A Journey to Birthing on Country: A First Mother’s Triumph and a Call for Better Indigenous Health Outcomes
For Whitney Fordham, a proud Cullunghutti, Jerrinja, Wandi Wandandian woman, the prospect of motherhood was initially met with apprehension. “I was scared about pregnancy; to be honest, I never wanted kids. I was never maternal,” she confessed. The thought of a significant lifestyle change, coupled with a personal fear of needles and medical interventions, loomed large. The well-intentioned warnings about sleepless nights and the physical toll of childbirth only amplified her anxieties.
Further compounding Ms Fordham’s concerns was the classification of her as a high-risk patient due to her BMI. This meant she would need to travel away from her home on the south coast of New South Wales to a larger hospital, a prospect that deeply upset her. “I totally understood it, but … for that opportunity to be taken away from me, it hurt,” she shared, feeling that “BMI is just numbers on a bit of paper, and doesn’t define who I am.”
Fortunately, Ms Fordham found invaluable support through Waminda, a local Aboriginal health service. With her midwife, Rosie Downing, by her side, she navigated her high-risk appointments. This partnership culminated in the joyous delivery of her son, Mikaere, at her local hospital, thanks to Waminda’s “Birthing on Country” program. “It’s embedded in our culture, birthing our babies on country, naturally, and [it’s] just like a place of belonging for us,” she explained.
The birthing experience itself was a revelation for Ms Fordham. “I loved it right up until I was due and would be pregnant all over again,” she admitted, a far cry from her initial fears. Mikaere arrived three weeks early, but with a healthy birth weight of 2.92 kilograms, a testament to the care he received. A subsequent clinic visit confirmed he was “thriving,” as Ms Downing observed, “He’s growing so well. It’s so nice to see him so healthy, thriving and strong.”
The Stark Reality: Indigenous Babies and Healthy Birth Weights
While Ms Fordham’s story is one of success, it stands in contrast to the national picture for First Nations babies. Latest data from the Productivity Commission’s Closing the Gap report reveals a concerning disparity: only 88.9 per cent of Indigenous babies were born at a healthy weight, compared to 93.9 per cent of their non-Indigenous counterparts. The national target is to reach 91 per cent of Indigenous babies born at a healthy weight within five years.
Understanding the Factors Behind Low Birth Weight
The impact of birth weight on a child’s future is profound, according to Dr. Yvette Roe from the Molly Wardaguga Institute for First Nations Birth Rights at Charles Darwin University. “It’s like starting a race and you’re behind the start line,” she explained. Low birth weight, defined as under 2.5 kilograms, can lead to underdeveloped lungs and brains, increasing susceptibility to illness. This can have long-term health implications, including chronic diseases like diabetes and cardiovascular disease later in life.
Several factors contribute to low birth weight among Indigenous populations:
- Maternal Health: This includes smoking during pregnancy, a mother being underweight, or pre-existing health conditions like diabetes.
- Access to Care: Limited regional maternal services and food insecurity can hinder access to crucial antenatal care.
- Socioeconomic Factors: Babies born in very remote areas and those from socio-economically disadvantaged backgrounds are more likely to have lower birth weights. Dr. Roe points to inadequate housing, high living costs, and financial insecurity as significant barriers, advocating for a “whole of community approach.”
Waminda’s Culturally Safe Model: A Blueprint for Success
Waminda’s Birthing on Country program prioritises continuity of care, fostering trust and comprehensive support for expectant mothers and their families. This holistic approach extends to mental health and housing support, providing “emotional and psychological support … to really give that mum and baby the best step forward,” as Ms Downing highlighted. This model ensures women don’t have to repeatedly share their stories with different services, creating a safer and more nurturing environment.
Even Ms Fordham, a health practitioner herself at Waminda, opted for the midwifery team’s antenatal care, having heard “traumatic birthing stories” from friends and family. She credits Waminda’s “wrap-around support services and the love bubble” for shifting her mindset and contributing to her positive birth experience.
Studies on programs like Waminda and Queensland’s Birthing in Our Community program have demonstrated significant positive outcomes:
- Increased Normal Vaginal Births: First Nations women using Waminda reported a higher rate of normal vaginal births.
- Improved Breastfeeding Rates: Greater likelihood of exclusive breastfeeding post-discharge from hospital.
- Enhanced Engagement with Wellbeing Programs: Increased participation in culturally safe wellbeing initiatives.
- Reduced Preterm Births: The Queensland program saw mothers less likely to have preterm births (before 37 weeks).
- Decreased Neonatal Removals: The program also contributed to a reduction in the removal of newborn babies from their families.
Dr. Yvette Roe, who was involved in these studies, emphasised the importance of community-designed, tailored supports. She noted that “system failure” often occurs when mothers fall through the cracks, missing critical support. “We need to reconfigure the system [so] that it is mum and bub centred, but also it’s resourced appropriately from the primary healthcare sector to the hospital sector.”
Urgent Investment Needed to Close the Gap
Despite these successes, the national picture remains challenging. The Northern Territory and Western Australia have the lowest percentages of babies born at a healthy weight. Professor Rhonda Marriott, Pro Vice Chancellor of the Ngangk Yira Institute for Change at Murdoch University, points to systemic failures in providing appropriate care, particularly in remote areas where continuity of care is often disrupted by fly-in, fly-out services. “We don’t have maternity services that are providing the full care, antenatal service, labour and postnatal. It’s a system failure and it’s a workforce failure.”
In response, the federal government has announced $44.4 million in funding for ten Birthing on Country services, with a significant portion directed towards Aboriginal Community Controlled Services. While welcomed, Dr. Roe and Professor Marriott view this as “just the tip of the iceberg” and “a drop in the bucket” compared to the scale of the need.
Productivity Commissioner Selwyn Button stressed the necessity of “urgent investment” and governments working in “true partnership with communities and community control organisations.” He stated, “The evidence shows that those things do work. And in order for us to look at accelerating growth across the targets, we need to do more of it.”
Little Progress on Closing the Gap Targets
The latest Closing the Gap data update highlights a worrying lack of progress on several key targets. While land and sea rights show improvement, the rate of suicide continues to worsen, and the adult imprisonment rate has increased. Crucially, the target for healthy birth weights has regressed from “improving but not on track” to being similar to its 2017 baseline. Out of 19 targets, only four are currently on track.
A government spokesperson acknowledged the data, stating it “reinforces the need … to continue working together to achieve the outcomes” and urging state and territory governments to take action.
However, independent Victorian Senator Lidia Thorpe has reiterated calls for a more robust framework, including financial penalties and incentives. She described the current Closing the Gap approach as an “ineffective distraction” lacking enforceability, accountability, and recourse for First Peoples when commitments are breached.
The next round of Closing the Gap data updates is due in July, with a comprehensive review slated for later in the year, offering a crucial opportunity to re-evaluate and strengthen efforts to achieve genuine equity for First Nations mothers and babies.
