Use of Maternal Health Services by Remote Dwelling Aboriginal Women in Northern Australia and Their Disease Burden

Authors

  • Sarah Bar-Zeev BN, MPH, MNSc,

    National Health and Medical Research Council Doctoral Candidate in Indigenous Australian Health Research, Corresponding author
    • Centre for Rural Health North Coast, School of Public Health, Sydney Medical School, University of Sydney, NSW, Australia
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  • Lesley Barclay BA, MEd, PhD,

    Professor and Director
    1. Centre for Rural Health, North Coast, University of Sydney, Sydney, NSW, Australia
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  • Sue Kruske BHSC (Hons), PhD,

    Adjunct Professor, Director
    1. School of Health at Charles Darwin University, Darwin, NT, Australia
    2. Queensland Centre for Mothers & Babies, University of Queensland, Brisbane, Qld, Australia
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  • Naor Bar-Zeev MBBS (Hons) MPH,

    National Health and Medical Research Council Doctoral Candidate in Indigenous Australian Health Research
    1. Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
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  • Yu Gao MBBS, PhD,

    Research Fellow
    1. Centre for Rural Health, North Coast, University of Sydney, Sydney, NSW, Australia
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  • Sue Kildea BHSC (Hons) PhD

    Professor and Director
    1. Midwifery Research Unit, Australian Catholic University and the Mater Medical Research Institute, Qld, Australia
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Address correspondence to Sarah Bar-Zeev, BN, MPH, MNSc, National Health and Medical Research Council Doctoral Candidate in Indigenous Australian Health Research at the Centre for Rural Health, North Coast, School of Public Health, Sydney Medical School, University of Sydney, Sydney, NSW 2480, Australia.

Abstract

Background

Disparities exist in pregnancy and birth outcomes between Australian Aboriginal women and their non-Aboriginal counterparts. Understanding patterns of health service use by Aboriginal women is critical. This study describes the use of maternal health services by remote dwelling Aboriginal women in northern Australia during pregnancy, birth and the postpartum period and their burden of disease.

Methods

A retrospective cohort study of maternity care for all 412 maternity cases from two remote Aboriginal communities in the Northern Territory of Australia, 2004–2006. Primary endpoints were the number and type of maternal health-related complications and service episodes at the health centers and regional hospital during pregnancy, birth, and the first 6 months postpartum.

Results

Ninety-three percent of women attended antenatal care. This often commenced late in pregnancy. High levels of complications were identified and 23 percent of all women required antenatal hospitalization. Birth occurred within the regional hospital for 90 percent of women. By 6 months postpartum, 45 percent of women had documented postnatal morbidities and 8 percent required hospital admission. The majority of women accessed remote health services at least once; however, only one third had a record of a postnatal care within 2 months of giving birth.

Conclusion

Maternal health outcomes were poor despite frequent service use throughout pregnancy, birth, and the first 6 months postpartum suggesting quality of care rather than access issues. These findings reflect outcomes that are more aligned with the developing rather than developed world and have significant implications for future planning of maternity services that must be urgently addressed.

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