P43 - Providing health equity in midwifery continuity of care: Aboriginal Dads and Bubs

Abstract

Western Sydney Local Health District (WSLHD) has a large urban Aboriginal population, with numerous health and social inequities, which lead to health disparities including significantly higher rates of avoidable perinatal death, pre-term birth and low birth weight babies (McInerney et al. 2019). Optimising the early life environment is key to reducing these inequities. Sandall, Soltani, Gates, Shennan, & Devane's (2016) systematic review reports that women who received midwife-led continuity models of care were more likely satisfied with their care, engagement in perinatal care increased, and the risk of chronic disease was altered. Additionally, collaborative practice with Aboriginal Health Practitioners improves culturally sensitive health interventions, like smoking reduction. In 2019 the WSLHD quality project ‘review of outcomes for families with the father, or the baby, identified as Aboriginal or Torres Strait Islander’ were comparable to the outcomes of women identified to already receive continuity of care due to Aboriginality. From 2020, WSLHD’s new caseload model of care, Dragonfly Midwifery, is servicing families of women and fathers (or babies) who identify as Aboriginal and/or Torres Strait Islander to meet this comparative need, to impact on interventions that can reduce health inequity. 50% of Aboriginal women versus 7% were recorded as smoking in pregnancy in WSLHD. (eMaternity, 2021). NSW rates had declined previously, but not in WSLHD. Quit smoking in the first half of pregnancy in 2021, following a targeted smoking cessation program and Aboriginal caseload, has shown a 7% reduction in low birth weight babies in WSLHD in the last 3 months. Midwifery caseload and a smoking cessation program can impact smoking rates, hence including all pregnancies with First Nations babies may be optimal practice to impact intergenerational health.