Unique birthing program closes the gap for Indigenous families

Mater

A unique South East Queensland birthing initiative has made significant inroads in closing the gap for Aboriginal and Torres Strait Islander mothers and their babies, dramatically improving maternal and infant health outcomes.

Birthing in Our Community (BiOC) is a multi-agency partnership program between Brisbane’s Mater Mothers’ Hospital and two local Aboriginal and Torres Strait Islander community-controlled health services – the Institute for Urban Indigenous Health (IUIH) and the Aboriginal and Torres Strait Islander Community Health Service Brisbane (ATSICHS Brisbane).

The program provides comprehensive and culturally safe maternal and infant health services, which contribute to ‘closing the gap’ in maternal and infant health outcomes in the Aboriginal and Torres Strait Islander community.

In papers published in leading medical journal The Lancet, the BiOC model has demonstrated a reduction in preterm births, nursery admissions and low birthweight, helping to close the gap in outcomes for First Nations babies.

Mater Chief Medical Officer Associate Professor Mike Beckmann says it reflects Mater’s commitment to meeting the unmet needs of the community.

“It is difficult to come up with a greater unmet need than the health inequality of Australia’s First Nations peoples,” Dr Beckmann said.

“The outcomes achieved over the past 10 years are impressive and represent years of reciprocal relationship to redesign the ways of caring to truly meet the needs of First Nations women and families.”

The BiOC program integrates the midwifery services and expertise of the Mater Mothers’ Hospital – Australia’s largest and leading maternity services provider – with the expertise of IUIH and ATSICHS Brisbane in leading service reform, enabling a unique approach to delivery.

Prof Beckmann said the expertise that each partner organisation brings to the table through a reciprocal relationship has made BiOC a success.

“It’s promoted a move towards a model that is about community, that is safe and engaging and is about health in the truest sense of the word,” Prof Beckmann said.

“Health and wellbeing should be much more than hospitals – it is feeling safe, connected, and understood.

“It’s about meeting your physical needs as well as your emotional, psychological, spiritual and cultural needs, and that’s exactly what this program does.”

The papers published in The Lancet also applied a cost-effectiveness lens to the program, indicating it had the potential to save the Federal Government a considerable amount of money, primarily due to the reduction in preterm births and associated complications, which led to fewer neonatal nursery admissions.

In addition to this, it found the BiOC program successfully reduced two-thirds of out-of-pocket expenses by bringing the service closer to women and providing free transport.

IUIH CEO Adrian Carson said improved outcomes demonstrate the success of Aboriginal community controlled health services (ACCHSs) leading system reform with mainstream maternity services, such as Mater.

“The ACCHS sector has long advocated that models of care specifically designed for First Nations people and delivered by ACCHSs can achieve better outcomes for our people and be more cost-effective,” Mr Carson said.

“The model is achieving preterm birth rates for First Nations families that are better than those achieved by the Australian health system for the general population.

“Supporting its expansion makes sense from both a healthcare delivery and economic perspective.”

This is the tenth year BiOC has been operating in South Brisbane. Queensland Health is now replicating the original model across South East Queensland, with hubs opening in Logan, Capalaba and Strathpine in response to the growing Aboriginal and Torres Strait Islander population.

ATSICHS Brisbane CEO Renee Blackman said the success of the BiOC program shows what can be achieved when partners work together with a shared vision and a commitment to Aboriginal-led models of care.

“Investing in developing an Indigenous workforce to support women has been key to keeping women engaged in the program and also supports employment opportunities for Aboriginal and Torres Strait Islander people in the region,” Ms Blackman said.

“Every mum at BiOC gets their own midwife 24/7 working side by side with a multidisciplinary workforce to make sure all our women feel confident and safe to access the care they need for themselves and their bub.”

Former landscaper Natalie Page said she benefitted from the program when she fell pregnant with her third daughter Unarra.

The 30-year-old single mum said she had a “hectic” pregnancy with her first child Emariah, now 11, and wished the service was available to her at the time.

“I was living in Bowen and suddenly went into labour with Emariah. My mum and I drove to the nearest hospital,” Natalie said.

“I was scared, so scared.”

She said the service and care provided by BiOC was “incredible”.

“Having constant support brought me a lot of comfort,” Natalie, from Beaudesert, said.

“My mother had a very traumatic time giving birth, and I kept thinking, ‘What if this is me? What if I don’t make it?’.

“But having a midwife by my side when Unarra was born at Mater Mothers’ Hospital made me feel at ease and was really comforting.”

Natalie said life with her three daughters – Emariah, 11, Calla’nimah, 3, and nine-month-old Unarra – was much easier thanks to BiOC.

“They have provided so many services, including transport to medical appointments and have been there to help provide milk and bread if needed,” she said.

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