Where do low risk women live relative to maternity services across Victoria? Expanding access to public homebirth models across Victoria

Abstract

Problem: Currently <1% of Australian women give birth at home.

Background: In Australia there are very few options for women to access public funded homebirth.

Aim: We aimed to use geo-mapping to identify the number of women eligible for homebirth in Victoria, based on the criteria of uncomplicated pregnancies and residing within 15-25kms of suitable maternity services, to plan future maternity care options.

Methods: Retrospective study of births between 2015 and 2017 in Victoria, Australia. All women who were identified as having a low risk pregnancy at the beginning of pregnancy were included. The number of women within 15 and 25km of a suitable Victorian public maternity hospital and catchment boundaries around each hospital were determined.

Findings: Between 2015 and 2017, 126,830 low risk women gave birth in Victoria, of whom half live within 25km of seven Victorian hospitals. Currently, 2% of suitable women who live close to the current public homebirth models accessed them.

Discussion: We present a method to inform the expansion of maternity service options using Victoria as an example. On the basis of the maximum number of low risk women living close by, we have also identified the Victorian maternity services that would be most suitable for creation of public homebirth or low risk continuity of midwifery models.

Conclusion: This approach could can be used to plan other maternity care services.

Keywords: Geomapping; Homebirth; Maternity care; Models of care.