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'Katitjin Mindamarra (knowledge through healing hands) Aboriginal Perinatal Navigators for Aboriginal women: Isn’t It About Time Aboriginal Women Got the Support They Deserve?'
Background
Aboriginal ways of knowing, being and doing have fostered physical, social, and emotional wellbeing for thousands of years. Using traditional birthing methods and medicines Aboriginal women experienced safe and positive births. However, due to the impact of colonisation, these ways of knowing being and doing have been diluted by western models of care, and a dispossession of traditional Aboriginal birthing methodologies leading to the loss of cultural birthing practices, self-determination, and languages (Kelly et al., 2014).
Although most Aboriginal women have healthy pregnancies and positive pregnancy outcomes, a small proportion of women have adverse pregnancy and birth outcomes including perinatal deaths, preterm births, and low birthweight (AIHW 2022). In Australia, Aboriginal women experience a significant disadvantage in prenatal, ante natal, birthing, and post-natal outcomes compared with their
non-Aboriginal counterparts (Sivertsen et al., 2020).
The lack of safe cultural practices and cultural awareness in mainstream maternity services typically results in higher levels of anxiety, and fear in Aboriginal women, often resulting in a very low attendance rates at antenatal appointments.
A review of the literature clearly demonstrates that the development and implementation of an educational program for Aboriginal doulas/birth navigators that is trauma informed and culturally safe will lead to improved outcomes for Aboriginal women and their babies (Ireland et al, 2022). Bertilone et al, (2016) identified a lack of trust, long waiting times, poor communication, previous negative experiences, and duplication of services as reasons Aboriginal women do not attend their antenatal appointments. Care and support by Aboriginal doulas for Aboriginal women could help address racism in the health system and promote intergeneration healing.
Objectives
The objectives are to explore what is required to develop an educational program for Aboriginal women to: Understand what women, want from a doula/birth navigator service; Plan an educational program for Aboriginal doulas/birth navigators that is trauma informed and culturally safe; Identify barriers that may lead to women being unable to access Aboriginal doulas/birth navigators; Provide an Aboriginal doula/birth navigator service that is effective, and Aboriginal women focused.
Methods
This study is utilising Indigenous qualitative research methods (Marriott et al 2019). In-depth interviews with Aboriginal women and stakeholders in Western Australia to review existing doula/birth navigator programs and explore the possibilities, feasibility, and acceptability of integrating Aboriginal doulas/birth navigators into the WA health system plan,
Findings
An Aboriginal doula/birth navigator course would be a gateway for Aboriginal women across Australia to access, be trained and certified to return back to their communities and provide the cultural support that is needed throughout the woman's pregnancy journey.
Conclusions
This program will support community self-determination, empowerment, and community self-sustainability, especially for remote homeland communities and improve culturally safe births for Aboriginal women in hospital settings away from their Country/homelands.
Key message
Creating safer environments for Aboriginal women birthing on, off or away from home/country/traditional lands with cultural, spiritual, and emotional support by creating and developing a sustainable and culturally safe educational program for Aboriginal women to support other Aboriginal women culturally, socially, and emotionally during their pregnancy journeys.
Ethics and conflicts of interest
No conflicts of interest and ethical approval for this study was approved through the ethics review process.
Aboriginal ways of knowing, being and doing have fostered physical, social, and emotional wellbeing for thousands of years. Using traditional birthing methods and medicines Aboriginal women experienced safe and positive births. However, due to the impact of colonisation, these ways of knowing being and doing have been diluted by western models of care, and a dispossession of traditional Aboriginal birthing methodologies leading to the loss of cultural birthing practices, self-determination, and languages (Kelly et al., 2014).
Although most Aboriginal women have healthy pregnancies and positive pregnancy outcomes, a small proportion of women have adverse pregnancy and birth outcomes including perinatal deaths, preterm births, and low birthweight (AIHW 2022). In Australia, Aboriginal women experience a significant disadvantage in prenatal, ante natal, birthing, and post-natal outcomes compared with their
non-Aboriginal counterparts (Sivertsen et al., 2020).
The lack of safe cultural practices and cultural awareness in mainstream maternity services typically results in higher levels of anxiety, and fear in Aboriginal women, often resulting in a very low attendance rates at antenatal appointments.
A review of the literature clearly demonstrates that the development and implementation of an educational program for Aboriginal doulas/birth navigators that is trauma informed and culturally safe will lead to improved outcomes for Aboriginal women and their babies (Ireland et al, 2022). Bertilone et al, (2016) identified a lack of trust, long waiting times, poor communication, previous negative experiences, and duplication of services as reasons Aboriginal women do not attend their antenatal appointments. Care and support by Aboriginal doulas for Aboriginal women could help address racism in the health system and promote intergeneration healing.
Objectives
The objectives are to explore what is required to develop an educational program for Aboriginal women to: Understand what women, want from a doula/birth navigator service; Plan an educational program for Aboriginal doulas/birth navigators that is trauma informed and culturally safe; Identify barriers that may lead to women being unable to access Aboriginal doulas/birth navigators; Provide an Aboriginal doula/birth navigator service that is effective, and Aboriginal women focused.
Methods
This study is utilising Indigenous qualitative research methods (Marriott et al 2019). In-depth interviews with Aboriginal women and stakeholders in Western Australia to review existing doula/birth navigator programs and explore the possibilities, feasibility, and acceptability of integrating Aboriginal doulas/birth navigators into the WA health system plan,
Findings
An Aboriginal doula/birth navigator course would be a gateway for Aboriginal women across Australia to access, be trained and certified to return back to their communities and provide the cultural support that is needed throughout the woman's pregnancy journey.
Conclusions
This program will support community self-determination, empowerment, and community self-sustainability, especially for remote homeland communities and improve culturally safe births for Aboriginal women in hospital settings away from their Country/homelands.
Key message
Creating safer environments for Aboriginal women birthing on, off or away from home/country/traditional lands with cultural, spiritual, and emotional support by creating and developing a sustainable and culturally safe educational program for Aboriginal women to support other Aboriginal women culturally, socially, and emotionally during their pregnancy journeys.
Ethics and conflicts of interest
No conflicts of interest and ethical approval for this study was approved through the ethics review process.
Janinne Gliddon
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Janinne Gliddon, Aboriginal Senior Research Fellow, FEALING Program,Yorga Maaman and Koolanga Research and Advocacy Centre, Ngangk Yira Institute for Change, Murdoch University WA
A proud Badimia-Yamatji and Ballardong-Nyoongar senior woman who also has a more important role as a Nan and loving it! Janinne is the Aboriginal Senior Research Fellow for the FEALING Program at the Ngangk Yira Institute for Change and is leading the development of a doula/birth navigator education program which will create a rich and critical enduring legacy of Aboriginal women’s cultural knowledges and practices. For over 35 years Janinne has had a varied public service career in public housing field and since 2008, in the health sector, with a focus on women’s and maternal health and Indigenous health promotion. During her time at KEMH, Janinne initiated a highly successful volunteers’ program, which draws on a group of Aboriginal women who visit women transferred from homeland communities and the regions to Perth for childbirth or women’s health care. In 2019 Janinne was awarded a prestigious Churchill Fellowship to conduct a study of Aboriginal doula programs in New Zealand, Canada, and the United States. Janinne has been a Chief Investigator on many research projects one being the NHMRC Birthing on Noongar Boodjar project and continues to provide high level advice to a range of Ngangk Yira Institute for Change projects |
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GOLD
Speaker Sponsor ~ Rhea Dempsey ~ Birthing Wisdom
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Doula Conference are proud and grateful to welcome Rhea Dempsey ~ Birthing Wisdom as the GOLD sponsor of Janinne Gliddon, who will be joining us in person from Western Australia to talk about her Aboriginal doulas for Aboriginal Women research.
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Rhea is also talking at this years conference and you can find out more about her presentation here:
Not only does Rhea offer in-person Birth Attendant Training in Melbourne, but she is also an incredible author of two highly recommended books, runs childbirth education workshops for birthing couples and counsels families about birth. To tap into any of her birthing wisdom click the links below:
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