Aboriginal and Torres Strait Islander mothers may have to travel away from their community to give birth due to a lack of acceptable or appropriate maternal health or acute services. In these instances, Birthing on Country models of care ensure mothers receive culturally safe care despite being away from their community (AIHW 2017; Barclay 2016; Kildea et al 2016).
For more information on Birthing on Country see Introduction and for more information on routine relocation see Antenatal length of stay.
The data below explore whether mothers gave birth in a hospital with a public maternity service in the same state or territory, Indigenous region (IREG) or Statistical area level 3 (SA3) as their usual residence. Note that these geographies of usual residence do not necessarily align with a mother’s Country, nor does the alignment of the geography of a mother’s usual residence with the geography of the public hospital they birthed in mean that the hospital followed Birthing on Country principles.
In 2020, of Aboriginal and Torres Strait Islander mothers who gave birth in a hospital with a public maternity service:
- 47% (6,288) gave birth in a hospital located in an SA3 that was different from the SA3 of their place of usual residence
- 15% (1,943) gave birth in a hospital located in an IREG that was different from the IREG of their place of usual residence
- 1.8% (239) gave birth in a hospital located in a state or territory that was different from the state or territory of their usual residence
In comparison, for non-Indigenous females who gave birth in a public hospital:
- 59% (120,911) gave birth in a hospital located in a SA3 that was different from the SA3 of their place of usual residence.
- 3.7% (7,573) gave birth in a hospital located in an IREG that was different from the IREG of their place of usual residence
- 1.2% (2,412) gave birth in a hospital located in a state or territory that was different from the state or territory of their usual residence
Note that the proportions displayed above for SA3 may reflect that many SA3s do not have a hospital within that area.
The Maternity Care Classification System collects data on models of care from participating Australian maternity services. A maternity model of care describes how a group of women are cared for during pregnancy, birth and the postnatal period, that is, how maternity care is provided. This includes identifying: the women a model is designed for; the maternity carers involved and the role they play; and aspects of how and where care is provided. Based on these characteristics, each model of care can be grouped into one of 11 major model categories. For example, the most common major model of care category is public hospital maternity care (AIHW 2022).
Some models of care involve the routine relocation of women prior to giving birth. The intention is that all women cared for in the model require relocation from their communities to another location prior to labour for intrapartum care and birth. Routine relocation usually applies to models where women reside in a rural or remote community with no access to a birth facility and are routinely relocated to a larger town or city some weeks prior to birth (AIHW 2022) (for more information on routine relocation see Antenatal length of stay).
Of the models of care that have routine relocation as a model characteristic:
- 74% (54) did not specifically target Aboriginal and Torres Strait Islander women, but were available to all women living in an area (including Aboriginal and Torres Strait Islander women)
- 26% (19) targeted Aboriginal and Torres Strait Islander women.
Note that models of care may or may not have a target group and those that do may have more than one target group.
Geography