title: Changing models of public antenatal care in Australia: is current practice meeting the needs of vulnerable populations?
abstract: OBJECTIVE
  to investigate women's views and experiences of public antenatal care.
  
  
  METHODS
  population-based survey in two states.
  
  
  METHODS
  South Australia and Victoria, Australia.
  
  
  METHODS
  4366 women surveyed at 5-6 months post partum.
  
  
  RESULTS
  of 8468 eligible women mailed the survey, 52% returned completed questionnaires. Fifty-seven per cent of women (2496/4339) received public antenatal care. Of these, half attended a GP for some/all antenatal visits, 38% attended a public hospital clinic or midwives clinic, and 12% had primary midwife care, mostly in a midwifery group practice. Women with complex needs - young women, those experiencing multiple social health problems, women of non-English speaking background, and women at higher risk of complications in pregnancy - were the least likely to say that care met their needs. Women attending a GP or midwife as a primary caregiver were the most positive about their antenatal care: 69% and 74% respectively describing their antenatal care as 'very good'. Women attending a standard public hospital clinic were the least positive about their antenatal care with only 48% rating their care as 'very good'. Women enroling in GP shared care or attending a midwives clinic at a public hospital gave intermediate ratings.
  
  
  CONCLUSIONS
  Models of public antenatal care involving a designated lead primary caregiver (GP or midwife) came closest to meeting women's need for information, individualised care and support.
authors.affiliation: Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia; General Practice and Primary Health Care Academic Centre, University of Melbourne, Parkville, Victoria 3053, Australia. Electronic address: stephanie.brown@mcri.edu.au.
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Brown
authors.affiliation: School of Population and Global Health, University of Melbourne, Parkville, Victoria 3052, Australia.
authors.forename: Georgina A
authors.initials: GA
authors.lastname: Sutherland
authors.affiliation: General Practice and Primary Health Care Academic Centre, University of Melbourne, Parkville, Victoria 3053, Australia.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Gunn
authors.affiliation: Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia.
authors.forename: Jane S
authors.initials: JS
authors.lastname: Yelland
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008875:Middle Aged; D008880:Midwifery / Q000592:standards*; D008962:Models, Theoretical; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards*; D013021:South Australia; D011795:Surveys and Questionnaires; D014739:Victoria; D055815:Young Adult
keywords: Antenatal care; Patient experience; Vulnerable populations