Evaluation of an Australian Aboriginal model of maternity care: The Malabar Community Midwifery Link Service

Hartz, DL; Blain, J; Caplice, S; Allende, T; Anderson, S; Hall, B; McGrath, L; Williams, K; Jarman, H; Tracy, SK

Evaluation of an Australian Aboriginal model of maternity care: The Malabar Community Midwifery Link Service

Hartz, DL

Blain, J Caplice, S Allende, T Anderson, S Hall, B McGrath, L Williams, K Jarman, H Tracy, SK

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Publication Type:: Journal Article
Citation:: Women and Birth, 2019, 32 (5), pp. 427 - 436
Issue Date:: 2019-10-01

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Field	Value	Language
dc.contributor.author	Hartz, DL https://orcid.org/0000-0002-4964-2106	en_US
dc.contributor.author	Blain, J	en_US
dc.contributor.author	Caplice, S	en_US
dc.contributor.author	Allende, T	en_US
dc.contributor.author	Anderson, S	en_US
dc.contributor.author	Hall, B	en_US
dc.contributor.author	McGrath, L	en_US
dc.contributor.author	Williams, K	en_US
dc.contributor.author	Jarman, H	en_US
dc.contributor.author	Tracy, SK	en_US
dc.date.available	2019-07-05	en_US
dc.date.issued	2019-10-01	en_US
dc.identifier.citation	Women and Birth, 2019, 32 (5), pp. 427 - 436	en_US
dc.identifier.issn	1871-5192	en_US
dc.identifier.uri	http://hdl.handle.net/10453/136262
dc.description.abstract	© 2019 Background: The urban-based Malabar Community Midwifery Link Service integrates multidisciplinary wrap-around services along-side continuity of midwifery care for Aboriginal and Torres Strait Islander mothers and babies. Aim: To evaluate the Malabar Service from 1 January 2007 to 31 December 2014. Methods: A mixed method design. Outcomes for mothers of Aboriginal and/or Torres Strait Islander babies cared for at an urban Australian referral hospital by the Malabar Service were compared to mainstream. Primary outcomes are rates of low birth weight; smoking >20 weeks gestation; preterm birth; and breastfeeding at discharge. Malabar outcomes are also compared to national and state perinatal outcomes. Results: The Malabar Service (n = 505) demonstrated similar rates of preterm birth (aOR 2.2, 95% CI 0.96–4.97); breastfeeding at discharge (aOR 1.1, 95% CI 0.61–1.86); and a higher rate of low birth weight babies (aOR 3.6, 95% CI 1.02–12.9) than the comparison group (n = 201). There was a 25% reduction in smoking rates from 38.9% to 29.1%. Compared to national and state populations, Malabar outcomes were better. Women experienced greater psychosocial complexity but were well supported. Malabar Mothers (n = 9) experienced: accessibility, preparedness for birth and cultural safety. Staff (n = 13) identified going ‘above and beyond’ and teamwork to provide culturally safe care counterbalanced with concerns around funding and cultural support. Conclusions: Dedicated integrated continuity of midwifery care with wrap-around services for Aboriginal and/or Torres Strait Islander mothers is highly valued and is culturally safe. The service is as safe as main stream services and promotes better clinical outcomes compared to national and state outcomes.	en_US
dc.relation.ispartof	Women and Birth	en_US
dc.relation.isbasedon	10.1016/j.wombi.2019.07.002	en_US
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject.classification	Obstetrics & Reproductive Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Smoking	en_US
dc.subject.mesh	Obstetrics	en_US
dc.subject.mesh	Midwifery	en_US
dc.subject.mesh	Pregnancy	en_US
dc.subject.mesh	Parturition	en_US
dc.subject.mesh	Cultural Characteristics	en_US
dc.subject.mesh	Maternal Welfare	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Oceanic Ancestry Group	en_US
dc.subject.mesh	Maternal Health Services	en_US
dc.subject.mesh	Health Services, Indigenous	en_US
dc.subject.mesh	Continuity of Patient Care	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.title	Evaluation of an Australian Aboriginal model of maternity care: The Malabar Community Midwifery Link Service	en_US
dc.type	Journal Article
utslib.citation.volume	5	en_US
utslib.citation.volume	32	en_US
utslib.for	1114 Paediatrics and Reproductive Medicine	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	11 Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Midwifery
utslib.copyright.status	closed_access	*
pubs.issue	5	en_US
pubs.publication-status	Published	en_US
pubs.volume	32	en_US

Abstract:

© 2019 Background: The urban-based Malabar Community Midwifery Link Service integrates multidisciplinary wrap-around services along-side continuity of midwifery care for Aboriginal and Torres Strait Islander mothers and babies. Aim: To evaluate the Malabar Service from 1 January 2007 to 31 December 2014. Methods: A mixed method design. Outcomes for mothers of Aboriginal and/or Torres Strait Islander babies cared for at an urban Australian referral hospital by the Malabar Service were compared to mainstream. Primary outcomes are rates of low birth weight; smoking >20 weeks gestation; preterm birth; and breastfeeding at discharge. Malabar outcomes are also compared to national and state perinatal outcomes. Results: The Malabar Service (n = 505) demonstrated similar rates of preterm birth (aOR 2.2, 95% CI 0.96–4.97); breastfeeding at discharge (aOR 1.1, 95% CI 0.61–1.86); and a higher rate of low birth weight babies (aOR 3.6, 95% CI 1.02–12.9) than the comparison group (n = 201). There was a 25% reduction in smoking rates from 38.9% to 29.1%. Compared to national and state populations, Malabar outcomes were better. Women experienced greater psychosocial complexity but were well supported. Malabar Mothers (n = 9) experienced: accessibility, preparedness for birth and cultural safety. Staff (n = 13) identified going ‘above and beyond’ and teamwork to provide culturally safe care counterbalanced with concerns around funding and cultural support. Conclusions: Dedicated integrated continuity of midwifery care with wrap-around services for Aboriginal and/or Torres Strait Islander mothers is highly valued and is culturally safe. The service is as safe as main stream services and promotes better clinical outcomes compared to national and state outcomes.

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http://hdl.handle.net/10453/136262