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Women’s Health
Another study identified that Aboriginal women were more likely to have
three or more social issues during pregnancy (OR 2.69 [95% CI
1.2-5.9]).(Yelland. J et.al 2010).
The issue cont...
Possible determinants of maternal stress during pregnancy:
➢ Previous trauma associated with pregnancy, labour or miscarriages (C. L. Woods-Giscombé, 2010)
➢ Intergenerational trauma (J. Atkinson, J. Nelson and C. Atkinson, 2010)
➢ Less than grade 11 education (S. Marquis, E. Butler, 2001)
➢ Lack of connection to community and support (S. Elsenbruch et.al, 2006)
➢ Recent loss of a family member (Weetra et al. BMC Pregnancy and Childbirth, 2016)
➢ Young age (<25 years old) (C. Rubertsson, J. Hellstrom, M. Cross, G. Sydsjo, 2014)
➢ Indigenous (Yelland. J et.al 2010)
Protective factors:
➢ Social support network (S. Elsenbruch et.al, 2006)
➢ Ability to gain control of stressful situations (P. La Marca-Ghaemmaghami, U. Ehlert, 2014)
➢ Consistent prenatal care
➢ Adequate rest
➢ Healthy diet
➢ Avoidance of alcohol, smoking and other drugs
➢ Psychological resources such as higher dispositional optimism ,self-mastery, and self-esteem
➢ Relaxation interventions i.e yoga (A. Beddoe, K. Lee, 2008)
Low birth weight babies by Mothers indigenous status and remoteness 2011
Source: waminda.org.au
“We believe that in order to be physically well and
strong, you need to be in a mentally safe space and be
in a good state of mind” - Kate Stein, Waminda
Midwife
WHo helped?
- This corporation is made up of local indigenous women who
are self nominated and willing to share their cultural
knowledge, ensuring that it is a culturally appropriate
service.
Source: waminda.org.au
Has it worked?
- No data to see whether or not it has worked
What else can we do?
Waminda could implement a program running in conjunction with the Nesting
education program which involved Aboriginal health workers and midwives to
link women with culturally safe antenatal care.
This program could include:
- Antenatal checks
- Ultrasounds
- Antenatal classes
- Pap Smears
- GP clinic visits
- Sessions with Aboriginal health workers and midwives where they can ask
questions about breastfeeding, nutrition, available birthing pathways etc
Timeline
What Else can we do?
Exemplar program: Aboriginal Midwifery Access Program (ACT)
- Aims to provide access to antenatal care and improve pregnancy and birth outcomes for Aboriginal and Torres
Strait Islander women.
- Includes antenatal and postnatal care, community at home support, baby health checks, breastfeeding support,
immunisations and a range of women's health services.
- Of 187 women in the program 50.3% presented in the first trimester and 94.7% attended five or more antenatal
visits
- Compared with the ACT Maternal and Perinatal Collection, Aboriginal and Torres Strait Islander AMAP clients
had a lower caesarean delivery rate (20.0 vs 27.6%), a slightly lower proportion of preterm babies (18.8 vs 21.6%), a
slightly lower proportion of low-birthweight babies (18.8 vs 21.0%) but a higher smoking rate (63.8 vs 49.0%).
What Else Can We do?
Necessary professionals:
❖ Midwives
❖ General Practitioners
❖ Psychiatrists specialising in prenatal and postnatal issues
❖ Epidemiologists and public health professionals in the local area
❖ Aboriginal elders and other members of the Aboriginal community
❖ Aboriginal health care workers
❖ Mothers
WHat else can we do?
Community capacity building
- Aboriginal elders
- Partnership with UOW?
- Research paper
- Community meetings
References
1. Beddoe A, Lee K. Mind-Body Interventions During Pregnancy. Journal of Obstetric, Gynecologic & Neonatal Nursing. 2008;37(2):165-175.
2. Australian mothers and babies [Internet]. Aihw.gov.au. 2015 [cited 2 May 2018]. Available from:
https://www.aihw.gov.au/getmedia/728e7dc2-ced6-47b7-addd-befc9d95af2d/aihw-per-91-inbrief.pdf.aspx?inline=true
3. The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples, Oct 2010 [Internet]. Abs.gov.au. 2016 [cited 30 April
2018]. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/lookup/4704.0Chapter610Oct+2010
4. 4. 2016 Census QuickStats: Shoalhaven (C) [Internet]. Censusdata.abs.gov.au. 2016 [cited 1 May 2018]. Available from:
http://www.censusdata.abs.gov.au/census_services/getproduct/census/2016/quickstat/LGA16950
5. Waminda: Mums and Bubs Program. Aboriginal And Islander Health Worker Journal [Internet]. 2012 [cited 28 April 2018];(36):17-19.
Available from: https://www.researchgate.net/publication/281212554_Waminda_Mums_and_Bubs_program
6. HealthStats NSW Population by Local Health District and year [Internet]. Healthstats.nsw.gov.au. 2017 [cited 1 May 2018]. Available from:
http://www.healthstats.nsw.gov.au/indicator/dem_pop_lhnmap
7. Howitt A. The native tribes of south-east Australia. London: Macmillan Co.; 1904.
8. Ferguson-Hill S, Atkinson J, Nelson J. Working together. 2nd ed. Barton, ACT: Telethon Institute for Child Health Research/Kulunga
Research Network; 2014.
9. AIHW, NPESU. 1.01 Low birthweight | Aboriginal and Torres Strait Islander Health Performance Framework 2014 Report [Internet].
Pmc.gov.au. 2014 [cited 1 May 2018]. Available from:
https://www.pmc.gov.au/sites/default/files/publications/indigenous/Health-Performance-Framework-2014/tier-1-health-status-and-outcomes/
101-low-birthweight.html
References
10. Prandl K, Rooney R, Bishop B. Mental health of Australian Aboriginal women during pregnancy: identifying the gaps. Archives of Women's
Mental Health [Internet]. 2012 [cited 1 May 2018];15(3):149-154. Available from:
https://link.springer.com/article/10.1007%2Fs00737-012-0276-0
11. WONG R, HERCEG A, PATTERSON C, FREEBAIRN L, BAKER A, SHARP P et al. Positive impact of a long-running urban Aboriginal
medical service midwifery program. Australian and New Zealand Journal of Obstetrics and Gynaecology [Internet]. 2011 [cited 29 April
2018];51(6):518-522. Available from: https://obgyn-onlinelibrary-wiley-com.ezproxy.newcastle.edu.au/doi/10.1111/j.1479-828X.2011.01326.x
12. Woods-Giscombé C, Lobel M, Crandell J. The impact of miscarriage and parity on patterns of maternal distress in pregnancy. Research in
Nursing & Health [Internet]. 2010 [cited 3 May 2018];33(4):316-328. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070408/
13. Marquis S, Butler E. Practice Guidelines for Prenatal and Postnatal Outreach in British Columbia. BC Ministry for Children and Families.
2001;.
14. Rubertsson C, Hellström J, Cross M, Sydsjö G. Anxiety in early pregnancy: prevalence and contributing factors. Archives of Women's Mental
Health. 2014;17(3):221-228.
15. Elsenbruch S, Benson S, Rücke M, Rose M, Dudenhausen J, Pincus-Knackstedt M et al. Social support during pregnancy: effects on
maternal depressive symptoms, smoking and pregnancy outcome. Human Reproduction [Internet]. 2006 [cited 8 May 2018];22(3):869-877.
Available from: https://doi.org/10.1093/humrep/del432
16. La Marca-Ghaemmaghami P, Ehlert U. Stress During Pregnancy. European Psychologist [Internet]. 2015 [cited 4 May 2018];20(2):102-119.
Available from: http://Stress During Pregnancy Experienced Stress, Stress Hormones, and Protective Factors
17. Kildea S, Stapleton H, Murphy R, Low N, Gibbons K. The Murri clinic: a comparative retrospective study of an antenatal clinic developed for
Aboriginal and Torres Strait Islander women. BMC Pregnancy and Childbirth. 2012;12(1).
18. Walker M, Fredericks B, Mills K, Anderson D. “Yarning” as a Method for Community-Based Health Research With Indigenous Women: The
Indigenous Women's Wellness Research Program. Health Care for Women International. 2013;35(10):1216-1226