(Transcript from SBS World News Radio)
Indigenous Australian women are at greater risk of dying due to complications related to pregnancy and childbirth, despite Australia's otherwise low rates of maternal death.
A new report shows Indigenous women are dying at more than twice the rate of other Australian women from complications during pregnancy and childbirth.
Peggy Giakoumelos reports.
(Click on the audio tab above to hear the full report)
The Australian Institute of Health and Welfare says there were 105 maternal deaths between 2008 and 2012, including women who died while pregnant or within 42 days of the end of pregnancy.
The report Maternal deaths in Australia, shows the maternal death rate among Indigenous mothers was 13.8 deaths per 100-thousand women who gave birth, twice as high as that for non-Indigenous women.
The report's lead author Professor Michael Humphrey says there are many reasons behind the difference.
"Some of it is related to a group of Aboriginal and Torres Strait Islander women not accessing ante-natal care as much as others and whether that in turn is related to not having sufficiently culturally sensitive care providers. Some of it is related to the general health of the Aboriginal and Torres Strait Islander population in Australia. Some of it's related to an increasing incident of general health issues such as heart disease in Aboriginal and Torres Strait Islander people. Some of it, potentially, is related to the relative remoteness in which some of these women live."
The report shows both physical and mental health issues are factors.
Maternal deaths are divided into direct and indirect deaths.
Direct deaths are those that result directly from complications of pregnancy or its management.
Indirect deaths are those that are due to other diseases, but where disease progression is influenced by pregnancy.
Being an indigenous woman or having mental health issues are both the biggest risk factors related to maternal mortality.
And Professor Michael Humphrey believes it's these women who need to be targeted in any health campaigns.
"I think for Aboriginal and Torres Strait Islander women we could be doing more about training culturally appropriate health care professionals for them. I think we need to do more about providing good mental health care for women with mental health issues in pregnancy, and after pregnancy with suicide being one of the most important causes of indirect maternal death those are the two things that stick out at me."
Professor Humphrey says the leading causes of all direct maternal deaths included obstetric thromboembolism, and hypertensive complications of pregnancy.
The leading indirect cause was cardiac disease and deaths due to mental health and substance abuse issues.
Professor Humphrey says deaths due to cardiac conditions and psychosocial causes were also a major concern amongst Indigenous mothers.
Sue Kruske is the Regional manager of maternal child health for the Institute of Urban Indigenous Health .
She says the maternal mortality rate for indigenous women remains unacceptable.
"If you look at Aboriginal and Torres Strait Islander mortality rates, they're comparable to developing world countries such as Sri Lanka and other countries such as Malaysia. So I think we do have to remember that the rates of ATSI women dying in childbirth related illnesses in Australia is totally unacceptable and we have to do lots more in areas of working in partnership with Aboriginal organisations and Aboriginal people to find solutions to address the inequitable status of ATSI women in Australia today."
Sue Kruske says indigenous women in remote areas experience the highest rates of maternal mortality.
She says this group needs more targeted care.
"The majority of them just want to birth closer to where they live and where their families live and what we do instead is that we continue to ship them out at 36-38 weeks of the pregnancy where they sit in lonely hostels in foreign cities, where there is lots of grog without any access to their family support. We have good evidence to support birthing services in these areas can be delivered safely and we have a national maternity service plan which is our national policy which clearly states that this birthing on country model should be piloted in Australia. That was released in 2011 and has not been acted upon. So there's lots of things we could do very quickly to address this problem in Australia I think.
