A Somalian mum who has given birth to five daughters at South Brisbane's Mater Mothers' Hospital is one of hundreds of women to benefit from an Australian-first refugee midwifery service.
Fartun Hussein, 27, said the one-on-one care she received at Mater Mothers' Hospital during the births of her daughter's Sundus (5), Sidra (4), Sakina (3), Sahar (2) and Sabah (1) were "memorable".
Mrs Hussein, who works in early childhood care, came to Australia in 2005 and said giving birth in Somalia would have been a "completely different" experience.
"Back home in some situations women die during childbirth," Mrs Hussein, from Springwood, said.
"For me, what is special about the service in Brisbane is having the same midwife for each of my pregnancies and also that one-on-one care."
The Mater Refugee Midwifery Group Practice (RMGP) includes direct access to a midwife, pregnancy check-ups, support through labour and birth, and up to six weeks postnatal care.
About 160 women from refugee background access the RMGP at Mater Mothers' Hospital each year.
Now expecting her sixth baby, Mrs Hussein said she was grateful for the care provided to women from refugee backgrounds.
"During my pregnancies, if I had any pain, wasn't feeling well or had any questions, my midwife would guide me through everything," she said.
"During my births, my midwife advocated for me and each time goes out of her way to make sure I have a positive experience.
"The last time I gave birth, I was home the same day! When the kids came home from childcare they had another sibling – I trusted my midwife and she knew I was safe to be at home."
During Perinatal Mental Health Week (17-23 November), Mater Midwifery Group Practice Clinical Midwife Michelle Steel is highlighting the practice model which was adapted to meet the clinical and cultural needs of refugee women improving outcomes for mothers and babies.[1]
Compared to native-born women, immigrant and refugee women are more likely to experience perinatal mental illness, are less likely to use perinatal mental health services, and less likely to seek help for their emotional difficulties.[2]
Ms Steel said the RMGP helped to address challenges refugee women experience with perinatal mental health and wellbeing.
"Women in the care of the RMGP have fewer emergency caesareans than those receiving care from any other model of maternity care," Ms Steel said.
"They are less likely to have complications in pregnancy and birth and are less likely to use epidural analgesia or have a preterm baby."
Women from a refugee background who resettle in high-income countries have poorer perinatal outcomes when compared to the general population, Ms Steel said.
"Refugee women have higher rates of pre-eclampsia, postpartum haemorrhages, gestational diabetes, postnatal depression, preterm birth, low birthweight babies, caesarean sections, and neonatal nursery admissions," she said.
"But thanks to this model of care we are seeing things turn around at Mater Mothers' Hospital."
Ms Steel said the RMGP showed positive improvements in natural birth rates, attendance to antenatal care, VBAC (vaginal birth after caesarean section) rates and breastfeeding rates.[3]
"The RMGP midwives have been well received in the refugee community and have developed high levels of trust in the care being provided," Ms Steel said.
"We know this group of women have other stressors in their life including homelessness, financial stress, visa stress, war trauma, are victims of domestic violence, or survivors of torture".
The RMGP was established following a research project within the antenatal clinic at Mater.
"As part of the research, we identified that women of all refugee backgrounds needed culturally appropriate care," Ms Steel said.
"This included an interpreter, a social worker, meeting cultural requirements during childbirth, and having a medical model of midwifery care for a safe birth.
"Adaptations included moving antenatal care from the hospital into a community venue, delivery of language specific group antenatal care and education sessions, face-to-face and phone interpreting services when required."
Mater midwives have cared for refugee women from about 80 countries, including Sudan, Somalia, West Africa, Tanzania, Afghanistan, and India.
Meanwhile Eritrean refugee Wegahta Gebreyesus, 39, has given birth to four children at Mater Mothers' Hospital and said she felt "extremely lucky" to have specialist care throughout her pregnancies.
Mrs Gebreyesus described her children Magdalen (7), Mishael (5), Merab (2) and Meadi (6 months) as "blessings".
"Having the support of a midwife 24-7 was really comforting and provided me with reassurance," she said.
"The level of care was fantastic and helped me cope mentally and physically.
"I was given courage and comfort from the moment I found out each time I was pregnant."
Mrs Gebreyesus, who lives in Inala and works as a nursing home assistant, came to Australia in 2012 and said the maternity care she received in Brisbane was "remarkable".
"I wouldn't have received this type of care back home. I have seen how other pregnant mums struggled during pregnancy and some mums die delivering their babies," she said.
"My midwife called to check in on me each time I gave birth and even visited me at home when we needed some help.
"When I look at my children, I know how lucky I am to have them here with me."
[1] Refugee MGP: Creating a midwifery group practice for refugee women
[2] Perinatal Mental Health needs of immigrant and refugee women
[3] Effect of an Australian community-based caseload midwifery group practice service on maternal and neonatal outcome for women from a refugee background – Journal of the Australian College of Midwives
