A pioneering Birthing on Country maternity services program will increase and support the Indigenous maternity workforce, expand culturally competent maternity care, and establish primary maternity units.

The Australian College of Midwives (ACM), the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM), the University of Queensland and the University of Sydney have joined forces to launch the program at the CATSINaM International Indigenous Health Workforce Meeting this week.

Birthing on Country involves traditional practices and connection with land and country to ensure the best start to life for Aboriginal and Torres Strait Islander mothers and their babies.

The new program will work to close the gap on health inequality with integrated, holistic and culturally appropriate models of care for Indigenous women, families and their communities.

Professor Sue Kildea, director of the Midwifery Research Unit in the Mater Research Institute, a collaboration between the Mater Health Services in Brisbane and University of Queensland (MRI-UQ), said the initiative was a major milestone in advancing culturally safe health services for Indigenous women.

“We’ve now got funding to progress the Birthing on Country project and I am going to be applying for more NHMRC funding to try and progress this work,” she said.

“We will be looking at a couple of sites for testing the Birthing on Country framework. We are wanting to work with communities that want to have a Birthing on Country model up and running and tested.”

In a report, published in The Medical Journal of Australia, Professor Kildea has reviewed the success of the National Maternity Services Plan (NMSP), which set out a five year vision for 2010-2015.

While the NMSP resulted in strengthening maternity services in some areas, the report states it failed to achieve “notable results” in the three priority areas of increasing the Indigenous workforce, boosting culturally competent maternity care, and developing dedicated programs for Birthing on Country.

Professor Kildea has called on Australian federal, state and territory governments to fund critical initiatives, such as Birthing on Country programs, to improve maternal and birth outcomes for Aboriginal and Torres Strait Islanders.

The NMSP highlighted the importance of developing Birthing on Country programs for Indigenous women, yet she said no progress had been made to establish and evaluate Birthing on Country services in remote or very remote parts of Australia.

Professor Kildea said Indigenous babies are almost twice as likely to be born at a low birthweight than non-Indigenous or Indigenous babies from similar countries, while growing evidence points to the importance of pregnancy and birth on health outcomes later in life.

“You just can’t argue the fact that interventions around the time of birth, so pregnancy - the year before birth and the year after birth, are the two most crucial years in a mother’s and baby’s life,” she said.

“If we can get interventions there that can actually make a difference to the rates of pre-term, low birthweight, perinatal mortality then we’re going to be making a difference to everything - to those chronic diseases in later life, but we will also be making a difference to the Indigenous families in our country.

“That’s a massive priority and it was great to see that it was outlined in the National Maternity Services Plan…but there was not a lot of direct funding attached to all of the action items.”

Professor Kildea, who is working with two Aboriginal Community Controlled Health Organisations and two large maternity hospitals to develop and evaluate an Urban Birthing on Country service model in Brisbane, said the next step is to move towards primary maternity units in remote communities.

Earlier this year, ACM, CATSINaM and CRANAplus released a position statement calling for the government to develop a strategic approach to implementing and evaluating Birthing on Country programs.