Aboriginal and Torres Strait Islander mothers and babies

Antenatal care

Antenatal care is a planned visit between a pregnant woman and a midwife or doctor to assess and improve the wellbeing of the mother and baby throughout pregnancy. Antenatal care is associated with positive maternal and child health outcomes – the likelihood of receiving effective health interventions is increased through attending antenatal care. It does not include visits where the sole purpose is to confirm the pregnancy (AIHW 2022).

Aboriginal and Torres Strait Islander mothers are more likely to engage with maternity care when Aboriginal and Torres Strait Islander peoples are involved in the design and delivery of services and when care is woman-centred, culturally safe and involves continuity of care (DoHAC 2020; Kildea et al. 2021; Parker et al. 2014).

Some examples of programs which are designed to meet the needs of Aboriginal and Torres Strait Islander mothers, and have reported positive outcomes are:

• Birthing in our Community (BiOC) Program: based in urban Queensland, this program reported improvements include increased antenatal care attendance, a reduction in preterm birth, and an increase in exclusive breastfeeding at discharge from hospital (Kildea et al. 2021).
• Aboriginal Maternal and Infant Health Service: based in New South wales, this service reported outcomes include increased likelihood of attending antenatal care in the first trimester of pregnancy and attending 7 or more antenatal care visits and a reduced likelihood of babies being born preterm or of low birthweight (HCA 2019).
• Aboriginal Family Birthing Program:  based in South Australia, participants in this program reported positive experiences of antenatal care, (Middleton et al. 2017) and there were reported improvements in attending antenatal care in the first trimester of pregnancy and attending 5 or more antenatal care visits (Brown et al. 2016).

Duration of pregnancy at the first antenatal care visit

The first antenatal visit is important as it involves a comprehensive physical, emotional and social assessment, providing advice on a range of topics, and identifying if additional care is required (DoHAC 2020).

The Australian Pregnancy Care Guidelines (DoHAC 2020) recommend that a woman has her first antenatal care visit within the first 10 weeks of pregnancy.

Note that in some instances the first antenatal visit may be the first hospital antenatal clinic visit and that in these cases, earlier antenatal care provided in the Primary Care setting would not be reported.

In 2020, 58% of Aboriginal and Torres Strait Islander females who gave birth had their first antenatal care visit in the first 10 weeks of pregnancy, and 71% had their first antenatal care visit in the first trimester (before 14 weeks’ gestation) of pregnancy (compared with 67% and 80%, respectively, for non-Indigenous females).

Over time, the proportion of Aboriginal and Torres Strait Islander mothers who had their first antenatal care visit in the first 10 weeks of pregnancy has increased (from 35% in 2012 to 58% in 2020), as has the proportion who had their first antenatal care visit in the first trimester of pregnancy (from 50% in 2012 to 71% in 2020).

The data visualisation below shows the proportion of Aboriginal and Torres Strait Islander and non-Indigenous females who gave birth who had their first antenatal care visit in the first 10 weeks of pregnancy or the first trimester of pregnancy, from 2012.

Figure 1: Proportion of Aboriginal and Torres Strait Islander and non-Indigenous females who gave birth by duration pregnancy at their first antenatal care visit from 2012 to 2020

In 2020, Aboriginal and Torres Strait Islander mothers who had greater proportions of having attended their first antenatal care visit in the first trimester were those who:

• lived in the fourth area of disadvantage (quintile 4) (74%, compared with 69% of those who lived in the most disadvantaged areas)
• lived in Inner regional and Outer regional areas (both 73%, compared with 63% for Remote areas)
• were aged 20-24 years, 25-29 years and 30-34 years (all 71%, compared with 62% of those aged 40 years and over)
• first-time mothers (75%, compared with 56% of those with a parity of 4 or more).

The data visualisation below presents data on the duration of pregnancy at their first antenatal visit of Aboriginal and Torres Strait Islander females who gave birth, by selected maternal characteristics for 2020.

Figure 2: Proportion of Aboriginal and Torres Strait Islander females who gave birth by duration of pregnancy at first antenatal care visit and selected topic for 2020

Number of antenatal care visits

Ongoing antenatal visits are required for specific activities as pregnancy progresses, including assessing fetal growth, testing for pregnancy-related conditions, and preparing for labour and birth (DoHAC 2020).

For first-time mothers (primiparous), at least 10 antenatal visits are recommended during pregnancy, for women who have given birth before (multiparous) and for subsequent uncomplicated pregnancies, 7 visits are recommended (DoHAC 2020).

In 2020, 53% of Aboriginal and Torres Strait Islander females who gave birth and were first-time mothers had 10 or more antenatal care visits and 71% of Aboriginal and Torres Strait Islander females who had previously given birth had 7 or more antenatal care visits. In comparison, 59% of non-Indigenous females who gave birth and were first-time mothers had 10 or more antenatal care visits and 85% of non-Indigenous females who had previously given birth had 7 or more antenatal care visits.

Between 2012 and 2020, the proportion of Aboriginal and Torres Strait Islander first-time mothers who had 10 or more antenatal care visits has fluctuated, ranging from 52% to 57%.

In the same period, the proportion of Aboriginal and Torres Strait Islander mothers who had previously given birth and had 7 or more antenatal care visits has also fluctuated, ranging from 68% to 72%.

The data visualisation below shows the proportion of Aboriginal and Torres Strait Islander and non-Indigenous females who gave birth and had 10 or more antenatal care visits for primiparous females or 7 or more antenatal care visits for multiparous females, from 2012.

Figure 3: Proportion of primiparous or multiparous Aboriginal and Torres Strait Islander and non-Indigenous females who gave birth by number of antenatal care visits from 2012 to 2020

In 2020, 87% of Aboriginal and Torres Strait Islander mothers had 5 or more antenatal care visits.

The proportion of all mothers who had 5 or more antenatal care visits is a commonly used measure for indicator reporting. For example, the proportion of pregnant Aboriginal and Torres Strait Islander women with 5 or more antenatal visits is a supporting indicator measure for Closing the Gap socioeconomic outcome area 2: ‘Aboriginal and Torres Strait Islander children are born healthy and strong’ (Productivity Commission 2020).

In 2020, the proportion of Aboriginal and Torres Strait Islander mothers who had 5 or more antenatal care visits decreased as relative disadvantage increased.  For example, 92% of Aboriginal and Torres Strait Islander females who lived in the least disadvantaged areas had 5 or more antenatal care visits, compared with 86% of those living in the most disadvantaged areas.

Aboriginal and Torres Strait Islander mothers were slightly less likely to have had 5 or more antenatal care visits if they:

• lived in Remote areas (85%, compared with 88% for all other remoteness areas)
• were aged 40 years or more (85%, compared with between 86% and 88% for other maternal age groups)
• had a parity of 4 or more (78%, compared with 92% of first-time mothers)

The data visualisation below presents data on the number of antenatal visits for Aboriginal and Torres Strait Islander females who gave birth, by selected maternal characteristics for 2020.

Figure 4: Proportion of Aboriginal and Torres Strait Islander females who gave birth by number of antenatal care visits and selected topic for 2020

For related information see:

• the Regional Insights for Indigenous Communities section on Antenatal care.
• Aboriginal and Torres Strait Islander Health Performance Framework indicator 3.01 antenatal care.