMC Pregnancy Childbirth 2018; 18:431. [PMID: 30382852 PMCID: PMC6211601 DOI: 10.1186/s12884-018-2067-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 10/19/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND With persisting maternal and infant health disparities, new models of maternity care are needed to meet the needs of Aboriginal and Torres Strait Islander people in Australia. To date, there is limited evidence of successful and sustainable programs. Birthing on Country is a term used to describe an emerging evidence-based and community-led model of maternity care for Indigenous families; its impact requires evaluation. METHODS Mixed-methods prospective birth cohort study comparing different models of care for women having Aboriginal and Torres Strait Islander babies at two major maternity hospitals in urban South East Queensland (2015-2019). Includes women's surveys (approximately 20 weeks gestation, 36 weeks gestation, two and six months postnatal) and infant assessments (six months postnatal), clinical outcomes and cost comparison, and qualitative interviews with women and staff. DISCUSSION This study aims to evaluate the feasibility, acceptability, sustainability, clinical and cost-effectiveness of a Birthing on Country model of care for Aboriginal and Torres Strait Islander families in an urban setting. If successful, findings will inform implementation of the model with similar communities. TRIAL REGISTRATION Australian New Zealand Clinical Trial Registry # ACTRN12618001365257 . Registered 14 August 2018 (retrospectively registered).
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Affiliation(s)
- Sophie Hickey
- Midwifery Research Unit, Mater Research Institute-University of Queensland, Brisbane, QLD Australia
| | - Yvette Roe
- Midwifery Research Unit, Mater Research Institute-University of Queensland, Brisbane, QLD Australia
| | - Yu Gao
- Midwifery Research Unit, Mater Research Institute-University of Queensland, Brisbane, QLD Australia
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia
| | - Carmel Nelson
- Institute for Urban Indigenous Health, Brisbane, QLD Australia
| | - Adrian Carson
- Institute for Urban Indigenous Health, Brisbane, QLD Australia
| | - Jody Currie
- Aboriginal and Torres Strait Islander Community Health Service Brisbane Limited, Brisbane, QLD Australia
| | | | - Kay Wilson
- Mater Misericordia Limited, Brisbane, QLD Australia
| | - Sue Kruske
- Institute for Urban Indigenous Health, Brisbane, QLD Australia
| | - Renee Blackman
- Aboriginal and Torres Strait Islander Community Health Service Brisbane Limited, Brisbane, QLD Australia
| | | | - Anton Clifford
- Midwifery Research Unit, Mater Research Institute-University of Queensland, Brisbane, QLD Australia
| | - Sally Tracy
- The University of Sydney, Sydney, NSW Australia
| | - Roianne West
- Griffith University, First Peoples Health Unit Queensland, Brisbane, Australia
| | - Daniel Williamson
- Department of Health, Aboriginal and Torres Strait Islander Health Branch, Brisbane, QLD Australia
| | | | | | - Joan Webster
- National Centre of Research Excellence in Nursing Interventions, Griffith University, Menzies Health Institute, Brisbane, QLD Australia
| | - Sue Kildea
- Midwifery Research Unit, Mater Research Institute-University of Queensland, Brisbane, QLD Australia
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia
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16
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Dela Cruz R, Grant J, Heck JE, Cash HL. Disparities in Adverse Perinatal Outcomes Among Pacific Islanders in the Commonwealth of the Northern Mariana Islands. Prev Chronic Dis 2018. [PMID: 29522702 PMCID: PMC5858154 DOI: 10.5888/pcd15.170385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction Although other studies have found evidence for perinatal health disparities among Pacific Islanders in other regions, no studies have evaluated racial/ethnic disparities in adverse perinatal health outcomes in the small US island territory of the Commonwealth of the Northern Mariana Islands (CNMI). Methods We used retrospective cohort data on 8,427 singleton births from 2007 to 2014 at the Commonwealth Healthcare Corporation (CHCC), the only hospital in the CNMI. We used multivariate logistic regression to estimate risk for preterm birth (<37 weeks) and macrosomia (>4,000 g) among the racial/ethnic groups in the CNMI. Results Indigenous CNMI mothers (Chamorros and Carolinians, hereinafter Chamorro/Carolinian) and other Pacific Islander mothers were significantly more likely to have a preterm birth than Chinese mothers (adjusted odds ratio [AOR] = 2.7; 95% confidence interval [CI], 2.0–3.6 for Chamorro/Carolinians and AOR = 2.9; 95% CI, 2.1–4.1 for other Pacific Islanders). Additionally, Chamorro/Carolinian mothers and other Pacific Islander mothers were also significantly more likely to deliver babies with macrosomia (AOR = 2.4; 95% CI, 1.7–3.5 and 2.3; 95% CI 1.4–3.6 respectively) than Filipino mothers. Conclusion Although underlying causes for these disparities are still unknown, these findings add to the limited knowledge on maternal and neonatal health among Pacific Islanders and provide support for further research and intervention development to aid in reducing racial/ethnic disparities of perinatal health in the CNMI.
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Affiliation(s)
- Rica Dela Cruz
- Commonwealth Healthcare Corporation, 1 Lower Navy Hill Rd, Saipan, MP 96950. .,Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California
| | - Jeanolivia Grant
- Commonwealth Healthcare Corporation, Saipan, Northern Mariana Islands
| | - Julia E Heck
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California
| | - Haley L Cash
- Regional Epidemiology Unit, Pacific Island Health Officers' Association, Honolulu, Hawaii
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17
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Rich R, D'Hont T, Linton J, Murphy KE, Veillard J, Chatwood S. Performance indicators for maternity care in a circumpolar context: a scoping review. Int J Circumpolar Health 2016; 75:31470. [PMID: 27938636 PMCID: PMC5149666 DOI: 10.3402/ijch.v75.31470] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/27/2016] [Accepted: 09/19/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In circumpolar regions, harsh climates and scattered populations have prompted the centralization of care and reduction of local maternity services. The resulting practice of routine evacuation for birth from smaller towns to larger urban centres points to a potential conflict between the necessity to ensure patient safety and the importance of delivering services that are responsive to the health needs and values of populations served. OBJECTIVE To identify recommended performance/quality indicators for use in circumpolar maternity care systems. METHODS We searched Scopus, Ebscohost databases (including Academic Search Complete and CINAHL), the Global Health Database, High North Research Documents, and online grey literature. Articles were included if they focused on maternal health indicators in the population of interest (Indigenous women, women receiving care in circumpolar or remote regions). Articles were excluded if they were not related to pregnancy, birth or the immediate post-partum or neonatal periods. Two reviewers independently reviewed articles for inclusion and extracted relevant data. RESULTS Twenty-six documents were included. Twelve were government documents, seven were review articles or indicator compilations, four were indicator sets recommended by academics or non-governmental organizations and three were research papers. We extracted and categorized 81 unique health indicators. The majority of indicators reflected health systems processes and outcomes during the antenatal and intra-partum periods. Only two governmental indicator sets explicitly considered the needs of Indigenous peoples. CONCLUSIONS This review demonstrates that, although most circumpolar health systems engage in performance reporting for maternity care, efforts to capture local priorities and values are limited in most regions. Future work in this area should involve northern stakeholders in the process of indicator selection and development.
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Affiliation(s)
- Rebecca Rich
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Canada;
| | - Thomsen D'Hont
- Institute for Circumpolar Health Research, Yellowknife, Canada
| | - Janice Linton
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, Canada
| | - Kellie E Murphy
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Canada
- Mount Sinai Hospital, Toronto, Canada
| | - Jeremy Veillard
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Health, Nutrition and Population Global Practice, The World Bank, Washington, DC, USA
| | - Susan Chatwood
- Institute for Circumpolar Health Research, Yellowknife, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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18
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Corcoran PM, Catling C, Homer CSE. Models of midwifery care for Indigenous women and babies: A meta-synthesis. Women Birth 2016; 30:77-86. [PMID: 27612623 DOI: 10.1016/j.wombi.2016.08.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 07/26/2016] [Accepted: 08/05/2016] [Indexed: 11/27/2022]
Abstract
ISSUE Indigenous women in many countries experience a lack of access to culturally appropriate midwifery services. A number of models of care have been established to provide services to women. Research has examined some services, but there has not been a synthesis of qualitative studies of the models of care to help guide practice development and innovations. AIM To undertake a review of qualitative studies of midwifery models of care for Indigenous women and babies evaluating the different types of services available and the experiences of women and midwives. METHODS A meta-synthesis was undertaken to examine all relevant qualitative studies. The literature search was limited to English-language published literature from 2000-2014. Nine qualitative studies met the inclusion criteria and literature appraisal - six from Australia and three from Canada. These articles were analysed for coding and theme development. FINDINGS The major themes were valuing continuity of care, managing structural issues, having negative experiences with mainstream services and recognising success. DISCUSSION The most positive experiences for women were found with the services that provided continuity of care, had strong community links and were controlled by Indigenous communities. Overall, the experience of the midwifery services for Indigenous women was valuable. Despite this, there were still barriers preventing the provision of intrapartum midwifery care in remote areas. CONCLUSION The expansion of midwifery models of care for Indigenous women and babies could be beneficial in order to improve cultural safety, experiences and outcomes in relation to pregnancy and birth.
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Affiliation(s)
- Patricia M Corcoran
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia.
| | - Christine Catling
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia
| | - Caroline S E Homer
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia
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Whish-Wilson T, Tacey M, McCarthy E, Howat P. Indigenous birth outcomes at a Victorian urban hospital, a retrospective 5-year cohort study 2010-2014. Aust N Z J Obstet Gynaecol 2016; 56:238-44. [DOI: 10.1111/ajo.12439] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 12/22/2015] [Indexed: 12/26/2022]
Affiliation(s)
| | - Mark Tacey
- Melbourne EpiCentre and Northern Clinical Research Centre; Melbourne Victoria Australia
| | - Elizabeth McCarthy
- Obstetrics and Gynaecology; University of Melbourne; Heidelberg Victoria Australia
| | - Paul Howat
- Women's Health; The Northern Hospital; Melbourne Victoria Australia
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20
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Vosnacos E, Pinchon DJ. Survey of women's perceptions of information provided in the prevention or treatment of iron deficiency anaemia in an Australian tertiary obstetric hospital. Women Birth 2014; 28:166-72. [PMID: 25466172 DOI: 10.1016/j.wombi.2014.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 11/06/2014] [Accepted: 11/07/2014] [Indexed: 01/07/2023]
Abstract
BACKGROUND There is limited literature to understand the perceptions of Australian women regarding the information provided by healthcare professionals relating to the prevention and treatment of iron deficiency anaemia in pregnancy. AIM To establish an insight into the key themes and trends within a tertiary obstetric hospital related to the provision of dietary advice and use of iron supplements in pregnancy. METHODS A prospective patient survey of pregnant women and women up to 4 weeks postnatal attending hospital. FINDINGS Of the 110 women who participated, 73.6% were provided with information on iron rich foods and 67% made dietary changes. Eighty percent of women were advised to take oral iron and 65.5% of women were taking it at the time of the survey. In women who had independently ceased oral iron, 41.7% failed to inform their healthcare professional. In the women who did inform their healthcare professional 89.5% received advice to help overcome the reason that led to cessation. The main causes included forgetfulness and side effects. Women were less likely to require intravenous iron if oral iron was commenced early. CONCLUSIONS Compliance with recommended oral iron is variable within a population of pregnant women. Women are provided with information on a range of issues relating to the prevention and treatment of iron deficiency anaemia; yet there is a disparity between the information provided and the resulting action. Further research should focus on targeted measures to improve understanding and compliance with treatment from the both women's and health professionals perspective.
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Affiliation(s)
- Emma Vosnacos
- Infusion Unit, King Edward Memorial Hospital, Perth, WA, Australia
| | - Deborah J Pinchon
- Obstetric and Gynaecology Clinical Care Unit, King Edward Memorial Hospital, Perth, WA, Australia.
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