NSW Primary Maternity Care: A Woman-Centered Outcomes Critical Report

This report critically analyzes woman-centered outcomes in primary maternity care provided by Level 5 hospitals in New South Wales (NSW), Australia, with a focus on culturally and linguistically diverse (CALD) women. It discusses the importance of prioritizing individual needs in maternity services and assesses the effectiveness of clinical interventions using tools like Perinatal Data Collection, the Edinburgh Postnatal Depression Scale, and the National Perinatal Data Collection. The report identifies key stakeholders, including maternity service providers, government bodies, and community groups, and recommends the use of Perinatal statistics tool with SMART measures to improve maternity care services. It further highlights the significance of quality improvement data systems and stakeholder consultation for enhancing the well-being of CALD women during pregnancy and childbirth.

PRIMARY MATERNITY CARE
(CRITICAL ANALYSIS OF WOMAN
CENTRED OUTCOMES)

TABLE OF CONTENTS
1. INTRODUCTION.......................................................................................................................3
2. DISCUSSION..............................................................................................................................3
3. RECOMMENDATIONS.............................................................................................................6
4. CONSULTATION......................................................................................................................7
REFERENCES................................................................................................................................9

1. INTRODUCTION
Australia is a country in which to have a baby and compares well on a number of
accepted measures of safety and quality of care. The basic purpose of this report is to describe
the primary maternity care that has been given by the level 5 hospitals NSW to the CALD
women in Australia. The services are properly approached by healthcare settings which
represents a wide perspective of services and places in which the health care happens. It includes
health care hospitals, urgent care centres, nursing homes and other long-term care facilities.
Level 5 hospitals are highly equipped with experienced medical officers and nursing staff on site
24 hours (Betron and et.al., 2018). All the specialists and other staff members are available on
call 24x7. These establishments are highly able to manages the highly complex patients as well
as procedures. It has been identified that highest number of CALD women are presented in
Australia for which the average birth rate per year is of 4000 (Fontein-Kuipers, de Groot & van
Staa, 2018). CALD women are those who are culturally and linguistically diverse in nature.
These women were born overseas or have their parents born overseas and thus speak diversified
languages. The project is structured in a manner which provides detailed information about the
women centred outcome measures, analysis of new born outcome measures, different tools
utilised during pregnancy along with certain recommendations that are prepared on the basis of
SMART measures. This study will also highlight the identification of key stakeholders within the
community and health settings.
2. DISCUSSION
Women centered outcome measure can be recognized as appropriate care that has been
provided to the women in maternity services. So, it is a concept related to healthcare services are
provided to women through prioritizing the women individual unique needs in order to provide
continuous care. In another words, it measures the outcome of women centered services that are
provided to cultural and linguistic diverse women for their better health and well-being. In
facility level 5 hospital in NSW has an average 4000 birth per year so appropriate care needs to
be provided to CALD women for better outcome. Thus, women centered outcome measure is an
effective method of assessing the effectiveness of clinical intervention and standardized measure
in order to determined best practices that can be used to delivered good maternity care to CALD
women in Australia (Karaca & Durna, 2019).

Furthermore, it has been identified that cultural and linguistic diversity in Australia is rising
at rapid stage. CALD are group of women that have born outside the Australia/ New Zealand and
are non-Caucasian, non-English speaking and refugees. Along with it, most of the women of
CALD group are often childbearing age that directly influence on pregnancy outcome. Through
the survey it has been identify that the women are highly satisfied with the maternity care
provision provided by the Level 5 hospital in NSW (Liu & et.al., 2018). In addition to it, first
time mother has been given more care, continuous care, staff qualities and better services as
compared to multiparous mother. Thus, it has been find out that care has been provided to
women in five areas such as women focused care, family focused care, continuity of care and
staff qualities that has helped in gaining better outcome in context of maternity care.
Perinatal Data Collection is one of the data collection method on the information related to
pregnancy and childbirth. This information’s are generally collected from different sources such
as from mothers or from hospital and notification form for each birth. Thus, it helps in effective
planning of healthcare services to women that are belong to group of CALD in Australia.
Moreover, the main purpose of making use of Perinatal Data Collection method is that it helps in
monitoring the outcome pattern within the midwifery and obstetrics. The gap is that they are not
collected for similar purposes.
Edinburgh Postnatal Depression Scale is valuable and efficient way that helps in
identifying the patient at which risk for” perinatal depression. It has also been find out that it is
most easy to administer and proven effective screening tool. In addition to this, the scale helps in
identifying or driving what a mother has felt during its previous week of delivery. Likewise, as
per this the women that has achieve score above 13 are more likely to suffer depression illness
therefore careful clinical assessment should be completed for better diagnosis (de Bruin-
Kooistra, & et.al., 2012). Postnatal Depression Scale does not detect information related to
whether the mother has been feeling anxiety, personality disorder or phobias. Therefore, it is tool
that have set of screening question that helps in finding out whether the symptoms are similar to
what a women feel during the pregnancy such as depression and anxiety.
My experience matter is also one of the tool that helps in gathering information related to
the experience of CALD women that they have face during the period of pregnancy. It helps in
identifying and understanding whether they all have same experience during their maternity care
or different. Furthermore, it also helps in understanding key areas that needs to be improved so

that more effective care can be provided to women for their optimum health and well- being
(Nilvér, Begley & Berg, 2017). Thereby it also helps in gaining information related to different
challenges that the CALD women has faced during its maternity care so necessary steps can be
taken to improve the same.
National Perinatal Data Collection it is another tools that is mainly used to measure
women centered care that involves national- population based cross-section. It contains
information related to NPDC for both that have live births and stillbirth having birthweight at
least 400 grams and gestational age of 20 weeks. So, this tools also contribute in having all
information related to healthcare services or maternity care that are provided to women belong to
Cultural and linguistic diverse group.
Monthly Perinatal Mobility and Mobidity meetings is mainly used for reviewing the
death as part of professional learning that lead in consequence of unsafe clinical practices.
National health services hospital as well as the government of Australia in order to measure the
increasing rate of mortality or monitor the quality of inpatient care make use of monthly
perinatal mobility meeting. So, it can be stated that Mobidity meetings are crucial components
of clinical government and have potential to improve patient outcome, attitude towards the
patient safety and quality of care provided to them (Rich & et.al., 2016). Thus, the main purpose
of making use of Monthly Perinatal Mobility and Mobidity meetings Mobidity meetings is to
educate clinical staff related to the way services or maternity care needs to be offer to the patient.
Women satisfaction survey is also tool or method that is used in measuring the outcome
pertaining to women centered care provided in context of maternity. In this survey of women
which belong to group of culture and linguistic diverse has been taken to know whether they are
provided satisfactory maternity care in Level 5 hospital in nsw or not. So, that sufficient steps
related to improving the healthcare services and facilities can be improved for better outcome
and care of CALD women living in Australia (Australian Medical Association (AMA) (2016).
So, all these are various women centered outcome measures that has been used to identified
type of care and services provided to women of CALD in Australia. Whether they are sufficient
or needs to be improved for effective results.

3. RECOMMENDATIONS
Women centred outcome measures have been recognized as the benchmark of quality of
maternity services that are provided to the CALD women in Australia. This particular care
prioritizes the the women's individual unique needs that are highly recommended at the time of
maternity stage. From the above detailed analysis it has been identified that there are certain
measuring tools that are covered under the concept of women centred outcome measures such as
Quality improvement data system and Perinatal statistics report. The quality improvement data
system is a systematic approach in order to evaluate the performances and efforts in order to
improve them. The benefits from this tools is that details that are collected about the maternity
mothers are error free, it increases the adaptability of the data, increases the productivity while
data collection and enhances the morale value of individuals (Shakibazadeh & et.al., 2018).
While it also consists of certain drawbacks as well such as it lacks down in specificity, expensive
to obtain the data, not that much valid instrument to collect the data. Another tools is Perinatal
statistics report which is collection, processing, management and reporting of data on all births
nationality meets the requirements of data users. It is important as it describes the latest trend of
health including the impact of changes in the birth outcomes statistics. It also describe the ways
through which the primary care can be taken place. However, the certain limitations consists that
it requires collection of complete data of the women after which the tool is able to provide details
in accurate manner (McCormack, Henderson & Wilson, 2007). From the above two tools the
Perinatal statistical tool is highly recommendable that even after few drawbacks the tools is
effectively able to provide proper statistical data in order to collect the details about the primary
care that has been provided to the CALD women in Australia. In order to apply the tool in most
appropriate manner the SMART measures have been prepared below:
1. Specific: Creation of healthy pregnancy committee comprised of service providers
according to the set goals of the NSW hospital level 5 guidelines within 4 months of
duration of time.
2. Measurable: Increases expectant mothers services rate in their primary stage by 15%
improvement by the end of this year.
3. Achievable: Identify best practices related to improving prenatal care along with
inclusion of care models to improve the outcome in coordinated manner by the 6 months
of period.

4. Relevant: The tools i.e. Perinatal statistics enables to increases the birth of healthy
babies of CALD women and also allows to provide primary maternity services in most
efficient manner with complete evaluation of drawbacks that are incurred in the whole
procedure
5. Time-frame: This particular tools will be implemented and considerable for the results
by the next year in most fruitful manner.
Thus, with the help of the Perinatal statistics tool, the data of child birth has been
collected and according to that the future corrective measures had been taken place. From the
overall collection of data, it will be identified that the child birth rate is good enough or not
which describes the quality of services provided to the CALD women in Australia.
4. CONSULTATION
Identification of key stakeholders and their position
Stakeholders are the individuals that are interested in function and operation of health care
institution and other organisation so that qualitative services can be provided to the women or of
CALD. Therefore, the different key stakeholders that need to be consulted about the potential
changes to outcome measure can be illustrated as follows:
Maternity service provider: These are healthcare professional that provide services to women
during their pregnancy so that they need to be informed about the potential changes that need to
be made in outcome measures. Thereby more appropriate detailed related to women centered
services outcome can be derived (Rich & et.al., (2016).
Government: Government is responsible for formulating rules and regulation, monitoring all
the action or steps taken to improve the healthcare institution for better health and wellbeing of
people living in society. So, they also need to be informed in order to take their permission that
whether perinatal statistical tool can be used to measure women centered outcome (Muir, &
Dean, 2017).
Community group: The people living in society or women that belong to CALD group also
need to be shared information pertaining to changes that is planning to made in context of
women centered measure outcome. As they are only individuals from which data will be
collected and used to improve maternity care and healthcare services.

IT and other hospital services: Other hospital services and IT also need to be consulted to
know their suggestion related to whether perinatal statistical tool is useful or not. Or they have
any other suggestion related to the way changes can be made in women centered measure
outcome to have completed detailed related to whether better services are provided to CALD
women or not.

REFERENCES
Books and Journals
Betron, M. L., & et.al. (2018). Expanding the agenda for addressing mistreatment in maternity
care: a mapping review and gender analysis. Reproductive health, 15(1). pp.1-13.
de Bruin-Kooistra, M., & et.al. (2012). Finding the right indicators for assessing quality
midwifery care. International Journal for Quality in Health Care, 24(3). 301-310.
Fontein-Kuipers, Y., de Groot, R. & van Staa, A. (2018). Woman-centered care 2.0: Bringing the
concept into focus. European journal of Midwifery, 2.
Gadson, A., Akpovi, E. & Mehta, P.K. (2017), August. Exploring the social determinants of
racial/ethnic disparities in prenatal care utilization and maternal outcome. In Seminars in
perinatology (Vol. 41, No. 5, pp. 308-317). WB Saunders.
Karaca, A. & Durna, Z. (2019). Patient satisfaction with the quality of nursing care. Nursing
open, 6(2). pp.535-545.
Liu, X., & et.al. (2018). Hospital nursing organizational factors, nursing care left undone, and
nurse burnout as predictors of patient safety: A structural equation modeling
analysis. International journal of nursing studies, 86. pp.82-89.
Nilvér, H., Begley, C., & Berg, M. (2017). Measuring women’s childbirth experiences: a
systematic review for identification and analysis of validated instruments. BMC
pregnancy and childbirth, 17(1). 203.
Rich, R., & et.al. (2016). Performance indicators for maternity care in a circumpolar context: a
scoping review. International Journal of Circumpolar Health, 75. 14.
Shakibazadeh, E., & et.al. (2018). Respectful care during childbirth in health facilities globally: a
qualitative evidence synthesis. BJOG: An International Journal of Obstetrics &
Gynaecology, 125(8). pp.932-942.
Online
Australian Medical Association (AMA) (2016). [Online]. Available Through:< Position
Statement – Measuring Clinical outcomes in General Practice- 2016. Retrieved
from: https://ama.com.au/position-statement/measuring-clinical-outcomes-general-
practice-2016>.

McCormack, B., Henderson, E., & Wilson, V. (2007). [Online]. Available Through:<Workplace
Culture Critical Analysis Tool (WCCAT). Retrieved
from: https://www.fons.org/resources/documents/Tools%20and%20resources/19-
WCCAT.pdf>.
Muir, S., & Dean, A. (2017). [Online]. Available Through:< Evaluating the outcomes of
programs for Indigenous families and communities. Retrieved
from https://aifs.gov.au/cfca/sites/default/files/publication-documents/evaluating-
outcomes-porgrams-indigenous.pdf>.

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