title: Positive impact of a long-running urban Aboriginal medical service midwifery program.
abstract: BACKGROUND
  The Winnunga Nimmityjah Aboriginal Health Service Aboriginal Midwifery Access Program (AMAP) was established in 2001 to provide antenatal care, birth support and postnatal care to clients in the Australian Capital Territory (ACT).
  
  
  OBJECTIVE
  To describe the uptake and impact of AMAP services on access to antenatal care, behavioural risk factors and pregnancy outcomes and to compare the characteristics of AMAP clients with other women giving birth in the ACT.
  
  
  METHODS
  A descriptive study of medical records for AMAP clients who gave birth in 2004-2008.
  
  
  METHODS
  maternal and baby characteristics, antenatal visits, behavioural risk factors and complications. Characteristics of AMAP clients were compared with the ACT Maternal and Perinatal Collection.
  
  
  RESULTS
  Of 187 women, 11.2% were aged <20 years, 50.3% presented in the first trimester and 94.7% attended five or more antenatal visits. Of 193 babies, 17.1% were born preterm and 18.1% had low birthweight. Compared with the ACT Maternal and Perinatal Collection, Aboriginal and Torres Strait Islander AMAP clients had a higher smoking rate (63.8 vs 49.0%), a lower caesarean delivery rate (20.0 vs 27.6%), a slightly lower proportion of preterm babies (18.8 vs 21.6%) and a slightly lower proportion of low-birthweight babies (18.8 vs 21.0%).
  
  
  CONCLUSIONS
  Aboriginal Midwifery Access Program provides high-quality antenatal care in a trusted environment. The high rate of smoking in pregnancy needs to be addressed.
authors.affiliation: Medical School, Australian National University, Canberra, Australia.
authors.forename: Raphael
authors.initials: R
authors.lastname: Wong
authors.forename: Ana
authors.initials: A
authors.lastname: Herceg
authors.forename: Carolyn
authors.initials: C
authors.lastname: Patterson
authors.forename: Louise
authors.initials: L
authors.lastname: Freebairn
authors.forename: Ann
authors.initials: A
authors.lastname: Baker
authors.forename: Peter
authors.initials: P
authors.lastname: Sharp
authors.forename: Peter
authors.initials: P
authors.lastname: Pinnington
authors.forename: Julie
authors.initials: J
authors.lastname: Tongs
mesh_terms: D000328:Adult; D020958:Australian Capital Territory / Q000453:epidemiology; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D006297:Health Services Accessibility; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008880:Midwifery; D009819:Office Visits / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000208:ethnology; D011295:Prenatal Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012907:Smoking; D055815:Young Adult