” Indigenous midwives will gather and march in Redfern to highlight the need to close the gap in healthcare in Indigenous communities.
Indigenous Midwifery facts:
- There are only 230 Indigenous midwives nationally; a further 618 are needed
- Indigenous mothers are three times as likely to die as their non-Indigenous counterparts
- Indigenous babies up until the age of one are twice as likely to die as non-indigenous children
Aboriginal and Torres Strait Islander midwives led by Leona McGrath, Indigenous Health advisor, NSW Government and Dr Donna Hartz from the National Centre for Cultural Competence at the University of Sydney will walk through Redfern on 5 May to celebrate International Day for the Midwife and highlight a number of key issues in the sector.
” Aboriginal women in Australia have significantly worse pregnancies than non-indigenous women.
In fact, they fare worse on just about every health measure.
And yet all the evidence tells us there will be no significant improvement in the shocking rates of poor indigenous health until we significantly improve the health of indigenous women. ”
This article serves as a clarion call from the President of RANZCOG, Professor Stephen Robson. We can only hope policy makers heed this call, as the health of the nation’s indigenous communities depend on it. See full article below
” Picture above 2016 Midwives across Western Sydney Local Health District (WSLHD) banded together with the Australian College of Midwives to raise funds for the Rhodanthe Lipsett Indigenous Midwifery Charitable Fund, which will sponsor Indigenous student midwives and their midwifery studies.
WSLHD midwives, supported by WSLHD Aboriginal Liaison Officer Narelle Holden and Professor of Midwifery at Western Sydney University Hannah Dahlen, representing the Australian College of Midwives, proudly presented a cheque to Leona McGrath, the co-chair of the Rhodanthe Lipsett Indigenous Midwifery Charitable Fund “
Dr Hartz says there is a greater need for Indigenous midwives due to the significantly higher mortality rate for Indigenous mothers and babies.
“We have really embarrassingly poor outcomes for Aboriginal and Torres Strait Islander mothers and babies here in Australia in 2017,” says Dr Hartz.
“We have women dying at three times the rate of non-Indigenous women. We have Indigenous babies dying at twice the rate and we have babies being born prematurely or at a low birth weight at nearly twice the rate of non-Indigenous babies.
“The current rates of preterm and low birth weight babies means that many babies are predisposed to chronic diseases later in life. When we have Indigenous women caring for Indigenous women in childbirth, the outcomes improve for both mother and baby.”
Currently 50 per cent of Indigenous women live where there are no local birth services. Dr Hartz says the training of Aboriginal midwives is crucial to providing culturally sensitive care to Indigenous mothers.
“We’ve had closing of maternity services from rural, regional and remote areas which has meant that Aboriginal and Torres Strait Islander women have to travel hundreds and hundreds of kilometres to receive care.
“In terms of spirituality, tradition and culture, the women are Birthing off Country – Birth on Country is of great spiritual significance to have connection to Country. What we’re hoping through programs of training midwives is to bolster maternity services back in the communities so women can have care and give birth closer to their homes,” she says.
Only one per cent of Australian midwives are of an Aboriginal or Torres Strait Islander background whereas six per cent of all Australian births are Indigenous. A further 618 Indigenous midwives are required for parity.
“On International Day of the Midwife for the first time in Australia we’re going to have the biggest gathering of Aboriginal midwives in one event. I think it will speak loudly to how we feel about healing our communities and training more midwives.”
Organisers of the march invite interested parties to “Walk with Midwives” in aid of an Australian College of Midwives campaign that aims to raise funds for the Rhodanthe Lipsete Trust. The Trust aims to increase the number of Indigenous midwives.
The University of Sydney campaign is supported by the National Centre for Cultural Competence, the Congress of Aboriginal and Torres Strait Islander Nurses & Midwives and the Poche Centre for Indigenous Health.
Indigenous women and the hidden health-gap
‘ At an international scientific meeting in Brisbane, just over two years ago, I attended a session devoted to the health of Aboriginal and Torres Strait Islander Australians. The statistics presented and the picture painted for the assembled group was disheartening. The gap between the health of Indigenous and non-Indigenous Australians seemed too great to bridge.”
Stephen Robson BMedSc MBBS MM MPH MD FRANZCOG FRCOG
President, Royal Australian and New Zealand College of Obstetricians and Gynaecologists
Discouraged, I asked one of the senior presenters where we could even start to help, to put things right. “That’s easy,” he replied, “You start by making women healthy. The rest will follow.” At the time, I was Vice-President of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). This advice was something I could work with. Two years later, I am President of RANZCOG. Improving the health of Indigenous women is the biggest challenge that I, and my College, face.
“That’s easy,” he replied, “You start by making women healthy.
Women, and mothers in particular, hold a special place in Indigenous communities. Women manage not only their own health, but the health of their children; the health of their partners; and often the health of other relatives. Women who are healthy and health-literate are the single most important influence on the health of their communities.
Health begins in the womb. A healthy environment for a baby during pregnancy is perhaps the strongest influence on life-long health for all of us. This is especially true for Indigenous Australians. Babies of Aboriginal women tend to be smaller, and this reflects many influences: socioeconomic disadvantage; the mother’s nutrition; illnesses during pregnancy. Importantly, it can reflect alcohol consumption and use of tobacco.
Indigenous women have less opportunity to become healthy and prepare for pregnancy. When pregnant, they see their midwives and doctors later in pregnancy, and less often than non-indigenous women. They have lesser access to the standards of antenatal care that other women take for granted during pregnancy. They suffer racism, marginalisation, and exposure to violence.
The babies of Aboriginal women are more likely to be born prematurely, and more likely to die in pregnancy or soon after birth. As infants, their mortality rates exceed those of non-Indigenous infants. They are more likely to suffer childhood diseases.
The babies of Aboriginal women are more likely to be born prematurely, and more likely to die in pregnancy or soon after birth.
As adults, Indigenous Australians are more likely to be hospitalised. The reasons for this include injuries, infections, and kidney disease in particular. Cancers – lung cancer and cancer of the cervix – are much more likely to strike Aboriginal women. Women are more likely to die from cancer, and cervical cancer in particular has a death rate more than four times higher. Indigenous women are less likely to participate in screening programs that can prevent cervical cancer.
So many of these problems are completely preventable, and arise from what we call ‘social determinants of health.’ Social conditions and economic opportunity influence health at all levels, from the individual up to the entire community. Education, income and employment, adequate housing, access to health and other services, social supports – all of these play a role in shaping health.
Many Australian doctors struggle to understand how Indigenous people view medical treatment. For many Aboriginal people, health is viewed as the social, emotional, and cultural wellbeing of the whole community. It is subsumed into a connection to the land, the community, social relationships, and the environment.
Trust is a major factor influencing the way Indigenous people access, and interact with, the health system. Many will have had bad experiences with our hospitals and health-care workers, however well-meaning many doctors and nurses are. It is common to have Aboriginal people discharge themselves from hospital against the advice of their carers.
Pregnancy is a time when it is possible to turn this around. It is a time when it should be possible to build good, trusting relationships with women and their families. By making the effort to tailor maternity care to the needs of Indigenous women, it should be possible to engage in a positive way. To promote health screening, and help build enduring relationships with carers.
Pregnancy is a time when it is possible to turn this around. It is a time when it should be possible to build good, trusting relationships with women and their families.
Recently, the Presidents of a number of medical Colleges met with the Indigenous Health Minister, the Honourable Ken Wyatt. Over the course of the morning, it became clear that there is a new determination to put things right. To identify and work hard to remove the roadblocks to health for Indigenous Australians.
As the saying goes, every great journey begins with a single step. Making sure that Indigenous women prepare for pregnancy, have healthy pregnancies and births, and that their children are healthy, are all key to long-term improvements in community health. I am hoping that we can all take these steps together.
Learn more about Indigenous women’s health at:
http://www.healthinfonet.ecu.edu.au/population-groups/women/reviews/our-review#infant-mortality