Closing the gap in midwifery care

Baggarrook first birthday celebration
The Women's Baggarrook midwives (wearing scarves) celebrated the program's first birthday with some of the mothers they cared for and babies they delivered in the past year
6 March 2018 | Pregnancy

A new partnership between the Royal Women’s Hospital, La Trobe University and three other Victorian public hospitals is giving pregnant Indigenous women greater access to “gold standard” maternity care, resulting in better health outcomes for mothers and babies.

The program was first introduced at the Royal Women’s Hospital in March last year and has since resulted in a ten-fold increase in the number of pregnant Aboriginal and Torres Strait Islander women receiving one-on-one (also known as caseload) midwifery care.

La Trobe and the Women’s Professor of Midwifery Della Forster said women who chose this care had the same midwife looking after them during pregnancy, birth and after the birth.

“Funding from the National Health and Medical Research Council and the Women’s has allowed us to set up the ‘Baggarrook’ program at the Women’s to specifically support Aboriginal women,” Professor Forster said.

“Baggarrook involves three dedicated midwives providing care to Aboriginal women. In just 12 months, we have seen the number of indigenous pregnant women receiving one-on-one care increase from six to more than 60.”

La Trobe Professor of Midwifery Helen McLachlan, the project leader, said, “We know from our previous research that one-on-one care is the gold standard in maternity care, and thousands of healthy babies have been born under this model.

“Unfortunately, many eligible Aboriginal and Torres Strait Islander pregnant women have been missing out due to a number of reasons, including the lack of places available in the model, and sometimes because of later presentation to hospital due to being transferred from outside Melbourne.”

Professor McLachlan said La Trobe was also working with Mercy Hospital for Women in Heidelberg, Sunshine Hospital and Goulburn Valley Health in Shepparton as part of the same project.

“We know that there are major differences in health outcomes for Aboriginal mothers and babies including issues like preterm birth, pregnancy loss, low birthweight and special care nursery admissions.

“Our aim therefore is to close the gap in access to this model of midwifery care (which is known to improve these outcomes) and so improve the health outcomes for Aboriginal women and their babies across the state. In the future we’d love to see this model of care made available at all maternity hospitals and to all Victorian women.”

In 2012, La Trobe and the Women’s published findings from Australia’s first trial of one-to-one care that found pregnant women who received care from a primary midwife were not only more likely to have a positive experience, but also to have fewer childbirth complications and better clinical outcomes for both mothers and babies.