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Table 2 Models of care available to Aboriginal and Torres Strait Islander families at study sites

From: The Indigenous Birthing in an Urban Setting study: the IBUS study

Birthing in Our Community (Group 1) Standard Care (Groups 2, 5) Ngarrama Maternity Service (Group 4)
Indigenous governance (operating through a Steering Committee) functioning in accordance with Terms of Reference and underpinned by a MOU A community-based Midwifery Group Practice (MGP), which provides continuity of care to enrolled women throughout pregnancy, birth and up to six weeks postnatally Care is provided according to hospital guidelines and protocols in the home and at community venues where regular cultural and education days are held 24/7 access to caseload midwife who works in MGP of 4FTE on annualised salary with each woman allocated a primary midwife. Midwife support during birthing is likely to be by a known midwife. Location for birth is the Birth Suite (no homebirth or Birth Centre services provided)a Indigenous Maternal Infant Health/ Family Support Workers and Indigenous student midwives work with the caseload midwives to provide culturally tailored care Referral to and integration with Indigenous community support agencies as required; All women are offered a formal handover to child health services with other referrals as required (e.g. paediatric, allied health) Clinical and cultural supervision for staff. Antenatal care may be received from community based general practitioner, hospital based midwives or doctors who rotate throughout the service on rosters. Midwife support during birthing is likely to be by a midwife the woman has never met. Postnatal care or phone call from a rostered community midwife might take place if the woman meets the criteria for early discharge—before 48h for vaginal birth and 72h for caesarean section usually for up to less than two weeks No 24/7 access to MGP midwife but can call hospital birthing suite in emergency Location for birth same as other groups for the hospitals A hospital-based Midwifery Group Practice (MGP) with a community clinic one day a week, which provides continuity of care to enrolled women throughout pregnancy, birth and up to six weeks postnatally. Care is provided according to hospital guidelines and protocols, regardless of setting (women’s homes, community venues or hospital) 24/7 access to MGP midwives who work in a small team and are on annualised salary with each woman allocated a primary midwife. Midwife support during birthing is likely to be by a known midwife. Location for birth may be in the Birth Suite or the co-located Birth Centre (eligibility criteria apply); Access to Cultural Capability Officers of the regional (Metro North) Aboriginal and Torres Strait Islander Health Unit who provide additional cultural guidance and support.
Indigenous Liaison Officers are based in the hospitals to strengthen culturally responsive care and support Access to medical staff, allied health professionals, social workers, child safety officers and other professionals (e.g. diabetic educator) as required Discharge letter to referral doctor and referrals to community support agencies as required
  1. aDespite community recommendations for an Indigenous Birthing Centre, funding has not yet been secured