Primary health care for Aboriginal women and children in the year after birth: findings from a population-based study in South Australia

Abstract

Objective: To investigate the extent to which Aboriginal women access primary care for themselves and their infant in the year after childbirth.

Method: Cross sectional population-based survey of women giving birth to Aboriginal babies in South Australia between July 2011 and June 2013.

Results: A total of 344 women took part in the study 4-9 months after giving birth. The majority had seen a primary health care practitioner since the birth: 86% had seen a Child and Family Health Service (CaFHS) nurse, 81% a general practitioner (GP), and 61% an Aboriginal health worker (AHW). Women living in remote areas were more likely to have seen primary care practitioners than women living in Adelaide (GP: OR 2.3, 95% CI 1.0-5.2; CaFHS: OR 2.4, 95% CI 1.0-5.8; AHW: OR 5.2, 95% CI 2.8-9.8). Around 16% of women with gestational diabetes and 10% with hypertension had not seen a GP since the birth, and 24% of women who had a low birthweight infant had not seen a CaFHS nurse.

Conclusions: Despite high prevalence of maternal and infant morbidity, a sizeable minority of women did not access primary care practitioners postpartum. Implications for public health: Stronger efforts are needed to ensure Aboriginal women and families receive appropriate postnatal follow-up.

Keywords: Aboriginal maternal and child health; health disparities; population-based study; postpartum; primary health care.