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Photograph: Pat Josse

Birthing on Country

 

Centre for Research Excellence

Achieving equity in birth outcomes, health status and life expectancy for Aboriginal and Torres Strait Islander families in urban Southeast Queensland.

Indigenous Birthing in an Urban Setting

(IBUS)

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In 2010, an evaluation of Mater Mothers’ Hospital specialist antenatal clinic for Aboriginal and Torres Strait Islander women (the ‘Murri Clinic’) revealed that although women were very satisfied with the service, they were unhappy with the lack of continuity by a known carer during labour/birth and the early weeks of the baby’s life. Added to this was a strong desire to improve maternal and infant health outcomes for Indigenous mothers and babies.

 

This led to the development of a partnership between three Brisbane-based organisations: Institute for Urban Indigenous Health (IUIH), Aboriginal and Torres Strait Islander Community Health Service (ATSICHS) Brisbane Limited and Mater Health Service (MHS). These organisations agreed to share resources to redesign maternal and infant health services in a program called Birthing in our Community (BiOC). This is an enhanced midwifery group practice-based model specifically tailored to the needs and preferences of Aboriginal and Torres Strait Islander families. This new model has been operating since 2013 and is already making a difference to the families who access the services. It has also seen an increase in our Indigenous workers with some training to be midwives.

The BiOC program includes:

  • 24/7 midwifery care in pregnancy to six weeks postnatal by a named midwife supported by Indigenous family support workers, as well as transport, childcare, social work and mental health support, allied health, and women’s health doctor available at a designated community-based Mums and Bubs hub

  • Partnership with the Aboriginal community health services

  • Oversight from a Steering Committee, including Indigenous governance

  • Clinical/cultural supervision monthly cultural education days

  • Support for Indigenous student midwives through cadetships and placement within the partnership.

For more information about the history of the Birthing in Our Community partnership, click here.

The IBUS Study is a five-year research evaluation that compares different models of care for women having Aboriginal and Torres Strait Islander babies at two major maternity hospitals in urban South East Queensland, Australia. Pregnant women were recruited from the Mater Mothers Hospital and the Royal Brisbane Women’s hospital. Surveys were conducted with over 600 families to know what women thought of the different programs. Clinical data are being analysed to see whether the programs made a difference to health outcomes. The study will also include an economic analysis to test cost effectiveness as well as qualitative yarns (interviews) with families and staff involved for an in-depth understanding of what works best for families and how to best implement this sort of program. For more information about what the study involves, click here.

5th Birthday of the Birthing in Our Community Service

Pictured L-R: Dr Carmel Nelson, Shannon Watego, Kyleigh Brown-Lolohea, Dr Sue Kildea, Karina Hogan and Elliot Dunn

5th Birthday of the Birthing in Our Community Service

Pictured L-R: Dr Carmel Nelson, Shannon Watego, Kyleigh Brown-Lolohea, Dr Sue Kildea, Karina Hogan and Elliot Dunn

5th Birthday of the Birthing in Our Community Service

Pictured L-R: Dr Carmel Nelson, Shannon Watego, Kyleigh Brown-Lolohea, Dr Sue Kildea, Karina Hogan and Elliot Dunn

The Statement of Commitment

The partners signed a Statement of Commitment that through partnership, they are able to advance more effectively than as individuals towards the shared goal of achieving equity in birth outcomes, health status and life expectancy for Aboriginal and Torres Strait Islander families in urban Southeast Queensland. 

Reduction in Preterm Birth

The IBUS Study recorded a profound reduction in preterm birth for women accessing the Birthing in Our Community service. This is a huge achievement that could not have been possible without the three partner organisations: the Institute for Urban Indigenous Health, the Aboriginal and Torres Strait Islander Health Services, Brisbane, and the Mater Hospital. Preterm birth can be stressful and can increase the chance of illness or chronic disease in later life. Having more babies born full-term is a social and intergenerational investment in community well being. For more information about how this was achieved, read our paper published in E-Clinical Medicine, a Lancet publication.

Stop Smoking in Its Tracks 

IBUS sub-study

“Stop Smoking in its Tracks” (SST) is a smoking cessation program designed specifically for pregnant Aboriginal and Torres Strait Islander women or women with Aboriginal and Torres Strait Islander partners, in collaboration with a community reference group of Aboriginal women and Aboriginal Health Workers (Passey and Stirling 2018). The main components of the program include: intensive support for cessation for women; free nicotine replacement therapy; financial rewards for confirmed abstinence; support for household members to support the woman’s quit attempt and to quit themselves. The program continues for six months post-partum. It will be provided to pregnant women who smoke as an integral component of the BiOC model, by the midwives and Indigenous workers.  It is a single arm intervention study that aims to assess the effectiveness, acceptability, and feasibility of the SST program to achieve smoking cessation and quit attempts among pregnant women who report currently smoking at the booking-in visit and are receiving antenatal care through the Birthing in Our Community Service, Brisbane.

IBUS Publications

 
 

Projects

Estimating the life long impact of the Birthing in Our Community (BiOC) Service on health adjusted l
BOOST 2: Extending the Building on Our Strengths (BOOSt) Study, NHMRC (GNT1135125) 2018-22
Redesigning services and developing the remote exemplar site North West Qld
Australian Yolŋu Doula Support Course, Prime Ministers and Cabinet 2018-20
Supporting the retention of First Nations students in midwifery5 Jul 2019
The RISE Birthing on Country short course and toolkit to support scale-up
Preventing unborn notifications in pregnancy, and child removal at birth
Healing the Past by Nurturing the Future: Implementing trauma-integrated care
Increasing support within the first 1,000 days for vulnerable babies
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Birthing on Country acknowledges the traditional custodians across the lands on which we live and work, and we pay our respects to Elders both past and present.

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