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Redressing the balance

Health outcomes for indigenous women during pregnancy could be improved with the growing number of Aboriginal midwives.

For the last 20 years Aboriginal peri-natal mortality has been well above the average and has not improved. One critical way to address this is to educate more Aboriginal women as midwives, with research showing problems are picked up more quickly when women are able to develop close relationships with a midwife they feel they can trust and who understands them.

This is according to Heather Hancock, associate professor of midwifery at Southern Cross University.

“They have a greater level of satisfaction with the care they receive, are more likely to keep their appointments and take responsibility for their health and wellbeing, and there is a greater likelihood of improved outcomes for both mother and baby,” says Hancock.

Bringing this theory into real-life practice, indigenous students account for more than 10 per cent of students enrolled in SCU’s new bachelor of midwifery.

Six of the 50 students enrolled in the degree at the Tweed Heads campus are of Aboriginal descent, with one relocating from Yass near Canberra to undertake the course and others commuting from as far afield as Kempsey and Broken Hill to complete intensive units of study.

“We believe this is the largest percentage of Aboriginal students ever seen for any bachelor of midwifery course in Australia,” says Hancock, who recently spent four years in the Northern

Territory involved in peri natal primary health in Indigenous communities.

Would-be midwives previously had to complete a nursing qualification before studying midwifery, but stand-alone courses such as SCU’s three-year bachelor of midwifery have made it possible to enter the midwifery profession directly.

Indigenous student Tanya Bonner says the cultural needs of Aboriginal women were very different to other women.

“There is a distrust of the mainstream hospital system because many Aboriginal women have a fear of prejudice and of being judged so they choose not to go,” says Bonner.

“Many hospitals have an Aboriginal liaison person but sometimes this person is a man, who can’t be involved in women’s business.

“Traditionally Aboriginal women gave birth ‘on country’ with other women around them, and there are important ceremonies that take place outside on country that welcome the child into the world.

“Now, in isolated communities the women are flown to a regional hospital at 36 weeks into their pregnancy and have to stay in accommodation in town without their extended family until they give birth in the nearby hospital.

“The women feel they have no choice, and if babies aren’t born on country they lose some of their link to the land. I hope that if I train as a midwife I will be able to help these women and maybe even be situated in their community so they could have their babies on country if they choose.

“I want to help Aboriginal women to be fully informed, educated and empowered during their pregnancies.

Aboriginal student Tamara Jones, who travels from Broken Hill with her four-month-old son Lachlan to attend intensive units of study, says she previously tried the traditional pathway of studying to be a nurse first.

“I studied to be a nurse for a year, but I gave up because I wasn’t interested in studying to be a nurse - I always wanted to be a midwife and now I have realised that I can achieve this goal,” says Jones.

“Maternal peri-natal rates are two to five times higher for Aboriginal women and I see these as deaths that I could help prevent.

“In many rural and remote areas Aboriginal women haven’t had access to antenatal care and education so they will do things like feed their babies powdered milk if they find breast feeding difficult because it’s cheaper and they don’t understand the risks.

“There are higher rates of STIs, low birth weight and later in life it leads to higher rates of preventable chronic diseases. I hope that by making a difference from birth, at the beginning of life, I can also have a roll-on impact for the future health of the whole family.”

Hoping to continue to redress the balance, Jones plans to get involved in mentoring a new indigenous student next year.

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