O98 - Optimising antenatal care for marginalised and at-risk women at the Kirketon Road Centre (KRC), Kings Cross, NSW

Abstract

KRC is an integrated primary health care centre which aims to meet the health and social welfare needs of ‘at risk’ youth, people who inject drugs and sex workers. Pregnant women who engage with KRC are often homeless and have multiple complex needs. Many have had children removed from their care, and many have been in out of home care themselves, have a history of intimate partner violence, sexual abuse, financial instability, and have substance using partners. These women often lack social support and their networks encourage instability. KRC operates under a non-judgemental multidisciplinary care model which supports these women in multiple ways including antenatal care and opiate agonist therapy such as methadone and suboxone. KRC provides a dedicated antenatal clinic staffed by a part-time midwife. The aim is to engage women to attend for antenatal care as well as case management and to form a holistic health relationship that extends beyond the birth of their child. KRC works opportunistically, as typically these women do not engage with conventional hospital-based antenatal services. Furthermore, KRC’s community outreach program reaches women who cannot or do not want to engage with the fixed-site service. Integral to the model are strong relationships with services in our area health district such as the Chemical Use in Pregnancy program and direct referral pathways to the Royal Hospital for Women, and to the Malabar Midwives for Aboriginal women. KRCs model of care is able reach and provide much needed antenatal care and SUD treatment to marginalised and at risk women with SUD. This is achieved through a flexible and non-judgmental approach to health care delivery, in partnership with relevant community and tertiary based services.