Engagement With Antenatal Care: Analysis of Routinely Collected Data at Two Hospitals Implementing Group Pregnancy Care for Women of Refugee Background.

BACKGROUND: Women of refugee background in high income countries experience inequitable perinatal health outcomes, prompting the development of Group Pregnancy Care (GPC). GPC was implemented at two sites in Melbourne, Australia and this study aimed to describe (1) sociodemographic and obstetric characteristics of Australian-born, migrant and refugee background women; (2) the quality of antenatal care for refugee background women attending GPC (i.e., number of antenatal visits, gestation of first visit, interpreter when required); and (3) the economic costs of providing GPC. METHODS: A cross-sectional study of routinely collected perinatal data provided by the two participating hospitals. Statistical analyses included Chi-squared tests, linear and logistic regression. RESULTS: Of the 28,898 women giving birth at the two sites, 39.0% were born in Australia, 51.9% overseas, and 9.1% were of refugee background. Australian Pregnancy Care Guidelines were met for the majority of the 225 GPC participants: first visit < 14 weeks gestation (81.3%), attending recommended number of antenatal visits (84.4%); and having an interpreter > 80% of antenatal visits (83.7%). Refugee background women attending GPC had odds between 2 and 4 times higher of meeting guidelines compared to refugee background women in usual care. CONCLUSION: GPC has the potential to facilitate earlier and increased engagement with antenatal attendance, coupled with access to an interpreter when required. Future expansion of GPC for women of refugee background should be conducted within a rigorous evaluation framework that includes the extension of the program to diverse population groups with appropriate cultural guidance and adaptation.