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

Abstract

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.

A call for culture-centred care: exploring health workers' perspectives of positive care experiences and culturally responsive care provision to Aboriginal women and their infants in mainstream health in South Australia

“…Despite this, it is currently not consistently demonstrated across the first 1000 days of Aboriginal infants’ lives [ 25 ]. Indeed, Midwives have limited knowledge about Aboriginal women’s cultural needs and limited access to cultural education [ 27 ]. South Australian child and family health Nurses had little understanding of what constitutes racist practice and inconsistencies in knowledge of the impact of racism on children and families [ 28 ].…”

Culturally Competent Care for Native American and Alaska Native Childbearing Families

“…There is a growing body of research focusing on culturally appropriate care of this group of childbearing families in the United States and globally. Marriott et al (2021) focused on knowledge of Australian midwives on provision of care that included increased understanding of cultural differences in indigenous women and the need to address racism in health care systems to reduce risk and improve outcomes. Wood et al (2021) incorporated voices of aboriginal Australian women, describing suggestions to improve perinatal care of First Nation expectant mothers with gestational diabetes to reduce maternal and neonatal complications.…”

A call for culture-centred care: Is continuity of care possible if culture remains an appendix in the mainstream health care system for Aboriginal families [across the first 1000 days] in South Australia?

“…Despite this, it is currently not consistently demonstrated across the rst 1000 days of Aboriginal infants' lives (22). Indeed, midwives have limited knowledge about Aboriginal women's cultural needs and limited access to cultural education (23). South Australian child and family health nurses had little understanding of what constitutes racist practice and inconsistencies in knowledge of the impact of racism on children and families (51).…”