Routine psychosocial assessment was introduced at an Australian public hospital's antenatal clinic in 2001. After modification, this assessment consists of 12 questions together with the Edinburgh Depression Scale (EDS). Data are reported for responses to these questions from over 2,000 English-speaking women presenting to the clinic in a 12-month period. These 12 questions and the EDS were categorised into seven risk domains, with 12% of the women (n = 260) having three or more of these risk domains. Referral information to one of our two clinical services shows that 6.7% of women assessed in the antenatal clinic become clients having face-face counselling, and a further 7.2% have just telephone contact with this specialist perinatal mental health service. This information should prove useful for services considering implementing routine psychosocial assessments (or "screening") in the antenatal period.

In early 1993 a birth plan for the South Western Sydney (Australia) Area Health Service was introduced in two district hospitals. Its ease of use and effectiveness were evaluated from May to July 1993, using a questionnaire that was completedpostnatally by the first 100 women who had completed a prenatal birth plan. All women were asked to complete the questionnaire regardless of whether they had used the written birth plan during labol: Ninety-fve percent of women said that they would encourage other women to use the plan. It increased their own understanding about the processes of labor and birth, and the hospital options open to them. Women said it was helpful, enabled them to express their needs and preferences, enhanced their confidence, and improved communication between them and sta& Birth plans show the commitment of health caregivers to recognizing and supporting diversity, allow for critical reappraisal of existing hospital policies and practices, and provide an opportunity for quality improvement in the context of client rights and preferences. They empower women by increasing their knowledge and understanding of birth practices, and helping them make informed choices. (BIRTH 22:1, March 1995)

Few studies have explored the socio-economic profile, service utilisation, obstetric history and pregnancy outcomes of ethnic women who utilise ethno-specific obstetric services in Australia. The purpose of this study was to form a profile of women who accessed the Ethnic Obstetric Liaison Services (EOLO) in South Western Sydney Area Health Service (SWSAHS), New South Wales and explore their beliefs about using maternal and infant health services. We found that the prevalence of risks and special needs varied significantly by language groups in this study sample. Our results suggest that equity of access to quality care for this group of mothers and infants can be assured if models similar to the EOLO in SWSAHS are thoroughly planned and developed, and take account of cultural appropriateness for the population served.

In Australia, perinatal depression affects 15%-20% of pregnant women. Depression does not go away on its own, getting help at early stages shown to be effective in treating antenatal depression. Aim of this study is to assess and describe the screening of women through the antenatal clinic and measure the outcome of services provided (such as counselling, social assistance) for those at risk of depression, in a general hospital setting in an ethnically diverse part of Sydney, Australia. Data from 193 women were obtained through accessing the psychosocial and screening assessments completed at the antenatal clinic between 2007 and 2008. Data regarding patients' psychosocial characteristics, referrals and interventions were also gathered from hospital records. Data revealed that 60.4% of women screened scored ≥10 on the Edinburgh Postnatal Depression Scale (EDPS) which is indicative of significant depressive symptomatology. Of these women, 39.4% went on to receive a formal diagnosis. Women who indicated that they had planned their pregnancies (47.2%) were significantly less likely to report having major worries and stressors over the last 12 months (p < 0.05) in comparison to those who indicated that their pregnancies were unplanned. Data showed while screening methods are effective, regrettably a high proportion of women, despite presenting with "at risk" symptomatology levels, do not engage in intervention programs. Further research is required to explore the barriers in accessing both screening and intervention services (particularly in a culturally diverse area such as this), and how services can improve processes and patient participation.