Enabling the context for Aboriginal and Torres Strait Islander Community Controlled Birthing on Country services:...

Area of Science:

• Indigenous Health
• Maternity Care Reform
• Health Service Implementation

Background:

• Birthing on Country services offer health and cost benefits but require maternity care redesign.
• Previous feasibility studies faced challenges with endorsed midwife use and birth centre licensing.

Purpose of the Study:

• To identify barriers preventing Community Controlled Health Services from implementing Birthing on Country services in Queensland and New South Wales.

Main Methods:

• Utilized participatory action research to identify implementation barriers.
• Conducted iterative document analysis synthesizing policy, economic, social, technological, legal, and environmental factors.

Main Results:

• Policy barriers restrict Community Controlled Health Services from employing endorsed midwives in public hospitals.
• Economic barriers include lack of sustainable funding and inadequate Medicare-billing for endorsed midwives.
• Legal barriers necessitate a medical practitioner in birth centers, impeding independent operation.

Conclusions:

• Study findings align with existing literature on midwifery practice barriers.
• Recommendations include a national audit of barriers, developing funding streams, and aligning private facility regulations with safe birth center evidence.
• Government intervention is crucial to overcome barriers and scale up Aboriginal and Torres Strait Islander Community Controlled Birthing on Country services.