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Translating evidence into practice: implementing culturally safe continuity of midwifery care for First Nations women in three maternity services in Victoria, Australia.

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dc.contributor.authorMcLachlan H.L.
dc.contributor.authorNewton M.
dc.contributor.authorMcLardie-Hore F.E.
dc.contributor.authorMcCalman P.
dc.contributor.authorJackomos M.
dc.contributor.authorBundle G.
dc.contributor.authorKildea S.
dc.contributor.authorChamberlain C.
dc.contributor.authorBrowne J.
dc.contributor.authorRyan J.
dc.contributor.authorFreemantle J.
dc.contributor.authorShafiei T.
dc.contributor.authorJacobs S.E.
dc.contributor.authorOats J.
dc.contributor.authorBlow N.
dc.contributor.authorFerguson K.
dc.contributor.authorGold L.
dc.contributor.authorWatkins J.
dc.contributor.authorDell M.
dc.contributor.authorRead K.
dc.contributor.authorHyde R.
dc.contributor.authorMatthews R.
dc.contributor.authorForster D.A.
dc.date.accessioned2024-11-19T05:30:35Z
dc.date.available2024-11-19T05:30:35Z
dc.date.copyright2022
dc.date.issued2022-05-28en
dc.description.abstractBackground: Strategies to improve outcomes for Australian First Nations mothers and babies are urgently needed. Caseload midwifery, where women have midwife-led continuity throughout pregnancy, labour, birth and the early postnatal period, is associated with substantially better perinatal health outcomes, but few First Nations women receive it. We assessed the capacity of four maternity services in Victoria, Australia, to implement, embed, and sustain a culturally responsive caseload midwifery service. Method(s): A prospective, non-randomised research translational study design was used. Site specific culturally responsive caseload models were developed by site working groups in partnership with their First Nations health units and the Victorian Aboriginal Community Controlled Health Organisation. The primary outcome was to increase the proportion of women having a First Nations baby proactively offered and receiving caseload midwifery as measured before and after programme implementation. The study was conducted in Melbourne, Australia. Data collection commenced at the Royal Women's Hospital on 06/03/2017, Joan Kirner Women's and Children's Hospital 01/10/2017 and Mercy Hospital for Women 16/04/2018, with data collection completed at all sites on 31/12/2020. Finding(s): The model was successfully implemented in three major metropolitan maternity services between 2017 and 2020. Prior to this, over a similar timeframe, only 5.8% of First Nations women (n = 34) had ever received caseload midwifery at the three sites combined. Of 844 women offered the model, 90% (n = 758) accepted it, of whom 89% (n = 663) received it. Another 40 women received standard caseload. Factors including ongoing staffing crises, prevented the fourth site, in regional Victoria, implementing the model. Interpretation(s): Key enablers included co-design of the study and programme implementation with First Nations people, staff cultural competency training, identification of First Nations women (and babies), and regular engagement between caseload midwives and First Nations hospital and community teams. Further work should include a focus on addressing cultural and workforce barriers to implementation of culturally responsive caseload midwifery in regional areas. Funding(s): Partnership Grant (# 1110640), Australian National Health and Medical Research Council and La Trobe University.Copyright © 2022 The Author(s)
dc.identifier.citationeClinicalMedicine. Vol.47, 2022.
dc.identifier.doihttps://dx.doi.org/10.1016/j.eclinm.2022.101415
dc.identifier.institution(McLachlan, Newton, McLardie-Hore, McCalman, Chamberlain, Shafiei, Hyde, Matthews, Forster) Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia
dc.identifier.institution(McLachlan, Newton, Hyde) School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia
dc.identifier.institution(McLardie-Hore, McCalman, Bundle, Ryan, Jacobs, Hyde, Matthews, Forster) The Royal Women's Hospital, Parkville, VIC 3052, Australia
dc.identifier.institution(Kildea) Molly Wardaguga Research Centre, School of Nursing and Midwifery, Charles Darwin University, Alice Springs 0870, Australia
dc.identifier.institution(Chamberlain, Freemantle, Oats, Blow) Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC 3053, Australia
dc.identifier.institution(Jacobs) Murdoch Children's Research Institute, University of Melbourne, Parkville, VIC 3052, Australia
dc.identifier.institution(Jacobs) Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, VIC 3052, Australia
dc.identifier.institution(Browne, Gold) Deakin University Institute for Health Transformation, Geelong, VIC 3220, Australia
dc.identifier.institution(Jackomos) Mercy Hospital for Women, Heidelberg, VIC 3084, Australia
dc.identifier.institution(Watkins, Dell) Joan Kirner Hospital, Western Health St Albans, VIC 3021, Australia
dc.identifier.institution(Freemantle, Ferguson) Rural Health Academic Centre, The University of Melbourne, Shepparton, VIC 3630, Australia
dc.identifier.institution(Read) Goulburn Valley Health, Shepparton, VIC 3644, Australia
dc.identifier.institution(Chamberlain) Ngangk Yira: Murdoch University Research Centre for Aboriginal Health and Social Equity, Murdoch, WA 6150, Australia
dc.identifier.institution(Chamberlain) The Lowitja Institute, Carlton, VIC 3053, Australia
dc.identifier.institution(Browne) Victorian Aboriginal Community Controlled Health Organisation, Collingwood, VIC 3066, Australia
dc.identifier.urihttps://lowitja.intersearch.com.au/handle/1/830
dc.relation.ispartofeClinicalMedicine
dc.subject.keywordsMaternal health
dc.titleTranslating evidence into practice: implementing culturally safe continuity of midwifery care for First Nations women in three maternity services in Victoria, Australia.
dc.typeArticle

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