Aboriginal women and babies experience poorer perinatal outcomes than non-Aboriginal women. Aboriginal women are often at high risk of pregnancy complications and require specialist obstetric care available only in tertiary hospitals like King Edward Memorial Hospital in Perth. Current national strategies emphasise access to primary maternity care, with the support of Aboriginal Health Workers (AHW).
Our study aims to extend national strategies into tertiary care by introducing AHWs to improve cultural safety and achieve better outcomes for mothers and their babies. The study is designed as a pre-intervention and post-intervention trial to assess the benefits of the introduction of AHWs and to evaluate their role in supporting the pregnancy care for the Aboriginal women who attend King Edward Hospital during pregnancy.
We will assess the benefits of pregnancy care supported by AHWs and determine the best way for this introduction by comparing standard tertiary care (before AHWs are introduced) with the care supported by AHWs (after AHWs are introduced). Aboriginal women receiving antenatal care at King Edward Memorial Hospital will be recruited either before or after the introduction of AHWs. We aim to recruit approximately 220 women per group.
Comparison of outcomes between the two groups will include assessment of access and engagement with care, quality and satisfaction with care and clinical effectiveness of care.
Our study will evaluate the role of AHWs in improving outcomes in a tertiary setting and define the mainstream model of care that is effective as well as acceptable to Aboriginal women.
The AMSSU and the Telethon Institute for Child Health Research are working together with Aboriginal communities across the state to meet and yarn with young Aboriginal women about their needs during pregnancy. The research team – Anne-Marie McHugh, Lli Chapman, Lisa Morrison and Tracy Reibel – are assisted by a Project Reference Group of Aboriginal and non-Aboriginal women who will provide advice and guidance as the project goes along.
In 2013, Lisa and Tracy will be visiting communities from the south to the north and out to the east as well as meeting with Aboriginal women across the metropolitan area. We hope to listen to many stories from young women about what they know, what they want to know, who they want to care for them during pregnancy and how they want this to be done.
Understanding these features of pregnancy care from young women’s perspectives will help the research team design guidelines and an age and culturally appropriate model of care framework for all antenatal services to use.