Women who most need comprehensive antenatal care, including those with low educational attainment, ethnic minority status, or psychosocial risk factors, are lest likely to access it. Lack of engagement with antenatal care predicts adverse perinatal outcomes including preterm birth (<37 weeks), small-for gestational age, intrauterine fetal or neonatal death, and reduced rates of breastfeeding, along with long-term health concerns. Four years ago, an integrated, relationship based, community co-designed maternity service continuity of midwifery care model known as the Community Maternity Hubs (Hubs) was implemented in a regional health district with a culturally diverse and socially disadvantaged population. The service (Hubs) now cares for approximately 28-30 per cent of the birthing population of the area. A 2020 mixed methods Evaluation of the service demonstrated increased engagement and improved short-term outcomes for those attending the service. The outcomes of the qualitative and quantitative evaluation were positive, particularly for priority populations, and will be presented. Further research has commenced and aims to identify barriers to and facilitators of inclusion in the way the service currently operates and to establish baseline data for long-term evaluation strategies of paediatric development and behavioral outcomes in the health district over the program’s lifespan. Cohorts include: Aboriginal and Torres Strait Island families; Maori and Pacific Island; Culturally and linguistically diverse refugee and migrant backgrounds; young persons 18 and under.
Findings show that midwifery group practice care provided in the community maternity Hubs model within Logan Hospital is safe, improves antenatal attendance and engagement and a range of maternity and neonatal outcomes including social determinants of health for priority populations. Women and midwives are highly satisfied with the model and implementation has been successful across the majority of indicators evaluated. Due to the time constraints of the evaluation period, this evaluation did not explore other longitudinal community outcomes that may be achieved as a result of the planning and capacity building within Logan and the community maternity Hubs. This is an area for consideration and funding has been sought to commence this work in 2022. Upscaling of these models should continue as a priority until 50 per cent (or more) women at Logan can access this care.
