Remote access and care: A comparison of Queensland women's maternity care experience according to area of residence |
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| Authors: | Julie Hennegan Sue Kruske Maggie Redshaw |
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| Affiliation: | 1. Queensland Centre for Mothers & Babies, School of Psychology, The University of Queensland, Brisbane, Australia;2. National Perinatal and Epidemiological Unit, University of Oxford, Oxford, United Kingdom;1. School of Public Health, Faculty of Medicine, University Centre for Rural Health, North Coast, The University of Sydney, New South Wales 2006, Australia;2. University Centre for Rural Health, North Coast, School of Public Health, Faculty of Medicine, The University of Sydney, New South Wales 2006, Australia;3. Graduate School for Health Practice, Institute of Advanced Studies, Charles Darwin University, Darwin 0909, Australia;4. School of Nursing and Midwifery, Australian Catholic University and the Mater Medical Research Institute, Brisbane, Queensland 4010, Australia;1. School of Nursing and Midwifery, Maternity and Family Unit, Research Centre for Clinical and Community Practice Innovation (RCCCPI), Griffith Health Institute, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia;2. Queensland Centre for Mothers & Babies, University of Queensland, Australia;3. University Centre for Rural Health North Coast, Sydney Medical School, University of Sydney, Australia;4. Southern Cross University, University of Western Sydney, University of Wollongong, with the North Coast Area Health Service NSW, PO Box 3074, Lismore, NSW 2480, Australia;5. Women''s Mental Health University of Melbourne, Austin Health, PO Box 5555, Heidelberg 3081, Australia;6. Department of Obstetrics and Gynecology, Institution of Women''s and Children''s Health, Karolinska Institutet/Karolinska University Hospital, SE 171 76 Stockholm, Sweden;1. Menzies School of Health Research, Darwin, Northern Territory, C/O PO Box 391, Katoomba, New South Wales 2780, Australia;2. Menzies School of Health Research, Darwin, Northern Territory, PO Box 41096, Casuarina, NT 0811, Australia;3. National Drug Research Institute, Curtin University, GPO Box U1987, Perth, WA 6000, Australia |
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| Abstract: | BackgroundThis study fills a gap in the literature with a quantitative comparison of the maternity care experiences of women in different geographic locations in Queensland, Australia.MethodData from a large-scale survey were used to compare women's care experiences according to Australian Standard Geographical Classification (major city, inner regional, outer regional, remote and very remote).ResultsCompared to the other groups, women from remote or very remote areas were more likely to be younger, live in an area with poorer economic resources, identify as Aboriginal and/or Torres Strait Islander and give birth in a public facility. They were more likely to travel to another city, town or community for birth. In adjusted analyses women from remote areas were less likely to have interventions such as electronic fetal monitoring, but were more likely to give birth in an upright position and be able to move around during labour. Women from remote areas did not differ significantly from women from major cities in their satisfaction with interpersonal care. Antenatal and postpartum care was lacking for rural women. In adjusted analyses they were much less likely to have booked for maternity care by 18 weeks gestation, to be telephoned or visited by a care provider in the first 10 days after birth. Despite these differences, women from remote areas were more likely to be breastfeeding at 13 weeks and confident in caring for their baby at home.ConclusionsFindings support qualitative assertions that remote and rural women are disadvantaged in their access to antenatal and postnatal care by the need to travel for birth, however, other factors such as age were more likely to be significant barriers to high quality interpersonal care. Improvements to maternity services are needed in order to address inequalities in maternity care particularly in the postnatal period. |
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| Keywords: | Remote and rural Maternity care Pregnancy Childbirth Postnatal care |
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