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Culturally appropriate maternity care crucial for indigenous women’s wellbeing

For midwife Rebecca Clarke, pregnancy and birth was so second nature, that she rarely gave a second thought to encouraging women of all cultures to come to hospital to delivery their babies.

That was until she encountered an indigenous woman who felt she simply couldn’t give birth at the local hospital, instead choosing to travel much further.

“I couldn’t understand why,” says Ms Clarke, who was a midwife at Midwifery Group Practice, specifically catering to young Aboriginal and Torres Strait Islander or remotely residing women.

“History has engrained forceful assimilation, and this felt no different – telling women they should come to the hospital to birth was something so normal for me and I had not considered a different perspective

“I later discovered that she had lost a loved one in the hospital and had been told she would catch an infection and die.

“There was nothing I could do in the time frame I had before she would birth. But it played on my mind.”

It was this experience that prompted Ms Clarke to investigate the development of a culturally appropriate space for aboriginal women to give birth.

“All women deserve a place that feels safe and comfortable to give birth to their child,” she says. 

“For many indigenous women a hospital is a place of death and dying, not a place to give birth.

“I was at an Aboriginal Cultural safety conference and through working with members of the local community I learnt a number of important factors.

“Firstly, I learnt that it was important to have the space blessed and smoked to cleanse of the passed spirits.

“And secondly, I began to consider how I could make this an inviting space that women would want to come to give birth.

“I knew I needed to consult the women, so I did past and present clients including elders of the community.

“I consulted my unit manager and put a plan together.”

Fortunately, Metro South Health Hospital District was also supportive of Ms Clarke’s findings and granted her the approval to develop a dedicated space at Redlands Hospital, in conjunction with Birthplace – however funds were needed to make it happen.

“I was very lucky to have a significant donations, which meant that the pipe dream was becoming a reality.

“I was so excited by the women’s response in the community, so I got to work finding the right people to involve in the project.

“Well respected Aboriginal Artist Shara Delaney painted a beautiful mural on the wall in the room in which she had previously birthed.

“I was delighted to find aboriginal fabrics from Alice Springs in which I consulted the community on suitable designs which included embracing the importance of the saltwater to the Quandamooka people and additionally suited aspects of the Torres Strait Islander women’s culture.

“Fabulous Janet Purcell from Birthplace brought the fabrics to life creating a bed cover, and bassinet sheet and cushions.

“I had also discovered the tradition of the coolamon (a shield) traditionally used to collect berries which we believed would be a nice touch for women to weigh their babies in on the scales rather than the cold plastic.”

Ms Clarke says the overall goal was to incorporate as much culturally significant aspects as they could to give women a strong connection with their culture.

The room also features:

  • Large wall mural by artist Shara Delaney
  • Culturally inspired photography by Miriam Ackroyd
  • Soft furnishing/cot linen and textile art using Aboriginal Fabrics by Birthplace
  • Coolamon
  • Soft lighting
  • Appropriate music including ability for women to Bluetooth their own music.

Ms Clarke says it’s crucial for all midwifes to be aware of cultural preferences when working with Aboriginal women.

“It is vital that midwives are aware of possible aspects but not to assume that because a woman is Aboriginal or Torres Strait Islander that these aspects are a given and care should always be led by the woman.

“I believe that this culturally appropriate birthing space and the continuity of care that is offered by the MGP program that works collaboratively with the Aboriginal and Torres Strait Islander Health workers at Redland Hospital is creating positive experiences for women beginning and building their families.

“Throughout the pregnancy, labour and birth and until 6weeks postnatal the Midwife and Health Worker works with the women to help ensure that both her and her babies health is optimal both socially and emotionally.

“Sometimes this involves complex problem solving and out of the box thinking to ensure the best care possible is delivered and outcomes achieved for mothers and babies.

“I honestly believe this period in a woman and family’s life has the capacity to either be transformative or possibly damaging.

“Ensuring that the model of care encompasses a women’s individual needs is paramount and I feel we as a team have achieved this.”

Ms Clarke says she would love to see more Aboriginal and Torres Strait Islander midwives.

“The goal must be creating stronger beginnings for Aboriginal mothers and babies ensuring that culture is valued and not dismissed.”

View article on Health Times