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Improving maternity services for Indigenous women in Australia: moving from policy to practice

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The disparities in health outcomes between Aboriginal and Torres Strait Islander (hereafter called Indigenous) and non-Indigenous Australians are well established, with the life expectancy gap being among the worst in the world.1 There is growing evidence that the chronic diseases that are prevalent in Indigenous Australian adults (diabetes, hypertension, cardiovascular and renal disease) have their genesis in utero and in early life.2,3 One of the greatest medical threats to the wellbeing of Indigenous children is being born preterm or at a low birthweight (LBW). Australian Indigenous babies are almost twice as likely to be born LBW than Australian non-Indigenous babies or Indigenous babies from similar countries (Box). Other contributors to poor outcomes include the enduring effects of colonisation, social exclusion, sustained institutionalised racism, and stark inequities across many of the social determinants of health, including income, employment, education, and access to goods, services and health care.6,7

Australia’s National Maternity Services Plan (NMSP) states that Australia is “one of the safest countries in the world in which to give birth or to be born. However, this is not…