“Our culture, how it is to be us” — Listening to Aboriginal women about on Country urban birthing

Marriott, Rhonda; Reibel, Tracy; Coffin, Juli; Gliddon, Janinne; Griffin, Denese; Robinson, Melanie; Eades, Anne‐Marie; Maddox, Jade

doi:10.1016/j.wombi.2019.06.017

Cited by 42 publications

(45 citation statements)

References 17 publications

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“…The lack of flexibility, in combination with the absence of continuity of carer or woman centred care. .. were all considered to have negative impacts, leading to women feeling unsafe and fearful" [7].…”

Section: Organisational Initiatives and Constraintsmentioning

confidence: 99%

“…Aboriginal women's birthing stories highlight that in addition to empathy and relationship-building, cultural humility and "cultural champion" advocacy by midwives, a responsive, flexible health care system that accommodates cultural traditions around childbirth is required to prevent pregnant and birthing mothers feeling isolated and unsafe [7]. While an expanded Aboriginal maternity workforce is vital, culturally respectful midwives who advocate for change can also contribute to more positive birthing experiences for mothers and their families.…”

Section: Organisational Initiatives and Constraintsmentioning

confidence: 99%

“…The focus of this paper is on the second priority of the NMSP, namely culturally competent maternity care provision for Aboriginal women, although the three priorities are interrelated. Early access to pregnancy care by Aboriginal women is influenced by a range of factors including widespread social disadvantage, proximity to services and lack of trust in the health care system due to past experiences and institutional racism; all act as disincentives to engage, with long-term consequences for maternal and infant health [2,[5][6][7]. Culturally safe practice is a requirement of the Australian Code of Conduct for Midwives; it is anticipated that program content and clinical placements will develop the cultural capabilities required to deliver safe care.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cultural respect in midwifery service provision for Aboriginal women: longitudinal follow-up reveals the enduring legacy of targeted program initiatives

Thackrah

Wood

Thompson

2020

Int J Equity Health

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Background Culturally competent maternity care provision to Aboriginal and Torres Strait Islander women was identified as a priority area by Australia’s National Maternity Services Plan in 2011. While midwifery programs responded by including core Indigenous content and community placements in curricula, little is known about whether knowledge learned, and insights gained in response to these initiatives have endured and been applied in clinical practice. This follow-up study explores the impact of a compulsory Indigenous unit and a remote clinical placement on two cohorts of non-Indigenous midwives who were participants in an earlier 2012–14 study. Methods Fourteen non-Indigenous participants who were either students or recent graduates in 2012–14 were located and re-interviewed in 2019–20. In-depth interviews based on a semi-structured interview guide were conducted by telephone or face-to face; recordings were transcribed and thematically analysed using standard qualitative procedures. Results Exposure to Indigenous content and settings during training had an enduring impact on participants’ midwifery practice; most felt better prepared to provide culturally safe care, build respectful relationships and advocate for improved services for Aboriginal women. Despite this positive legacy, they also expressed apprehension about causing offence and recognised their own knowledge deficits with regard to Aboriginal cultural practices. Organisational constraints, including restrictions on the number of family members accompanying a birthing mother were identified as barriers to optimal care; some positive organisational initiatives were also described. Conclusions This follow-up study provides encouraging evidence that well-designed and delivered Indigenous content and community placement opportunities in midwifery programs can have a lasting impact on service provision to Aboriginal women, contribute to a more informed, empathetic and culturally competent maternity workforce and help catalyse health service changes towards more culturally safe care.

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Section: Organisational Initiatives and Constraintsmentioning

confidence: 99%

Section: Organisational Initiatives and Constraintsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cultural respect in midwifery service provision for Aboriginal women: longitudinal follow-up reveals the enduring legacy of targeted program initiatives

Thackrah

Wood

Thompson

2020

Int J Equity Health

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“…Midwives in this study frequently referred to women‐centered care, in the absence of Aboriginal specific models of care, as the best way to meet Aboriginal women's needs during childbearing. However, claims by midwives that their practice of woman‐centered care substitutes for culturally safe care were not upheld by Aboriginal women's experiences of care 19 . We have previously reported that Aboriginal women find it challenging to access care which supports their cultural birth practices and avoids the racialized assumptions too frequently directed at them 19 …”

Section: Discussionmentioning

confidence: 95%

“…A lack of culturally safe health services 13‐15 and institutional racism 16,17 combined with inequities in the social determinants of health 18 persists. The BONB study has previously reported Aboriginal women's exposure to racism, inadequate or inappropriate care and a lack of support for their cultural requirements, 19 for example, by restricting the number of people allowed in birth suites or postnatal wards. This directly conflicts with the highly developed cultural practice of childbirth as a valued collective kinship event.…”

Section: Introductionmentioning

confidence: 99%

Midwifery knowledge of equitable and culturally safe maternity care for Aboriginal women

Marriott

Reibel

Barrett

et al. 2020

Birth

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Background The Birthing on Noongar Boodjar project (NHMRC Partnership Project #GNT1076873) investigated Australian Aboriginal women and midwives’ views of culturally safe care during childbearing. This paper reports on midwifery knowledge of Aboriginal women's cultural needs, their perceptions of health systems issues, and their ability to provide equitable and culturally safe care. Method A qualitative study framed by an Indigenous methodology and methods which supported inductive, multilayered analyses and consensus‐driven interpretations for two clinical midwife data groups (n = 61) drawn from a larger project data set (n = 145) comprising Aboriginal women and midwives. Findings Midwives demonstrated limited knowledge of Aboriginal women's cultural childbearing requirements, reported inadequate access to cultural education, substituted references to women‐centered care in the absence of culturally relevant knowledge and consistently expressed racialized assumptions. Factors identified by midwives as likely to influence the midwifery workforce enabling them to provide culturally safe care for Aboriginal women included more professional development focused on improving understandings of cultural birth practices and health system changes which create safer maternal health care environments for Aboriginal women. Conclusions Individual, workforce, and health systems issues impact midwives’ capability to meet Aboriginal women's cultural needs. An imperative exists for effective cultural education and improved professional accountability regarding Aboriginal women's perinatal requirements and significant changes in health systems to embed culturally safe woman‐centered care models as a means of addressing racism in health care.

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Community views on ‘Can perinatal services safely identify Aboriginal and Torres Strait Islander parents experiencing complex trauma?’

et al. 2022

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Family and extended kinship systems which nurture healthy, happy children are central to Aboriginal and Torres Strait Islander cultures. Since colonisation, Aboriginal and Torres Strait Islander communities have been impacted by intergenerational cycles of trauma, stemming from colonial violence, genocidal policies and discrimination, including the forced removal of children from their families. Becoming a parent offers a unique life‐course opportunity for trauma recovery and preventing intergenerational trauma. However, identifying or ‘recognising’ complex trauma carries significant risk of harm for Aboriginal and Torres Strait Islander parents due to reactive prenatal child protection involvement potentially compounding experiences of trauma, and limited benefits due to lack of culturally appropriate support. The Aboriginal‐led participatory Healing the Past by Nurturing the Future project aims to co‐design safe, accessible and feasible perinatal awareness, recognition, assessment and support strategies for Aboriginal and Torres Strait Islander parents experiencing complex trauma. This paper presents views of 38 workshop participants to determine prerequisites for ensuring benefits outweigh risks of assessment to safely recognise parents experiencing complex trauma, consistent with screening criteria. Six essential elements were identified from thematic analysis: high‐quality holistic care; cultural, social and emotional safety; empowerment, choice and control; flexible person‐centred approaches; trusting relationships; and sensitive, skilled communication. Key Practitioner Messages The impacts of colonisation and rates of Aboriginal and Torres Strait children in out‐of‐home care mean that there can be a myriad of issues facing Aboriginal and Torres Strait Islander parents with regard to perinatal child protection involvement. The benefits must outweigh the risks of identifying parents experiencing complex trauma. Assessment must be offered within foundations of supportive relationships and holistic care in culturally‐safe, empowering settings, where choices are respected and skilled communication approaches are used.

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“Our culture, how it is to be us” — Listening to Aboriginal women about on Country urban birthing

Cited by 42 publications

References 17 publications

Cultural respect in midwifery service provision for Aboriginal women: longitudinal follow-up reveals the enduring legacy of targeted program initiatives

Cultural respect in midwifery service provision for Aboriginal women: longitudinal follow-up reveals the enduring legacy of targeted program initiatives

Midwifery knowledge of equitable and culturally safe maternity care for Aboriginal women

Community views on ‘Can perinatal services safely identify Aboriginal and Torres Strait Islander parents experiencing complex trauma?’

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