Trying to Make a Difference: A Critical Analysis of Health Care during Pregnancy for Aboriginal and Torres Strait Islander Women

By Hunt, Jenny | Australian Aboriginal Studies, Fall 2006 | Go to article overview

Trying to Make a Difference: A Critical Analysis of Health Care during Pregnancy for Aboriginal and Torres Strait Islander Women


Hunt, Jenny, Australian Aboriginal Studies


Abstract: This paper critically examines pregnancy health care and services for Aboriginal and Torres Strait Islander women, to explore the question of what might 'make a difference'. More antenatal care, and in particular Aboriginal women attending for care earlier and more often, is often put forward as what is needed to improve pregnancy outcomes, as well as the health of future populations. However, evidence from epidemiological, clinical and health services research problematises this assertion. An alternative and preferable driver for the reform of maternity services for Aboriginal women would be to allow women themselves to have more say in decision making at both individual and institutional levels.

**********

Aboriginal and Torres Strait Islander women experience a greater frequency of adverse pregnancy outcomes than other Australian women, and this has been documented for years (Day et al. 1999; Plunkett et al. 1996). Health care during pregnancy aims to improve the health and wellbeing of women and their babies. However, the capacity of such care to improve the pregnancy outcomes of Aboriginal women has rarely been investigated systematically, or at all. (1) A critical exploration of antenatal care and maternity services is useful to inform changes to policy and practice that will 'make a difference' to the health of pregnant Aboriginal women and their babies.

Here I draw on several literature-based and data-based research projects that I undertook between 1999 and 2003 while completing doctoral studies (Hunt 2003). These studies followed several years' work as a clinical and public health doctor in Aboriginal Community Controlled Health Services in Darwin and elsewhere. During this time I had a particular interest in Aboriginal women's health, including the care of women during pregnancy.

Antenatal care--a selective history

In countries like Australia, health care during pregnancy has been institutionalised since the early 1900s. Initially, medical care during pregnancy was promoted as a way of improving the health of populations; it was considered that 'medical supervision' could have a positive impact on infant and maternal mortality (Campbell 1930). In at least some cases, this belief in the positive effects of medical care turned out to be unsupported by subsequently available evidence. Loudon's (1992) review of historical trends in maternal mortality demonstrated that, in the days before antibiotics, being attended by an obstetrician increased a woman's chance of dying of puerperal fever. Later epidemiological studies suggested that doctors were spreading infection through bacterial carriage.

Antenatal care has generally included various screening activities to check on the health of mother and baby during pregnancy as well as interventions aimed to improve health and wellbeing. An increasing number of tests and procedures have been added to what has been considered routine in antenatal care. While there are many examples of innovations with positive health impacts, the history of antenatal care also includes some cautionary tales, including examples of tests being adopted without their safety being assessed adequately. For example, X-rays were used to diagnose or exclude pregnancy and to assess gestation from the time of their invention in the 1900s until the 1950s when ultrasound took over as a way of visualising babies in utero, despite accumulating evidence of their role in causing childhood cancer (Oakley 1984).

It seems unlikely that antenatal care technologies introduced in more recent times will have as dramatically adverse impacts on the health of women and babies as X-rays turned out to have. Since the 1970s the 'evidence-based' medicine and consumer health movements have been instrumental in stressing the importance of new and existing medical technologies being better evaluated before being adopted (Cochrane 1972). (2) However, many tests and procedures used in clinical practice have not been subjected to rigorous evaluation. …

The rest of this article is only available to active members of Questia

Upgrade your membership to receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • A full archive of books and articles related to this one
  • Ad‑free environment

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Upgrade your membership to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Trying to Make a Difference: A Critical Analysis of Health Care during Pregnancy for Aboriginal and Torres Strait Islander Women
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved in your active project from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Upgrade your membership to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.