Timing of transfer for pregnant women from Queensland Cape York communities to Cairns for birthing.

Abstract

OBJECTIVE: To determine whether the current planned transfer of pregnant women from Cape York communities to Cairns at 36 weeks' gestation for birthing is medically appropriate. DESIGN AND SETTING: Retrospective audit of travel details and demographic and obstetric outcome data on all women from Cape York communities who travelled to Cairns for late pregnancy care and birth at Cairns Base Hospital in 2006. MAIN OUTCOME MEASURES: Length of stay in Cairns; gestational age at birth. RESULTS: In 2006, 172 women from 14 Cape communities travelled to Cairns to give birth. Of these, 76% identified as Aboriginal or Torres Strait Islander, 20% as Caucasian and 4% were from other ethnic groups. The mean time of stay in Cairns before birth (range) was 24 (0-86) days. Eleven women (6%) gave birth between 36 and 37 weeks of pregnancy; this point marked the beginning of a significant rise in births for increasing gestational ages. CONCLUSION: Aiming for 36 weeks' gestation for transfer is medically appropriate, but results in long periods of separation of women from Cape communities from family and friends, with detrimental social, cultural and financial consequences. Reopening maternity units in towns serving the Cape communities could reduce the number of women from the region having to travel to Cairns for pregnancy care and birth.