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Use of “At Risk” Antenatal Score Card by Aboriginal Health Workers in Arnhem Land

The detection and understanding of the significance of "high risk factors" in pregnancy is essential to good antenatal care. An antenatal scoring card was pretested among health workers of a facility in Arnhem Land and modified prior to its general introduction to the region. The introduction and acceptance of the scoring sheet by the aboriginal health workers in this region has increased the detection rate of "historical" high risk factors from 50% to 78% and "clinical" high risk factors from 30% to 73%. It has also proved of value as a teaching aid for those instructing the health workers in midwifery. Health workers now recognize those risk factors common amongst their people such as tobacco smoking anemia multiparity and recurrent urinary tract infections. The relatively low prevalence of toxemia and the complete absence of rhesus incompatability is apparent. The scoring sheet described is now recommended for use by health workers in the Northern Territory of Australia. Ideally however the scoring system might be incorporated into the standard antenatal record.