Maternal and Baby Health Issues

The statistical profile of Aboriginal and Torres Strait Islander mothers and babies varies significantly from that of other cohorts.

• In 2008, Indigenous women had more babies and had them at younger ages than did non-Indigenous women - teenagers had one-fifth of the babies born to Indigenous women, compared with only 4% of those born to non-Indigenous mothers. 
• The median age of Indigenous mothers was 24.7 years, compared with 30.7 years for all women. The fertility of teenage Indigenous women (75 babies per 1,000 women) was more than four times that of all teenage women (17 babies per 1,000) 
• The average birthweight of babies born to Indigenous mothers in 2007 was 3,182 grams, almost 200 grams less than the average for babies born to non-Indigenous mothers (3,381 grams). 
• Babies born to Indigenous women in 2007 were twice as likely to be of low birthweight (LBW) (12.5%) than were those born to non-Indigenous women (5.9%). (LBW, defined as a birthweight of less than 2,500 grams, increases the risk of death in infancy and other health problems.) 
• The low-birthweight proportions for babies born to Indigenous women were highest for WA and SA (both 16.2%).

Source: Birth and pregnancy outcomes: Overview of Indigenous health status 2010

Improving outcomes for mothers and babies is seen as critical in improving the life expectancy of the Aboriginal and Torres Strait Islander population.
Issues Include:

• Smoking during pregnancy;
• Poor nutrition, and;
• Lack of access to prenatal and postnatal care

Childbirth: Women's Business

One of the most significant areas in  Aboriginal women's knowledge was childbirth. While there was some variation across the continent, in all cases documented, birthing support was provided by women only. This was often designated members of the mother's female relatives but other women from the group who were considered skilled in assisting with birth might also be present.

Written histories of Aboriginal women's birthing practices in the Sydney region were documented by early colonists such as Lieutenant David Collins. Drawing on that material Featherstone comments:

Childbirth in Sydney began with the women's business of Indigenous mothers. Women's 'birthing' was not merely the labour and birth of an infant, but part of a wider symbolic process, covering the land and country, the Dreaming and the Law.

Records like these coupled with Aboriginal oral histories and continuing practices provide a good picture of the cultural norms for birth. For instance, Jilpia Nappaljari Jones comments

The female midwives such as my grandmothers and other designated women attended to give physical and emotional support such as holding and massage, and this lessened the discomfort of labour. More particularly it removed fear, and fear is responsible for so many prolonged and complicated labours. Birthing in our traditional society was always "Women Business".

Birthing on Country

The link between birth and culture cannot be overstated. Within most Aboriginal cultures, where you are born may give you rights to land and responsibilities to care for the country and participate in or prepare for ceremonies. The Coordinator of Gumileybirra Women's Clinic explains this link as follows:

You are born on country, you belong to that country and your spirit is there.

Evidence suggests that the care provided to Aboriginal mothers within their own cultures had good rates of success. Aboriginal women also often acted as midwives to White women in colonial Australia.

The dispossession of Aboriginal people forced settlement away from country, shattering the continuity of many cultural practices. Increased medical intervention has also encouraged hospital births, which for some rural and remote Aboriginal women has meant long journey's to medical facilities away from both their family and country.

To counter the removal of women from their country there is a strong movement calling for Birthing on Country - this aims to support women to remain in their communities to give birth and to continue cultural traditions.

Further information:

• Felton-Busch, C. 2009, 'Birthing on country: An elusive ideal?' Contemporary Nurse (33)2 NEWCAT access