Birthing on Country (in Our Community): a case study of engaging stakeholders and developing a best-practice Indigenous maternity service in an urban setting
Sue Kildea A B L , Sophie Hickey A , Carmel Nelson C , Jody Currie D , Adrian Carson C , Maree Reynolds E , Kay Wilson E , Sue Kruske B C , Megan Passey F , Yvette Roe C , Roianne West G , Anton Clifford H , Machellee Kosiak I , Shannon Watego E and Sally Tracy J KA Mater Medical Research Institute, Midwifery Research Unit, Level 2 Aubigny Place, Raymond Terrace, South Brisbane, Qld 4101, Australia.
B University of Queensland, School of Nursing and Midwifery, St Lucia, Qld 4072, Australia.
C Institute for Urban Indigenous Health, 23 Edgar Street, Bowen Hills, Qld 4006, Australia.
D Aboriginal and Torres Strait Islander Community Health Service Brisbane Limited, 55 Annerley Road, Woolloongabba, Qld 4102, Australia.
E Mater Misericordiae Health Services Brisbane Ltd, Raymond Terrace, South Brisbane, Qld 4101, Australia.
F The University of Sydney, University Centre for Rural Health North Coast, 61 Uralba Street, Lismore, NSW 2480, Australia.
G Griffith University School of Medicine, First Peoples Health Unit, Gold Coast, Qld 4222, Australia.
H University of Queensland, Queensland Alcohol and Drug Research Centre, Herston Road, Herston, Qld 4006, Australia.
I Australian Catholic University, School of Nursing Midwifery and Paramedicine, 1100 Nudgee Road, Banyo, Qld 4014, Australia.
J University of Sydney, 88 Mallett Street, Camperdown, NSW 2050, Australia.
K Poche Centre for Indigenous Health, University of Sydney, NSW 2006, Australia.
L Corresponding author. Email: sue.kildea@mater.uq.edu.au
Australian Health Review 42(2) 230-238 https://doi.org/10.1071/AH16218
Submitted: 30 September 2016 Accepted: 24 January 2017 Published: 7 April 2017
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.
What is known about the topic? Birthing on Country has been described as a metaphor for the best start in life for Aboriginal and Torres Strait Islander babies, and services that incorporate Birthing on Country principles can improve outcomes for mothers and babies. Currently, few such models exist in Australia.
What does this paper add? This paper demonstrates that Birthing on Country principles can be successfully applied to the urban context. We present a real case example of the experience of setting up one such best-practice, community-engaged and informed partnership model of maternity and child healthcare in south-east Queensland. We share our experience using a World Café to facilitate community engagement, service delivery and workforce planning.
What are the implications for practitioners? Health professionals providing maternity care for Aboriginal and Torres Strait Islander families are encouraged to incorporate Birthing on Country principles into their model of care to address the specific needs and demands of the local Indigenous community and improve maternal and infant health outcomes.
Additional keywords: health services, Indigenous health.
References
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